EDITORIAL: Scrub typhus threat

Now that most of the Tarai is inundated by floods there is more danger of the disease spreading due to lack of hygiene and rise in the number of dangerous rodents 

Cases of scrub typhus are on the rise in Chitwan district. In the past month alone a total of 105 persons were diagnosed with this disease. They are now undergoing treatment in various health facilities of the district. So far, one patient has succumbed to scrub typhus there. This ailment is transmitted to humans and also rodents by chigger bites. Chigger mites are the main vector for scrub typhus and are commonly found on rats/mice. They are not transmitted from human to humans.  The disease surfaces mainly in areas such as forest clearings, riverbanks and grassy regions in which the infected mites thrive. This disease was first reported in Nepal in 2015. Then 101 people had tested positive for scrub virus. It had then affected 16 districts and eight people died from the disease. Also in 2016, 831 tested positive for the disease in 14 districts. Then 14 people died from the deadly disease.

Previously scrub typhus had been detected mainly in the rural areas of Nepal. Now it is being increasingly detected in urban areas like Kathmandu too. Exposure to rats and mice enhances the risk of transmission of scrub typhus. Nearly half a dozen people with rat and mouse bites are found visiting Sukraraj Tropical and Infectious Disease Hospital for treatment meaning that there is greater risk of an outbreak of scrub typhus in the coming days. As of now there is no vaccine available to prevent humans from contracting scrub typhus. This disease is caused by bacteria and the best means to cope with it is to wear protective clothing, use insect repellent and avoid staying on bare ground or grass. Rats and mice thrive in these areas. Farmers and people living in houses with bushes nearby or those who travel in areas where the risk of scrub typhus is high are particularly vulnerable and are at greater risk of contracting the disease. In Nepal, usually health care workers tend to regard this disease as typhoid and are treated as such. They receive medicine for treatment of typhoid fever from the health care workers and many of them attempt to treat it on their own as is common in Nepal.

Deaths can be averted if scrub typhus is identified in its initial stage as it is treatable. Laboratory testing is a must for the diagnosis of scrub typhus. This can be very difficult if symptoms mimic other infectious diseases such as typhoid fever, dengue, or malaria. High fever for seven days and headache should not be taken lightly. These symptoms appear 10 to 12 days after infection. Unless something is done immediately it is very likely that the disease will spread particularly during the monsoon. It could even reach epidemic proportions if not dealt with timely. The disease should be diagnosed by training the health workers as well. They should also be provided with the necessary medicines. As the reports come in of more people with this disease from various parts of the country the authorities should do their level best to confront the impending disaster by taking timely measures. Now that most of the Tarai is inundated by floods there is more danger of the disease spreading due to lack of hygiene and rise in the number of dangerous rodents.

Embossed plate

The Department of Transport Management (DoTM) has finalised its preparatory work to install embossed number plate replacing the traditional hand-written number plate that does not bear any specific records of the vehicle and its owner. The DoTM started installing the embossed number plate in the government owned vehicles in the Kathmandu Valley. After its trial on the government-owned vehicles becomes successful the department will install it on the vehicles owned by the diplomatic agencies and others registered with the Bagmati Zonal Office. The new service will also be expanded to other parts of the country after it provides the new number plates within the Valley.

The department officials have said it will be easy to track a vehicle on the basis of the embossed number plate which will have several features on it. The embossed number plate will keep digital record of a vehicle; it will have a radio frequency identification system which will reveal the model and manufacturer’s name and user’s name. Traffic police can easily monitor the movement of a vehicle with the help of the embossed number plate installed on a vehicle. Police can easily take a vehicle under control if it is used in any kind of crime.