Scrub Typhus

Scrub Typhus Natna Mizoramah (Dr Samuel-a)

Kaihtawi:

Chigger's Scrub Typhus hi Mizoram leh India ram mai bakah khawvel hian Indopui II hnu lamah a hmel a hmu tam lo hle mai a. Japan rama hmuhchhuah hmasak ber niin, a tamna hmun chu Asia chhim lam leh pacific-ah te a ni ber a, tin, "tsutsugamushi triangle" an tih Japan leh far-eastern Russia atanga Australia hmar lam, tin, Pakistan leh Afghanistan thlengin a bial bawk. India ramah pawh state hrang hrangin an lo nei tawh a. South India ah te pawh kum 2001 thlasik lai vel khan outbreak a lo awm tawh a ni. North-east ah hriat theih chinah chuan Meghalaya leh Assam-in an report tawh a. Hman laiin manipur imphal-ah pawh hmuh a ni tawh a, tuna an dinhmun hriat mai a harsa a, mahse RIMS medical college ah khi chuan tun hnaiah report a awm lo niin a lang. Keini ramah hian a lo thleng ve mek a. Amaherawhchu, he natna hian lanchhuah dan bik chiang taka han thliarhranna a neih loh avangin hriatthiam a harsa hle a, awlsam tea antibiotic bik hmanga tihdam theih a nih laiin, diagnose fuh loh erawh chuan natna khirhkhan tak tak a thlen thei a. Thihpui tham tak a nih avangin he natna hi a hunlaia hriatchhuah vat a tulin, mipui nawlpui pawhin kan hmelhriat a tul ta.

Natna Hrik :

Scrub Typhus hi a thlentu chu Orientia tsutsugamushi,Rickettsial diseases an tih zing ami a ni a, Spotted fever an tih zingah an dah bawk. Hei hi hrik pakhat 'Chiggers' (0.2-0.4 mm a lian) an tih seh atanga kaichhawn a ni a. A seh atanga ni 6-20 (avg 10 days) velah a natna hi langchhuak thin.

Nat dan :

He natna hian lanchhuah dan bik tak (pathognomic signs and symptoms) a nei lem lo a, hei vang tak hian hriatchhuah emaw han rinhlelh mai pawh a har hle. A tlangpui chuan khawsik leh taksa na tein an rawn kal a, thal be bawk (lymphadenopathy) te an nei thei a, nikhaw hre lo deuh thaw a rawn kal te pawh an awm. Naupang ah kawthalo leh luak te, vual te pawh an awm thin. Tin, nuin a nau pai laiah a kaichhawn thei bawk (vertical transmission) tih hmuhchhuah a ni tawh. Heng bakah hian lanchhuah dan leh natna dang thlentir theih hrang hrang a nei a, chungte chu:

1) Vunah: A hrik ( Chigger)-in a sehna hnuhma vunah hmuh tur a awm thin tlangpui a, hei hi a natna rinhlelh dan ber chu a ni mai awm e. Belkang (eschar) ang deuh hian a awm a, a laiah a khir a awm a, vun kang sen ang hian a hual thin (cigarette burn like). Hei hi banah te, hnute bawr velah te, nghawng te, serh leh mawng bawrah te a awm duh hle. He eschar hi a natna vei zawng zawngah a awm kher lova, 50-70% bawr velah chauh hmuh a ni.

2) Thluak lamah ( central nervous system) : He natna hi enkawl vat loh chuan thluak-a khawsik lut kan tih mai Encephelitis ang hian a thawk ve thei a, hei vang hian thihna tam tak a thlen a. Hei bakah hian rilru lam buaina (psychiatric disorders) tihdam hleihtheih tawh loh a thlen thei bawk a. Tin, a lo vei tawh dam chhuak te zingah pawh damchhunga 'Kaih' (seizure) enkawl dam theih loh te pawh an awm a ni.

3) Polyneuritis :

Hei hi tha ( neuromuscular) lam natna a ni a. Mi tam tak Scrub typhus vei ten tha zawi leh tha hit mup leh tha mur te an nei a. Thenkhatah chuan chet theih loh hial te pawh a awm chho thei a ni.

4) Chuap leh lung lamah : Pneumonia leh ARDS kan tih, chuap lam natna avanga thawhah vak vak te a siam thei a. Tin, lung natna myocarditis kan tih a thlen thei bawk.

5)

Thisen-ah : Disseminated Intravascular Coagulation ( DIC) leh Thrombocytopenia a thlen thei a. Hei hian thi (bleeding) tawp thei tawh lo a thlen a, ek-a thi tel leh thikhara ek chhuah te pawh a awm thei a ni. An chauh phah a thisen pek te an ngai a, buaipui vak an ngaih chang te pawh a awm.

6) Bengchhet (deafness)

hi a natna tak dam hnuah mi tam takah a awm ve thei.

7) Kal na (renal failure)

te pawh a nasa ah chuan a thlen chho thei ( 9% bawr velah)

Diagnosis : Thisen-ah a hrik leh a hnuhma a hmuh theih thin a. Indirect immunofluorescence Antibody (IFA) test an tih hi a diagnose nan a tha ber a. Weil-Felix te, ELISA te, PCR test an tih te pawh hi a tha hle a, test chi dang dang pawh a la awm a. Mahse heng test hi mizoramah kan nei rih lo niin a lang. Rapid test kan tih Immunochromatographic assay ( IgG, IgM leh IgA) hmanga test theihna hi mizoramah chuan kan neih a ni mai a. A definitive test chu a ni lo nangin a tha tawk viau mai a (specificity 95%). Hemi test hmang leh a natna lanchhuah dan (clinical presentation) hmangin Scrub typhus hi kan diagnose thei a ni.

Scrub Typhus Mizoramah :

He natna hi mizoram tan chuan natna thar tak mai a nih laiin, kum 3 vel chhung lek hian nunna tam tak a lo la tawh a ni. Kum 2008 kum tawp lam khan Presbyterian Hospital, Durtlang ah diagnosed a ni a. Hemi kum vek hian November- December chhung lekin confirmed cases 23 (ELISA test hmangin) lai hmuh hman a ni a. A hma daih atangin a lo awm tawh maithei a, mautam-in a rawn ken tel pawh a ni maithei. Chumi hnu chuan hmuhchhuah a ni ta zeuh zeuh reng a, a thlentu tak hriat loha hman deuha septicemia vanga boral an tam viau nachhan pawh kha he natna vang hi a ni maithei e.

Tun kumah June thlengin confrimed case panga hmuhchhuah tawh a ni a, pakhat chu a thi nghe nghe a. Heng zingah hian naupang thla 11 mi lek a tel a. Unconscious-in hun rei tak chhung a awm tawh a, enkawl lai mek niin that lam erawh a pan ve hret hret zel. Sawi tawh angin tuna kan test neih hi a lawngin confirm na atan tling lo mah se, damlo te nat dan leh vun khir (eschar) kan tih ang nei ngei an nih avangin Scrub Typhus hi a ni ngei a ni tih pawm a ni. Tin, damlo te awm dan hmang hi malaria nen hian a inang hle a. Chuvangin, malaria hrik an hmuh si loh khawsik tlut tlut mai leh eschar kan tih nei ngei nia hriatah chuan Scrub typhus hi rinhlelh nghal tur a ni.

A natna hian mipa leh hmeichhia, upa leh naupang, sik leh sa a thliar hrang em em lem lo a. Amaherawhchu, tlema thingtlang deuh leh ram kal mi leh kut hnathawk mi angah te hian a tam bik a. Sazu leh ran vulh hrang hrang atangte pawhin a kai theih. Chuvangchuan, khawpuiah pawh khawsak dan leh khawsakna hmun te pawhin thui tak a hril a.

Tunah hian he natna hi mizoram hmun hrang hrangah hriatchhuah si lohin vei tam tak an awm thei a. Fimkhur a tulin kan inhaivar a tul hle mai.Amaherawhchu, a natna vei te atanga awlsam taka inkaichhawn theih chi a ni lem lova, a hrik 'chigger' seh chauhin a kai theih a ni.

Treatment: Hetianga natna khirhkhan tak leh thihpui tham hial ni thei si hi a damdawi erawh kan hriat tlanglawn a ni lawi a. Doxycycline hi a damdawi ngeih ber a ni a. Hei bakah hian chloramphenicol leh Azithromycin te, rifampicin te pawh a ngeih em em mai a. Ram dangah pawh heng damdawi tho hi an hman a ni a. Mahse, mizoramah hian he natna hi kan hriat lar loh leh a tira kan suspect a nih loh fo avangin kan hmuhchhuah meuh chuan thenkhat an lo tha lo hle tawh a, an thih phah ta thin niin a lang.

• Inven dan:

Tunah hian Scrub Typhus laka invenna vaccine hi hmuhchhuah a la ni lo a. Amaherawhchu, a treatment damdawi ei lawk hian invenna engemaw chenah a thlen ve thei. A pawimawh berah erawh chuan in hmunhma tihfai that te, sazu tihrem zung zung leh kan ran vulhna hmun te pawh tihfai ngun tur a ni. In leh a chheh vel leh thawmhnaw ah te a hrik huat tur damdawi phul tur te pawh a awm a, insect repellent spray ang chi te pawh a tha hle a. He natna lanchhuah dan leh kalhmang hi hriselna lama hnathawktu leh mipui te hian kan hmelhriat a, invenna lamah tan lak leh rinhlelh thuah damdawiin pan vat thin nachang hriat a pawimawh em em a ni.

(source. Hriselna magazine)