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Scrub typhus (bush typhus) is a disease caused by bacteria called Orientia tsutsugamushi. It spreads to people through bites of infected chiggers (larval mites).Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or traveling to areas where scrub typhus is found could get infected.

The first case of scrub typhus came to light in Japan in 1899.

India encountered its first case in the Assam and West Bengal region, during World War II. Since then, the disease has affected tens of millions of people across South-East Asia, South Asia (mainly China and India) and North Australia. The disease has become endemic in a few regions of India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand.Globally, 1 million people suffer from scrub typhus every year despite getting treated with antibiotics like doxycycline.

Again Scrub Typhus is back in the middle of COVID-19 pandemic. Forty-eight cases of scrub typhus, has been reported in which 16 died, 70 are getting treated in four large hospitals in Delhi since July. Over 55 patients have tested positive, including a two-year-old girl, who is currently being treated in the pediatric ICU at the Government Medical College and Hospital in Nagpur.

Symptoms of scrub typhus usually begin within 10 days of being bitten.

It includes:

• Fever and chills

• Headache

• Body aches and muscle pain

• A dark, scab-like region at the site of the chigger bite (also known as eschar)

• Mental changes, ranging from confusion to coma

• Enlarged lymph nodes

• Rash

People with severe illness may develop organ failure and bleeding, which can be fatal if left untreated.

The difficulty lies not so much in treating scrub typhus, as diagnosing it early enough. Diagnosis of scrub typhus is often missed as the infection mimics symptoms of common monsoon infections, such as dengue and chikungunya. The infection can be fatal if not treated on time with antibiotics, which are not prescribed for dengue and chikungunya.

Treatment includes antibiotic mostly doxycycline. It can be used in persons of any age. Antibiotics are considered most effective if given soon after symptoms begin. People who are treated early with doxycycline usually recover quickly. Complications of untreated scrub typhus include swelling of the lungs, brain encephalitis, renal failure or even heart problems.

• Preventive measures include avoiding contact with infected chiggers.

• Avoid areas with lots of vegetation and brush where chiggers may be found as vaccine is available to prevent Scrub typhus.

Is there any other disease that is yet to make a comeback from history?