A group of acute infectious diseases characterized by exhaustion, severe headache, generalized rash of macules and papules, consistent high fever, and advanced neurological involvement that ends in a crisis in 10 to 14 days. Scrub typhus is also known as tsutsugamushi disease or mite-borne typhus fever, and is caused by Rickettsia tsutsugamushi.

A chigger (mite larva) bite causes human infection. Typhus, in epidemic portions, occurs most in areas with unsanitary conditions. It is more prevalent on shipboard, in army camps, and where poor living conditions and congestion are common. Incidence of the disease in the United States is rare.

The incubation period is 6 to 21 days. The disease is characterized by a sudden onset of symptoms which include severe headache, chills, fever and generalized lymphadenopathy. In classic cases, an eschar at the site of the chigger feeding is often found.

Serologic tests, and isolation and identification of the rickettsia from the blood, tissues, or skin are done to confirm the diagnosis.

Chemotherapy and care that supports the patient is the treatment focus.

The progress of the disease results in increased pulse rate and blood pressure, delirium, stupor, and muscular twitching. An enlarged spleen is possible, as well as, inflammation of the myocardium. If left untreated, high fever may continue for more than 2 weeks, then decrease over several days. With treatment, decrease in fever usually begins within 36 hours, and recovery is quick and uncomplicated.

1. This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under §3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of §3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], §3.309(a) [chronic disease].

2. May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% and/or other requirements/qualifications under 38 CFR §3.350 [Special monthly compensation ratings]. Also reference 38 CFR 3.155(d)(2).

• Rate under the appropriate body system any residual disability of infection, which includes, but is not limited to, bone marrow, spleen, central nervous system, and skin conditions.

• This diagnostic code includes, but is not limited to, scrub typhus, Rickettsial pox, African tick-borne fever, Rocky Mountain spotted fever, ehrlichiosis, or anaplasmosis.