Two people have died within a week in Darma Rural Municipality of Salyan after testing positive for scrub typhus, while another person with similar symptoms has also died, raising fears of a wider outbreak.

Two of the three victims tested positive for scrub typhus, while the third had similar symptoms but was not confirmed to have the disease.

The deaths have alarmed residents as infections continue to rise and local health facilities run short of testing kits, forcing patients to seek care outside the municipality.

The victims were 69-year-old Tul Bahadur Khadga of Layata Dhankadam in ward 5, 82-year-old Bal Bahadur Thapa of Maliwang in ward 6, and Nar Bahadur Budhathoki of Maliwang, who had symptoms similar to scrub typhus.

Residents say four to five people are testing positive every day in Darma as the infection spreads. With testing kits unavailable at local health facilities, many patients are being forced to visit private clinics or travel outside the municipality for treatment.

Children and elderly people with chronic illnesses are considered particularly vulnerable to complications from the disease.

Residents have called for free scrub typhus testing at local health facilities after reports of infections and deaths resurfaced in Darma, similar to last year.

“We are becoming afraid because the same problem we saw last year is happening again,” said Nim Bahadur Khadga of ward 5. He said the number of people suffering from fever and suspected scrub typhus had increased, but patients were struggling to get tested because local health facilities lacked kits.

Those who can afford it are seeking treatment at private clinics, he said, while poorer families are bearing the brunt of the outbreak.

Those who can afford it are seeking treatment at private clinics, he said, while poorer families are bearing the brunt of the outbreak.

“When treatment is not available at local health facilities, people have to go to private clinics and, for further treatment, travel as far as Nepalgunj,” Khadga said. “People who are better off can manage this, but those with little money are being pushed into greater hardship. Some have to borrow from relatives and neighbours just to travel for treatment.”

He said the failure to bring the rural municipality’s planned 15-bed hospital into operation had made the situation even more difficult for residents.

The rural municipality is preparing to launch a health camp in coordination with the District Health Office, Salyan, to test all patients with fever for scrub typhus and provide treatment, Yagya Bahadur Basnet, chief of the rural municipality’s health section, said.

A team including doctors from the District Health Office is expected to arrive in the rural municipality, he said.

Basnet urged residents to take extra precautions while working in fields and forests during the monsoon. Scrub typhus is transmitted by the bite of infected chiggers, tiny mite larvae commonly found in vegetation.

The rural municipality has also launched a surveillance campaign to contain the disease, with health workers preparing to visit homes to identify and treat patients, Basnet said.

Tek Raj Bohara, a health worker at Bhalchaur Health Centre, said the number of patients seeking treatment had risen sharply as cases of fever and suspected scrub typhus increased.

The centre normally sees 15 to 20 patients a day, but attendance has risen to as many as 30, he said. Patients whose fever does not improve after taking medication are being advised to visit a nearby hospital and seek treatment under a doctor’s supervision.

Nim Bahadur KC, the rural municipality chair, said health workers were preparing to visit homes across the rural municipality to test and treat people with fever in an effort to prevent the disease from spreading further.

He said the rural municipality would immediately replenish the shortage of scrub typhus testing kits at local health facilities.