2. HISTORY
 Most wide spread A/C febrile illness caused by
orienta tsutsugamushi
 First identified in china in 313 AD
 Intacellular gram neg.org.isolated in japan in
1930
 Zoonoses in nature exists in nature between
mites and rodents

3. Geographical
distribution

4. Mode of transmission
 Mite  Rat,Mice  Mite  Rat,Mice
Man
 Maintained in nature transovarially in mites
 Adult and nymph mites are free living
 Larva (chiggar) feed on man introducing
bacteria

6. Adult
Larva
(chigger)

8. Clinical features
 Incubation period 6to20 days
 A/C fever and chills 104-105*c
 Head ache, Malaise, Prostration,
 Macular rashes -5th day
 ESCHAR-punched out ulcer with central
necrosis
 Lymph adenitis
 Hepato splenomegally

9. Eschar

10. Complications
 ARDS
 Myocarditis
 A/C Renal failure
 DIC

11. Diagnosis and treatment
 4 fold increase in antibody titre
 Weil felix positive withOXK STRAIN
 Immuno peroxidase test
 Immuno flurocent test
Responds to tetracycline,doxycycline,azithromyci etc.

12. PREVENTIVE MEASURES
 Avoid areas where there is known typhus
outbreak
 Avoid over crowded living conditions
 Spray for ticks fleas mites
 Practice good hygeine
 Care farmers working in farms,in
bushes,andthose who are close to
rodents,domestic animals etc.
 NO VACCINE at present