Seroprevalence of Scrub Typhus, Murine Typhus and Spotted Fever Group in North Korean Refugees.

Abstract Objectives The aim of this study was to investigate the seroprevalence of antibodies against scrub typhus, murine typhus, and spotted fever among North Korean refugees within one year of their defection. Methods We recruited North Korean refugees who had settled in South Korea after a short stay in a third country and did not have any health problems. The antibody titer was measured using a commercial indirect fluorescence assay immunoglobulin G antibody kit. Results The seroprevalence of antibodies against scrub typhus, murine typhus, and spotted fever among the 99 participants was 22.2%, 17.2%, and 10.1%, respectively, with 8.1% of participants testing positive for both spotted fever and murine typhus. Conclusions North Korean refugees may be exposed to rickettsial infections not only in North Korea but also during their journey out of North Korea. The present study is the first to report that the seroprevalence of antibodies against the three most common rickettsial diseases among North Korean refugees. These findings suggest that rickettsial infections should be added to the list of differential diagnoses for North Koreans with fever after entering South Korea.