Cases presented with fever, lymphadenopathy, hepatosplenomegaly and rashes from remote hilly villages of District Mokokchong. Deaths were taking place in young adults mostly with the history of movement in forest areas especially for jhoom cultivation. Clinico-eco-epidemiologically we suspected rickettssial infection and oral doxycycline started.

This yielded in prevention of deaths and early recovery of cases. Subsequently, NCDC labs confirm that these were scrub typhus cases.