J Pediatr Infect Dis 2017; 12(02): 114-118
DOI: 10.1055/s-0037-1599835
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Emerging Infections in Children in North India: Scrub Typhus

Shyam S. Mina
1   Department of Paediatrics Medicine, VMMC & Safdarjung Hospital, New Delhi, India
,
Viredra Kumar
2   Department of Paediatrics Medicine, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
,
Viswas Chhapola
2   Department of Paediatrics Medicine, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
› Author Affiliations
Further Information

Publication History

21 November 2016

12 January 2017

Publication Date:
05 April 2017 (online)

Abstract

Rickettsial infections are re-emerging zoonotic bacterial infections in the Indian subcontinent. This study summarizes the epidemiologic aspects, clinical and laboratory features of scrub typhus in pediatric patients. Children who presented with fever for more than 5 days without an identifiable cause were investigated for scrub typhus by immunoglobulin M enzyme-linked immunosorbent assay. A total of 72 cases were screened. Forty-three of them were categorized as probable cases and qualified for specific antirickettsial therapy. Effective management and early administration of antibiotics might prevent the complications and mortality associated with scrub typhus.

 
  • References

  • 1 Lee SH, Kim DM, Cho YS, Yoon SH, Shim SK. Usefulness of eschar PCR for diagnosis of scrub typhus. J Clin Microbiol 2006; 44 (03) 1169-1171
  • 2 Singh P. Scrub typhus, a case report: military and regional significance. Med J Armed Forces India 2004; 60 (01) 89-90 doi: 10.1016/S0377-1237(04)80174-6
  • 3 Mathai E, Lloyd G, Cherian T, Abraham OC, Cherian AM. Serological evidence for the continued presence of human rickettsioses in southern India. Ann Trop Med Parasitol 2001; 95 (04) 395-398
  • 4 Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in the Himalayan region of India. Jpn J Infect Dis 2005; 58 (04) 208-210
  • 5 Isaac R, Varghese GM, Mathai EJ M, Joseph I. Scrub typhus: prevalence and diagnostic issues in rural southern India. Clin Infect Dis 2004; 39 (09) 1395-1396
  • 6 Kothari VM, Karnad DR, Bichile LS. Tropical infections in the ICU. J Assoc Physicians India 2006; 54: 291-298
  • 7 Zhang S, Song H, Liu Y. , et al. Scrub typhus in previously unrecognized areas of endemicity in China. J Clin Microbiol 2010; 48 (04) 1241-1244
  • 8 Varghese GM, Abraham OC, Mathai D. , et al. Scrub typhus among hospitalised patients with febrile illness in south India: magnitude and clinical predictors. J Infect 2006; 52 (01) 56-60
  • 9 Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E. Serological evidence for wide distribution of spotted fevers & typhus fever in Tamil Nadu. Indian J Med Res 2007; 126 (02) 128-130
  • 10 Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S, Purty S. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India 2010; 58: 24-28
  • 11 Somashekar HR, Moses PD, Pavithran S. , et al. Magnitude and features of scrub typhus and spotted fever in children in India. J Trop Pediatr 2006; 52 (03) 228-229
  • 12 Bhalwar R, Vaidya R. Textbook on Public Health and Community Medicine, 1st ed. Pune: Department of Community Medicine, Armed Forces Medical College: World Health Organization; 2009: 955-959
  • 13 Mahajan SK, Kashyap R, Kanga A, Sharma V, Prasher BS, Pal LS. Relevance of Weil-Felix test in diagnosis of scrub typhus in India. J Assoc Physicians India 2006; 54: 619-621
  • 14 Kim DM, Kim SW, Choi SH, Yun NR. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis 2010; 10: 108
  • 15 Lee CS, Hwang JH, Lee HB, Kwon KS. Risk factors leading to fatal outcome in scrub typhus patients. Am J Trop Med Hyg 2009; 81 (03) 484-488
  • 16 Koh GC, Maude RJ, Paris DH, Newton PN, Blacksell SD. Diagnosis of scrub typhus. Am J Trop Med Hyg 2010; 82 (03) 368-370
  • 17 Scrub typhus & other rickettsioses. CD Alert monthly newsletter of the National Centre for Disease Control (NCDC). Directorate General of Health Services: India; ; May–July, 2009 Available at: http://www.ncdc.gov.in
  • 18 Sonthayanon P, Chierakul W, Wuthiekanun V. , et al. Association of high Orientia tsutsugamushi DNA loads with disease of greater severity in adults with scrub typhus. J Clin Microbiol 2009; 47 (02) 430-434
  • 19 Digra SK, Saini GS, Singh V, Sharma SD, Kaul R. Scrub typhus in children: Jammu experience. JK Sci J Med Educat Res 2010; 12: 95-97
  • 20 Kim DE, Lee SH, Park KI, Chang KH, Roh JK. Scrub typhus encephalomyelitis with prominent focal neurologic signs. Arch Neurol 2000; 57 (12) 1770-1772
  • 21 Kumar S, Kumar PS, Kaur G, Bhalla A, Sharma N, Varma S. Rare concurrent infection with scrub typhus, dengue and malaria in a young female. J Vector Borne Dis 2014; 51 (01) 71-72
  • 22 Lee N, Ip M, Wong B. , et al. Risk factors associated with life-threatening rickettsial infections. Am J Trop Med Hyg 2008; 78 (06) 973-978
  • 23 Phimda K, Hoontrakul S, Suttinont C. , et al. Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrob Agents Chemother 2007; 51 (09) 3259-3263