Two UG cadres surrender
IMPHAL, Jun 17: An active cadre of KCP, identified as SS Maj Angom Ibochouba alias Punshiba alias Shelungba s/o Ibomcha Singh of Moirang, Bishnupur district surrendered to the troops of Red Shield Division at Moirang Khunou with a .32 mm Pistol and two .....
Heart camp
IMPHAL, Jun 17: A five-day long heart camp organised by Sky Hospital and Research Centre in association with Manipur Heart Foundation at the hospital concluded today. Altogether 250 heart patients including 35 children between one to 10 years were exam.....
Two officers suspended in controversial Moreh land deal
IMPHAL, Jun 17 : In connection with the controversial sale of 160 acres of land located near Kondong Lairembi complex, Moreh to the Assam Rifles, SDC Ibohal and Assistant Settlement Officer Imocha have been suspended from service. This was stated by Re.....
Manipur PMT fiasco AG fails to produce SC verdict before Court
Imphal, Jun 17 : Even as the State Cabinet recently cancelled the current year’s PMT citing a Supreme Court’s verdict issued on May 15, the State Advocate General could not produce a copy of the same when the matter was heard before the Manipur high C.....
Process on for visa on arrival at Moreh
IMPHAL, Jun 17: Indian authorities have initiated due process for opening an office for issuing visa on arrival to Myanmarese nationals coming to Manipur through Moreh, particularly those coming for medical treatment. According to an official source, .....
Decks Cleared To Pay Fitting Homage To Martyrs Of June 18 Traffic arrangement for June 18 laid down
IMPHAL, Jun 17: In order to ensure smooth traffic regulation, SP Imphal West District has made some arrangements for the commuters on June 18. On the other hand, volunteers joined hands in sprucing up Kekrupat where homage would be paid to the martyrs .....
Ministry reshuffle effected Kharge made Railways Minister, 8 inducted as Ministers
New Delhi, Jun 17 : In perhaps the last reshuffle and expansion of the Union Council of Ministers, Mallikarjun Kharge was today made the Railways Minister as eight more were inducted with veterans Sis Ram Ola and Oscar Fernandes making a comeback. Aft.....
State to have own medical council
IMPHAL, June 17: Manipur will soon have its own medical council. Health minister Phungzathang Tonsing informed the House on Monday that approval for setting up of state medical council has been given to the State Government and efforts are underway to .....
Army not misusing AFSPA: Parnaik
Udhampur Jun 17 : Insisting that the revocation of AFSPA might put at stake the “fragile” peace existing in Jammu and Kashmir, Army today said it has given advice to the Centre on the issue and it was for the government to take a call. “It is a m.....
Bandh against ‘taxes’
DIMAPUR, Jun 17: Unable to bear the rampant imposition of ‘taxes’ on the business community and also on the general public any longer, the denizens of Dimapur, the commercial hub of Nagaland are all set to enforce a bandh on June 18 from 6 am to 6 pm......
New recruits to add to man power
IMPHAL, Jun 17: The State Government is planning to make up security shortfalls in hill districts by chalking out an adjustment formula once the recruitment process of 2000 police personnel is completed. Taking part in the discussion of demands at the .....
AITSA demands
IMPHAL, Jun 17: The All India Tribal Students’ Association, (AITSA) Delhi, a branch of the Mongoloid Peoples Forum, Delhi, has termed the deliberate sale of application forms for PMT exam for the session 2013-2014 by the Directorate of Health Services, .....
Capital punishment
IMPHAL, Jun 17: The JAC constituted against the gang-rape of an u-morok trader has demanded that the culprits be awarded capital punishment. The trial Court convicted four accused persons in the case on June 12. The Court will announce the quantum o.....
Ramlal Paul HSS
IMPHAL, Jun 17: The Ramlal Paul Higher Secondary School Students’ Union has opposed the State Government’s move to admit students of TG Higher Secondary School at the school. It may be mentioned that the State Government decided to turn Ramlal Paul.....
Hongmahn refutes
IMPHAL, Jun 17: Reacting to the allegations raised by the chief of Thingjang village and which was published in the June 15 edition of this paper, the Hongmahn (Khongbal) Tangkhul Village Authority has clarified that the land which the Thingjang village c.....
The politics in name: Myanmar versus Burma
A three-day long of the 22nd World Economic Forum for East Asia concluded on June 7 in Nay Pyi Taw. It was the first time Myanmar hosted an international gathering of such magnitude. The event was attended by around 900 participants from over 50 countries.....
Solar Power in Manipur
Editor’s note : This article is being repeated as the one published earlier contained a number of erraneous figures, particularly with reference to the power units, brought about by the change in the character of the words once it was transferred to our.....
Frequently asked questions on blood donation-III
28. What are benefits of voluntary blood donation? a. General benefits: * Blood donation a goodwill act, one of the noblest and selfless of all deeds. After donation you experience a feeling of contentment saving somebody’s life the feeli.....
Dust kicked up by peace processes Politics of ceasing hostility
Ceasing hostility followed by negotiation. So is this the beginning of the journey towards a solution ? In political speak, the answer will undoubtedly be a big yes but take a closer look and the answer may not be this simple. An example of politics not e.....
Sit in
IMPHAL, Jun 17: As part of the agitation demanding the enforcement of ILPS in the State, a sit in was held today at Nongmeibung Bazar. The demonstration was organised jointly by Eastern Students' Club, Nongmeibung and Nongmeibung Women Development Meir.....
General Articles
By : Sangai Articles
Scrub typhus – a threat to life
By Dr Shongsir Warson Monsang
“As an educationist and being a responsible citizen, I take this privilege of directing my thoughts to the medical awareness strategy where it is expected to benefit the readers – common - men, experts, doctors, farmers, children at schools, officers and all those who are literally literate. Day after day, we encountered different threats of our lives - psychological, physical or mental. The advancement of today’s technology has taken us to such a limitless boundary that we are at the point of receiving the penal where we don’t really deserved to get in reality – the emerging problems associated with global warming and biological weapons. In our context, HIV, Swine flu, bird flu, malaria, Japanese encephalitis besides many others are being experienced in daily life. But people still tended to be ignorant or remained neglected which results in severe mortality; otherwise, where it could have been avoided if proper measures and precautions were undertaken at individual or community levels. Therefore, as I personally felt the pain of seeing a common innocent man losing hope of life in future; this article was best collected and prepared so that a little hope of spreading clean n fresh awareness may be taken at appropriate time”.
Recent reports of the Sangai express (16/11/2012; E-pao (17/11/2012; Indian Express (17/11/2012) reported the outbreak of an endemic disease later identified to be what is medically termed as “Scrub typhus”. It might be recalled that this unknown disease that broke out at Bishnupur district in 2008/2009 and which claimed a number of lives after malaria, dengue and swine flu recently project as a threat to the other hilly adjoining districts like Ukhrul and Senapati owing to various climatic reasons and other associated factors. Fortunately, casualty from other districts has not been reported so far.
Scrub Typhus, also called tsutsugamushi disease is a febrile illness caused by bacteria of the family rickettsiaceae and named Orientia tsutsugamushi. Scrub typhus is endemic to a geographically distinct region, the so-called tsutsugamushi triangle, which includes Japan, Taiwan, China, and South Korea. It also occurs in Nepal, northern Pakistan and the Australian states of Queensland and northern new South Wales. In India, the disease had occurred among troops during World War II in Assam and West Bengal, and in the 1965 Indo-Pak war. It is known to occur all over India, including Southern India and northern India.
In scrub typhus, an eschar approximately 5 to 20 mm in diameter is formed at the site bitten by trombiculid mites, and this may be considered the most important clinical finding for the diagnosis of scrub typhus. The site bitten by chiggers is initially a papule followed by a blistered ulcer, and this is then covered with a black crust; the border of the eschar is surrounded by reddish erythema. Such a typical eschar is formed at the time when symptoms are manifested
Scrub typhus lasts for 14 to 21 days without treatment. Severe infections may be complicated by interstitial pneumonia, pulmonary edema, congestive heart failure, circulatory collapse, and a wide array of signs and symptoms of central nervous system dysfunction. Death may occur as a result of these complications, usually late in the second week of the illness.
By contrast, patients treated with appropriate antibiotics typically become afebrile (absence of fever) within 48 hours of starting therapy. This response to treatment may be useful diagnostically; failure of defervescence within 48 hours is often considered evidence that scrub typhus is not present, and that an alternate diagnosis such as malaria or dengue should be considered. However, in a 2004 report, 20 of 93 patients with serologically confirmed scrub typhus had a delay in defervescence to more than 48 hours, making the reliability of this long-standing clinical truism suspect. The authors of another report retrospectively examined the clinical characteristics of 18 patients with Q fever (9), scrub typhus (7) or murine typhus (2) who failed to respond within 48 hours to treatment with doxycycline and compared their clinical features to 88 cases who responded promptly. Delayed deferves- cence was associated with jaundice and relative bradycardia.
Causes and geographical distribution
Scrub typhus is transmitted by some species of trombiculid mites (“chiggers”, particularly Leptotrombidium deliense), which are found in areas of heavy scrub vegetation. The bite of this mite leaves a characteristic black eschar (scar) that is useful to the doctor for making the diagnosis. It is endemic to a part of the world known as the tsutsugamushi triangle (after O. tsutsugamushi). This extends from northern Japan and far-eastern Russia in the north, to the territories around the Solomon Sea into northern Australia in the south, and to Pakistan and Afghanistan in the west.
It affects females more than males in Korea, but not in Japan, and this is conjectured to be because sex-differentiated cultural roles have women tending garden plots more often, thus being exposed to plant tissues inhabited by chiggers. The incidence is increasing day-by-day in southern part of Indian Peninsula.
Symptoms and signs
Symptoms include fever, headache, muscle pain, cough, and gastrointestinal symptoms. More virulent strains of O. tsutsugamushi can cause hemorrhaging and intravascular coagulation. Maculopapular rash, eschar, splenomegaly and lymphadenopathies are typical signs. Leukopenia and abnormal liver function tests are commonly seen in the early phase of the illness. Pneumonitis, encephalitis, and myocarditisoccur in the late phase of illness. Acute scrub typhus appears to improve viral loads in patients with HIV.
Diagnosis
In endemic areas, diagnosis is generally made on clinical grounds alone. Where there is doubt, the diagnosis may be confirmed by a laboratory test such as serology. However, the choice of laboratory test is not straightforward, and all currently available tests have their limitations.
—to be contd
dr anil
dr worsan congratulation you have done a wonderful job. this information will go a long way to help the people and the medical fraternity as well. this was written at the perfect time very nicely. also congratulation goes to the reporter of The Sangai express for the news coverage on Scrub typhus.
dr warson
dr anil, tnks so much for your appreciation and acknowledgement. I really hope many people will read this article and get benefited. Thanks also to sangai for publishing this article.
