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- Title
Rickettsial Illnesses as Important Causes of Febrile Illness in Chittagong, Bangladesh.
- Authors
Kingston, Hugh W.; Hossain, Mosharraf; Leopold, Stije; Anantatat, Tippawan; Tanganuchitcharnchai, Ampai; Sinha, Ipsita; Plewes, Katherine; Maude, Richard J.; Chowdhury, M. A. Hassan; Paul, Sujat; Erfan Uddin, Rabiul Alam Mohammed; Siddiqui, Mohammed Abu Naser; Zahed, Abu Shahed; Sayeed, Abdullah Abu; Rahman, Mohammed Habibur; Barua, Anupam; Uddin, Mohammed Jasim; Sattar, Mohammed Abdus; Dondorp, Arjen M.; Blacksell, Stuart D.
- Abstract
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.
- Subjects
CHITTAGONG (Bangladesh); RICKETTSIAL diseases; NUCLEOTIDE sequencing; TSUTSUGAMUSHI disease; ENDEMIC flea-borne typhus; PATHOGENIC microorganisms
- Publication
Emerging Infectious Diseases, 2018, Vol 24, Issue 4, p638
- ISSN
1080-6040
- Publication type
journal article
- DOI
10.3201/eid2404.170190