Health authorities in Darma Rural Municipality of Salyan have expanded testing for scrub typhus after seven people died from the infection in the past month and two to five new cases have been detected each day.

A team of health workers has begun visiting affected settlements to test and treat residents as the outbreak spreads, according to the rural municipality’s health section.

The seven people who died were 82-year-old Bal Bahadur Thapa from ward 6, 69-year-old Tul Bahadur Khadka from Ward 5, 67-year-old Nar Bahadur Budhathoki from ward 6, 51-year-old Khimananda KC from ward 1, 12-year-old Naresh Oli from ward 2, and 67-year-old Totaram Sunar and 61-year-old Narendra Rokaya, both from ward 1.

All seven died while receiving treatment at hospitals outside the district after receiving initial treatment at local health facilities, said Yagya Bahadur Basnet, chief of the rural municipality’s health section.

On Monday, health workers tested 191 people to assess the extent of the infection, with 60 testing positive for scrub typhus, Basnet said.

“A large number of those tested were found to be infected,” he said. “Our stock of test kits is also running low.”

The rural municipality needs between 1,000 and 1,200 additional test kits and has sought support from the provincial and federal governments, Basnet said.

Scrub typhus has been reported in Darma since last year. Four people died and 145 tested positive in 2025, according to the health section.

Cases began appearing in the last week of July, and the first death this year was recorded on Bhadra 1, Basnet said. The number of patients with fever has increased in several settlements in the rural municipality, with two to five people testing positive each day. More than 100 people have tested positive so far this year, according to the health section.

Health workers say the tendency among people with fever to buy medicines from private medical shops instead of getting tested at health facilities is also making the situation worse. They said people often take medicines based on symptoms and use strong drugs without medical advice, putting those with chronic illnesses at particular risk.

As infections increased, a team from the Salyan District Hospital, including doctors and carrying medicines and testing supplies, travelled to Darma.

The team, led by Dr Balaram KC of the district hospital, will conduct testing at two locations in the rural municipality, according to the District Health Service Office.

Dr Pratibha BK of Salyan District Hospital said testing began at Darma Health Post in ward 1, which has been the hardest-hit area. Testing will be conducted at the ward 5 office on Thursday.

Patients who test positive will be assessed and provided treatment and necessary medical advice, she said.

Public health officer Tara Rijal said the team would also educate residents about ways to prevent infection. The campaign will advise people to take precautions while working in grass, vegetation and bushes during the monsoon, seek testing at a health facility as soon as they develop a fever, and avoid taking medicines without advice from health workers.

Darma Rural Municipality has also started testing at four locations following the rise in cases. In coordination with the Health Service Office, it conducted a health camp in the second week of Bhadra to test and treat people with fever, according to the health section.

Health officials said scrub typhus is not limited to Darma. Cases have also been reported in other local units in Salyan, including Kumakh and Bagchaur.

Over the past two months, 335 people were tested in Darma and Bagchaur, with 116 testing positive. About 35 percent of those tested were infected.

The District Administration Office said it was preparing to coordinate with the Health Service Office to assess the overall situation in the district and discuss measures to contain the infection.

Health workers have urged residents to take precautions during the monsoon, when people are more likely to work in vegetation and forests where mites that transmit scrub typhus are found. They have advised anyone who develops a fever to visit a health facility for testing.

Health officials are concerned that cases are also increasing in Kumakh, Bagchaur and other local units. Citing figures showing that 116 of 335 people tested in Darma and Bagchaur over the past two months were infected, lawmaker Ramesh Kumar Malla raised the issue in Parliament and urged the government to provide the health supplies and personnel needed for testing, treatment and prevention.