Detection of scrub typhus at a tertiary health centre in Central Kerala

Abstract

SCOPE: Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi, transmitted by the bite of Leptotrombidium mites. It presents clinically as a non-specific febrile illness and is often overlooked. In India, there are reports of resurgence of scrub typhus. We did a cross-sectional study to detect scrub typhus among patients presenting with fever. MATERIALS AND METHODS: This study was conducted in the Department of Microbiology at a tertiary health centre in Central Kerala from January 2014 to September 2015. Two hundred and eight serum samples collected from patients presenting with fever, and whose serological tests were negative for dengue, leptospirosis, enteric fever and malaria were tested using IgM enzyme-linked immunosorbent assay (ELISA) for O. tsutsugamushi. RESULTS: Out of the 208 samples collected, 23 (11%) were positive for scrub typhus by IgM ELISA. The maximum number of cases was found in the age group of 41–60 years (56.5%). All the clinical findings were non-specific. Only one patient had an eschar. CONCLUSIONS: In the present study, we found that scrub typhus is prevalent in the districts of Central Kerala as well. Serological tests are the mainstay of diagnosis of scrub typhus and should be considered in the panel of tests ordered for patients presenting with non-specific febrile illnesses.