query: Can you die from orientia tsutsugamushi?
passage: Orientia tsutsugamushi
O. tsutsugamushi causes a complex and dangerous infection scrub typhus. Infection starts when chiggers bite on the skin during their feeding. The bacteria are deposited at the site of feeding (inoculation), where they multiply. They cause progressive tissue damage (necrosis). Necrosis progresses to inflammation of the blood vessels called vasculitis. This in turn causes inflammation of the lymph nodes, called lymphadenopathy. Within a few days, vasculitis extends to various organs including liver, brain, kidney, meninges and the lung.[53] The disease is responsible for nearly a quarter of all the febrile (high fever) illness in endemic areas. Mortality in severe case or due to improper treatment or misdiagnosis may be as high as 30-70%.[54] About 6% of infected people die untreated, and 1.4% of the patients die even with medical treatment. Moreover, death rate can be as high as 13% where medical treatment is not properly handled.[55] In cases of misdiagnosis and failure of treatment, systemic complications rapidly develop including acute respiratory distress syndrome, acute kidney failure, encephalitis, gastrointestinal bleeding, hepatitis, meningitis, myocarditis, pancreatitis, pneumonia, septic shock, sub-acute thyroiditis, and multi-organ dysfunctions.[56] Harmful symptoms involving multiple organ failure and neurological impairment are difficult to treat, and can be lifelong debilitation or directly fatal.[56] The central nervous system is often affected and result in various complications including cerebellitis, cranial nerve palsies, meningoencephalitis, plexopathy, transverse myelitis, neuroleptic malignant syndrome, and Guillan-Barré syndrome.[57] Death rates due to complications can be up to 14% in brain infections, and 24% with multiple organ failure.[55] It is the major cause of acute encephalitis syndrome in India, where viral infection Japanese encephalitis has been regarded as the main factor.[58]
passage: Leptotrombidium
It was originally thought that rodents were the main reservoir for "O. tsutsugamushi" and that the mites were merely vectors of infection: that is, the mites only transferred the contagion from the rodents to humans. However, it is now known that the mites only feed once in their lifetime, which means that transmission from rodent to human via the mites is impossible (for it to have been possible, the mite would have to feed at least twice, once on the infected rodent and again on the human who would then be infected). Instead, the bacterium persists in the mites through transovarial transmission, where infected mites transmit the infection to their unborn offspring. Leptotrombidium mites are therefore both vector and reservoir for "O. tsutsugamushi". The infection predominantly affects female mites, and does not appear to otherwise harm the mites.