Scrub Typhus:Jammu Outbreak-2009

This is a first report of 20 adult cases describing clinical feature, epidemiological profile and treatment outcomeof clinically diagnosed scrub typhus confirmed by test for antibodies (IgM) to O.tsutsugamushi using ELISAkit. Majority of the cases belonged to the district Rajouri (45%) froming hilly & rural belts.Outbreak wasAutumn Winter type as all cases reported in month of September and October. The common clinical featureswere fever 100%, myalgia 50%, headache 30%, conjunctival congestion 30%, eschar 35%, rash 25%,lymphadenopathy 45%, splenomegaly 40%, hepatomegaly 40%, edema 25%, ARDS 35%, altered sensorium10%, hypotension 20% & metrorrhagia in 5% of patients. Use of Immunological test helped to establishdiagnosis of scrub typhus.Thus all the cases were managed successfully without any mortality with doxycyclineand or azithromycine & one with addition of rifampicin.