U.S. Naval Medical Research Unit No. 2, Gatot Subroto Army Hospital, Jl. Abdulrachman Saleh No. 24, Directorate of Health, Army Headquarters, U.S. Naval Medical Research Institute, Walter Reed Army Institute of Research, Centers for Disease Control and Prevention, Jakarta, Indonesia
Indonesian peacekeepers in Cambodia provided a unique study population to estimate the threat of rickcttsial exposure to Rickettsia typhi (murine typhus), Orientia tsutsugamushi, (scrub typhus), and R. conorii (spotted fever) for the region. Prescreening prevalence measure showed a large proportion (36%) of soldiers with antibodies to R. typhi. Predeployment prevalence for antibodies to O. tsutsugamushi was 8%, with no evidence of background R. conorii infections. Actual seroconversions of R. typhi (3) and O. tsutsugamushi (1), attributed to exposure(s) in Cambodia, translated into annualized incidence rates of 24 and 8 per 1,000 per year, respectively. Surveillance of rickettsial infections and/or disease is particularly warranted in Cambodia with recent recognition of drug-resistant scrub typhus in neighboring Thailand.