Four people have died from scrub typhus in Darma Rural Municipality in Salyan in the past three weeks, while more than 100 people have tested positive as cases continue to rise.

The outbreak has left residents increasingly concerned, with health facilities detecting three to four new cases a day. Some patients have had to be referred to hospitals in Dang and Nepalgunj for treatment.

Yagya Bahadur Basnet, chief of the health section at the rural municipality, said three people died in late August and another later during treatment at hospitals in Dang and Nepalgunj. All four had tested positive for scrub typhus.

The rural municipality, in coordination with the District Health Office, has been running health camps and conducting rapid tests in affected areas. More than 100 people have tested positive so far, and new cases continue to be detected.

Tek Raj Bohara, a health worker at Bhalchaur Health Post, said the facility normally sees around 15 to 20 patients a day, but the number has risen to as many as 30 since the outbreak began.

“We test patients whose fever does not improve after taking medication,” he said.

Health officials are also concerned about people taking medicines without consulting health workers. Basnet urged residents with persistent fever to get tested rather than self-medicate.

“People should not take medicines on their own when they develop a fever. They should consult health workers and get tested if necessary,” he said.

Health camps and treatment services have been expanded in the affected areas, but health officials say the outbreak has not yet been brought fully under control.

Scrub typhus is transmitted through the bite of infected chiggers, tiny mites found in vegetation. The risk tends to rise during the monsoon, when people spend more time in grassland and forest areas for farming, collecting fodder and other work.

The recent cases have also highlighted the need for people to recognise the symptoms early and seek treatment.

Devi Ram Nepali, a resident of Darma, initially took ordinary medication after developing a fever. When his condition did not improve, health workers advised him to get tested for scrub typhus. The test was positive, and he is now recovering after starting treatment.

Another resident, Bimala Khadga, said cases of fever, cough and cold symptoms had increased in the area.

Health officials have urged residents to take precautions when working in grassy or forested areas and to seek medical attention if a fever persists.