A survey of scrub and murine typhus in the Ancol section of Jakarta, Indonesia.

Rickettsia tsutsugamushi was isolated from L. (L.) arenicola chiggers and three species of rats in an area of scrub and sedge along the Bay of Jakarta. This is the only finding in Indonesia of a cycle of the agent of scrub typhus associated with L. (L.) arenicola. A serologic survey of nearly 300 persons living in two kampungs near the site at which rickettsiae were recovered revealed one individual with antibodies to R. tsutsugamushi. Murine typhus, with a seropositivity rate of 6.5%, may be endemic at low levels.

Intestinal and blood parasites in the Torro Valley, Central Sulawesi, Indonesia.

Approximately 300 blood and fecal specimens were examined in a parasitologic survey of indigenous inhabitants of the small isolated Torro Valley in the mountains of Central Sulawesi. Schistosoma japonicum was not found although the parasite is endemic in the neighboring Lindu and Napu valleys. Hookworm infection (71%) was the most common helminthiasis. The prevalences of ascariasis (3%) and trichuriasis (2%) are low for Indonesia in general but similar to those found in nearby mountainous areas of Sulawesi. Intestinal protozoa endemic to the area are: Entamoeba histolytica (8%). E. coli (23%). Endolimax nana (9%), Iodamoeba butschii (9%) and Giardia lamblia (14%). Plasmodium vivax infections were found in 4% and P. falciparum in 2% of persons examined. Brugia malayi microfilaremia was found with a prevalence of 25%. The high rate of splenic (54%) and hepatic (22%) enlargement found on examination of 206 persons of all ages is considered to be a result of combined effects of endemic malaria and hereditary ovalocytosis.

Scrub typhus survey of Biak and Owi islands: ectoparasites of small mammals and rickettsial isolations.

A survey of smnall mammals and their ectoparasites was conducted on the islands of Biak and Owi, Indonesia, in August 1976. Two species of chiggers known to serve as vectors of scrub typhus were found: Leptotrombidium (Leptotrombidium) deliense from Rattus exulans, R. ruber, and R. r. septicus; L. (L.) flectcheri from R. exulans, R. leucopus and R. r. septicus. Rickettsia tsutsugamushi was isolated from the spleens of R. exulans and R. r. septicus. The favored ecotype of the chigger and rat hosts of R. tsutsugamushi appeared to be coarse, low-lying native vegetation on a porous coralline soil. These and similar nearby coral islands should be considered high risk areas for scrub typhus.

Intestinal and blood parasites of man on Alor Island Southeast Indonesia.

A survey of blood and intestinal parasites in a coastal and a mountainous area of the remote island of Alor, southeastern Indonesia revealed widespread infection with pathogenic intestinal protozoa and helminths, malaria and filaria. Amoebiasis (31.2%), ascariasis (35.3%) and hookworm infections (28.6%) were common, reflecting primitive sanitation and hygiene. Trichuriasis rates (6.8%) were less than expected perhaps due to the prolonged dry season and soil factors in the area. Timor filariasis was found in coastal villagers (10.5%), but not in persons living at an elevation of 500 meters; a low rate of bancroftian filariasis (1.8%) was found in both areas. Malaria, caused by P. vivax, P. falciparum and P. malariae was mesoendemic. Soil-transmitted and vector-borne parasitic infections are an important health problem in the populations examined.

Electrocardiographic changes in scrub typhus patients.

Ninety-eight cases of scrub typhus were examined electrocardiographically. Various findings beyond the normal range were as follows: In the febrile stage, sinus arrhythmia with some beats below 60 per minute, flat or low T waves in the left precordial leads, sinus tachycardia, ST segment elevation of 4-l mm in V2, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, incomplete right bundle branch block, T wave inversion in V3-4, first degree A-V block, Q-Tc interval prolongation, notched T waves in V3, AV junctional escapes, prominent Ta waves or depression of PR segments in V2, and right axis deviation; in the convalescent stage, sinus arrhythmia with some beats below 60 per minute, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, flat or low T waves in the left precordial leads, incomplete right bundle branch block, sinus tachycardia, first degree A-V block, Q-Tc interval prolongation, T wave inversion in V3-4, ST segment elevation of 4 mm in amplitude in V2, ventricular premature contractions, atrial premature contractions, and right axis deviation. In comparison with the electrocardiographic findings in 101 asymptomatic normal subjects, flat T waves in the precordial leads, tall and peaked T waves in V2-4 in both acute and convalescent stages, and sinus arrhythmia with some beats below 60 per minute in the convalescent stage were more frequent in cases. Electrocardiographic abnormalities were present most commonly in the acute illness, and our findings support the impression that, with few exceptions, prompt treatment of scrub typhus with antibiotics prevents the serious cardiac complications seen prior to the antibiotic era.

Brugia timori: experimental infection in some laboratory animals.

Experimental infection with Brugia timori of 7 jirds (Merionesunguiculatus), 4 cats and 2 monkeys (Macaca fascicularis) is described. Although no microfilariae were detected by examining 20 microliter samples of tail blood of jirds, adult worms were recovered from 6 of the 7 jirds at autopsy 69-141 days following infection. Some worms were gravid and microfilariae were found in visceral blood of 2 animals. The adult recovery rate in jirds was 16%; the male to female ratio was 1:3. In cats patent infection developed in 95-105 days but microfilaraemias were of low level and transient. No parasites were recovered from monkeys.