SEROEPIDEMIOLOGIC EVIDENCE FOR MURINE AND SCRUB TYPHUS IN MALANG, INDONESIA

Indonesian military personnel stationed in Malang, East Java were amon g troops deployed to central Cambodia as part of the United Nations' T ransition Authority Cambodia peace-keeping operation in 1992. Predeplo yment blood samples obtained from a cohort of Indonesian soldiers indi cated a high prevalence of antibodies to antigens of Rickettsia typhi or Orientia (formerly Rickettsia) tsutsugamushi, the etiologic agents for murine and scrub typhus, respectively. To evaluate the potential r isk of these rickettsial diseases in the Malang area, a subsequent ser oepidemiologic survey was conducted. This study involved civilian pers onnel residing within one of three Malang kelurahans (neighborhoods) r epresenting urban, suburban, and rural communities. The heads-of-house holds from 197 homes completed a detailed epidemiologic survey. In add ition, blood samples were collected from 464 individuals residing with in the households surveyed. Examination of civilian blood samples disc losed that 34.7% and 1.3% of the study participants were seroreactive to R. typhi and O. tsutsugamushi, respectively. These results were sim ilar to those obtained earlier from the military samples. In addition, assessment of 78 blood samples obtained from peridomestic rodents tra pped from within or near the households surveyed showed that 28 were r eactive to R. typhi antigens and four were reactive to O. tsutsugamush i antigens. These data indicate that military and civilian personnel l iving in the Malang area of East Java are at risk of infection with ri ckettsiae that are antigenically indistinguishable from those that cau se murine and scrub typhus.