Scrub Typhus: Causes, Symptoms, Treatment, Complications & Prevention Tips

Written by Medicover Team and Medically Reviewed by Dr Vineesha Kamini General Medicine

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Scrub typhus is an infection caused by a tiny germ called Orientia tsutsugamushi. It spreads to people through the bite of an infected chigger (tiny red mites found in grassy or bushy areas). This illness is common in rural and farming regions, especially during the rainy season.

When a person gets bitten, the germ enters the body and causes fever, body aches, and sometimes a dark scab at the bite site. With early treatment, most people recover fully. Without treatment, the infection can become serious.

What Is Scrub Typhus?

Scrub typhus is a bacterial infection spread by chiggers, tiny insect-like mites that you usually can't see with your eyes. These mites live in bushes, grass, and farmlands. When they bite, they can pass the infection to humans.

Once infected, people may get a high fever, chills, headache, and tiredness within 6-21 days. Many patients notice a black, crusted sore at the bite area called an eschar, which is a significant sign of scrub typhus.

If not treated early, the infection can spread to the lungs, brain, kidneys, and other organs.

What Are the Symptoms of Scrub Typhus?

Scrub typhus symptoms can come on quickly and may feel very similar to a common flu-like sickness at first. Because the early signs are not specific, people often don't realize they've been infected. Paying attention to the full range of symptoms can help catch the illness early and begin the proper treatment.

Common Symptoms

• High fever and chills
• Severe headache
• Body and joint pain
• Tiredness and weakness
• Rash on the body
• A dark scab (eschar) where the bite occurred
• Swollen lymph nodes
• Loss of appetite

Severe Symptoms (if not treated)

• Breathing difficulty
• Confusion or drowsiness
• Low blood pressure
• Organ failure (lungs, kidneys, brain)
• Bleeding or clotting problems

If someone has a fever for more than 5 days and lives in or has visited rural or bushy areas, scrub typhus should be suspected.

What Are the Causes of Scrub Typhus?

Scrub typhus is caused by a tiny germ called Orientia tsutsugamushi. You can get this infection when you are bitten by infected chiggers, which are tiny red mites found in grassy or bushy areas. Most people never feel the bite because chiggers are extremely small.

You may be exposed if you:

• Walk barefoot or sit on grass, bushes, or farmland
• Spend time in forests, farms, or areas with tall grass
• Work outdoors in fields or rural areas

Important: Scrub typhus does not spread from one person to another. You can only get it through the bite of an infected chigger.

What Are the Risk Factors of Scrub Typhus?

You are more likely to get scrub typhus if you spend time in places where infected chiggers live. These mites are common in grassy, bushy, or rural areas.

You may have a higher risk if:

• You live in or travel to villages or rural regions
• You work outdoors, such as in farming, forestry, or field labor
• You go camping, hiking, or walking through tall grass or bushes
• You do not use insect repellents while outdoors
• You sit, rest, or sleep directly on the ground
• Children play outside in grassy or muddy areas

Anyone who spends time in outdoor, natural environments, especially during the rainy season, can be at risk of scrub typhus.

How Is Scrub Typhus Diagnosed?

Doctors diagnose scrub typhus by looking at your symptoms and asking about any recent outdoor activity. One important sign they look for is an eschar, which is a dark, scab-like spot at the bite area. Not everyone has it, but when present, it helps confirm the infection.

Types of Tests Conducted Under Diagnosis

To be sure, doctors may order a few tests:

Blood Tests

• To look for signs of infection in the body
• To check if any organs are affected
• Special tests, such as ELISA or PCR, are used to confirm scrub typhus bacteria

Physical Examination

• Checking the skin for a rash or eschar
• Feel for swollen lymph nodes
• Checking breathing, pulse, and overall health

Laboratory Tests

• Serological Tests: The Weil-Felix test and the indirect immunofluorescence assay (IFA) are commonly used for diagnosing scrub typhus. These tests detect antibodies against Orientia tsutsugamushi in the patient's blood.
• Polymerase Chain Reaction (PCR): PCR can detect DNA from Orientia tsutsugamushi and is a highly specific and sensitive diagnostic tool.
• Culture Methods: Although less common due to complexity, culturing the bacterium from blood or tissue samples can confirm the diagnosis.

Clinical Diagnosis

Clinical diagnosis involves a thorough examination of symptoms and patient history. The presence of an eschar at the site of the chigger bite is a significant clinical indicator. Physicians also consider the patient's travel history to endemic regions.

Early diagnosis is essential because starting treatment quickly helps prevent serious complications and leads to a faster recovery.

What are the Treatment Options for Scrub Typhus?

Scrub typhus is treatable, and most people start feeling much better when they get the right medicine early. The primary treatment is antibiotics, which help kill the bacteria causing the infection.

Common Treatments

• Doxycycline: The most commonly used antibiotic, and it works very effectively.
• Azithromycin: An alternative for patients who cannot tolerate doxycycline, such as pregnant women and children.
• Chloramphenicol: Another effective antibiotic, although it is less commonly used due to potential side effects.

Supportive Care

Along with antibiotics, doctors may also recommend:

• Fever control using medicines to reduce temperature and discomfort
• Hydration, either by drinking fluids or receiving IV fluids if the patient is too weak
• Hospital care for severe cases, especially if the lungs, kidneys, or other organs are affected

Most patients begin to improve within 24 to 48 hours after starting antibiotics. Getting treatment early helps prevent serious complications and speeds up recovery.

When to See a Doctor?

Scrub typhus can start with symptoms that feel like the flu, so it’s essential to know when to seek medical help. Getting checked early helps prevent complications and ensures a quick recovery. If you have been in grassy, bushy, or rural areas and develop a fever or other symptoms, it’s safer to consult a doctor.

See a doctor if you experience:

• Fever lasting more than 2-3 days, especially after outdoor exposure
• Severe headache, body aches, or extreme tiredness
• A dark scab (eschar) at the bite site
• Rash on the body
• Swollen lymph nodes
• Nausea or vomiting
• Breathing difficulty or chest discomfort
• Confusion, drowsiness, or unusual behavior
• Symptoms are getting worse despite home care
• Any high fever in children, especially after playing outdoors

Early treatment with antibiotics can prevent serious complications and help you recover much faster.

What are the Complications of Scrub Typhus?

If scrub typhus is not treated early, the infection can become serious and affect different parts of the body. The longer the treatment is delayed, the higher the risk of complications.

Possible complications include:

• Pneumonia: An Infection spreading to the lungs, causing breathing problems
• Kidney failure: When the kidneys stop working properly
• Brain inflammation (meningitis): Leading to confusion, severe headache, or drowsiness
• Liver damage: Causing jaundice or abnormal liver tests
• Multi-organ failure: When several organs stop functioning
• Shock: A life-threatening drop in blood pressure

Early diagnosis and prompt treatment with antibiotics greatly reduce the chances of these complications and help ensure a faster, safer recovery.

Prevention of Scrub Typhus

There is currently no vaccine to protect against scrub typhus, but you can greatly reduce your risk by taking a few simple precautions. Since the infection spreads through bites from tiny chiggers found in grass, bushes, and farmland, protecting yourself while outdoors is the best way to stay safe.

How to Prevent Scrub Typhus

Wear protective clothing:

• Wear long-sleeved shirts and long pants when walking through fields, forests, or grassy areas.
• Tuck your pants into your socks to prevent chiggers from reaching your skin.

Use insect repellent:

• Apply insect repellent to your skin and clothing, especially when spending time outdoors.
• Choose repellents recommended for protection against mites.

Avoid sitting or lying on the ground:

• Use mats or blankets when outdoors.
• Avoid direct contact with grass or soil where chiggers may be present.

Keep surroundings clean:

• Trim tall grass and bushes around your home.
• Maintain clean living environments to reduce chigger habitats.

Shower after outdoor activities:

• Take a bath and change clothes after returning from farms, fields or forests.

Wash clothes properly:

• Wash outdoor clothing in hot water to remove any mites that may be attached.

Protect children:

• Encourage children to wear shoes and avoid playing barefoot in grassy areas.
• Teach them not to sit or roll in bushes or tall grass.

These simple steps can significantly lower your chances of getting scrub typhus, especially if you live in or travel to areas where the disease is common.

What to Avoid to Stay Safe from Scrub Typhus

• Don’t sit or lie directly on grass or soil, as chiggers often live in these areas and can easily bite exposed skin.
• Don’t allow children to play barefoot in fields or tall grassy areas, where the risk of chigger bites is higher.
• Don’t ignore a fever, especially if it starts after outdoor activities. Early medical care can prevent complications.

Avoiding these actions, along with following the recommended precautions, can significantly lower your risk of getting scrub typhus.

Our Experience Treating Scrub Typhus at Medicover

At Medicover, we have substantial experience in diagnosing and treating scrub typhus with care and accuracy. Our medical team understands how quickly this infection can progress, so we focus on early detection and fast treatment to protect your health.

Here’s how we help our patients:

• Early and accurate diagnosis: Our doctors carefully examine your symptoms and use reliable lab tests to confirm the infection.
• Prompt treatment: We provide the most effective antibiotics to ensure quick recovery.
• Close monitoring: For patients with severe symptoms, we closely watch for any complications and offer advanced medical support when needed.
• Supportive care: We manage fever, dehydration, and other discomforts to help you feel better sooner.
• Guidance on prevention: We educate patients and families on how to avoid future infections, especially if they live or work in high-risk areas.

At Medicover, our goal is to help you recover safely, comfortably, and as quickly as possible, so you can get back to your daily life without worry.