Taiwan health officials are warning the public to take precautions against scrub typhus this Qingming Festival, or Tomb Sweeping Festival.  To prevent chigger bites, the public is advised to wear protective clothing such as long-sleeved shirts and pants, apply officially approved insect repellents to exposed skin, and change clothes and take a shower immediately doing activities such as cleaning graves, camping, hiking, and visiting chigger-infested areas such as bush areas.

Image depicts an adult and a larval chigger poised on the head of a pin/CDC

According to Taiwan CDC’s surveillance data, as of March 25, 2018, a total of 67 scrub typhus cases have been confirmed in Taiwan this year, including 20 cases in Taitung County and 15 cases in Hualien County.

Scrub typhus is a disease caused by the organism, Orientia tsutsugamushi, 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, a painless 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 symptoms such as persistent fever, headache and eschar develop, please seek medical attention immediately and inform the doctor of your travel and exposure history to serve as a reference for clinical diagnosis.