A new multi-institutional study has reported that the risk of scrub typhus infection may be higher inside village households than in agricultural fields, challenging the long-standing understanding that the disease primarily affects people exposed to forests, farmlands, and wilderness areas.
The findings were reported by researchers from the London School of Hygiene & Tropical Medicine (LSHTM) and collaborating with Christian Medical College (CMC) Vellore, based on field investigations conducted in Tamil Nadu. The study suggests that transmission dynamics may be shifting, with household environments emerging as significant exposure sites.
Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi, transmitted through the bite of infected larval mites (chiggers). It is endemic across parts of South and Southeast Asia, including India.
For decades, scrub typhus has been associated with:
Rural communities
Agricultural workers
Forested or scrubland areas
Outdoor occupational exposure
Earlier reports highlighted that rural populations were considered at particularly high risk due to frequent exposure to vegetation and fields where infected mites reside.
However, the new research indicates that domestic settings, including living rooms and sleeping areas may now play a larger role in disease transmission than previously recognized.
According to reports, researchers conducted community-based investigations in Tamil Nadu, South Indian villages and observed:
Higher infection risk within household premises compared to fields
Evidence suggesting that rodents carrying infected mites may be contributing to indoor transmission
Increased exposure among women, children, and elderly individuals who spend more time indoors
The findings suggest that scrub typhus may no longer be confined to occupational exposure in fields but may be occurring in routine domestic environments.
Researchers noted that improving household hygiene, rodent control, and environmental management inside villages may be important components of prevention strategies.
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. It is transmitted by the bite of infected chiggers, which are commonly found in grassy areas, shrubs, and soil.
Symptoms usually appear 6–21 days after a bite and may include:
Sudden high fever
Headache
Muscle pain
Swollen lymph nodes
Rash
Cough or breathing difficulty in severe cases
One of the hallmark features of scrub typhus is the formation of an eschar, a painless, black, scab-like lesion at the site of the chigger bite. The eschar resembles a cigarette burn and is considered an important diagnostic clue, although it may not be present in all patients.
In some cases, untreated scrub typhus can lead to serious complications such as:
Acute respiratory distress syndrome (ARDS)
Meningitis or encephalitis
Multi-organ dysfunction
Scrub typhus is treatable with antibiotics, and early diagnosis significantly improves outcomes.
Commonly used antibiotics include:
Doxycycline
Azithromycin
Most patients respond rapidly to treatment when therapy is initiated promptly. Delayed diagnosis, however, may increase the risk of complications.
The study’s findings suggest a need to reassess current prevention strategies that focus primarily on outdoor exposure. If transmission is increasingly occurring inside homes, public health messaging may need to expand beyond field workers.
(Rh)
