Scrub typhus has killed one person and infected eight others in Bajhang district in the past one week.

This is the first time the mite-borne bacterial infectious disease has occurred in Bajhang, say health workers.

On Thursday, a 22-year-old woman from Durgathali Rural Municipality died of scrub typhus while undergoing treatment at the District Hospital in Chainpur.

“We could not save the woman because her condition was already serious by the time she was brought to the hospital,” said Dr Milan Khadka at the hospital.

Another 17-year-old girl, meanwhile, is said to be in a critical condition. 

Khadka said the hospital refers critical patients to better equipped hospitals in the Tarai districts, which they haven’t been able to do because of the Covid-19 pandemic.

Most hospitals are currently occupied with Covid-19 patients, said Khadka.

“All ICUs and ventilators in hospitals are occupied, so we couldn’t refer scrub typhus patients. Travel restrictions and prohibitory orders due to the Covid-19 crisis have also made it difficult for patients to seek treatment outside the district,” said Khadka.

Scrub typhus could be treated if the infected patients get immediate medical care. But in Bajhang, health officials say most scrub typhus patients had been self-medicating at home for fever and headache—common symptoms of scrub typhus—and decided to seek medical help only after their conditions got worse. 

According to the District Hospital, three of the patients are from Thalara Rural Municipality, two from Masta Rural Municipality, two from Jayaprithvi Municipality, one from Khaptad Chhanna Rural Municipality and one from Durgathali Rural Municipality.

The District Hospital has reported to the Provincial Health Directorate of Sudurpaschim about the scrub typhus infection outbreak in Bajhang and asked to provide test kits and medicines.
“The health units in places where the disease has been reported have been told to stay on high alert and immediately refer the patients with scrub typhus symptoms to the hospital,” said Dr Sandip Okheda, chief at the District Hospital. 

Scrub typhus, also sometimes called bush typhus, is an infectious disease that is caused by the parasite Orientia tsutsugamushi, a mite-borne bacterium, and spreads in the human body after they are bitten by infected chiggers (larval mites) found in mice.

High fever, headache, abdominal pain, backache, joint and muscle pain, dull red rash, nausea and vomiting are some of the symptoms of scrub typhus infection. Patients with severe illness may develop bleeding which could lead to organ failure and turn fatal if left untreated.

“Scrub Typhus infections are usually seen during the monsoon season across the country but this is the first instance of scrub typhus being reported from Bajhang,” said Okheda.

Nepal saw a surge in scrub typhus cases after the 2015 earthquakes. Three months after two massive earthquakes, the BP Koirala Institute of Health Sciences, Dharan had alerted the Epidemiology and Disease Control Division about six children with unusual fever and severe respiratory features.

The magnitude of the outbreak escalated in 2016—831 cases of scrub typhus were reported in 47 districts and 14 people died by the end of that year.