Rickettsial infections, once thought to have disappeared from Malaysia, are very much alive — and causing serious disease in places like Kuala Lipis, Pahang, and Negeri Sembilan, where scrub typhus has led to severe illness and preventable deaths. Through renewed research efforts and stronger collaboration with the Institute for Medical Research (IMR), led by Dr. Siti Rose, diagnostic practices and clinical awareness have been transformed, reshaping how physicians and laboratories approach undifferentiated fever. This presentation traces that journey — from forgotten pathogen to national priority — showing how attention to “neglected” diseases can save lives. And yes, while we may be in Penang, this story is not about char kway teow, but about rediscovering and confronting a hidden threat in Malaysian medicine.