By Ajita Rijal

Kathmandu, Sept. 28: Scrub Typhus is posing a threat to public health as the disease has already spread to more than 63 districts. Scrub Typhus is a disease caused by bacteria called Orientia tsutsugamushi and it passes on the people through bites of infected chiggers (larval mites).
A total of 695 persons have been tested positive for scrub typhus in 63 districts in the last two months, said the Epidemiology and Disease Control Division (EDCD) under the Ministry of Health and Population (MoHP). EDCD reported that three persons have died of scrub typhus as of September 23 this year.
As per the EDCD data, Dhading district recorded the highest cases at 75, followed by 61 cases in Dadeldhura, 59 in Palpa, 46 in Rupandehi, 36 in Gulmi, 26 in Kathmandu, 11 in Lalitpur, 17 in Kavre, 18 in Kapilvastu, 18 in Arghakhanchi, 13 in Bardiya, 10 in Syangja, and 20 in Banke districts.
The Sukraraj Tropical and Infectious Disease Hospital (STIDH) in Teku have reported more than 340 scrub typhus cases since mid-July this year.
According to Dr. Bibek Lal, Director of EDCD, scrub typhus was first recorded in Nepal after the earthquake of 2015. Now, the number of cases is considered high despite growing awareness among the people about the disease, said Lal.
Due to the increasing awareness and availability of diagnosis kit in the health facilities, the death rate has also been decreased as compared to the last year, he added.
The dense areas like forest clearings, bushy areas, riverbanks and grassy areas are favourable environment for infected mites to increase, said Chief consultant of Tropical Medicine and spokesperson of Sukraraj Tropical and Infectious Disease Hospital, adding the mites are also found in rats and mice.
People working in agricultural farms should use clothes to cover their entire body. People should avoid areas with lots of vegetation and bushes where mites may be found, said Dr Bastola.
Infected chiggers are specifically found during the rainy season in the dense bush areas as they lay their eggs there, added Bastola.
Some of the symptoms of scrub typhus include sudden fever accompanied by severe headache, chills, muscle pain and cough, dark scar or blackish spot on the bitten area, enlarged lymph nodes and rashes. The symptoms also include redness of the eyes, drowsiness and nausea.
Dr. Bastola warned that the disease may infect blood, affect kidney, liver, and even brain and lungs if not treated in time.
According to Dr Bastola, the diagnosis of scrub typhus needs test kits and due to the confusion in using the kits, many cases remain undiagnosed thus risking the patients’ life. Treatment of scrub typhus should be initiated early, based on clinical examinations and patients should take antibiotics for at least five days, said Dr. Bastola.
According to doctors, farmers and forest workers, people living at the edge of villages, those wearing short sleeved clothes or working bare hands and feet, and immune deficiency are at high risk of catching Scrub Typhus.