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Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019
BACKGROUND: Southern China is at risk for arborvirus disease transmission, including Zika virus and dengue. Patients often present to clinical care with non-specific acute febrile illnesses (AFI). To better describe the etiology of AFI, we implemented a two-year AFI surveillance project at five sent...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239456/ https://www.ncbi.nlm.nih.gov/pubmed/35763515 http://dx.doi.org/10.1371/journal.pone.0270586 |
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author | Rainey, Jeanette J. Siesel, Casey Guo, Xiafang Yi, Lina Zhang, Yuzhi Wu, Shuyu Cohen, Adam L. Liu, Jie Houpt, Eric Fields, Barry Yang, Zhonghua Ke, Changwen |
author_facet | Rainey, Jeanette J. Siesel, Casey Guo, Xiafang Yi, Lina Zhang, Yuzhi Wu, Shuyu Cohen, Adam L. Liu, Jie Houpt, Eric Fields, Barry Yang, Zhonghua Ke, Changwen |
author_sort | Rainey, Jeanette J. |
collection | PubMed |
description | BACKGROUND: Southern China is at risk for arborvirus disease transmission, including Zika virus and dengue. Patients often present to clinical care with non-specific acute febrile illnesses (AFI). To better describe the etiology of AFI, we implemented a two-year AFI surveillance project at five sentinel hospitals in Yunnan and Guangdong Provinces. METHODS: Between June 2017 and August 2019, we enrolled patients between 2 and 65 years of age presenting at one sentinel hospital in Mengla County, Yunnan, and four in Jiangmen City, Guangdong, with symptoms of AFI (acute onset of fever ≥ 37.5°C within the past 7 days) without respiratory symptoms or diarrhea. Demographic, epidemiologic, and clinical information was obtained and entered into a web-based AFI surveillance database. A custom TaqMan Array card (TAC) was used to test patients’ whole blood specimens for 27 different pathogens using real-time polymerase chain reaction assays. RESULTS: During the two-year project period, 836 patients were enrolled; 443 patients from Mengla County and 393 patients from Jiangmen City. The median age was 33 years [range: 2–65], and most were hospitalized [641, 77%]. Of 796 patients with valid TAC results, 341 (43%) were positive for at least one of the 10 unique pathogens detected. This included 205 (26%) patients positive for dengue virus, 60 (8%) for Orientia tsutsugamushi, and 42 (5%) for Coxiella burnetii. Ten patients (1%) in Jiangmen City tested positive for malaria, 8 of whom reported recent travel outside of China. TAC results were negative for 455 (57%) patients. None of the patients had a positive TAC detection for Zika virus. CONCLUSIONS: The project detected variability in the etiology of AFI in Southern China and highlighted the importance of differential diagnosis. Dengue, O. tsutsugamushi, and C. burnetii were the most frequently identified pathogens among enrolled AFI patients. As a non-notifiable disease, the frequent detection of C. burnetii is noteworthy and warrants additional investigation. The project provided a framework for routine surveillance for persons presenting with AFI. |
format | Online Article Text |
id | pubmed-9239456 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-92394562022-06-29 Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 Rainey, Jeanette J. Siesel, Casey Guo, Xiafang Yi, Lina Zhang, Yuzhi Wu, Shuyu Cohen, Adam L. Liu, Jie Houpt, Eric Fields, Barry Yang, Zhonghua Ke, Changwen PLoS One Research Article BACKGROUND: Southern China is at risk for arborvirus disease transmission, including Zika virus and dengue. Patients often present to clinical care with non-specific acute febrile illnesses (AFI). To better describe the etiology of AFI, we implemented a two-year AFI surveillance project at five sentinel hospitals in Yunnan and Guangdong Provinces. METHODS: Between June 2017 and August 2019, we enrolled patients between 2 and 65 years of age presenting at one sentinel hospital in Mengla County, Yunnan, and four in Jiangmen City, Guangdong, with symptoms of AFI (acute onset of fever ≥ 37.5°C within the past 7 days) without respiratory symptoms or diarrhea. Demographic, epidemiologic, and clinical information was obtained and entered into a web-based AFI surveillance database. A custom TaqMan Array card (TAC) was used to test patients’ whole blood specimens for 27 different pathogens using real-time polymerase chain reaction assays. RESULTS: During the two-year project period, 836 patients were enrolled; 443 patients from Mengla County and 393 patients from Jiangmen City. The median age was 33 years [range: 2–65], and most were hospitalized [641, 77%]. Of 796 patients with valid TAC results, 341 (43%) were positive for at least one of the 10 unique pathogens detected. This included 205 (26%) patients positive for dengue virus, 60 (8%) for Orientia tsutsugamushi, and 42 (5%) for Coxiella burnetii. Ten patients (1%) in Jiangmen City tested positive for malaria, 8 of whom reported recent travel outside of China. TAC results were negative for 455 (57%) patients. None of the patients had a positive TAC detection for Zika virus. CONCLUSIONS: The project detected variability in the etiology of AFI in Southern China and highlighted the importance of differential diagnosis. Dengue, O. tsutsugamushi, and C. burnetii were the most frequently identified pathogens among enrolled AFI patients. As a non-notifiable disease, the frequent detection of C. burnetii is noteworthy and warrants additional investigation. The project provided a framework for routine surveillance for persons presenting with AFI. Public Library of Science 2022-06-28 /pmc/articles/PMC9239456/ /pubmed/35763515 http://dx.doi.org/10.1371/journal.pone.0270586 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Rainey, Jeanette J. Siesel, Casey Guo, Xiafang Yi, Lina Zhang, Yuzhi Wu, Shuyu Cohen, Adam L. Liu, Jie Houpt, Eric Fields, Barry Yang, Zhonghua Ke, Changwen Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title_full | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title_fullStr | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title_full_unstemmed | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title_short | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
title_sort | etiology of acute febrile illnesses in southern china: findings from a two-year sentinel surveillance project, 2017–2019 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239456/ https://www.ncbi.nlm.nih.gov/pubmed/35763515 http://dx.doi.org/10.1371/journal.pone.0270586 |
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