Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 1;119(4):338-345.
doi: 10.1093/trstmh/traf017.

History of scrub typhus in Indonesia

Kartika Saraswati  1   2   3   4 , J Kevin Baird  1   3 , Stuart D Blacksell  2   3 , Marlous L Grijsen  1   3 , Nicholas P J Day  2   3
Affiliations
Review

History of scrub typhus in Indonesia

Kartika Saraswati et al. Trans R Soc Trop Med Hyg. .

Abstract

Scrub typhus is a common but underrecognized cause of fever in the Asia-Pacific region. This review is the first to examine the history of scrub typhus in the context of notable historical events in Indonesia. Scrub typhus was first observed in 1902 and has since been documented through colonial and modern times. However, the available evidence is sparse. This lack of data is influenced by wider factors, including geopolitical climate and socio-economic factors. During the colonial era and World War II, research focused on economic and military interests. There were research gaps during the unstable period following independence in 1945. More research commenced only in the 1970s, mainly under the auspices of the Ministry of Health. Since 2000, there have been sporadic attempts to study scrub typhus on several major islands (Java, Sumatra, Sulawesi, Borneo, Bali). We found 51 relevant articles documenting the presence of the pathogen and its vectors, with only a single case confirmed with standard laboratory testing. This lack of data, combined with low awareness and diagnostic capacity, makes it difficult for policymakers to appreciate the impact of scrub typhus. Indonesia needs sustainable and continuous surveillance systems, infrastructure and research funding to ensure diseases of public health importance are not neglected.

Keywords: Orientia; Indonesia; history; scrub typhus; tsutsugamushi.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Wilhelm August Paul Schüffner. Source: Wellcome Collection 578821i (Public Domain Mark)
Figure 2.
Figure 2.
The Senembah Company Hospital at the tobacco plantation of Tanjung Morawa. Source: Tropenmuseum, CC BY-SA 3.0, via Wikimedia Commons
Figure 3.
Figure 3.
Map of Indonesia with provinces named and relevant locations referred to in the text annotated. The locations of interest are represented with red triangles. The base layer used to create this map was modified from the UN Food and Agriculture Organisation's Global Administrative Unit Layers., Deli Serdang is the current district name of the area that includes old Deli. NTB: Nusa Tenggara Barat (West Nusa Tenggara); NTT: Nusa Tenggara Timur (East Nusa Tenggara).
Figure 4.
Figure 4.
Workers clearing the overgrown area within the plantation. Source: Walch and Keukenschrijver, Geneeskundig Tijdschrift voor Nederlandsche Indie 1924, Vol. 64, Issue 2, page: 250–251
Figure 5.
Figure 5.
David Dennis and Soeroto Atmosoedjono (NAMRU-2 Jakarta) pictured during field investigation of scrub typhus vector. Photograph courtesy of David Dennis.
Figure 6.
Figure 6.
Tuti Hadi, pioneering Indonesian acarologist, pictured in her office. Photograph courtesy of Lenny Ekawati
See this image and copyright information in PMC

References

    1. Saraswati K, Elliott I, Day NPJ et al. Geographical distribution of scrub typhus and risk of Orientia tsutsugamushi infection in Indonesia: evidence mapping. PLoS Negl Trop Dis. 2023;17(9):e0011412. - PMC - PubMed
    1. Schüffner W. Pseudotyphoid fever in Deli, Sumatra (a variety of Japanese Kedani fever). Philipp J Sci. 1915;10(5):345–53.
    1. Schüffner W. Verslag der vergadering van de Afdeeling Sumatra's Oostkust der Vereeniging tot Bevordering der Geneeskundige Wetenschappen in Ned.-lndië. Geneeskundig tijdschrift voor Nederlandsch Indie. 1909;49:64.
    1. Walch E, Keukenschrijver NC. Eenige opmerkingen aangaande de Epidemiologie van de Pseudotyphus. Geneeskundig Tijdschrift voor Nederlandsche Indie. 1924;64(2):247–76.
    1. Wellcome Collection . Wilhelm Schüffner. Photograph. Available from: https://wellcomecollection.org/works/vk6t2jdh [accessed 26 January 2021].