A study on serodiagnosis of scrub typhus in a Teaching Hospital of South India

Abstract

Background: crub typhus is caused by Orientia tsutsugamushi (rickettsial disease) commonly transmitted by the bite of larval chiggers of trombiculid mites. It has been one of the important causes of febrile illness, especially in south India. The clinical diagnosis is difficult owing to the non-specific presentation. We in the current study tried to evaluate the serodiagnosis of scrub typhus with the Weil Felix test and IgM ELISA. Methods: This study was conducted in the Department of Microbiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. All the sera samples were subjected to the Weil Felix test using Proteus OX2, OX19, OX-K strain agglutination test, and subsequently, Scrub typhus IgM ELISA test. Results: All the samples were subjected to the Weil Felix test n=4(6.06%) were positive for scrub typhus (OXK antigen) n=11(16.67%) were positive for the spotted group of fever (OX2 antigen) and n=10 (15.15%) were positive of typhus group (OX19 antigen). N=5 sera samples were positive for more than one type of antigens. All the n=66 serum samples were subjected to IgM ELISA for scrub typhus. Out of n=66, only two serum samples (3.03%) were positive by IgM ELISA. Conclusion: Scrub typhus is emerging as an important public health issue. It is one of the important causes of acute febrile illness. Although it is difficult to distinguish scrub typhus based on the clinical symptoms alone a simple test such as Weil Felix was found to be promising in the diagnosis of scrub typhus. ELISA IgM test may be performed additionally in laboratories with adequate facilities. Hence for clinicians, any case with a fever of unknown origin should arouse suspicion of scrub typhus