Publication:

Mites, monsoon and multisystem mayhem: clinico-demographic profile of scrub typhus at a tertiary care centre in upper Assam

Background Scrub typhus, caused by Orientia tsutsugamushi and transmitted via larval trombiculid mite bites, is a re-emerging public health threat in Northeast India. Data from upper Assam remain sparse. This study characterises the clinico-demographic profile of confirmed scrub typhus patients at a tertiary hospital in Dibrugarh.

Methods A hospital-based, cross-sectional observational study was conducted at the Department of Medicine, Assam Medical College and Hospital (AMCH), Dibrugarh over one year (October 2024–September 2025). Eighty patients with confirmed scrub typhus (IgM ELISA and/or quantitative real-time PCR) were enrolled. Demographic, clinical, laboratory, and radiological data were analysed using descriptive statistics and Chi-square tests.

Results The 31–40-year age group was most affected (33.75%; mean age 40.25±14.74 years). Male predominance was significant (67.5%; M: F=2.08:1; p=0.002). Three-quarters of patients (76.25%) were from rural backgrounds, and farmers comprised the largest occupational group (37.5%). Fever (100%), headache (92.5%), and jaundice (45%) were the commonest symptoms. Eschar was detected in 35% of patients. Near-universal transaminase elevation (100%), thrombocytopenia (96.25%), hypoalbuminaemia (97.5%), and elevated creatinine (87.5%) reflected multi-organ tropism. Peak incidence occurred in March–April (42.5%). Mortality was 8.75%.

Conclusions Scrub typhus in upper Assam disproportionately affects rural male farmers with a distinctive spring-season peak. Multi-organ involvement is the rule. Early IgM ELISA-based diagnosis and prompt doxycycline initiation remain paramount. Community awareness and vector control are essential to reduce the regional disease burden.