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Scrub Typhus Disease

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Published Date : Sep 2023
Category : Infectious Diseases
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Beating Scrub Typhus with Data-Driven Analysis of DiseaseLandscape Insights (DLI)

Scrub Typhus is one of the most severe and life-threatening conditions that individuals are experiencing worldwide and has become a general medical problem. NIH states that Scrub Typhus is projected to affect 1 billion people globally covering more than 8 million kilometers from rural areas of South and Southeast Asia, the Western Pacific from Korea to Australia as well as Japan, India, and Pakistan. Approximately, 1 million cases of Scrub Typhus occur annually.

However, an NIH report states that, according to prospective fever studies conducted in Asia, Scrub Typhus is a considerable contributor to non-malarial febrile diseases. The prevalence rate of widespread Orientia tsutsugamushi infection ranges from 9.3% to 27.9% and the incidence is increasing daily, specifically in Asia.

A systematic analysis of the Scrub Typhus burden in India's "Tsutsugamushi Triangle" indicated that Scrub Typhus accounts for at least 25.3% of people with acute undifferentiated febrile illness (AUFI). Scrub Typhus continues to be an overlooked disease in terms of research and the development of health care policy while being one of the most prevalent infections of the cause of such frequently observed diseases.

Moreover, in 2022, research looked at the clustering of Scrub Typhus cases among children in three adjacent administrative areas in South India over the course of five years. It discovered that temperature, humidity, and rainfall all played a significant effect on the occurrence of Scrub Typhus.

Furthermore, the importance of climate in increasing the rate of extremely contagious disease has been highlighted by a rise in instances of Scrub Typhus in Odisha. According to government sources, at least six cases of disease-related deaths have been documented from the western regions of the state since September 1, 2023 — five in the Bargarh district and one in the Sundargarh district.

In addition to that it has also been reported in areas like Himachal Pradesh, where sources claim ~295 people have been affected and at least nine people have died as a result of the Scrub Typhus disease in the Shimla district.

At the Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Bural there were 30 positive cases of Scrub Typhus in September 2023 reported by the Times of India News. The condition of all of the patients is now stable and they have been cured with the best medical treatment.

The rickettsial bacteria Orientia tsutsugamushi causes the infectious disease Scrub Typhus. Antigenic variation is abundant in the causative organism. The bite of a Trombiculid mite larva transmits it to humans. The disease can affect persons of all ages as well as travelers from all over the world who have visited endemic areas.

After an incubation period of 6-21 days, clinical symptoms such as fever, headache, myalgia, and gastrointestinal symptoms commonly appear. Scrub Typhus is distinguished by the development of an eschar, which generally begins as a primary papular lesion and eventually crusts to create a black ulcer with core necrosis. Eschar occurs in 10% to 90% of cases of acute Scrub Typhus; however, these cases are sometimes ignored as per NIH.

The market for infections with Scrub Typhus is projected to be influenced by factors comprising the increasing incidence of Scrub Typhus nationwide. The sector is expanding significantly due to the increased frequency of medical conditions worldwide and the difficulties in determining the underlying causes of disease development.

As a result of the Scrub Typhus outbreak, there are higher hospitalizations and thus, increased demand for therapeutic products for symptomatic treatment has become an important factor for market growth. In addition to the above, the government's initiatives from different regions to halt the spread of the bacteria Orientia tsutsugamushi and stop the outbreak of a new pandemic are also assisting the industry's development. 

DiseaseLandscape Insights facilitates making informed choices in the field of medical technology, treatments, and diagnostics where different technologies and remarkable advancements will transform the landscape leading to higher growth.

Scrub Typhus Diagnostic Analysis

"Diagnostic Revolution in Scrub Typhus Disease: Optimizing Individuals' Health"

For proper patient care, early detection of Scrub Typhus infection is essential because it guides treatment decisions and assists in minimizing complications. The following serological diagnostic tests are performed to detect the scrub typhus infection.

  1. The Indirect Immunofluorescent Antibody (IFA)

The Indirect Immunofluorescent Antibody (IFA) is considered the gold standard test for diagnosis of scrub typhus disease. The test works on a concept of detecting antibodies in the serum of the infected patient using fluorescence-labeled anti-human immunoglobulin.

This approach has a number of drawbacks since it needs further testing to show the distinction between a fourfold rise in antibody titers in the acute phase of serum samples and later in the subsequent phase. As a result, it is a historical diagnosis and does not influence how to handle an acute illness.

  1. Indirect Immunoperoxidase (IIP)

After changing the IFA techniques, the IIP test was introduced to address the previous flaw. Since this technique employs peroxidase-labeled antibodies rather than fluorescein, a diagnosis is established without the need for a fluorescent microscope. Results from IIP techniques have been comparable to those from IFA. The different strains, like in IFA, have an impact on this test's sensitivity. A fluorescence microscope is no longer necessary, although technical knowledge is still required.

  1. Enzyme-linked Immunoabsorbent Assays (ELISA)

As IFA resources are not frequently available in common laboratories, it is now the method of choice for serological diagnosis in acute scrub typhus infection. For its detection, recombinant p56-kDa type-specific antigens of O. tsutsugamushi strains are combined with IgM antibodies made against the strains of Karp, Kato, Gilliam, and TA716 in acute infections. A recent infection with O. tsutsugamushi is detected with the sensitive test IgM ELISA.

  1. Polymerase Chain Reaction (PCR) Techniques

PCR has a significant advantage in that it identifies infections sooner since it detects diseases before antibodies are detected by serological techniques. Eschar tissue cultures, however, have shown beneficial findings even up to 7 days after the administration of antibiotics. The expense of PCR hinders its use in routine diagnosis in endemic regions, despite the fact that it is very sensitive and specific in identifying very low quantities of copies.

  1. Bacterial Culture Test

Bacterial Culture tests are performed by collecting the sample from blood or skin biopsy. The sample is cultured on specific media at biosafety level 3 and requires technical expertise to conduct the test. However, because of these time-consuming procedures, culture is rarely effective as a diagnostic tool in a clinical environment. Therefore, the work is still only being done for study at reference labs.

Among all the tests listed above, the Indirect Immunofluorescent Antibody is the standard test used to diagnose scrub typhus. Because it is a more specific and sensitive test compared to others. However, the Indirect Immunofluorescent Antibody test is generally not available in developing countries where scrub typhus is widely present. The key players have opportunities to manufacture Indirect Immunofluorescent Antibody test kits.

The market for diagnosis of Scrub Typhus is evolving and expanding. Market players should use technologies to develop novel diagnostic kits and instruments. The development of rapid, low-cost kits and technologies to improve patient health is also essential in the diagnostic field of scrub typhus.

DiseaseLandscape Insights assists the industry leader in the use of new technologies for improving the existing diagnostic method and provides data on current market players and their products for more knowledge about market dynamics. By using the data from DLI, stakeholders choose the path of their business and implement strategies for the growth of the market.

The following table lists the names of the market leaders who are redefining healthcare with their forefront diagnostic innovations and their product names used for the diagnosis of scrub typhus:

Market Players

Diagnostic Products

Euroimmun

EURORealTime

Takara Bio Inc.

Takara Ex Taq®

Titanium®

Living Colors®

Repligen Corporation

CTech SoloVPE System

CTech FlowVPX System

CANDOR Bioscience GmbH

LowCross® HRP Stab

Antibody Stabilizer

Becton Dickinson

Hu C3a OptEIA ELISA Kit

Proteintech Europe Ltd

AuthentiKine™ ELISA kits

Elabscience

Elabscience® ELISA test

 

Scrub Typhus Treatment Analysis

"Treatment Advances: A Beginning toward a Healthier Life"

Scrub Typhus is spread widely in the world. So, there is a need to manage the Scrub Typhus with proper medications. As the bacteria are present everywhere individuals get affected easily. The treatment options available to manage the scrub typhus are antibiotics.

  1. Antibiotics

For scrub typhus, Tetracycline, Azithromycin, Doxycycline, and Rifampicin are efficient antibiotics. Several trials, notably on Doxycycline and Azithromycin, utilized diverse dosage regimens that included a loading dose of both medicines followed by maintenance doses with an average length of therapy of 7 days for Doxycycline and 3 days for Azithromycin. Tetracycline and Rifampicin are also effective scrub typhus antimicrobials.

However, after 3 days, the bacterial count was decreased by doxycycline, rifampin, and azithromycin individually to 6.2%, 8.8%, and 9.6% of the baseline bacterial count, which provide the excellent effectiveness of antibiotics now used in clinical practice. Studies on antibiotic combinations for the treatment of scrub typhus are few. In cell culture, combinations of doxycycline and azithromycin, doxycycline and rifampin, and rifampin and azithromycin had antibacterial properties comparable to those of the individual drugs.

Development of a combination of antibiotics, research on new antibiotic sources, and low-cost techniques for extraction and purification of antibiotics are the main areas where market players enter into the scrub typhus treatment industry. 

To explore and grow in the treatment field market players choose the market research and consulting services of DiseaseLandscape Insights. We guide you to stay stronger and ahead of the competition through our detailed analysis of treatment options, new products, and technologies. DLI offers extensive support in arranging, carrying out, and evaluating clinical studies for new drug development.

The below table shows the names of antibiotics, their dose range, manufacturer name, and duration.

Antibiotics

Manufacturer

Dose Range

Duration

Doxycycline

Hetero Healthcare Ltd.

100mg twice a day

Orally

7 to 14 days

Azithromycin

Pfizer

500 mg on first day then 250 mg.

Oral

2 to 5 days

Roxithromycin

Zydus Cadila Healthcare Ltd.

150 mg twice a day

Oral

5 to 10 days

Chloramphenicol

Anant Pharmaceuticals Pvt. Ltd.

500 mg a day

Oral

7 to 14 days

Rifampicin

Healthy incorporation and Healthy life pharma Pvt ltd

600 mg daily

Oral

5 days

 

Regulatory Framework

“Regulatory Program: Ensuring a Better Working Environment”

DiseaseLandscape Insights analyzes the regulatory ecosystem of various nations for scrub typhus disease. The market player obtains information on import/export laws across the globe, risk evaluation rules, and inspection from DLI services. Utilizing DLI data, market players will prevent and combat the outbreaks of scrub typhus disease.

However, for keeping track of bacterial diseases such as scrub typhus disease, Active Bacterial Core surveillance (ABCs) is developed which is a population- and laboratory-based monitoring strategy for invasive bacterial pathogens like O. tsutsugamushi. ABCs offer a foundation for future public health research, such as studies to identify disease risk factors, test vaccination efficacy, and track the impact of preventative strategies.

Moreover, the FDA has approved the study for comparison of Doxycycline and Azithromycin treatments for scrub typhus. The study was regarding the evaluation of clinical and microbiological responses in patients of scrub typhus to the dosage of doxycycline and azithromycin.

Market Trends

"Market Interpretation for Stronger Business Strategies"

The market for scrub typhus treatment and diagnosis is growing worldwide because there is a need for the development of various low-cost diagnostic techniques and formulations of antibiotics for better treatment analysis and to improve the health of patients. In-depth research is required to come up with combination antibiotic therapies and other treatment options for scrub typhus.

However, Indirect Immunofluorescent Antibody test kits are the most used diagnostic technique for Scrub Typhus. Innovation in the techniques, development of new products, and increasing the manufacturing rate of kits in the countries where the scrub typhus is widely spread is an essential domain. The market players enter into product manufacturing for the diagnosis of Scrub Typhus and generate huge revenue.

Also, new medicine production, novel therapy, and diagnostic kit manufacture have raised market size and hence the income of existing important players. Innovative technology, regulatory approval, government initiatives for patient health, and the introduction of laws and regulations in the research sector have expanded the market's influence.

Clinical Trial Data Assessment

The crucial role of clinical trials in the practice of evidence-based medicine and health care reform is highlighted by the government's increasing concentration on comparing the effectiveness of studies. One of the main goals of reforming healthcare is achieved by the market participants accurately examining medical therapy with the use of clinical data.

The below table shows the name of the study title ongoing in phase IV.

Phase IV

The Scrub Typhus Antibiotic Resistance Trial (START) Comparing Doxycycline and Azithromycin Treatment Modalities in Areas of Reported Antimicrobial Resistance for Scrub Typhus

 

Conclusion

DiseaseLandscape Insights (DLI) provides a piece of essential knowledge and data to key players who are involved in the launching of treatment products and manufacturing of new diagnostic kits. However, due to increased awareness and outbreaks of scrub typhus disease, there is an increase in demand for new detection techniques, alternative treatment options, and vaccine development.

DiseaseLandscape Insights guides the stakeholders for easy establishment of clinical trials for novel products, patient recruitment strategies, and regulatory compliance. DLI also assists in analyzing the competition for the scrub typhus disease market, new regulations, and rules across the world, and expected growth of the market to the industry player.

This allows market leaders to do concentrated R&D, learn about contract manufacturing organizations, discover raw material suppliers, and assure legal compliance for the business. DiseaseLandscape Insights (DLI) assists all market participants in gaining a stronger foothold in the Scrub Typhus Disease sector.

SUMMARY
VishalSawant
Vishal SawantBusiness Development
vishal@diseaselandscape.com

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