Mystery fever breaks out in Darjeeling... Two patients have tested positive for scrub typhus. Test results are awaited on more cases

Amitava Banerjee , HT, 1 Sep 2015, DARJEELING: An unknown fever is stalking the Hills. The fever has been attributed to Scrub typhus or Bush typhus. Two patients have tested positive to scrub typhus. Test results are awaited for patients with similar symptoms.

“For the past three weeks I have been getting numerous patients with symptoms including fever which then leads to jaundice, kidney problems, breathing problems, low blood platelet count and then coma. Most of the tests including typhoid, hepatitis tests show negative. The patients are usually from the rural belt,” said Dr Plaban Das, Director, Darjeeling Dooars Medical Association.

A 60 year male was brought dead to a nursing home from Bijanbari.

His relatives complained of a 3-day fever accompanied by the above symptoms. A 40- year-old with similar symptoms in a critical state was referred to Siliguri (as Darjeeling does not have any ICU facility) where he died.

“A 72 year old woman was brought in from 10th Mile, Lopchu with such symptoms. While treating her I noticed a black eschar (a bite mark of a mite.) I immediately suspected Scrub typhus. I started administering the drugs and her condition started improving. I sent her blood sample for Weil-Felix Test to Siliguri and it tested positive. Another patient with similar symptoms has tested positive. We have many test results awaited but all are responding positive to the drug Doxycycline,” added Dr Das.

Scrub typhus is transmitted by some species of mites (chiggers) which are found in areas of heavy scrub vegetation. The bite of this mite leaves a characteristic black mark known as eschar. Scrub typhus or Bush typhus is a form of typhus caused by the intracellular parasite Orientia tsutsugamushi, of family Rickettsiaceae first isolated and identified in 1930 in Japan. The mortality rate is 30%.

“It is very difficult to diagnose as the clinical symptoms overlap with other infectious diseases like dengue fever and paratyphoid. The Weil-Felix test can be done only after 7 days of infection. Others tests are too costly for patients who are poor,” claimed Dr Das.

“People working in open fields and gardens should wear protective clothing like boots and gloves. In case of bites, Doxicycline can be administered as a preventive measure,” he added.

Rats are carriers of this disease along with lice. “Personal hygiene has to be maintained. Drinking water should be boiled and containers sterilised to prevent transmission of this disease,” said Dr Das.

In the past four years there have been similar cases. The disease increases during monsoons. “We had notified the chief medical officer of health along with copies of the test report on Saturday,” said Dr. Das.

“My mother had gone to cut grass for the cattle. After returning she started feeling feverish. We admitted her to the Government Hospital in Darjeeling. After 7 days with no signs of recovery she was referred to Siliguri. Now, she has been cured and has been discharged,” said the daughter of a 72-year-old patient from Lopchu.

In India, the disease had occurred among troops during World War II in Assam and West Bengal and in the 1965 Indo-Pak war. In 2014 there was a scrub typhus outbreak in Rajasthan. “Such cases have not come to my notice. I have not heard of any such cases in the Hills,” claimed Dr. Asit Biswas, CMOH, Darjeeling. Shared in Kalimpong News bu KalimNews from Hindustan Times  at http://kalimpongonlinenews.blogspot.com/2015/09/mystery-fever-breaks-out-in-darjeeling.html and http://kalimpongnews.net/2015/09/01/mystery-fever-breaks-darjeeling-patients-tested-positive-scrub-typhus-test-results-awaited-cases/