Seroprevalence with Clinical Manifestations and Laboratory Profiles of Scrub Typhus Infection in Patients Attending to a Tertiary Care Hospital in Kota, South-East Rajasthan, India

Abstract

Background: Scrub typhus, a zoonotic rickettsial illness, is caused by Orientia tsutsugamushi, an obligate intracellular Gram-negative bacterium. It is transmitted by the bite of larval (chiggers) trombiculid mites.Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is being described as a re-emerging infectious disease in India. Overall mortality varies from 7 to 30%. Objectives: The objective of the present study was to evaluate serological evidence and analyze clinical manifestations and laboratory profile of scrub typhus infection in febrile patients in South-East Rajasthan. The ultimate goal of this study was to identify scrub typhus infection in early phase of disease and prevent future complications. Methodology: The present study was conducted in the central laboratory of Govt. Medical College, Kota from period of 1st January, 2018 to 31th December 2018 to evaluate the seroprevalence of scrub typhus infection in South-East Rajasthan. Sera were tested by InBiOS scrub typhus detect TM IgM ELISA system test for IgM antibody detection as per kit insert. Results: Out of total 4928 serum samples tested, 365 (7.41%) were found positive for scrub typhus infection. Of all the patients tested, 2611 (52.98%) were males and 2317 (47.02%) were females. 172 (47.12%) positive samples were of male patients and 193 (52.88%) positive samples were of female patients. Scrub typhus affected males and females in a ratio of about 1:1.1. Out of the total positive for scrub typhus, age groups mostly affected were 21-30 years, 41-50 years and 31-40 year 20.55, 16.71 and 16.16% respectively. Seasonal trend showed a gradual increase in scrub typhus positives started from August (6.85%) with a peak in September (50.14%) and October (33.70%). CONCLUSION: Scrub typhus has emerged as an important cause of febrile illness in various parts of India. There is no vaccine available for any rickettsial infections including scrub typhus. For this, rapid and accurate diagnosis becomes necessary, especially in the absence of eschars for preventing morbidity, mortality and further complications. This study thus emphasizes that in all undifferentiated fever patients who had lymphocytosis (50.14% reported in this study) and other clinical features suggest scrub typhus in endemic region; then scrub typhus should be high on card of probability.

Keywords: Scrub typhus, Orientia tsutsugamushi, chiggers, trombiculid mites, ELISA, rickettsial disease

Cite this Article
Bhupendra Kumar Mandawat, Ghanshyam Soni, Preetam Singh Mandawat. Seroprevalence with Clinical Manifestations and Laboratory Profiles of Scrub Typhus Infection in Patients Attending to a Tertiary Care Hospital in Kota, South-East Rajasthan, India. Research & Reviews: A Journal of Microbiology & Virology. 2020; 10(1): 1–9p.