KATHMANDU, JUNE 23

With the monsoon beginning to advance across Nepal, the latest weekly disease surveillance data shows dengue, scrub typhus and kala-azar continuing to be reported across multiple provinces, while influenza cases have remained steady in recent weeks, according to the Epidemiological Week 25 Surveillance Bulletin issued by the Epidemiology and Disease Control Division under the Department of Health Services.

The bulletin, covering the week of June 15 to 21, recorded a total of 1,655 cases of diseases and syndromes nationally across all seven provinces.

• Dengue

Dengue reported 53 cases during the week, with Lumbini Province recording the highest count at 22, followed by Koshi at 13 and Bagmati at 12. Gandaki reported three cases, Madhesh one and Karnali two, while Sudurpaschim reported no dengue cases for the week.

Trend data from the bulletin shows dengue has remained persistent over the past nine weeks, fluctuating between 47 and 70 cases per week since Week 17. The condition peaked at 70 cases in Week 19 before gradually easing, though it has not fallen below 47 cases during the entire tracking period - a pattern that health expert say warrants continued monitoring as the monsoon, which creates conditions favourable for mosquito breeding, advances further into the country.

• Scrub Typhus

Scrub Typhus recorded 19 cases nationally during Week 25, with Sudurpaschim Province accounting for 17 of them - a concentration that points to the far-western hills as the primary hotspot for the tick-borne disease this season. Bagmati reported one case and Gandaki one, while the remaining four provinces recorded none.

The weekly trend shows scrub typhus was at its highest in Week 17 at 34 cases, declining steadily through the following weeks before stabilising in the 19 to 22 case range in recent weeks. Scrub typhus, transmitted through the bite of infected larval mites, is particularly associated with scrub vegetation and is more prevalent in hilly and forested areas during and after the monsoon season.

• Kala-azar

Kala-azar, a vector-borne disease transmitted by sandfly bites and concentrated largely in the Terai, reported four cases in Week 25. Sudurpaschim accounted for three of these and Bagmati for one, with the remaining provinces reporting none.

The nine-week trend shows a gradual increase in kala-azar cases from a single case in Week 17 to a peak of seven in Week 23, before easing slightly to five in Week 24 and four in the latest week. While the numbers remain low, the upward trajectory over recent weeks is notable given that kala-azar is considered a neglected tropical disease that disproportionately affects marginalised and low-income communities in Nepal's southern plains.

• Influenza

Influenza cases stood at five during Week 25, distributed across Bagmati with three cases, Gandaki with one and Sudurpaschim with one. The weekly trend shows influenza was most active early in the tracking period, peaking at 15 cases in Week 17 and 14 in Week 18 before declining sharply to three cases in Week 20. Cases have since hovered between five and seven per week, suggesting low but steady transmission.

Separate from confirmed influenza, Influenza Like Illness, a broader syndromic category, remained among the most reported conditions nationally, with 488 cases in Week 25, a figure that has remained elevated over most of the nine-week period and peaked at 738 cases in Week 23.

• Acute Gastro Enteritis and other conditions

Acute Gastro Enteritis remained the single most reported condition during the week at 720 cases, though the trend line shows a gradual decline from a peak of 933 cases in Week 19. Bagmati Province bore the heaviest burden with 381 cases, followed by Sudurpaschim at 97 and Lumbini at 86.

Severe Acute Respiratory Infection was the third most reported condition nationally with 339 cases for the week, down from a peak of 503 cases in Week 21. Lumbini recorded the highest provincial count at 80, followed by Bagmati at 98 and Koshi at 41.

Fever with Rash reported 18 cases during the week, with cases spread across Koshi at six, Bagmati at three, Lumbini at three, Madhesh at two and Sudurpaschim at three. The condition has fluctuated between 10 and 27 cases over the nine-week tracking period, peaking in Week 23. Febrile Illness with Jaundice reported nine cases in Week 25, concentrated in Madhesh with three cases and Bagmati with four, following an unusually sharp spike of 61 cases in Week 20 that has since returned to single digits.