Scrub typhus spreading in Nepal

Scrub typhus has become quite common in Nepal, with patients showing symptoms of the disease, such as high fever and severe body aches, treated frequently in hospitals. According to data provided by the Integrated Health Information Management Section under the Department of Health Services, over 16,000 people across the country were infected with scrub typhus in the fiscal year 2024-25. The highest number of infections was recorded in Lumbini Province (4,322), followed by Sudurpaschim Province (3,746 cases), Karnali Province (2,539), and Koshi Province (2,119). However, there could have been more cases because several frequently escape the attention of health authorities. Potential fatalities may also have not been reported due to the difficulty in identifying scrub typhus as the leading cause of death. Experts are especially concerned about the spread of the disease in urban settings. Until a few years ago, it mainly affected agricultural workers in rural areas.
The surge in scrub typhus cases began after the devastating earthquakes of 2015 that killed nearly 9,000 people. A few weeks after the quakes, the BP Koirala Institute of Health Sciences in Dharan alerted the Epidemiology and Disease Control Division about six children with unusual fevers and severe respiratory problems. Later tests confirmed their infection with scrub typhus, with four children succumbing to the disease. By the end of 2015, there were 101 confirmed cases and four more deaths. Since then, the disease has continued to spread across the country, with 2,900 cases reported in 2022 and over 5,000 in 2023. Doctors say the severity of the disease can be minimised through early diagnosis and treatment with antibiotics. However, many health facilities lack the necessary equipment to diagnose and cure patients properly. The risk of misdiagnosis is particularly high because scrub typhus symptoms are similar to those of other illnesses.