Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia

Grigg, Matthew J.; William, Timothy; Clemens, Emily G.; Patel, Kaajal; Chandna, Arjun; Wilkes, Christopher S.; Barber, Bridget E.; Anstey, Nicholas M.; Dumler, J. Stephen; Yeo, Tsin W.; Reller, Megan E.

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Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia

Published Date:

Jul 2020

Source:

Emerg Infect Dis. 26(7):1409-1419

Language:

English

[PDF-2.09 MB]

Details:

Alternative Title:

Emerg Infect Dis

Personal Author:

Grigg, Matthew J. ; William, Timothy ; Clemens, Emily G. ; Patel, Kaajal ; Chandna, Arjun ; ... More ▼

Description:

Orientia tsutsugamushi, spotted fever group rickettsioses, and typhus group rickettsioses (TGR) are reemerging causes of acute febrile illness (AFI) in Southeast Asia. To further delineate extent, we enrolled patients >4 weeks of age with nonmalarial AFI in Sabah, Malaysia, during 2013-2015. We confirmed rickettsioses (past or acute, IgG titer >160) in 126/354 (36%) patients. We confirmed acute rickettsioses (paired 4-fold IgG titer rise to >160) in 38/145 (26%) patients: 23 O. tsutsugamushi, 9 spotted fever group, 4 TGR, 1 O. tsutsugamushi/spotted fever group, and 1 O. tsutsugamushi/TGR. PCR results were positive in 11/319 (3%) patients. Confirmed rickettsioses were more common in male adults; agricultural/plantation work and recent forest exposure were risk factors. Dizziness and acute hearing loss but not eschars were reported more often with acute rickettsioses. Only 2 patients were treated with doxycycline. Acute rickettsioses are common (>26%), underrecognized, and untreated etiologies of AFI in East Malaysia; empirical doxycycline treatment should be considered.

Subject:

[+]

Pubmed ID:

32568664

Pubmed Central ID:

PMC7323546

Document Type:

Journal Article

Place as Subject:

Malaysia

Collection(s):

Emerging Infectious Diseases

Main Document Checksum:

[+]

Supporting Files:

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