Over 3,500 Cases of Scrub Typhus Reported Since Mid-July

Since mid-July, more than 3,500 people across the country have contracted scrub typhus, marking the start of this fiscal year. 

Health officials from the Epidemiology and Disease Control Division anticipate that the number of cases will continue to rise as scrub typhus tends to peak in September.

"As in previous years, we've seen hundreds of infections this time as well," said Dr. Gokarna Dahal, head of the Vector Control Section at the division. "We expect more cases in the coming days, as the peak season is still ahead."

Scrub typhus, also known as bush typhus, is a disease caused by the parasite *Orientia tsutsugamushi*, transmitted to humans through bites from infected chiggers (larval mites) that often live on mice.

In the past, it was believed that rural populations or those working in fields and grasslands were most at risk. However, urban areas are now also seeing cases.

"More than 100 people in Hetauda Sub-metropolitan city have contracted scrub typhus this year," said Krishna Bahadur Major, head of the Health Office in Makawanpur. "Though most cases are from rural areas, urban regions are also affected."

Common symptoms of scrub typhus include high fever, headache, abdominal and back pain, joint and muscle aches, red rash, nausea, and vomiting. Severe cases may result in bleeding, leading to organ failure. If left untreated, the infection can cause respiratory distress, brain and lung inflammation, kidney failure, and ultimately multi-organ failure, which could be fatal.

Nepal witnessed a spike in scrub typhus cases after the 2015 earthquakes, which claimed nearly 9,000 lives nationwide. 

Three months post-earthquake, the BP Koirala Institute of Health Sciences in Dharan alerted authorities to six children suffering from unexplained fevers and severe respiratory issues. Subsequent tests in Kathmandu and Bangkok confirmed a scrub typhus outbreak, with four children succumbing to the illness by that point. By the end of the year, 101 cases were confirmed across 16 districts, with four additional deaths.

The outbreak grew more severe in 2016, with 831 cases reported across 47 districts, resulting in 14 fatalities by the year's end.

According to the Ministry of Health and Population, more than 1,026 cases were recorded in 2020, increasing to 1,999 in 2021, and surpassing 2,900 in 2022.

In 2023, over 5,000 individuals were infected.

Doctors stress that early diagnosis and treatment can significantly reduce the risk of severe outcomes. Common antibiotics like doxycycline and azithromycin, available for free at government health facilities, can effectively treat the disease.

However, a major concern remains the lack of awareness among health workers about scrub typhus diagnosis. Many health facilities also lack the necessary reagents to conduct tests for the infection.

While doctors can often diagnose scrub typhus based on symptoms, there’s a high risk of misdiagnosis due to its similarities with other illnesses. Delaying treatment while waiting for lab results, which can take up to a week, could result in the patient falling into a coma or experiencing multi-organ failure.