Island fever, medically known as scrub typhus, is a serious illness passed to humans through tick, mite or chigger bites. The name "Island Fever" most likely came from the fact that most of the infected insects tend to live in sandy areas. Without treatment, which is a course of antibiotics, the mortality rate of Island Fever can reach 30%.
Island fever is somewhat of a misnomer. While people on islands in the Pacific Ocean may be vulnerable, it is also possible to contract scrub typhus on the mainland of many Southeastern Asian countries. It can also be contracted in Northwestern Pacific countries like Pakistan, Australia, or Korea.
Early symptoms of Island fever begin to emerge anywhere from 6-14 days after a bite from an infected insect. Symptoms include an extremely high fever, often between 104-105° F. (40-40.55° C.). Fever tends to be accompanied by a severe headache. Swelling in the lymphnodes is frequently present about a week into the illness. As well, a palpable rash may develop on the trunk of the body by the end of the first week of illness. In rare cases, Island fever may also affect the central nervous system and cause confusion, speech difficulties, or hearing problems.
Diagnosis of Island fever tends to be made by observing the symptoms, and also through blood test, which will confirm pathogens causing the illness. Since there are several illnesses, called flavoviruses, that are similar to Island fever, diagnosis will rule these out. Once diagnosis is made, treatment is relatively straightforward.
In most cases, Island fever is treated with the antibiotics tetracycline or chloramphenicol. In children however, the use of tetracycline is contraindicated because it causes permanent staining of the teeth. Appropriate treatment for children with Island fever tends to be doxycycline. Ciproflaxacin may be considered for adults or children, but this antibiotic has a high rate of side effects and tends to be used as an antibiotic of last resort.
Island fever tends to resolve prior to the end of antibiotic treatment, which usually lasts for two weeks. However, feeling better does not mean one should stop taking the antibiotics. Not finishing a course of antibiotics can cause an antibiotic resistant strain of Island fever to reoccur.
In rare cases, patients may need intravenous antibiotics and fluids if the disease has gone untreated. Since the fever is so high, and frequently occurs in very warm climates, dehydration is a particular concern and can complicate the course of Island fever. Resting and drinking lots of fluids can help prevent complications.
There is not vaccine for Island fever, but one may cut down one’s risk of contracting it in areas of risk by wearing long-sleeved shirts and long pants. Use of insect repellents that contain DEET can also cut down on the risk of a bite. Even with these interventions, it is possible to get Island fever, so there is no single way to completely prevent the illness. Focus for now is on the cure rather than prevention.
