Scrub typhus: a growing health challenge in children

 Scrub typhus: a growing health challenge in children

Recently, an 11-year-old girl was admitted to Rapti Institute of Health Sciences in Dang due to high fever and physical weakness. Initially, he was treated for a simple fever, but after a few days, his condition worsened. On further examination, it was discovered that he had scrub typhus.

In the absence of timely treatment, the disease seriously affected his liver, kidneys, and lungs, resulting in multi-organ failure. The girl was kept on a ventilator, although various life-saving measures were taken, but it became a challenge to improve her health.

In the last few years, there has been a significant increase in the incidence of scrub typhus in Nepal. Scrub typhus is a type of bacterial disease that is spread by insects (chiggers) found in wooded areas infected with the bacterium Orientia tsutsugamushi. In children, this disease can cause serious health problems, as evidenced by a recent complex case of multi-organ failure in an 11-year-old girl.

What is scrub typhus?

Scrub typhus, also known as 'bush typhus', is an infectious disease transmitted by the bite of small insects. The spread of this disease is seen more in the rural and hilly areas of Nepal.

Symptoms and signs

Symptoms and signs of scrub typhus usually begin to appear 6 to 14 days after infection. Early symptoms include fever, headache, muscle aches and fatigue. Other symptoms and signs also appear.

- High fever: rising suddenly and lasting for a long time.

- Body aches and fatigue: general physical weakness, muscle aches and extreme fatigue.

- Rashes: Red and blue lesions can be seen on the body, which gradually increase.

- 'Isar' stool-like spot: A black skin-like spot on the cut, which is a characteristic symptom of scrub typhus.

- Lymph node swelling: Swelling of the lymph nodes in the neck, upper part of the neck and lower part.

- Abdominal pain and vomiting: Abdominal pain, nausea and vomiting.

- Cough and shortness of breath: If the disease affects the lungs, coughing and shortness of breath can be a problem.

- Mental status changes: In severe cases, fainting, irritability and other mental changes may occur.

Also, if not recognized and treated in time, this disease can affect important organs like liver, heart, kidney and lungs and cause multi-organ failure.

Increasing scrub typhus in children

In recent days, scrub typhus is seen more in children. At Rapti Health Science Institute, one child out of every three to five fever cases is diagnosed with scrub typhus. This shows how much the risk of this disease is increasing in children. Since the initial symptoms are similar to other common fevers, the situation can become serious if not tested on time.

How to diagnose scrub typhus?

Diagnosing scrub typhus can be challenging, as its symptoms are similar to many other infectious diseases. But for accurate diagnosis the following methods are used:

Clinical history and physical examination: Initially, the doctor examines the patient's symptoms, the area of ​​infection, and any other specific symptoms, such as a rash.

Blood test: Serological tests like 'Indirect Immunofluorescence' and 'Enzyme-Linked Immunosorbent' are done to detect scrub typhus specific antibodies by taking a blood sample.

Multiplex PCR Test: It is a complex but effective diagnostic method which helps in direct detection of scrub typhus causative organism.

Biopsy: In severe cases, it can be examined by taking a sample of the spot or skin.

Prevention and treatment of scrub typhus

Timely use of the right antibiotic is important in the treatment of scrub typhus. Antibiotics such as doxycycline and azithromycin are considered effective. But in the absence of early diagnosis and timely treatment of the disease, complications may increase. Especially in children, immunity is weak, if a fever problem appears, they should be checked immediately according to the advice of health workers.

Prevention of scrub typhus

Avoid going to bushy areas: The main areas where scrub typhus spreads are bushes, grasslands, and forests. Therefore, when going there, stay in an open and safe place as much as possible.

Wearing clothes that cover the whole body: Wearing long-sleeved shirts, pants, hats and shoes helps to protect the body from insect bites.

Use of insecticides: Using effective insecticides such as DEET or Permethrin can protect the body from lice. Spraying insecticide on clothes is also beneficial.

Examination of the body: After traveling somewhere, the entire body should be examined thoroughly, so that even if the insects are attached, they can be removed quickly.

Cleaning the wound: If any wound or sore appears, it should be cleaned properly and a doctor should be consulted as soon as possible.

Public awareness should be spread: It is necessary to increase public awareness about scrub typhus, especially in rural areas, so that people can recognize the symptoms of this disease and take preventive measures.

As the outbreak of scrub typhus is increasing in Nepal, it is necessary to spread awareness about it among the common people. Especially in rural areas, where the risk of this disease is high, scrub typhus can be prevented by regular health check-ups, sanitation and the use of insecticides. Ignore even minor symptoms in children Complications can be avoided if the examination and treatment are started immediately.