An outbreak investigation of scrub typhus in Western Province, Solomon Islands, 2014
| Autor: | Elliot Puiahi, Jenny Longbottom, Alison Sio, Tenneth Dalipanda, Greg Jilini, Jennie Musto, Michael Marks, Cynthia Joshua, Katherine Longbottom, John Stenos |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Fever Non Theme Issue 030231 tropical medicine lcsh:Medicine Eschar Scrub typhus Disease cluster Disease Outbreaks 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine biology business.industry lcsh:Public aspects of medicine lcsh:R Outbreak lcsh:RA1-1270 Rickettsia Infections General Medicine bacterial infections and mycoses medicine.disease biology.organism_classification Virology Case definition outbreak investigation Spotted fever Rickettsia Scrub Typhus Melanesia rickettsial infections medicine.symptom business Typhus Outbreak Investigation Report |
| Zdroj: | Western Pacific Surveillance and Response Journal : WPSAR Western Pacific Surveillance and Response, Vol 7, Iss 1, Pp 6-9 (2016) |
| ISSN: | 2094-7313 2094-7321 |
| DOI: | 10.5365/wpsar.2015.6.3.007 |
| Popis: | Objective: To identify the etiology and risk factors of undifferentiated fever in a cluster of patients in Western Province, Solomon Islands, May 2014. Methods: An outbreak investigation with a case control study was conducted. A case was defined as an inpatient in one hospital in Western Province, Solomon Islands with high fever (> 38.5 °C) and a negative malaria microscopy test admitted between 1 and 31 May 2014. Asymptomatic controls matched with the cases residentially were recruited in a ratio of 1:2. Serum samples from the subjects were tested for rickettsial infections using indirect micro-immunofluorescence assay. Results: Nine cases met the outbreak case definition. All cases were male. An eschar was noted in five cases (55%), and one developed pneumonitis. We did not identify any environmental factors associated with illness. Serum samples of all five follow-up cases (100%) had strong-positive IgG responses to scrub typhus. All but one control (10%) had a moderate response against scrub typhus. Four controls had low levels of antibodies against spotted fever group rickettsia, and only one had a low-level response to typhus group rickettsia. Discussion: This outbreak represents the first laboratory-confirmed outbreak of scrub typhus in the Western Province of Solomon Islands. The results suggest that rickettsial infections are more common than currently recognized as a cause of an acute febrile illness. A revised clinical case definition for rickettsial infections and treatment guidelines were developed and shared with provincial health staff for better surveillance and response to future outbreaks of a similar kind. |
| Databáze: | OpenAIRE |
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