Macau’s Health Services have confirmed the first imported case of the year of tsutsugamushi disease (scrub typhus), an acute epidemic-type infectious disease transmitted by infected larvae.
The patient is a 31-year-old male resident of Macau who began presenting a black spot and rash on his left leg on February 26. Days later, on March 6, he developed fever, headaches and muscle pain, followed the next day by a generalised skin rash, prompting him to seek hospital care without improvement. On March 12, he went to Conde de São Januário Hospital Centre, where a physical examination identified a painless eschar approximately the size of a soybean on his left leg. Based on symptoms, clinical signs and a positive response to treatment, the patient was clinically diagnosed with tsutsugamushi disease. His fever has subsided and his condition is considered stable, though he remains hospitalised.
Epidemiological investigation points to a likely infection outside Macau. Between February 24 and 25, the patient was camping at a campsite in the city of Jiangmen in a grassy area, where he is believed to have been bitten by insects. Health Services note that cohabitants have shown no similar symptoms and that the patient did not visit parks or rural areas during his stay in Macau.
Tsutsugamushi disease is an acute infection caused by the bite of larvae carrying the bacterium Orientia tsutsugamushi. Rodents living in warm, humid areas with dense vegetation serve as natural hosts of the bacterium, and larvae can become infected by parasitising these animals before transmitting the disease to humans through their bite.
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Common symptoms include fever, headaches, muscle pain, rash and a characteristic painless eschar with a small central opening at the bite site. Health authorities warn that without timely treatment, a small percentage of cases can progress to serious complications including pneumonia, encephalitis and myocarditis, potentially causing respiratory failure, shock and death.
