IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|



Nepal For Specific Travellers:
Scrub Typhus


Scrub Typhus has been reported in Chitwan. 

Source: ProMED-mail

Last updated: November 10, 2020.



Scrub Typhus, also known as Tsutsugamushi Disease, is caused by Orienta tsutsugamushi bacteria. It is a zoonosis (an animal disease that can spread to humans) primarily affecting rodents, rabbits, and marsupials. This rickettsial infection is transmitted to humans through the bite of infected Leptotombidium mite larvae (chiggers). The mites are found in grasslands, forests, bush areas, wood piles, gardens, and beaches. Scrub Typhus can also be transmitted through unscreened blood transfusions and unhygienic needles. It does not spread from person to person.

>> Travel health advice on Epidemic Typhus and Murine Typhus.


The infection is endemic in Central Asia, southeast Asia, and northern Australia. Travellers undertaking outdoor activities such as visiting farms, camping, backpacking, hunting, archeological digs, or participating in ecotourism are at risk of getting bitten by chiggers. Scrub Typhus is an occupational health concern for farmers, park rangers, military personnel, geologist, miners, as well as oil palm workers. The presence of Scrub Typhus is related to increasing deforestation and urbanization. Scrub Typhus typically occurs during the rainy season, but can be present throughout the year.


Usually symptoms appear 6 to 20 days after exposure to the bacteria and include fever, headache, chills, sweating, muscle pain, eye infection, skin rash, and lymph node swelling. Often the bite area becomes red and a black scab, also known as an ‘eschar’, forms at the center. If untreated, the infection can progress to more severe symptoms including pneumonia, jaundice, hemorrhaging, multi-organ failure, and paralysis which can lead to death. Treatment includes a course of antibiotics and supportive care of symptoms.


Travellers who engage in hiking, camping, or similar outdoor activities in endemic regions  should take measures to prevent mite bites. There is no vaccine or preventive medication against Scrub Typhus.

  • Apply a DEET-containing repellent to exposed skin and soak clothing and gear in a permethrin solution. 
  • When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs. Wear long shirts and pants tucked into socks. 
  • Avoid walking barefoot or wearing sandals, and use a tarp when sitting on ground cover. 
  • If you’re going to an area where Scrub Typhus is endemic, ask your healthcare practitioner about preventive antibiotics.

Scrub Typhus images, life cycle, and distribution maps:

Infection Landscapes

Information last updated: November 17, 2020

Travel Health Journal