Volume 27, Number 2—February 2021
Dispatch
Murine Typhus in Canary Islands, Spain, 1999–2015
José María Robaina-Bordón, Cristina Carranza-Rodríguez, Michele Hernández-Cabrera, Margarita Bolaños-Rivero, Elena Pisos-Álamo, Nieves Jaén-Sánchez, Araceli Hernández-Betancor, Laura Suárez-Hormiga, and José Luis Pérez-Arellano
Table 1
Clinical findings for patients with cases of endemic murine typhus, Canary Islands, Spain, 1999–2015
| Finding | Total, no. (%) | IgM >1:1,280, no. (%)* | 4-fold IgG titer increase, no. (%)† | p-value |
|---|---|---|---|---|
| Symptom or sign | ||||
| Headache, n = 206 | 181 (87.9) | 59 (88.1) | 122 (87.8) | 0.95 |
| Sweating, n = 175 | 129 (73.7) | 44 (74.6) | 85 (73.3) | 0.85 |
| Myalgias, n = 186 | 135 (72.6) | 39 (65) | 96 (76.2) | 0.11 |
| Nausea/vomiting, n = 206 | 103 (50) | 32 (47.8) | 71 (51.1) | 0.66 |
| Dry cough, n = 200 | 79 (39.5) | 23 (36.5) | 56 (40.9) | 0.56 |
| Rash, n = 211 | 56 (26.5) | 14 (21.2) | 36 (25.2) | 0.53 |
| Abdominal pain, n = 200 | 45 (22.5) | 15 (22.7) | 30 (22.4) | 0.96 |
| Classic triad, n = 201‡ | 46 (22.9) | 14 (21.5) | 32 (23.5) | 0.75 |
| Conjunctivitis, n = 201 | 41 (20.4) | 12 (18.8) | 29 (21.2) | 0.69 |
| Diarrhea, n = 221 | 41 (18.6) | 11 (15.3) | 30 (20.1) | 0.38 |
| Odynophagia, n = 182 | 24 (13.2) | 16 (13.1) | 8 (13.3) | 0.97 |
| Tachycardia, n = 164 | 75 (45.7) | 28 (54.9) | 47 (41.6) | 0.11 |
| Hepatomegaly, n = 209 | 37 (17.7) | 12 (17.9) | 25 (17.6) | 0.96 |
| Relative bradycardia, n = 162§ | 21 (13) | 3 (5.9) | 18 (16.2) | 0.07 |
| Pharyngitis, n = 189 | 19 (10.1) | 8 (12.7) | 11 (8.7) | 0.39 |
| Lymphadenopathy, n = 198 | 16 (8.1) | 10 (15.6) | 6 (4.5) | 0.01 |
| Splenomegaly, n = 209 | 17 (8.1) | 5 (7.5) | 12 (8.5) | 0.81 |
| Altered pulmonary auscultation, n = 210 | 17 (8.1) | 7 (10.3) | 10 (7) | 0.42 |
| Flea bite, n = 93 | 6 (6.5) | 0 (0) | 6 (9.4) | 0.17 |
| Costovertebral angle tenderness, n = 199 | 11 (5.5) | 6 (9.2) | 5 (3.7) | 0.18 |
| Jaundice, n = 210 | 11 (5.2) | 4 (5.9) | 7 (4.9) | 0.75 |
*Patients given a diagnosis by testing of 1 sample (criterion 1). †Patients given a diagnosis by testing of 2 consecutive samples (criterion 2). ‡Fever, headache and rash. §Temperature >38.9°C and heart rate <110 beats/min in the absence of treatment with β-blockers.
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