Taiwan health officials are advising the public to take steps to prevent chigger bites as the number of scrub typhus rise in areas of the country. According to Taiwan CDC’s surveillance data, as of June 2016, a total of 117 scrub typhus cases have been confirmed in Taiwan this year, including 27 cases in Taitung County, 24 cases in Hualien County and 20 cases in Penghu County.
Scrub typhus cases are reported throughout the year in Taiwan, which usually begin to increase in May and peak during June and July. In addition, the second wave of outbreak usually occurs during September and October. Hualien County, Taitung County and the offshore islands report most cases.
Scrub typhus is a disease that is transmitted by chiggers. Chiggers like to stay at the tips of weeds, waiting for an opportunity to attach to passing humans or animals. Therefore, the chance of becoming infected with scrub typhus is much higher when people walk through bush areas. After being bitten by the chigger, an eschar will form over the bite, and the incubation period usually ranges from 9 to 12 days. Subsequently, symptoms such as persistent fever, headache, sweating and swelling or inflammation of the lymph gland will begin to develop. After having had fever for about 1 week, a dark red papule will appear in the trunk, spread to extremities, and disappear after several days. If left untreated, the fatality rate of scrub typhus can be as high as 60%. If treated promptly, the fatality rate is less than 5%.
Taiwan CDC urges the public to take prevention measures when visiting bush areas to ward off infection. Some of the prevention measures include wearing protective clothing such as long-sleeve shirts and pants, applying insect repellents to exposed skin to prevent chigger bites, and changing clothes and taking a shower immediately after a visit to the bush area to reduce the risk of infection. If suspicious symptoms develop, please seek medical attention immediately and inform the doctor of your travel and exposure history to serve as a reference for clinical diagnosis.