The re-emergence of ‘Scrub Typhus’ in the city has changed the pattern of occurrence of fevers. Symptoms of the disease are fever, headache, muscle pain, cough and gastrointestinal disturbances.

An intracellular parasite, Orientia tsutsugamushi, causes the fever, ESI Hospital Special Civil Surgeon T.V. Narayana Rao, who has been studying fevers in Vijayawada, told The Hindu. He said that there has been a steady increase in the number of Scrub Typhus cases in the city in the past 18 months.

The regular antibiotics have no impact on the parasite which can even cause death if it was undiagnosed and untreated.

More virulent strains of the parasite can cause haemorrhaging and clotting of blood in the vessels. Drop in the number of white blood cells (WBC) and abnormal liver functioning was seen in the early phases of the illness.

Lung and brain tissue, heart muscle inflammation and seen in the later stages of the disease. The parasite spread by the bite of a ‘Trombiculid mite’ can be diagnosed by the classical black ‘Eschar’ (dead tissue) in some concealed part of the patient’s body.

“Though it is inconvenient the patient has to be stripped completely and examined,” Dr. Narayana Rao said.

Once diagnosed the patient responds very well to Doxycycline 100 mg BID (twice a day) for 7 to 10 days, he said.

Another fever that Dr. Narayana Rao says is always cause for alarm was ‘Leptospirosis’. The disease, which spreads through rat urine, was a threat as long as the rat population in the city was high. The disease causes damage to the liver and the kidneys if not diagnosed and treated properly. Dengue fever that was reported only in North India is now a calendar event with cases reported from the city every rainy season. Some fevers particularly Malaria falciparum have become very difficult to treat. Despite great developments in drugs for treating these and some other fevers they will be around for some time to come, Dr. Narayana Rao opined.

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