TY - JOUR
T1 - Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh
AU - Kingston, Hugh W.
AU - Hossain, Mosharraf
AU - Leopold, Stije
AU - Anantatat, Tippawan
AU - Tanganuchitcharnchai, Ampai
AU - Sinha, Ipsita
AU - Plewes, Katherine
AU - Maude, Richard J.
AU - Hassan Chowdhury, M. A.
AU - Paul, Sujat
AU - Uddin, Rabiul Alam Mohammed Erfan
AU - Siddiqui, Mohammed Abu Naser
AU - Zahed, Abu Shahed Md
AU - Sayeed, Abdullah Abu
AU - Rahman, Mohammed Habibur
AU - Barua, Anupam
AU - Uddin, Mohammed Jasim
AU - Sattar, Mohammed Abdus
AU - Dondorp, Arjen M.
AU - Blacksell, Stuart D.
AU - Day, Nicholas P.J.
AU - Ghose, Aniruddha
AU - Hossain, Amir
AU - Paris, Daniel H.
PY - 2018/4
Y1 - 2018/4
N2 - We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies.
AB - We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies.
UR - http://www.scopus.com/inward/record.url?scp=85044246696&partnerID=8YFLogxK
U2 - 10.3201/eid2404.170190
DO - 10.3201/eid2404.170190
M3 - Article
C2 - 29553921
AN - SCOPUS:85044246696
VL - 24
SP - 638
EP - 645
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
SN - 1080-6040
IS - 4
ER -