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....
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2020
|
| _version_ | 1797050809119145984 |
|---|---|
| author | Grigg, MJ William, T Clemens, EG Patel, K Chandna, A Wilkes, CS Barber, BE Anstey, NM Dumler, JS Yeo, TW Reller, ME |
| author_facet | Grigg, MJ William, T Clemens, EG Patel, K Chandna, A Wilkes, CS Barber, BE Anstey, NM Dumler, JS Yeo, TW Reller, ME |
| author_sort | Grigg, MJ |
| collection | OXFORD |
| 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 | 2024-03-06T18:10:41Z |
| format | Journal article |
| id | oxford-uuid:02e9fc1c-6991-4ba3-8dad-5cf054707c21 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:10:41Z |
| publishDate | 2020 |
| publisher | Centers for Disease Control and Prevention |
| record_format | dspace |
| spelling | oxford-uuid:02e9fc1c-6991-4ba3-8dad-5cf054707c212022-03-26T08:43:20ZRickettsioses as major etiologies of unrecognized acute febrile illness, Sabah, East MalaysiaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:02e9fc1c-6991-4ba3-8dad-5cf054707c21EnglishSymplectic ElementsCenters for Disease Control and Prevention2020Grigg, MJWilliam, TClemens, EGPatel, KChandna, AWilkes, CSBarber, BEAnstey, NMDumler, JSYeo, TWReller, MEOrientia 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. |
| spellingShingle | Grigg, MJ William, T Clemens, EG Patel, K Chandna, A Wilkes, CS Barber, BE Anstey, NM Dumler, JS Yeo, TW Reller, ME Rickettsioses as major etiologies of unrecognized acute febrile illness, Sabah, East Malaysia |
| 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 |
| work_keys_str_mv | AT griggmj rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT williamt rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT clemenseg rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT patelk rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT chandnaa rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT wilkescs rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT barberbe rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT ansteynm rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT dumlerjs rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT yeotw rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia AT rellerme rickettsiosesasmajoretiologiesofunrecognizedacutefebrileillnesssabaheastmalaysia |