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Context: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. It is a re-emerging rickettsial disease known to occur all over India. Also no data exists as to what proportion of fever cases are due to scrub typhus in West Bengal. Aims: This study was aimed at identifying the proportion of Orientia tsutsugamughi infection among the patients presenting with acute febrile illness and their epidemiological characteristics, clinical profile and laboratory parameters. Methods and Material: Blood samples of patients suffering from acute undifferentiated febrile illness for more than five days duration were collected from different hospitals of Kolkata and IgM capture Enzyme Linked Immuno-Sorbant Assay (ELISA) was performed at referral virology laboratory of School of Tropical Medicine, Kolkata over the period, April 2017 to March 2018. Results: 89 cases were found reactive for scrub typhus IgM out of 259 suspected cases (34.36%). Scrub typhus was mainly prevalent in children with slight male predilection. Most of the patients were from rural belt with a history of poor housing conditions. The common symptoms associated with fever were headache, nausea/vomiting, cough and skin rashes. Common signs were hepatomegaly, splenomegaly, followed by eschar and lymphadenopathy. Important laboratory findings were anaemia, leucocytosis, thrombocytopenia, and elevated liver enzymes whereas serum urea/creatinine level was almost within normal limits. There was no mortality. Conclusions: In this study 34.36% of febrile patients (duration of fever ≥ five days) were positive for scrub typhus. So it needs to be included in the differential diagnosis of febrile illness in West Bengal.

Epidemiology, clinical profile and laboratory parameters of scrub typhus cases in West Bengal