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  • India Scrub Typhus 2014 & 2015

    Link to 2013 thread; http://www.flutrackers.com/forum/sho...d.php?t=211938

    Published Date: 2014-05-15 17:45:00
    Subject: PRO/AH/EDR> Scrub typhus - India: (MH)
    Archive Number: 20140515.2475762
    SCRUB TYPHUS - INDIA: (MAHARASHTRA)
    ***********************************
    A ProMED-mail post
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    Date: Wed 14 May 2014
    Source: Pune Mirror [edited]



    For a week, a 64-year-old [man] suffered from high fever, body ache, headache, and nausea, despite taking medicines. He later developed jaundice, gastrointestinal bleeding, septicemia and acute respiratory distress syndrome (ARDS).

    It was when he was admitted at Kharadi-based Columbia Asia Hospital [Pune, Maharashtra State] last month [April 2014], that [his] disease was diagnosed -- scrub typhus (ST) -- a rare illness that leads to multi-organ dysfunction, having a mortality rate of 90 percent. Doctors say the disease is curable using antibiotics, but it can get out of hand if diagnosis is delayed.

    ST is a mite-borne infectious disease caused by _Orientia tsutsugamushi_. Infectious diseases experts say that due to low literature [?], number of reported cases in the city cannot be enumerated.

    Dr Sanjay Pujari, director, Institute of Infectious Diseases (IID), said, "ST is rare, and I have not seen a case with so many complications. This type of infection is normally wrongly diagnosed as leptospirosis, malaria, jaundice and typhoid. Developing ARDS in this infection is even rarer. If patients slip into multiorgan failure, they have very low survival chances."

    [The patient] was treated by Dr Mahesh Lakhe, an infectious diseases specialist at Columbia Asia hospital. "He suffered from high fever and loss of appetite. He took treatment from a local doctor, but in vain. Later, he developed gastrointestinal bleeding, ARDS, meningitis and also septicemia. With so many complications he was admitted to the ICU and was diagnosed after a blood and biopsy test, as he had lesions all over his body. The samples were sent to Christian Medical College, Vellore [Tamil Nadu State], which confirmed the infection," Lakhe said. Saying that scrub typhus is frequently wrongly diagnosed, Lakhe added, "This infection looks like typhoid and jaundice, but if treated appropriately and on time, a patient can be saved."

    Elaborating on how [the patient] was treated, Dr Sunil Rao, general manager of Columbia hospital, said, "The patient was treated with antibiotics and hemodialysis, without any surgical intervention. We saved [the patient]'s life, even though ST infections have less than a 10 per cent survival rate."

    After successfully treating [the patient], the hospital, in association with Indian Medical Association, is now geared up to conduct workshops in rural areas to educate people about early diagnosis of this infection.

    Dr Rajesh Gadia, head of Infectious Diseases at King Edward Memorial (KEM) Hospital, said, "ST can be treated with strong antibiotics, but since it is reported rarely, maybe one case in 6 months, not many physicians are aware of the clinical presentations. If this infection is not treated within 3 days, it could lead to death."

    [Byline: By Nozia Sayyed]

    --
    Communicated by:
    =
    <promed@promedmail.org>

    [ProMED-mail previously reported on scrub typhus in the Indian state of Maharashtra: see ProMED-mail posts Scrub typhus - India (12): (MH) fatal 20121109.1402125 and Scrub typhus - India (03): (MH) 20120203.1031108.

    Scrub typhus is caused by _Orientia tsutsugamushi_, a rickettsia-like microorganism that is transmitted by chiggers, the larval stage of trombiculid mites, which feed on the skin cells of animals, including humans and rodents. After feeding on their hosts, chiggers drop to the ground and become nymphs, which then mature into adults that feed only on plant materials. The cutaneous reaction to chiggers leaves a characteristic black eschar that is useful for making the diagnosis. Humans become infected when they accidentally encroach in an area where the infected chigger-rodent cycle is occurring, most often areas of low-lying scrub brush or transitional vegetation. Rodents may serve as reservoirs, although transovarial transmission in mites is the dominant mechanism for maintenance of _O. tsutsugamushi_ in nature (http://www.cdc.gov/ncidod/EID/vol9no12/03-0212.htm).

    Illness in humans develops after an incubation period of 6 to 21 days and usually begins with an eschar at the site of a chigger bite. Fever, headache, lymphadenopathy, and myalgias are common, and a maculopapular rash may also be present. Pneumonitis, meningoencephalitis, jaundice, renal failure, and myocarditis can develop during the prolonged clinical course of untreated illness. Because death rates for untreated scrub typhus patients are 1-30 per cent, treatment with doxycycline should begin immediately upon suspicion of scrub typhus without awaiting laboratory confirmation (http://wwwnc.cdc.gov/eid/content/12/2/pdfs/v12-n2.pdf).

    The Weil-Felix test is an agglutination test based on the detection of antibodies to various _Proteus_ species, which contain antigens that cross-react with rickettsial antigens. The Weil-Felix test continues to be used for the diagnosis of scrub typhus in resource-poor regions, but it has poor sensitivity and specificity (http://www.japi.org/august2006/O-619.pdf). The gold standard for the diagnosis of scrub typhus is the indirect fluorescent antibody (IFA) assay, but the fluorescence microscopes that are required for performance of this assay are often not available in resource-poor settings where scrub typhus is endemic.

    Kharadi is the northeastern section of the city of Pune, the 7th largest city in India and the 2nd largest in the Indian state of Maharashtra. For a map of India showing the location of Kharadi, Pune, see https://www.google.com/maps/place/Kh...e833613a63004a. Columbia Asia is a Kuala Lumpur, Malaysia-based chain of hospitals in Asia, with 24 medical facilities across India, Malaysia, Vietnam and Indonesia (http://en.wikipedia.org/wiki/Columbia_Asia). The company offers full-service hospitals built in neighborhoods, rather than the central city. Columbia Asia Kharadi-Pune is a 100-bedded multispecialty facility, close to the IT parks in Kharadi (http://www.india.columbiaasia.com/hospitals/pune). - Mod.ML]

    [Photos of the eschar, rash and mite: http://4.bp.blogspot.com/_liYunANNUe...00/scrub2+.JPG. - Mod.JW

    2012
    ----
    Scrub typhus - India (12): (MH) fatal 20121109.1402125
    Scrub typhus - India (03): (MH) 20120203.1031108
    .................................................m l/je/dk
    ProMED is the largest publicly-available surveillance system conducting global reporting of infectious diseases outbreaks. Subscribe today.
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

  • #2
    Re: India Scrub Typhus 2014

    Epidemics control drive in state from May 19 (Kerala)
    TNN | May 13, 2014, 01.25 PM IST
    ...
    This year, diarrhoea and chickenpox cases are the most reported between January and May. As many as 1,31,688 cases of diarrhoea and 7,964 cases of chickenpox have been reported in the year besides six swine flu cases and 85 scrub typhus cases.

    The health department has decided to launch a massive epidemic control drive in the state from May 19 in view of the summer showers and the ensuing mo
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #3
      Re: India Scrub Typhus 2014

      Google translated, Rajasthan

      Swine flu knocks of scrub typhus
      Thursday, May 22, 2014, 03:38 hrs IST
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      Jaipur. Now, scrub typhus swine flu has also hit. Scrub typhus two cases, one of which is in Jaipur and one of Churu. Surprisingly, the disease is already the case before the rain came. According to sources, the 25-year-old resident of Mansarovar The first case of scrub typhus views. Saket He was admitted to the hospital, his condition is improving now. So she has been discharged from hospital. Meanwhile, another 25-year-old resident of Churu Saket has been admitted to hospital. was out of control last year, two years ahead of scrub typhus was spread in Jaipur, including the eastern regions of the state. Integrated disease surveillance program of scrub typhus outbreak last year in the state was declared. Scrub typhus again because of the health department has spent many sleepless. these districts over the last two years, then the Alwar, Bharatpur, Dausa and Jaipur has seen more scrub typhus. Not only because of its higher death toll in these districts, but the case was too great. scrub typhus is a special kind of rain during the cultivation of millet, the disease is transmitted by the bite of mite. Since the introduction of the common fever gradually headache, muscle aches and a high fever goes. Haemorrhage fever also seems to be fast. This time it came before the disease season. Similarly, an outbreak of swine flu in winter temperature fluctuation occurs during. This summer it is a terrifying thought. Jaipur position
      Year // fatalities // cases
      2012 // 30 // 224
      2013 // 3 // 180

      Note: &#252; 2013 Vsha the total 400 cases in the state.
      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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      • #4
        India Scrub Typhus 2014

        Source: http://www.ndtv.com/article/india/22...mizoram-550988

        22 Die of Scrub Typhus Infection in Mizoram
        All India | Press Trust of India | Updated: July 01, 2014 14:05 IST

        Aizawl: At least 22 people have died due to scrub typhus infection from ticks since 2012 in Mizoram, a state health department official said today.

        492 patients suffering from scrub typhus infection were treated during the same period, Dr Pachuau Lalmalsawma, Nodal Officer for the state Integrated Disease Surveillance Programme (IDSP) said...

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        • #5
          Re: India Scrub Typhus 2014

          Himachal Pradesh

          Scrub the five cases positive Tayfs

          HP knock Bureau. Shimla 7/18/2014 1:53:15 PM
          Clatter of rain in the capital has started to spread its tentacles in the scrub Tayfs. Scrub Tayfs Aijimsi of five new cases come again P ॅ ajitiv. Aijimsi sample of ten victims were sent to a lab for examination, in which five cases have come positive. Was brought to the hospital due to high fever. They do not cause fever a week in hospital on suspicion of Tayfs test was scrubbed them, which has been positive. Among the affected Sirmour, Solan and one is a matter of Bilaspur. Although now the monsoon has just knocked, but scrub Tayfs few patients now Aijimsi during rains are beginning to join. In just one week, 12 people have contracted scrub Tayfs. See last year's record came in the grip of people of all ages. These green grass ill because of exposure to Hna. It still came into view. This time Tayfs die of scrub on Thursday that five cases, which includes two children. Consider that last year the small Shimla Shimla, dizziness, cracked, Shoghi, Knleag, Mehli receive treatment were more than impressed. Shimla is clarity over the terms of the rainy days come Tayfs Hna scrub. Have now begun to appear. Now that the rainy season has begun in the capital may increase the number of Tayfs scrub. That day fever patients get treated in hospitals in Shimla is coming. Shimla noticed that every year, 200 people have contracted the disease Tayfs scrub, because these are coming in direct contact with the green grass. The state health department has already included in the sensitive area of ​​Shimla. The problem now is that the public conscious Tayfs scrub every time, even in time Hna not access hospital.
          Twitter: @RonanKelly13
          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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          • #6
            Re: India Scrub Typhus 2014

            Scrub typhus back to haunt people in HP; 137 taken ill
            HT Correspondent, Hindustan Times Shimla, July 21, 2014
            First Published: 10:57 IST(21/7/2014) | Last Updated: 10:59 IST(21/7/2014)

            Scrub typhus, also known as the World War II fever, is back this monsoon to haunt the in habitants, particularly the rural folk.

            So far, 137 people across the state have tested positive for the fever. The outbreak is more evident in Bilaspur district where so far 29 people have tested positive. As many as 36 patients infested with ricketssial-scrub typhus- have been hospitalised at the Indira Gandhi Medical College. The number of patients with scrub typhus was more in the low lying areas - 69 patients have been treated in the Dr Rajendra Prasad Medical College, Tanda.
            ...
            Twitter: @RonanKelly13
            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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            • #7
              Re: India Scrub Typhus 2014

              Himachal Pradesh

              Scrub typhus in 35 patients Aijimsi
              Bhaskar News Network | Jul 25, 2 014, 02 o'clock AM IST


              Scrub typhus in 35 patients Aijimsi
              Scrub typhus in the Aijimsi Brsatka seasons Aijimsi arriving patient is suffering from fever. Scrub typhus has been steadily growing number of patients. Yet arrived at the hospital for treatment of 35 patients. Although the fever has not killed anyone. Scrub typhus in Aijimsi Thursday symptoms were found in eight patients. Given the severity of the case Aijimsi administrations Test Samples were sent to the patients' blood. Scrub typhus after a report that would confirm them. Treat symptoms of fever detected in the beginning this is quite simple. Scrub typhus fever to go wrong but it can also be deadly. Last year the rainy season were patient enough to scrub typhus. 's nothing Symptoms Yhbukhar occurs in the rainy season. Sharp pain in the body during fever fever, body etc. Its main characteristic is to be Gutlian. The symptoms on the patient immediately to the nearest hospital Cakap done. ^ scrub typhus fever is treated fairly cheap. The Department of Health Doksisaiklin medicine for the fever is provided in the hospital. The drug is the treatment of fever. This fever is fatal negligence Hahe. Dormesh Chand, Superintendent Vrishtcikitsa people in rural areas while also taking the bait for animals in the woods and Gasnion When Should he be wearing full sleeved shirt. The greater part of his body is completely covered and hold. Scrub typhus signs of healing, go immediately go to the nearest hospital. How to Rescue Scrub typhus is caused by flea bites. This flea lives on the body of rats and weasels. His body except when it rains flea gets on the leaves of green grass. Animals in the forest or rural Gasniaen are bringing this to the grass during flea bites. How fever
              बरसातका मौसम आते ही आईजीएमसी में स्क्रब टाइफस बुखार से ग्रस्त मरीज आईजीएमसी पहुंचने लगे है। स्क्रब टाइफस के...
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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              • #8
                Re: India Scrub Typhus 2014

                West Bengal

                New disease named Scrub Tifus in Mirik
                Health, health news, mirik, mirik live news 10:27 AM


                Amidst rising scare of encephalitis across North Bengal, a new type of disease named Scrub Tifus has gripped Mirik following a reported infection on an adult man. The disease can even kill if not cured on time. CB Rai (49) from Malikthung Chota Kothi was admitted to Mirik hospital today with the disease.
                ...


                Andhra Pradesh

                Scrub Typhus fast spreading in cities
                G. VENKATARAMANA RAO


                Risk of getting the infection is more where rat population is high. The disease is spread by harvest mite, a microscopic parasite of rodents (mice, rats and bandicoots) and humans.

                Besides mosquito-borne diseases such as malaria and viruses like dengue and chikungunya, there is an infection caused by an intra-cellular bacteria, which is a cause for concern for people living in urban centres. The infection is called Scrub Typhus or Bush Typhus, and there is a growing incidence of it in cities.

                The disease is spread by harvest mite, a microscopic parasite of rodents (mice, rats and bandicoots) and humans.
                ...
                Risk of getting the infection is more where rat population is high. The disease is spread by harvest mite, a microscopic parasite of rodents (mice, rats and bandicoots) and humans.
                Twitter: @RonanKelly13
                The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                Comment


                • #9
                  Re: India Scrub Typhus 2014

                  Uttarakhand

                  Of scrub typhus, dengue and knock Doon
                  Bureau Tuesday, August 5th, 2014
                  Amar Ujala, DehradunUpdated @ 4:49 PM IST

                  Dengue and scrub typhus in Dehradun who knocked again. Gurus Indiresh patient was admitted to hospital scrub typhus and dengue two of the three prior Indiresh patient was admitted to the hospital. They include a woman. Doon Vihar resident enticed a woman was brought to the hospital a few days earlier. scrub typhus on Monday confirmed the woman's blood test. Paonta Sahib, Himachal Pradesh and Uttar Kashi resident of the village of Mori block Banol Two other patients were found to have symptoms of the disease. trio is being treated.
                  ...
                  Twitter: @RonanKelly13
                  The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                  • #10
                    Re: India Scrub Typhus 2014

                    From Week 29 IDSP report; http://idsp.nic.in/idsp/IDSP/rcntobrk.pdf



                    Tamil Nadu Theni
                    xxviii. Scrub Typhus
                    10 cases 1 fatal
                    Start: 11/07/14 Report: 20/07/14
                    Under Surveillance
                    Cases reported from Village Vinobaji Colony & Madurai
                    Veeran Street, SC Melachokkanathapuram, PHC
                    Silamarathupatti, Block Bodinayakanur, District Theni. 6
                    serum samples sent to DPHL Theni, 2 samples tested
                    positive for Leptospirosis and Scrubtyphius and 3 samples
                    positive for Scrub Typhus.
                    Source reduction and fogging
                    carried out. IEC done regarding personal protective
                    measures.
                    Twitter: @RonanKelly13
                    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                    • #11
                      Re: India Scrub Typhus 2014

                      The first death in the state this year Skrabtayfs
                      BureauWednesday, August 6th, 2014
                      Amar Ujala, ShimlaUpdated @ 11:55 PM IST
                      scrub typhus first death this year in himachal

                      Of scrub typhus in Shimla Aijimsi hospital Sitaram (57), resident of district Bilaspur has died. Hospital medical superintendent Dr senior. Ramesh confirmed. Scrub typhus Sitaram name of the patient deaths.

                      Tests are being suspected patients. So far, 584 patients in the hospital have been sampled. In 55 of these patients were found to have symptoms of scrub typhus. Wednesday came two patients. most patients coming from rural circles. In Shimla, Bilaspur, Mandi, Solan patients are coming from.
                      ...
                      Twitter: @RonanKelly13
                      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                      • #12
                        Re: India Scrub Typhus 2014

                        Himachal Pradesh

                        Team formed to deal with the scrub Aijimsi
                        Shimla. 8/8/2014 6:09:18 PM
                        Aijimsi team of doctors to deal with the scrub Tayfs has been formed. Tayfs screens and children in hospital after the death of the state health department has issued orders to all hospitals caution. However, Aijimsi eight doctors in the hospital scrub affected by administration of medicines to treat patients who have deployed. Aijimsi noticed that 55-year-old man living in Bilaspur late Monday Sitaram had abandoned his life. Last year, the state-scrubbed Tayfs over 40 people were killed. This year was the first death scrub the health department has sounded the alarm bell of course. As such the rural women and farmers and gardeners are most vulnerable to it. Rural women were not aware of time, so especially in comparison to Mahilana much in its grip. In twelve cases of scrub in the past week have been P ॅ ajitiv 9 women. Clear picture that protect women from the clutches of Tayfs scrub them conscious of the need to stay away from the green grass. Tayfs scrub in the state before the start of the rainy season had already knocking. Aijimsi which the patient died due to high fever last 3 days he was hospitalized. Halnaki now begun to rain, but few scrub during rain Tayfs patient lying Aijimsi seem to come faster. See also the record of the last two days, seven people have contracted Tayfs scrub.
                        Twitter: @RonanKelly13
                        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                        Comment


                        • #13
                          Re: India Scrub Typhus 2014

                          EDITORIAL
                          Year : 2014 | Volume : 18 | Issue : 8 | Page : 489-491
                          Scrub typhus: Emerging cause of multiorgan dysfunction

                          Narendra Rungta
                          Department of Critical Care, Jeevan Rekha Critical Care Trauma Hospital Research and Training Institute, Central Spine, Jagatpura, Jaipur - 302017, Rajasthan, India

                          Date of Web Publication 5-Aug-2014
                          Correspondence Address:
                          Narendra Rungta
                          A-670, Shiv Marg, Malviya Nagar, Jaipur - 302 017, Rajasthan
                          India


                          DOI: 10.4103/0972-5229.138137


                          How to cite this article:
                          Rungta N. Scrub typhus: Emerging cause of multiorgan dysfunction. Indian J Crit Care Med 2014;18:489-91

                          How to cite this URL:
                          Rungta N. Scrub typhus: Emerging cause of multiorgan dysfunction. Indian J Crit Care Med [serial online] 2014 [cited 2014 Aug 14];18:489-91. Available from: http://www.ijccm.org/text.asp?2014/18/8/489/138137


                          Scrub Typhus is a zoonotic infectious diseases caused by obligate intracellular gram negative, non-flagellate, and non-spore-forming Cocco-bacilli - the rickettsae Orientia Tsutsugumoshi. The disease is contracted via the bite of trombiculid mite larvae (chiggers). The chiggers live in wide range of vegetation type from scrubs (terrain between woods and clearings), primary forests to gardens, beaches etc. The epidemic period is influenced by activities of the infected mite which appear to occur more frequently during or after rainy seasons. This leads to in a spurt in cases during and after monsoon in India. Humans are accidental hosts and seen in people where activities bring them into contact with vector chiggers. [1]

                          Scrub typhus is grossly under-diagnosed in India due to its non specific clinical presentation, limited awareness and low index of suspicion among clinicians and lack of diagnostic facilities. [2] Scrub Typhus manifests clinically as a non-specific febrile illness often accompanied by headache, myalgia, nausea, vomiting, diarrhea, cough or breathlessness. Severity varies from subclinical illness to severe illness with multiple organ system involvement which can be serious unless diagnosed early and treated.

                          Eschar at the site of attachment of the larval mite or chiggers the most characteristic feature of scrub typhus, but it is not seen in all patients. It is a black necrotic lesion resembling a cigarette burn usually found in areas where skin is thin, moist or wrinkled and, where the clothing is tight. Eschar is found in about 50% cases. However, this detection requires careful and diligent search. The common sites involved are axilla, groin and breast. Often patients are not aware of the presence of the eschar, as it hardly produces any symptoms of discomfort. Diagnosis is confirmed by a positive IgM ELISA and/or pathognomonic eschar with PCR confirmation where feasible. [3],[4],[5]

                          Across the globe, more than one billion people are exposed to the risk of the disease and live in endemic areas. India has an annual incidence of approximately one million cases. [4]
                          ...
                          Twitter: @RonanKelly13
                          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                          • #14
                            Re: India Scrub Typhus 2014

                            Scrub typhus deaths of 2 women
                            2014-08-19 PM 06: 46: 21 |

                            Shimla: Scrub typhus in the state due to the deadly fever has killed 2. Yet to be vulnerable to life-threatening fever have 3 people lose their lives. Aijimsi Both deaths occurred in the hospital. Deadly fever caused 2 deaths and Nalagarh in Solan district Mandi initiation of the 28-year-old to 33-year-old has Byasa goddess. Meanwhile, those who are victims of murderous fever figure is constantly growing.


                            Aijimsi deaths due to the deadly fever Dicsha of the market on August 9 Aijimsi was brought for treatment. Meanwhile, on August 12 Aijimsi goddess bringing Byasa of Nalagarh After a woman late Monday night died of scrub typhus. Yet there have been deaths in the state due to the deadly fever them first and then Mandi and Bilaspur district are suffering from Nalagarh.


                            Scrub typhus in Aijimsi nearly one dozen cases come in 2 days. Moreover, just 85 scrub typhus patients were confirmed during the investigation. More cases of scrub typhus during the rainy're seeing. Of scrub typhus cases these days are too much.
                            ...


                            Scrub typhus is caused by the killing of two women. So far three people have died due to the deadly fever and scrub typhus patients have been found close to 85.
                            Ramesh Chand, senior medical superintendent, Aijimsi Shimla


                            Six cases of scrub in Mandi Tayfs
                            Publish Date: Wed, 20 Aug 2014 01:02 AM (IST) | Updated Date: Wed, 20 Aug 2014 01:02 AM (IST)

                            Dialogue Partner, Mandi: Mandi district Tayfs scrub at 10-day intervals are six new cases. Patients belong to distinct regions of the district. Aijimsi patient treatment at Shimla is one of these. Initiation victim identified (23) as resident has Gokdha. Also Pandoh resident Indru Ram, Tlyahd resident Rajbir, a resident of Mandi Indu Palace Colony, Rajendra, Hima Devi and Sanjeev has also confirmed Tayfs scrub.
                            Kotli victim was treated on July 23 at PHC not matter if she took the drug in Mandi Regional Hospital. Aijimsi regional hospital after first aid has been referred to Shimla. Doctors in Aijimsi patient is confirmed to be Tayfs scrub. Shimla on Tuesday, officials from the Health Department in this regard is made known to the district health officer. Mandi district after the woman reported to be suffering from scrub Tayfs district health department has to be cautious. Bimo Kotli is immediately sent to the team on the spot. Kotli health Gokdha under section devoted to make people aware of the health teams. Scrub Tayfs potential health team patients (which are visible signs of the disease) have been issued instructions to distribute the drug Doxycycline. Meanwhile, District Nodal Officer Durgeshwari doctor has confirmed six new cases. He said the health department teams are taking stock of the situation on the spot.
                            ...
                            Twitter: @RonanKelly13
                            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                            • #15
                              Re: India Scrub Typhus 2014

                              Himachal Pradesh

                              Scrub the third death from Tayfs
                              Shimla. 8/20/2014 6:24:06 PM
                              Tayfs third of children have died in the state screens. Late Sunday night, 33-year-old resident of Nalagarh Aijimsi Wyaso Devi gave up life. Last year, 40 deaths across the state was Tayfs scrub. Now scrub the third death from the health department has sounded the alarm. As such the rural women and farmer-gardeners are most vulnerable to Tayfs scrub. In time these farmer-gardener and rural women were not aware, either, especially for women, it will become more vulnerable. In the past twelve week 8 women scrub scrub Tayfs Tayfs positive cases has occurred. Now the third consecutive month has died in hospital. Scrub the time the young are more deaths. In Aijimsi the patient died due to high fever, he was admitted to hospital last 6 days. However, the rain has arrived, but only during a few rain-scrubbed Tayfs now looking into the patient lying Aijimsi from around the state.
                              Twitter: @RonanKelly13
                              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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