According to media, in recent weeks, the Sukraraj Tropical and Infectious Disease Hospital (STIDH) laboratory has detected dozens of scrub typhus-positive cases daily among febrile patients in Kathmandu, indicating a rare but rapidly emerging outbreak.
Scrub typhus (also called Tsutsugamushi fever) is transmitted to humans by chigger mite larvae. The disease occurs in clusters at the end of the rainy season. Orientia tsutsugamushi is classified as a rickettsial disease. After an incubation period of 6-21 days, a typical blackish skin lesion (eschar) may appear, as well as fever, headache and muscle pain, swollen lymph nodes and sometimes an exanthema. Antibiotic treatment (doxycycline) should be started as soon as Scrub typhus is suspected in order to avoid possible neurological (encephalitis) and cardiac complications, which can be fatal.
Scrub typhus is rare among travelers. There is an increased risk during outdoor activities (e.g., camping, trekking).
Prevention: Apply repellents to the skin, wear insecticide-impregnated clothing during outdoor activities. Consult a doctor in case of symptoms for rapid initiation of antibiotic therapy.
Rabies is still a serious public health problem in more than 150 countries, mainly in Asia and Africa, causing tens of thousands of deaths each year.
Despite dog vaccination efforts, many people are still bitten by unvaccinated dogs. Post-exposure prophylaxis (PEP) is crucial, as 99% of human rabies deaths are dog-mediated, yet access and cost barriers leave many bite victims at risk of death from a preventable disease.
Access to PEP is limited in many countries, especially for rabies immunoglobulins (RIG). According to a publication, out of 240 countries, access to RIG was limited in 134, while 70 countries had no access at all. For details, see JTM publication, 2022.
Geographic distribution of assessed rabies risk levels for travel health guidance:
Exposure to potentially rabid animals is common, especially during travel. Rabies can be prevented through pre-exposure vaccination!
Due to the global shortage of rabies immunoglobulins — crucial for unvaccinated individuals after potential rabies exposure — the Swiss Expert Committee for Travel Medicine advises a more generous approach to recommending rabies vaccination before travel. Pre-exposure rabies vaccination for travel should be considered a once-in-a-lifetime investment!
In general: avoid contact with animals and do not feed them.
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a high-quality medical center for post-exposure vaccination as soon as possible!
The La Paz Departmental Health Service (SEDES) confirmed the presence of yellow fever virus in a dead monkey within an ecological reserve in the municipality of Coroico, marking the first time rabies has been reported in this region.
The virus now appears to be near an urban area; Coroico is less than two hours from La Paz, which increases the risk of the virus reaching a major population.
In South America, deaths in monkeys frequently precede human cases of yellow fever and thus serve as an indicator of increased yellow fever virus circulation.
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