On 18 November 2025, the IIPH Shillong team, together with colleagues from Dr H.G. Roberts Hospital, convened a meeting after a noticeable increase in fever and suspected scrub typhus cases was reported from villages under Lyngiong HWC and Hima Lyngiong. During the initial review, clinical data from both Dr H.G. Roberts Hospital and Mawphlang CHC suggested possible transmission clusters, prompting the need for immediate on-ground assessment. In response, IIPHS, in collaboration with Dr H.G. Roberts Hospital, initiated a rapid outbreak investigation to understand the pattern of illness, identify local risk factors, and strengthen community awareness. Field activities were subsequently carried out from 25th November to 11th December 2025.
The outbreak investigation followed a multi-component approach, involving community awareness programmes, household visits, door-to-door fever screening, GPS-based mapping, rodent trapping, and qualitative interviews. These activities took place across 8 villages, Nongthymmai Rum, Umkaber, Thaiñ Thynroh, Laitmawpen, Mawponghong, Nonglwai, Mawser, and Umsawmat. IIPH Shillong team also collaborated with the IDSP team to conduct the awareness on scrub typhus in Umsawmat and Umkaber village. Awareness sessions covered the cause of scrub typhus, its mode of transmission, symptoms, early treatment, and preventive practices, including how to identify the eschar, a critical clinical sign. The BPH students’ skit played a key role in simplifying health messages, with villagers often remarking on how relatable and clear the performance was. Community members asked insightful questions about mite behaviour, seasonality, person-to-person transmission, and prevention for farmers who have limited clothing during winter. As part of the rodent trapping, 20 rodent traps were placed in Umkaber and Thaiñ Thynroh villages. Three rats were successfully captured and collected by ICAR for laboratory analysis.
The qualitative component—consisting of in-depth interviews and a focus group discussion— explored community perceptions and knowledge of scrub typhus, understanding of the eschar, beliefs about where mites originate, and seasonal trends. Several participants shared personal experiences of illness and past deaths due to scrub typhus, providing deeper insight into the social and emotional context of the outbreak. Overall, the outbreak investigation demonstrated the importance of a rapid, community-focused public health response. The combination of awareness programmes, door-to-door screening, and environmental assessment helped identify key risk areas while strengthening local understanding of scrub typhus. This work establishes a foundation for enhanced surveillance, targeted prevention strategies, and continued research to reduce the burden of scrub typhus in the region.
