SCRUB TYPHUS IN DUTCH NEW GUINEA

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Abstract
Ecological, epidemiological, clinical, laboratory and pathological studies were presented on a group of 1255 U. S. Army personnel with scrub typhus infection of a mild type. On Owi and Biak Islands, abandoned coconut groves and native gardens, corraline ridges, and margins of rain forests harbored rats and their parasitic mites, Trombicula fletcheri. The majority of cases occurred within a 3 month period with a peak incidence of 184 cases in 1 week. The causative agent of scrub typhus, Rickettsia orientalis, was isolated from patient''s blood by intraperit. inoculation in white mice. Cross immunity between these strains and those isolated elsewhere was demonstrated, but virulence for laboratory animals was considerably less. The patient mortality was 0.6%. The histopathological picture was the usual acute, generalized endangiitis, vasculitis, and perivasculitis which involved most of the organs of the body. The following clinical findings indicated the relative mildness of infection: Duration of fever[long dash]av. 13.7 days. Cough, bronchitis and pneumonitis[long dash]7.6%. Bronchopneumonia[long dash]1.3%. Central nervous system changes[long dash]4.1 %. Deafness[long dash]0.8%. Peripheral neuritis[long dash]0.2%. Eschar[long dash]51%. Rash[long dash]35%. Adenitis[long dash]97%. Headache[long dash]71%. Chills[long dash]6.8%. The Weil-Felix reaction showed a rising titre in convalescence and the average initial positive reaction occurred on the 8th to 10th day. These findings were compared with those of other writers.