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Scrub Typhus (Bush Typhus)

Scrub Typhus (Bush Typhus) Related Articles

Scrub Typhus

Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called Orientia tsutsugamushi. Scrub typhus is spread to people through bites of infected chiggers (larval mites). The most common symptoms of scrub typhus include fever, headache, body aches, and sometimes rash. 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.

Signs and Symptoms

Symptoms of scrub typhus usually begin within 10 days of being bitten. Signs and symptoms may include:

  • 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.

Diagnosis and Testing

  • The symptoms of scrub typhus are similar to symptoms of many other diseases. See your health care provider if you develop the symptoms listed above after spending time in areas where scrub typhus is found.
  • If you have recently traveled, tell your health care provider where and when you traveled.
  • Your health care provider may order blood tests to look for scrub typhus or other diseases.
  • Laboratory testing and reporting of results can take several weeks, so your health care provider may start treatment before results are available.

Treatment

Scrub typhus should be treated with the antibiotic doxycycline. Doxycycline can be used in persons of any age. Antibiotics are most effective if given soon after symptoms begin. People who are treated early with doxycycline usually recover quickly.

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Prevention

  • No vaccine is available to prevent scrub typhus.
  • Reduce your risk of getting scrub typhus by avoiding contact with infected chiggers.
  • When traveling to areas where scrub typhus is common, avoid areas with lots of vegetation and brush where chiggers may be found.

If you will be spending time outdoors:

  • Use Environmental Protection Agency (EPA)-registered insect repellents that contain 20% to 30% DEET, or other active ingredients registered for use against chiggers, on exposed skin and clothing.
    • Always follow product instructions.
    • Reapply insect repellent as directed.
    • Do not spray repellent on the skin under clothing.
    • If you are also using sunscreen, apply sunscreen before applying insect repellent.
  • If you have a baby or child:
    • Do not use insect repellent on babies younger than 2 months of age.
    • Dress your child in clothing that covers arms and legs, or cover crib, stroller, and baby carrier with mosquito netting.
    • Do not apply insect repellent onto a child's hands, eyes, or mouth or on cuts or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to child's face.
  • Treat clothing and gear with permethrin or purchase permethrin-treated items.
    • Permethrin kills chiggers and can be used to treat boots, clothing, and camping gear.
      • Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
      • If treating items yourself, follow the product instructions carefully.
      • Do NOT use permethrin products directly on skin. They are intended to treat clothing.

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Scrub Typhus Symptom

Fever

Body temperature measurements are usually measured by temperature devices inserted on or into the rectum, mouth, axilla (under the armpit), skin, or ear (ear thermometers). Some devices (laryngoscopes, bronchoscopes, rectal probes) may have temperature-sensing probes that can record temperature continually. The most common way to measure body temperature was (and still is in many countries) with a mercury thermometer; because of glass breakage and the possibility of subsequent mercury contamination, many developed countries use digital thermometers with disposable probe covers to measure temperature from all of the body sites listed above. Disposable temperature-sensitive strips that measure skin temperature are also used. Oral temperatures are most commonly measured in adults, but rectal temperatures are the most accurate because environmental factors that increase or decrease temperature measurements have the least effect on the rectal area. Rectal temperatures, when compared to oral temperatures taken at the same time, are about 1.8 F (0.6 C) higher. Consequently, an accurate measurement of body temperature (best is rectal core temperature) of 100.4 F (38 C) or above is considered to be a "fever" and the person has a febrile illness.

Reviewed on 1/18/2019
References
United States. Centers for Disease Control and Prevention. "Typhus Fevers: Scrub Typhus." Jan. 18, 2019. <https://www.cdc.gov/typhus/scrub/index.html>.

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