Kamala KC, 33, from Dalsing in ward 2 of Darma Rural Municipality, has been battling scrub typhus for more than a week. She has been taking medication on her doctor’s advice. Although her fever has subsided, she continues to suffer from headaches and dizziness, leaving her unable to work.

Since her husband died young, KC has been supporting her family of three through farming. Now, she has been unable to bring in the crops that have ripened in her fields. With Dashain approaching, she has little time to think about celebrating the festival. Her immediate concern is how to recover from the infection and protect her life.

Bhuma Dangi, 44, from ward 6 of Kumakh Rural Municipality, is in a similar situation. After suffering from a fever for 12 days, she tested positive for scrub typhus. She began taking medication four days ago. While her fever has subsided, she has yet to regain her strength.

Following advice from health workers, Dangi has been resting. She has made no preparations for Dashain.

“After eight people died in a neighbouring rural municipality, I became more concerned about getting better than celebrating the festival with great enthusiasm,” she said. “The most important thing is staying alive. If we survive, we can celebrate Dashain. It does not matter if we cannot celebrate it this time.”

Scrub typhus has been spreading in Salyan district for nearly three months. In Darma Rural Municipality alone, eight people have died, including a boy, a woman and six elderly men. Another woman has died in Chhatreshwari Rural Municipality. More than 700 people across the district have been infected, with Darma the worst-affected area.

Although infections have started to decline, fear remains widespread in the hardest-hit communities. The deaths and rumours about the disease and its treatment have heightened anxiety among residents, many of whom are now more concerned about protecting their lives than celebrating Dashain.

Medical teams from the federal, provincial, district and local levels have been running health camps to diagnose and treat the disease. The number of patients presenting with fever and confirmed infections has fallen since these interventions began. But a lack of public awareness has allowed misinformation to take hold, leaving residents fearful despite the decline in cases.

Sita BK, also from ward 2 of Darma Rural Municipality, is taking medication for scrub typhus. Although her condition has improved, she says she is still too weak to resume her daily routine. “When I heard about people suffering from high fever, severe headaches and body aches, and some even dying, I thought there was little hope for me,” she said. “After receiving treatment and taking medication, I feel better than before, but I still cannot manage the household chores.”

She has also been unable to harvest her crops, even as Dashain draws closer. “Some of my neighbours are painting their houses, while others are preparing for the festival. Seeing them makes me wonder what I should do,” she said. “I am afraid that if I force myself to work before recovering fully, the disease might return.”

Sudeep KC, ward 5 chair in Darma Rural Municipality, said residents’ fears had grown after the disease appeared during the monsoon for two consecutive years. Four people died of scrub typhus in the rural municipality last year and eight this year, while many patients have endured difficult recoveries. “Scrub typhus is generally associated with the monsoon, but the disease has not been brought fully under control even as winter approaches,” he said. “Some people are still testing positive when they undergo tests after showing symptoms.”

Residents have also become afraid to enter their fields to harvest ripe crops because of the risk of being bitten by mites that transmit the disease, he said.

Yagya Bahadur Basnet, chief of the health section at Darma Rural Municipality, said scrub typhus could be treated within 10 days with appropriate medication taken regularly. However, misinformation fuelled by a lack of public awareness had prevented residents from overcoming their fears.

A total of 262 people have tested positive for scrub typhus in Darma, where eight people have died, Basnet said. The local government has been conducting awareness programmes and providing advice to infected people and their families in an effort to contain the disease and reassure residents.