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Mystery fever in India identified as 2 separate pathogens as death toll tops 100

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New Delhi — India's health authorities have solved the mystery of an illness that has infected thousands and left more than 100 people dead in the northern state of Uttar Pradesh. The fever that confounded experts for two weeks has been identified as two separate diseases, one caused by a bacteria and the other a virus. 

People watch over children being treated for high fever, likely victims of parallel dengue and scrub typhus outbreaks, at a hospital in Firozabad, in India's northern state of Uttar Pradesh, September 3, 2021. ANI/Reuters

The cases have been identified as infections with scrub typhus and dengue. Combined, they have killed more than 100 people and infected thousands in Uttar Pradesh, India's most populous state in just a couple weeks. At least 40 of the victims have been children. 

Officials in Uttar Pradesh are reporting approximately 100 new cases of both fevers every day.  

Scrub yphus is a bacterial fever spread through bites from chiggers, or larval mites, found in bushes. Symptoms include fever, headache and body aches, which later progress to rashes and inflammation of the nervous system which can cause confusion and even coma.

Dengue is a viral infection that spreads through the bites of infected mosquitoes. Patients often suffer from fever, muscle and joint pain. In severe cases, as has been seen in recent outbreaks in India, the blood platelet count of the patient drops significantly, leading to internal bleeding and possible death. 

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Uttar Pradesh authorities first reported cases of a mystery fever in the Firozabad district on August 18. As of Tuesday, the district was still the worst hit, with 51 deaths including the 40 children.

The diseases have spread to at least five other districts in the state, including Agra, where the iconic Taj Mahal draws hundreds of thousands of visitors every year.

State health officials were going door-to-door to raise awareness of the most recent threat to public health in a bid to stem the spread.  

Some Indian news outlets reported that hospitals in the region were running out of beds and other resources to treat patients. The Times of India reported at least 5,000 people were being treated in hospitals in the Firozabad district alone. There have been no statistical breakdowns from regional authorities on how many cases are believed to be scrub typhus and how many are dengue.

A patient receives treatment in the dengue ward of a government hospital in Allahabad, in India's northern Uttar Pradesh state, August 30, 2021. SANJAY KANOJIA/AFP/Getty

India grapples with dengue outbreaks almost every year, typically in the rainy monsoon season when the Aedes aegypti mosquitos that carry the virus breed in and around homes in accumulated fresh water.

Tens of thousands of cases and dozens of deaths are reported most years, and Uttar Pradesh, with its 200 million inhabitants, is often hard-hit. Millions of people live below the poverty line in the state, with poor standards of sanitation and health care contributing to the spread of the disease. 

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