TY - JOUR AU - Kingston, Hugh AU - Hossain, Mosharraf AU - Leopold, Stije AU - Anantatat, Tippawan AU - Tanganuchitcharnchai, Ampai AU - Sinha, Ipsita AU - Plewes, Katherine AU - Maude, Richard AU - Chowdhury, M.A. Hassan AU - Paul, Sujat AU - Uddin, Rabiul Alam Mohammed Erfan AU - Siddiqui, Mohammed Abu Naser AU - Zahed, Abu Shahed AU - Abu Sayeed, Abdullah AU - Rahman, Mohammed Habibur AU - Barua, Anupam AU - Uddin, Mohammed Jasim AU - Sattar, Mohammed Abdus AU - Dondorp, Arjen AU - Blacksell, Stuart AU - Day, Nicholas P.J. AU - Ghose, Aniruddha AU - Hossain, Amir AU - Paris, Daniel T1 - Rickettsial Illnesses as Important Causes of Febrile Illness in Chittagong, Bangladesh T2 - Emerging Infectious Disease journal PY - 2018 VL - 24 IS - 4 SP - 638 SN - 1080-6059 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. KW - Bangladesh KW - scrub typhus KW - murine typhus KW - rickettsia KW - Orientia tsutsugamushi KW - Rickettsia typhi KW - Rickettsia felis KW - undifferentiated febrile illness KW - rickettsial disease KW - vector-borne diseases KW - bacteria DO - 10.3201/eid2404.170190 UR - https://wwwnc.cdc.gov/eid/article/24/4/17-0190_article ER - End of Reference