Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia
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 c...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2020-07-01
|
| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/26/7/19-1722_article |
| _version_ | 1818454941215227904 |
|---|---|
| author | Matthew J. Grigg Timothy William Emily G. Clemens Kaajal Patel Arjun Chandna Christopher S. Wilkes Bridget E. Barber Nicholas M. Anstey J. Stephen Dumler Tsin W. Yeo Megan E. Reller |
| author_facet | Matthew J. Grigg Timothy William Emily G. Clemens Kaajal Patel Arjun Chandna Christopher S. Wilkes Bridget E. Barber Nicholas M. Anstey J. Stephen Dumler Tsin W. Yeo Megan E. Reller |
| author_sort | Matthew J. Grigg |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-14T22:02:52Z |
| format | Article |
| id | doaj.art-142b02aab77340f3a0aedc41366918d7 |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-14T22:02:52Z |
| publishDate | 2020-07-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-142b02aab77340f3a0aedc41366918d72022-12-21T22:45:55ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592020-07-012671409141910.3201/eid2607.191722Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East MalaysiaMatthew J. GriggTimothy WilliamEmily G. ClemensKaajal PatelArjun ChandnaChristopher S. WilkesBridget E. BarberNicholas M. AnsteyJ. Stephen DumlerTsin W. YeoMegan E. RellerOrientia 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.https://wwwnc.cdc.gov/eid/article/26/7/19-1722_articlerickettsiosesacute febrile illnessSabahEast MalaysiaOrientia tsutsugamushispotted-fever group rickettsiosis |
| spellingShingle | Matthew J. Grigg Timothy William Emily G. Clemens Kaajal Patel Arjun Chandna Christopher S. Wilkes Bridget E. Barber Nicholas M. Anstey J. Stephen Dumler Tsin W. Yeo Megan E. Reller Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia Emerging Infectious Diseases rickettsioses acute febrile illness Sabah East Malaysia Orientia tsutsugamushi spotted-fever group rickettsiosis |
| title | Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia |
| title_full | Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia |
| title_fullStr | Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia |
| title_full_unstemmed | Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia |
| title_short | Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia |
| title_sort | rickettsioses as major etiologies of unrecognized acute febrile illness sabah east malaysia |
| topic | rickettsioses acute febrile illness Sabah East Malaysia Orientia tsutsugamushi spotted-fever group rickettsiosis |
| url | https://wwwnc.cdc.gov/eid/article/26/7/19-1722_article |
| work_keys_str_mv | AT matthewjgrigg rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT timothywilliam rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT emilygclemens rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT kaajalpatel rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT arjunchandna rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT christopherswilkes rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT bridgetebarber rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT nicholasmanstey rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT jstephendumler rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT tsinwyeo rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT meganereller rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia |