Let's find out exactly what the Scrub Typhus is that is spreading these days.

These days, we often hear about various types of fevers, don't we? Along with things like dengue and influenza, another name that comes to mind is "flea fever". Some people are actually afraid of this. So, what exactly is this flea fever? Is it dangerous? How can we be careful of it? Today, we will talk about all this very simply, as if we were talking to a friend.

Simply put, what is Scrub Typhus?

Scrub typhus, or `(Scrub Typhus),` is not actually a disease transmitted by fleas. It is transmitted by the bite of the larvae of a species of mite that is too small for our eyes to see. These mites are called `(chiggers).` This disease is caused by a bacterium called `Orientia tsutsugamushi.` Imagine how these little mites get this bacteria. Most of the time, this bacteria is transmitted to these mites from the skin of animals like rats. Then, when that mite bites us, the bacteria enters our body. These mites are so small that sometimes we can't even see them. They are usually red, yellow, or orange in color.

Where is this disease most common?

This disease is commonly seen in Asian countries, especially in rural, forested areas.

• Countries of Southeast Asia
• India
• Indonesia
• China
• Japan
• Northern Territories of Australia

These mites prefer to live in grassy, ​​shrubby, moist, and shady environments . This means they can be found in a poorly maintained area of ​​your garden, on the edge of a forest, in a pile of decaying leaf litter, or under a bush that is waterlogged. These mites are especially active in late spring and summer.

What are the symptoms of flea fever?

You may not even feel the bite of this mite. It is painless. But after a few hours, the area will start to itch a lot and you may see a small red rash. You may not feel anything for about 6-10 days after the bacteria has entered the body. Symptoms start to appear suddenly after 10-12 days. It is very important to know these symptoms exactly.

How does a doctor accurately diagnose flea fever?

If you have these symptoms, especially if you have been to a forest or bushy area, see your doctor immediately . The doctor will first examine your body, especially for the black scab (eschar). In addition, a blood test will be done to confirm the disease, and to check for antibodies that the body makes against the bacteria. One challenge with this is that the symptoms of flea fever are very similar to the symptoms of diseases that are common in our country, such as dengue, leptospirosis, and typhoid fever. Therefore, the doctor has to think about all these diseases and come to a diagnosis. Sometimes, if the first blood test cannot be found accurately, it may be necessary to do another test after 1-3 weeks. In such a case, the doctor may start treatment based on the symptoms without waiting for the results.

What are the treatments for this?

The good news is that flea fever is a disease that can be completely cured with antibiotics. The most important thing is to start treatment as soon as possible. Then you can get well soon. The doctor will probably tell youThe antibiotic doxycycline is given. This is given orally for 7 days or more. Sometimes it can be given intravenously (IV). For young children, especially if the disease is mild, a short course of 5 days is recommended. This is to avoid side effects such as tooth staining if this medicine is used long-term. For pregnant women or people who are allergic to doxycycline, other safer antibiotics such as azithromycin are given.

Serious complications that can occur if left untreated

If this disease is left untreated, thinking it's just a flu, it can damage vital organs in the body.

Body system	Possible complication
Heart	Conditions such as heart rhythm disorders and inflammation of the heart muscle (myocarditis).
Digestive system	Vomiting, diarrhea, liver problems, pancreatitis, and internal bleeding.
Respiratory system	In severe cases, fluid builds up in the lungs, making it difficult to breathe, leading to a life-threatening condition called `Acute Respiratory Distress Syndrome (ARDS).`
Kidneys	Acute kidney injury (AKI) and kidney failure.
Nervous system	Conditions such as meningitis and meningoencephalitis, which can cause seizures and behavioral changes.

If you experience any of these severe symptoms, see your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

Is there a vaccine for flea fever? How can we protect ourselves?

To date, no vaccine has been developed to prevent flea fever.

Therefore, the best thing to do is to protect yourself from the disease before it develops. That is, to avoid being bitten by a tick.

If you are going to a forested, bushy area, be sure to do these things:

• Dress in a way that covers your entire body. Wear long pants and long-sleeved shirts. It's even better if you can tuck the ends of your pants into your socks.
• Use insect repellent. Apply a repellent containing ` DEET` to exposed skin and clothing.
• Do not sit directly on the grass or bushes.
• When taking babies and toddlers outside, cover their arms and legs well. Cover their stroller or carrier with a safety net.
• Do not spray insect repellent directly on children's skin. Spray it on your hand first, then apply it to your child's skin. Ask a doctor before using it on children under 2 years old.
• After coming back from outside, soak all your clothes in hot water for about 30 minutes. Also, wash your body thoroughly with soap and hot water.
• If you frequently travel to forested areas, you can pre-treat your clothes and shoes with a liquid containing `Permethrin` 0.5% . This kills mites and remains effective even after multiple washings. Do not apply this to your skin. For clothing only.

Take-Home Message

• Scrub Typhus is a bacterial infection. It can be serious, but it can be completely cured with antibiotics .
• It is spread by biting small mites (chiggers) found in places like grass and bushes.
• The main symptoms are fever, body aches, and the formation of a black scab (eschar) at the site of the tick bite.
• If you have these symptoms, don't panic and see a doctor immediately. The sooner you start treatment, the better.
• The best thing to do is to prevent the disease. Cover your body when going into bushy areas, and use insect repellent.

Scrub Typhus, typhus, mites, Orientia tsutsugamushi, eschar, doxycycline, Sri Lanka, fever symptoms