Scrub typhus, the disease that killed Lt Gen Jaggi, is one of the most under-diagnosed in Asia

A file image of Lt. Gen P.S. Jaggi (right) paying tributes at the Amar Jawan Jyoti at India Gate New Delhi | PIB Twitter

A rare bacterial infection spread through insect bites can kill through mutliple-organ failure and is on the rise in India.

New Delhi: One of the Indian Army’s senior-most serving officers, Lt Gen P.S. Jaggi, AVSM, passed away in Delhi on Tuesday.

As condolences for the general poured in from defence minister Nirmala Sitharaman and Army chief General Bipin Rawat, sources revealed that he had contracted a bacterial infection through an insect bite which resulted in multiple organ failure.

The illness, known as Scrub Typhus, is considered to be a rare disease in the country and rarer in the army, an army hospital official said .

Lt. Gen Jaggi had been in the ICU for the last two weeks.

What is scrub typhus?

According to reports, scrub typhus is an extremely rare disease that had killed several hundred people in Assam during World War-II and had seemingly disappeared from India since.

The disease which is normally spread through mite or a rodent bite presents very similar symptoms to those found in other illnesses like dengue, typhoid, severe pneumonia and multi-organ dysfunction.

While scrub typhus is easy to cure if the antibiotic reaches the patient in the early days of fever, the difficulty in spotting cases of scrub typhus makes diagnoses of the illness extremely difficult and in most cases, patients are diagnosed too late.

Since the 1990s, there have also been signs of a re-emergence of the disease in India.

As of now, most cases of scrub typhus are being reported from Himachal Pradesh, Mizoram and Tamil Nadu. A few cases have been reported from the capital as well.

Mystery deaths

Health care professionals have been worried about the rise of the disease in India, especially in the last decade.

Times of India had reported in 2011 that a mystery fever had taken hold of Alwar’s Rajgarh and Raini areas causing the death of 60 people. Experts at the National Centre for Disease Control (NCDC) and Sawai Man Singh Hospital had been in the dark for 15 days before concluding that the mystery fever was actually scrub typhus.

During the Gorakhpur tragedy that claimed the lives of over 60 children in a hospital in Yogi Adityanath’s constituency in Uttar Pradesh, it was widely speculated that the cause of the deaths was Japanese encephalitis. However, a government-backed study later revealed that scrub typhus and not Japanese encephalitis was the probable cause of death.

In Kolkata, according to a survey conducted by a private hospital in 2017, scrub typhus turned out to be the second most frequent infectious disease in state after dengue in that year.

While the number of cases may have been lesser than dengue, the report found that the mortality rate of scrub typhus patients was much higher.

Severely neglected

Despite the growing prevalence of the disease across India, a 2013 report published by The American Society of Tropical Medicine and Hygiene revealed that it is perhaps the single most under-diagnosed, under-reported and severe illnesses in rural Asia.

Citing data from the World Health Organisation, the report claimed that one million cases of scrub typhus occurred each year, causing more deaths than dengue.

It also added that post the re-emergence of this mystery disease, cases were frequently spotted in India, Sri Lanka, the Maldives and Micronesia.