According to the Taiwan Centers for Disease Control (Taiwan CDC), thus far this year, a cumulative total of 66 scrub typhus cases have been confirmed in Taiwan, which is the highest among those reported during the same period in the recent 5 years (2013-2017).　　The majority of the cases are reported in Hualien County and Taitung County. Additionally, Pingtung County has also reported more cases this year as compared to the same period in the past 2 years and clusters have occurred in both Pingtung County and Hualien County. Since this year’s scrub typhus outbreak seems to have started earlier than usual, Taiwan CDC advises the public 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 after a visit to the bush area to prevent chigger bites. If suspicious symptoms develop, please seek timely medical attention and inform the doctor of your exposure history to facilitate prompt diagnosis and treatment.
 
According to Taiwan CDC’s surveillance data, as of March 19, 2017, a total of 66 scrub typhus cases have been confirmed in Taiwan this year, including 27 cases in Hualien County, 10 cases in Taitung County and 6 cases in Pingtung County.　Thus far this year, Pingtung County has reported more cases as compared to the same period in the past two years. Two clusters of cases have been recently reported in tour group members who respectively visited the mountain in Pingtung County and Hualien County in mid-January and late January. The 2 clusters respectively consist of 6 and 5 confirmed cases.

According to Taiwan CDC’s surveillance data, scrub typhus cases are reported throughout the year in Taiwan, which usually begin to increase during April and 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 usually report most cases. Nevertheless, the number of scrub typhus cases reported this February is higher than those reported during the same period in the recent 5 years, indicating that this year’s outbreak has apparently started earlier. 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%.

As this year’s Tomb Sweeping Festival is a 4-day weekend, 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. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).