THIRUVANANTHAPURAM: Scrub typhus is documented as an emerging infectious disease among children in the state with significant morbidity. It has claimed the life of a child. Sidharth, a Class 7 student, who loved to play in the fields around his house in Kilimanoor. He succumbed to the complications caused by the infection on Monday.
Earlier in June, 15-year-old Ashwathy, who loved her pets dearly, fell into the illness in Varkala. The disease which is considered curable has so far claimed four lives this year and 68 in a decade. Several children get severely affected and undergo prolonged treatment every year.
The disease was considered restricted to the border areas or fields where there is scrub vegetation. However, recent incidents show that mites in pets or other animals around have caused several Scrub Typhus cases, say health experts.
According to them, the change in ecological conditions has become more favourable for the disease to spread from animals to human beings. It calls for a detailed study of the causes behind the prevalence of infection in certain geographical locations. It also has to be ascertained whether the bacteria that causes the infection has become more deadly.
Thiruvananthapuram contributes 75% of the Scrub Typhus cases in the state, followed by Wayanad (10%), Kozhikode (5%), Kannur, Malappuram and Palakkad districts. In common parlance, Scrub typhus is called ‘mite fever’ because it is caused by bites of mites that carry the infection-causing bacteria named Orientia tsutsugamushi. It all starts with a fever and becomes complicated in some cases.
“Scrub Typhus patients are common here. Though a majority of them does not become severe, some cases do turn up in the ICU. We do get patients with multiple organ involvement rarely,” said Dr Sheeja Sugunan, a pediatric intensivist and assistant professor, Department of Paediatrics, Sree Avittam Thirunal Hospital Hospital, which treats some of the complex diseases affecting children.
“While checking the patients’ history, we found that most of them contracted the infection from pets. The disease has a regional and seasonal predilection,” she said.A study by a team of doctors in Government Medical College Hospital (GMCH), Thiruvananthapuram, in 2016 found a definite seasonal trend with clustering in hilly areas for Scrub Typhus. It also found out that late detection is the cause of failure of treatment, complications, and even mortality.
The disease was first reported in the state at Nedumangad in Thiruvananthapuram in 2002. While the infected larval mites are blamed for causing the disease in humans, the fact that mites are carried by pets and other domestic animals along with rodents and squirrels increases the chances of catching the infection even in urban settings. The cases have been reported from both the city area and the rural parts of Thiruvananthapuram, which has emerged as an epicentre of the disease.
“Most Scrub Typhus cases were reported from areas where there is scrub vegetation. The eggs of chigger mites dropped on the soil become larvae and moves to the tip of the grass. It then finds a suitable host, including human beings. But there have been instances in which the larva reached the human body from the floor of the house,” said Dr Althaf A, an epidemiologist and associate professor at GMCH, Thiruvananthapuram. He called for an ecological study to find out the regional predilections of Scrub Typhus.
Senior veterinary surgeon Dr Jacob Alexander blamed the uncontrolled growth of the stray dog population for the rise in infectious diseases, including Scrub Typhus.
“There has been a significant increase in the population of stray dogs and rodents. Poor food waste management is helping their growth. We need to move in the direction of the ‘One Health’ approach to tackle the situation,” he said.