Scrub typhus

• Sudden onset of fever, often high
• Severe headache
• Muscle aches (myalgia)
• Rash, which may appear a few days after fever onset
• A characteristic dark, crusted lesion (*eschar*) at the bite site
• Enlarged lymph nodes (lymphadenopathy)
• In severe cases, organ failure and pneumonia can occur

Scrub typhus is transmitted to humans through the bite of infected larval trombiculid mites, commonly known as chiggers. These mites acquire the bacterium *Orientia tsutsugamushi* from rodents, which serve as reservoirs, and can also pass the infection to their offspring (transovarial transmission). Human-to-human transmission does not occur.

• Avoid areas with dense scrub vegetation or tall grass where mites are common.
• Wear protective clothing (long sleeves, long pants tucked into socks/boots) when in endemic areas.
• Apply insect repellents containing DEET or picaridin to exposed skin.
• Treat clothing and gear with permethrin.
• There is currently no vaccine available for Scrub typhus.