Medical experts in Kerala have made a significant discovery, identifying a rare instance of scrub typhus in a resident of Thiruvananthapuram. What makes this case particularly noteworthy is that the individual had recently traveled from Dubai, United Arab Emirates—a country not typically associated with this disease.
This unusual case, detailed in a recent article published in the peer-reviewed journal *Mass Gathering Medicine*, highlights the alarming potential for the disease to spread into regions where it is not usually found. The researchers emphasized that such occurrences demand a closer look at global health protocols.
Key Insights from the Study
The study stressed the vital need for comprehensive epidemiological research to understand how scrub typhus might be affecting various populations in the region. Furthermore, it called for detailed entomological studies on local insect populations and continuous surveillance to monitor any potential outbreaks.
This groundbreaking research was conducted by a distinguished team of medical professionals. The authors include Althaf Ali and K.J. Anu from the Department of Community Medicine at Government Medical College, Thiruvananthapuram; Praseeda Chandran from the Department of Community Medicine at Government Medical College, Kannur; Zinia Thajudeen Nujum from the Department of Community Medicine, Kollam; Shahul H. Ebrahim from the University of Sciences and Techniques and Technology, Bamako, Mali; and Shaffi Muhammed from the Global Institute of Public Health, Thiruvananthapuram.
Scrub typhus is an illness caused by the bacterium *Orientia tsutsugamushi*, transmitted to humans through the bite of infected chiggers, which are larval mites. While typically endemic to specific regions, Dubai had only previously recorded one case, involving an Australian traveler in 2006. In Kerala, official data indicates approximately a thousand scrub typhus cases annually. A significant 70% of these cases originate from Thiruvananthapuram, with the remaining instances scattered across Kozhikode, Wayanad, Idukki, and Kollam. For example, in 2024 alone, Thiruvananthapuram accounted for 733 cases and eight deaths out of a total of 981 cases and 19 deaths across the state.
Dr. Althaf Ali advised that medical professionals should remain highly vigilant for scrub typhus, especially in patients presenting with characteristic symptoms, even if a visible eschar (a distinct skin lesion) is absent. He noted that common indicators include febrile illnesses, characterized by a sudden and temporary increase in body temperature.
He further emphasized the importance of recommending appropriate laboratory tests to confirm the diagnosis and ensuring prompt, effective treatment for confirmed cases.
The patient, a 52-year-old man, initially presented with four days of fever, chills, vomiting, and severe fatigue. His condition did not improve despite receiving broad-spectrum antibiotics during his treatment abroad. Upon returning to his hometown, he was admitted to a hospital.
While tests for common ailments like dengue, malaria, leptospirosis, and viral hepatitis yielded negative results, he subsequently tested positive for scrub typhus. Fortunately, treatment with doxycycline resulted in significant clinical improvement within just three days.