The three tiers of govt must work in tandem by strengthening all health facilities to bring scrub typhus under control

The threat of scrub typhus is real. While people are still struggling to recover from dengue outbreak, the Kathmandu Valley is now witnessing rapid spread of scrub typhus, also known as bush typhus, which is caused by parasites found in rats and mice. The number of patients suffering from scrub typhus has more than doubled this year compared to last year. According to Epidemiology and Disease Control Division (EDCD) of the Department of Health Services, the Valley reported 15 cases of scrub typhus in 2018, while the number of scrub typhus patients has more than doubled to 40 this year. Many people may have been infected with the disease, but they are not diagnosed properly as the symptoms of scrub typhus are similar to that of dengue. The most common symptoms of bush typhus are fever, headache, body aches and rashes, similar to dengue. But scrub typhus can be more fatal than dengue if one does not take appropriate treatment on time. The EDCD has said as many as 695 people have tested positive for scrub typhus in 61 districts between July 17 and September 23. In 2018, the number of people suffering from the disease stood at 1,098 nationwide. The possibility of the people contacting the disease cannot be ruled out as harvesting season has yet to start. People who work in the farmland may contact with rats.

Scrub typhus is an infectious illness caused by a parasite – chigger – which is found in rats and mice. The mites in their larval stage contact the disease by biting rodents. Infected chiggers are mostly found during the wet season in forest clearings, riverbanks and grassy fields. The Tarai region has the suitable environment for parasites causing scrub typhus. Therefore, people should avoid contacting with rats and mice at the time of harvesting paddy. According to studies, up to 30 to 70 per cent of those severely affected by the disease die globally due to lack of timely treatment. The bacterium that causes the disease severely affects bloods vessels leading to failure of vital organs such as kidneys and liver. This year, the disease has also been seen in high altitude areas due to the movement of people and climate change.

Considering the severity of the disease, doctors have advised the people to contact with the nearest health facilities in case such symptoms appear because mortality rate from scrub typhus is higher than from dengue. People can die if they do not receive proper treatment on time. So far, Dhading (74), Dadeldhura (61), Palpa (59), Rupandehi (46), Kailali (44) and Chitwan (39) are the districts most affected by scrub typhus, which is usually seen in August and September. This is the time when bushes grow rapidly by providing a fertile ground for the rodents to multiply. In order to bring the disease under control, the federal, provincial and local governments must work in tandem by strengthening the local health facilities and provincial hospitals along with the provision of modern diagnostic kits and adequate supply of medicine. An awareness campaign should also be launched in the affected districts, especially among those working in the fields and the forests. It is the duty of the three tiers of government to ensure right to health services to the people.

End extortion spree

On the eve of the Dashain festival, the Netra Bikram Chand-led Communist Party of Nepal is reported to be on an extortion spree in Bajura in far-west Nepal. It has targeted government offices, traders, people’s representatives as well as teachers and health personnel. According to the victims, the group has set the amount of donations to be handed over, which could be as much as a month’s salary. The party cadres know very well that everyone will be getting a Dashain bonus sometime next week – which amounts to a month’s salary - and it should have no difficulty collecting it as people easily give in to their threats and intimidation.

The ongoing extortion is not an isolated incident. They’ve used manhandling and bomb blasts to intimidate both people and organisations even in the capital. The state is bound to provide, if nothing else, at least security to its people. As millions of people will be travelling to their homes carrying some cash and expensive gifts for the festival, they could be easy targets on the highways. So the government is advised to bring the nefarious activities of the Chand-led party - and other groups – under control sooner than later.