SCRUB TYPHUS – NEPAL: (KATHMANDU)
Scrub typhus has not been [previously] reported from Kathmandu; the 75 cases reported 06 October 2015 were from other districts of Nepal. Thus, the report below is the 1st report from Kathmandu.
On 14 Oct 2015, a 28-year old previously healthy male patient presented at outpatient department of Sukraraj Tropical and Infectious Disease Hospital with complaints of high fever, cough (dry), sore throat, body ache, severe joint pain, red eyes, rashes over abdomen but without an eschar over a 1 week [period].
Tests for dengue IgM and IgG antibody were negative. Scrub typhus was suspected and tests were sent to the National Public Health Laboratory for confirmation. The patient was treated empirically with doxycycline and improved dramatically 48 hours after treatment was started. The diagnosis of scrub typhus was confirmed on 18 Oct 2015 by ELISA method.
This is the 1st known case of scrub typhus reported from Kathmandu (no travel history). Scrub typhus has been reported previously from various parts of the country, including the neighbouring Dhading district. Since then, the WHO and Epidemiology and Disease Control Division (EDCD) jointly initiated surveillance in areas from where suspected cases were being reported. However, Kathmandu has not been put under surveillance, although it remains at high risk for a scrub typhus outbreak, because patients with the disease might have been treated unnoticeably in private clinics or hospitals elsewhere and not reported to the government.
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