Paediatricians report rickettsial infection cases

Rickettsial infection, a disease hardly detected and under-reported owing to factors like lack of adequate equipment at most labs besides lower prevalence, is being reported by paediatricians in the city treating cases coming in from the outskirts like Panshet and even as far as Daund and Baramati. The Pune district health officers have ruled out any epidemic.

At KEM hospital, in the past month, consulting physician Dr Rajesh Gadia said he treated as many as 50 cases, most of them from the outskirts like Daund and Baramati. "There are five patients admitted to the Intensive Care Unit (ICU) and they are critical," Gadia told Newsline.

Ticks, fleas and lice are the vectors of the disease. Rickettsial infections are re-emerging throughout the world and have been reported from several districts of states like Maharashtra, Tamil Nadu and Karnataka.

The disease is marked by abrupt onset of fever and rashes. Sometimes chills are reported, occasionally with morning remissions. Headache and myalgia are also associated with the disease.

Diagnosis rickettsial infections should always be considered in patients with acute febrile illness accompanied with headache and myalgia, particularly in endemic areas with history of tick exposure or contact with dogs, says Dr Atul Kulkarni, paediatrician at Solapur's Ashwini hospital where every year they see at least 60-70 cases admitted. Some of them are critical and admitted to the ICU, Kulkarni says.

Dr Sanjay Mankar, a paediatrician, says he gets several patients from Panshet area. He says Doxycycline is the drug of choice and can be used safely even in chldren below 8 years of age. The fever is generally difficult to diagnose but untreated cases can have fatality rates of 30-35% but when diagnosed properly, they are often easily treated. "Often gangrene sets in or some of the complications include acute respiratory distress syndrome," says Mankar.

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