Qu Gong Disease: Understanding the Risks and Prevention

In recent years, increased international travel and population movement have brought attention to infectious diseases previously considered limited to tropical regions. Among these, Qu Gong disease, also known as scrub typhus, is a mosquito-borne illness that warrants public awareness. Even as most cases are imported, Taiwan has seen a higher number of reported cases in 2025 compared to previous years, raising concerns.

What is Qu Gong Disease?

Qu Gong disease is an infectious disease caused by the bacterium Orientia tsutsugamushi. It is spread through the bites of infected larval mites (chiggers) found in areas with dense vegetation, such as scrublands and forests. The disease is not directly transmitted from person to person.

Global and Taiwan Epidemic Situation

Globally, chikungunya virus (CHIKV) disease cases have been on the rise in 2025, with significant increases reported in South America, India, Southeast Asia, and southern China WHO. This surge puts continued pressure on border quarantine and community prevention efforts in neighboring countries.

In Taiwan, a total of 39 confirmed cases of Qu Gong disease were reported in 2025, all imported Taiwan National Infectious Disease Statistics System. The primary sources of infection were Indonesia, the Philippines, Guangdong Province in China, and Sri Lanka. As of early 2026, two new imported cases have been identified, indicating the ongoing international epidemic continues to pose a risk.

Currently, there have been no cases of local community transmission in Taiwan. All reported cases have been linked to travel outside the country. This suggests that the current prevention systems are effective, but continued vigilance is crucial.

How is Qu Gong Disease Transmitted?

Qu Gong disease is not spread directly between people. It is transmitted through the bites of mosquitoes carrying the virus, specifically Aedes aegypti and Aedes albopictus, both of which are found in Taiwan. These mosquitoes are also vectors for other mosquito-borne diseases like dengue fever and Zika virus.

When a mosquito bites an infected person, the virus enters the bloodstream. The individual is then in the “viremia stage” for approximately 2-5 days after the onset of illness. If a mosquito bites this person during this period, the virus can multiply within the mosquito and be transmitted to others.

Incubation Period and Common Symptoms

The incubation period for Qu Gong disease is typically 2 to 12 days, most commonly 4 to 8 days. Typical symptoms include:

• Sudden high fever
• Severe joint pain or arthritis
• Muscle soreness and fatigue
• Headache, nausea, and vomiting
• Skin rash (in about half of patients)

Joint pain often affects the fingers, wrists, knees, and ankles, and may be accompanied by swelling and limited movement. The severe joint pain is a hallmark symptom of the disease.

Complications and Long-Term Effects

While Qu Gong disease is rarely fatal, joint symptoms can persist for weeks or even months. Some individuals may develop chronic arthritis-like symptoms, impacting their quality of life. The elderly, pregnant women, and those with chronic illnesses may experience more severe symptoms or complications.

Diagnosis and Treatment

Currently, there are no specific antiviral drugs for Qu Gong disease. Treatment focuses on supportive care, including:

• Fever-reducing and pain-relieving medications
• Rest
• Hydration

If you have a travel history and develop suspected symptoms, it is important to inform your doctor of your travel location and dates to ensure accurate testing and reporting.

How to Prevent Qu Gong Disease

Since there is no vaccine or specific medication for Qu Gong disease, prevention relies on effective mosquito control and environmental management:

• Traveling to Epidemic Areas: Stay in screened or air-conditioned accommodations, wear long-sleeved clothing, use safe mosquito repellent (containing DEET or Picaridin), and avoid prolonged outdoor activity during peak mosquito hours.
• Health Monitoring After Returning Home: Monitor for symptoms for approximately 14 days after returning from travel. Seek medical attention if you develop fever, joint pain, or rash, and inform your doctor of your travel history.
• Daily Life Mosquito Control: Eliminate standing water in containers, clean plant trays and drinking water containers weekly, and implement the “inspection, pouring, cleaning, and brushing” principle. Install screens on windows and use mosquito nets or traps when necessary.

Conclusion

The increased number of imported Qu Gong disease cases in Taiwan in 2025 highlights the challenges posed by international travel and changing epidemic dynamics. While local transmission has not yet been detected, continued mosquito control measures and public health vigilance are essential to protect both individual and community health.