People had to fight a long battle against the Covid-19 pandemic that started in 2019. Over 12,000 people succumbed to the disease in Nepal. The pandemic left almost no one untouched. Many people are still struggling to recover from ‘long Covid’. No sooner had the country started emerging from Covid-19, dengue made a forceful reappearance on the scene. The virus has already spread to 76 districts this year and at least 20 people have died of and nearly 40,000 have tested positive since January. The number of unreported cases could be many times higher. Last year, 88 people died and more than 54,000 were infected by the same virus.

Now, another disease is troubling Nepalis in various parts of the country. Scrub typhus first spread in Nepal in the aftermath of the 2015 earthquakes. According to the Epidemiology and Disease Control Division, over 3,900 people have been infected by scrub typhus since January. Serious scrub typhus cases seen in hospitals this year have greatly alarmed doctors and health officials.

Scrub typhus, or bush typhus, is an infectious disease caused by the parasite Orientia tsutsugamushi, a mite-borne bacterium. It spreads to humans when they are bitten by infected chiggers (larval mites) found in mice. The disease was mostly seen in rural settings where people are bitten by infected chiggers when working in farms. But of late more and more urban residents are also testing positive for it.

According to health officials, diagnosing scrub typhus has been challenging for health workers as its symptoms are similar to other diseases. In fact, they often mistake it for common flu. Often, the condition of scrub typhus patients worsens as a result of the wrong diagnosis. By the time the real problem is diagnosed, the disease will already have seriously damaged the patient’s organs. Realising this, some major hospitals have now started conducting scrub typhus tests on all suspected cases. This practice needs to be widened.

The emergence of diseases like Covid-19, dengue and scrub typhus is made worse by growing effects of climate change. For instance, the diseases that were earlier only spotted in plains and hot places have now reached hills and mountains. But our health facilities and personnel are not well equipped to tackle these fast-mutating diseases.

It has become imperative to train health workers across the country and strengthen health institutions for early diagnosis and treatment of these ailments. People should be informed about the diseases, their symptoms, preventive measures and encouraged to visit healthcare facilities at the earliest. This is vital. Many patients of scrub typhus from remote areas, for instance, have had to be directly admitted to the ICU and even put on ventilators, as their diagnosis was delayed. As in the cases of Covid-19 and dengue, the authorities can make the general masses more aware about scrub typhus by spreading messages in jingles and other mediums and forms.

Given the rate at which the new diseases are appearing and old ones mutating, the country will have to be on high alert in order to avert another deadly pandemic.