Health officials take action on scrub typhus eradication

EOI, Kurseong, 28 September 2014: However, several measures have been taken by the health officials, the local political leadership and administration in the plains regarding the fatal disease Japanese Encephalitis that recently rocked north Bengal but another fatal disease Scrub Typhus that has already claimed several lives in the hills is yet to be noticed properly by the hills concerned bodies.

On 25 September only, a GJMM youth and Khambu Rai Community popular leader Bishal Rai from Kurseong breathed his last in a nursing home in Siliguri, reportedly following the same fatal disease Scrub Typhus. Presently, three to four persons have reportedly been admitted in Kurseong SD Hospital suspected to have scrub typhus.

It was learnt that scrub typhus was reported for the first time in West Bengal from the Kurseong S.D.Hospital in 2004. The blood samples for confirming scrub typhus then had been sent to the NICED, New Delhi. Since then, laboratory facility for diagnosing scrub typhus has been commissioned at Kurseong S.D.Hospital under local initiative. Further, in 2005-2006, a study was conducted to find the geographical areas affected by scrub typhus which included Pahilagaon and Duptin areas of Mirik. Similarly, areas of Ambootia, Makaibari, Mahanadi, Rinchingtong, Latpanchar and Sittong areas of Kurseong block were also found to be affected. However, there were no reports of outbreak happen during the period and hence no any reason for immediate concern.

The disease presents as fever with severe headache and a black scar called eschar at the site of bite. So far more then hundreds of cases have been diagnosed and treated over a period. As treatment is readily available deaths due to this disease is low. However, people should report it at an early stage if they have fever with a black scab mark. 
This disease is due to the bite of an infected mite which generally lives on the body of rats and shrews. These mites are predominantly present in areas where rats are present in large numbers. Humans get bitten by these mites accidentally when they are exposed to mite infected areas called ‘mite islands’. Earlier studies have found that having houses near bushes like bamboo groves, stacking piles of wood in the backyard of the house, rearing domestic animals near the house and working in the fields without protective clothing for long hours expose humans to the risk of the disease. Having separate work clothes and changing clothes before going to sleep were found to be protective. Further, having a wash or bath after daily work was also found to be protective.

As per the doctors and experts from Kurseong S.D.Hospital recommended that the best solution would be to take measures that would lead to control of rat population in and around households and place of work. This included proper storage of food in the households and proper disposal of waste food matters. Further, people should reporting to the nearest health unit in case of fever with black scab mark. Treatment for it is simple and available in all the PHCs, BPHCs and hospitals course.

It was learnt that when the disease had been first found in Kurseong region in early 2000 the medical officer from Kurseong SD Hospital Dr. AK Barui had played an important role to diagnose and prevent the out break of scrub typus. He visited many places in the country and hobnobbed with several medical and research experts in the field. Accordingly to curb the disease several other teams from various parts of the country visited Kurseong and investigated the matter.

But unfortunately maybe perhaps due to lack of proper awareness on the disease the human toll taken by it is reported from time to time. 

Related news: Mite-borne disease “Scrub typhus” claims 13 lives in India: 

Report New Delhi, Sept 19, IRNA -- At least 13 persons have lost their lives due to a mite-borne disease since July this year in Jaipur, capital of Rajasthan state. Mite-borne disease “Scrub typhus” claims 13 lives in India: Report Scrub typhus is caused by the bite of vectors like mites and fleas living on lush green grass during the rainy season. Nine patients died of scrub typhus while 169 others were found positive and are being treated at Sawai Man Singh Hospital, pti quoted Dr Raman Sharma, nodal officer and professor of medicine at the hospital, as saying today.

Areas where scrub typhus is endemic range from regions of typical tropical secondary growth (scrub) vegetation to temperate zones (for example, Kashmir, Korea, and Mount Fuji) and even to the Himalayas above 3000-m elevation.^[5] The disease agent is transmitted among wild rats by trombiculid mites in the larval stage (Figure 2). Many different chigger species may be found naturally infected with O tsutsugamushi, but this does not mean they are vectors. Traub et al^[9] demonstrated that the high frequency of O tsutsugamushi found in nonvectors may be caused by the uptake of rickettsiae during feeding. Larvae of the vector species, which are nearly all in the genusLeptotrombidium, infest rodents and insectivores, and the distribution of the mites is dependent on the home ranges of the hosts (Table). These home ranges do not usually overlap; mite colonies therefore tend to be isolated from each other and occur as "mite islands."^[4] The rickettsiae are transmitted transtadially through nonparasitic nymphal and adult mite stages; at these stages, mites are predatory on soil arthropods. The rickettsiae are also transmitted transovarially through the eggs to parasitic larvae of the next generation.

Scrub typhus, also known as Japanese river fever or flood fever, is an acute febrile typhus disease. There are cases every year, particularly in summer as the muggy weather is conducive to insects breeding. According to the report, the four people who died have something in common: they had all been and apparently ignored the warning signs. The first symptom of having been bitten by the bug is a fever, which patients usually mistake for a cold and delay seeking medical help. In addition, people don’t always pay attention to bites on the waist, armpit, abdomen or thigh.

However, doctors say that patients should not be too worried as the illness is curable if identified. The signs can be very subtle so if you have any symptoms such as high fever, dry and flaking skin or scabs, you may need to see a doctor immediately. Doctors warn that following precautions should be taken when in parks or other grassy areas:

• apply insect-repellent to your skin;
• Wear long sleeves;
• Do not sit or lie on the grass;
• Do not touch the crops;

As always, maintain a high level of personal hygiene.  But maybe the best advice?  Avoid going to such places, at least for now.