Travelling to Thailand is just not inherently dangerous, nevertheless it’s additionally essential to concentrate on sure tropical ailments that may have an effect on guests, particularly in rural or forested areas. One such illness is scrub typhus, a bacterial an infection endemic to components of Asia, together with Northern Thailand.
Whereas it’s comparatively uncommon amongst vacationers, and extra frequent amongst these working in agriculture, scrub typhus could be life-threatening if left untreated. A current case of a girl from the UK who was hospitalised upon her return from Thailand prompted me to write down this submit and inform my readers of the info, signs, prevention methods, and what to do when you suspect an infection.
What Is Scrub Typhus?
Scrub typhus is an acute febrile sickness brought on by the bacterium Orientia tsutsugamushi. It’s transmitted to people by the chew of contaminated chigger mites (larval mites of the Trombiculidae household), usually present in rural or forested areas with dense vegetation.
- It’s not transmitted person-to-person.
- The chew is usually painless and infrequently goes unnoticed.
- The illness is a part of the “typhus group,” however is biologically distinct from epidemic or murine typhus.
The place Is Scrub Typhus Discovered?
Scrub typhus happens in a area generally known as the “tsutsugamushi triangle”, which spans:
- Southeast Asia (together with Thailand, Laos, Cambodia, Vietnam, Myanmar)
- South Asia (India, Nepal, Sri Lanka)
- Components of China, Japan, and Northern Australia
In Thailand, circumstances are most typical in:
- Northern provinces like Chiang Mai and Chiang Rai
- Jungle and highland areas
- Throughout or after the wet season, usually June to November
How Widespread Is It?
In Thailand, scrub typhus is without doubt one of the most reported rickettsial ailments. In line with the Thai Ministry of Public Well being, over 10,000 circumstances are reported yearly, although this contains each locals and vacationers. The precise quantity is probably going greater attributable to underreporting and misdiagnosis.
One research utilizing nationwide surveillance information reported the next: Between 2003 and 2018, Thailand reported 103,345 circumstances of scrub typhus, with a big enhance over time. The illness affected extra males than girls, notably agricultural employees, and 72% of circumstances have been in folks aged 15–64.
The northern area carried the very best illness burden, accounting for 53% of annual circumstances. Inside this area, Chiang Rai, Chiang Mai, Tak, Nan, and Mae Hong Son made up 84% of northern circumstances, or 45% of all circumstances nationwide.
Most circumstances occurred between June and November, with much less seasonality noticed within the south. In Chiang Rai province, elements comparable to elevation, rainfall, temperature, inhabitants dimension, habitat complexity, and land cowl variety have been linked to greater incidence (supply).
What Are the Signs?
Signs normally seem 6–21 days after a mite chew. Widespread signs embrace:
- Sudden excessive fever
- Headache and physique aches
- Swollen lymph nodes
- Rash (usually on the trunk)
- Gastrointestinal points (nausea, vomiting)
- Cough or respiration difficulties
- A key signal is an eschar, which is a darkish, scab-like sore on the website of the mite chew, however this isn’t all the time current.
In additional extreme circumstances, the an infection can result in:
- Lung irritation (pneumonitis)
- Liver irritation or jaundice
- Meningoencephalitis
- Multi-organ failure
How Harmful Is It?
- If handled promptly, most sufferers get well absolutely inside a number of days.
- With out remedy, the illness could be extreme, with a mortality price of 6–20%, relying on entry to care.
- The usual remedy is the antibiotic doxycycline, which is broadly accessible in Thailand.
The way to Stop Scrub Typhus
There isn’t a vaccine for scrub typhus, so prevention focuses on avoiding mite bites, notably in high-risk environments:
Preventive Measures:
- Put on long-sleeved shirts and lengthy trousers when in grassy or forested areas.
- Apply insect repellent with at the very least 20–30% DEET on uncovered pores and skin.
- Deal with clothes and equipment with permethrin.
- Keep away from sitting or mendacity on the bottom or grass.
- Bathe and alter garments promptly after out of doors actions.
What to Do If You Suspect An infection
In the event you expertise unexplained fever, swollen glands, rash, or fatigue throughout or after journey to rural components of Thailand:
- Search medical consideration instantly.
- Inform the physician of your journey historical past, together with any forest trekking, mountain climbing, or rural publicity.
- Request testing for tropical fevers if signs persist.
- Early antibiotic remedy is essential and usually results in speedy restoration.
In Abstract
Scrub typhus is treatable and preventable, and whereas circumstances do happen – very like malaria in border areas or dengue throughout wet season – it needn’t be a significant concern when you take wise precautions. When mountain climbing or visiting rural areas, put on protecting clothes, use insect repellent, and select clear, well-maintained lodging with fundamental pest management.
Additional Studying & Sources:
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