Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019
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 hospita...
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| description | 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. 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 [greater than or equal to] 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. 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. 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. |
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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. 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 [greater than or equal to] 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. 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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0270586</identifier><identifier>PMID: 35763515</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Acids ; Analysis ; Biology and Life Sciences ; Dengue ; Dengue fever ; Diagnosis ; Diagnostic tests ; Diarrhea ; Differential diagnosis ; Disease control ; Disease susceptibility ; Disease transmission ; Enrollments ; Epidemiology ; Etiology ; Fever ; Health care ; Health risks ; Hospitals ; Illnesses ; Malaria ; Medical diagnosis ; Medical laboratories ; Medicine and Health Sciences ; Mosquitoes ; Pathogens ; Patients ; Polymerase chain reaction ; Public health ; Risk factors ; Signs and symptoms ; Social Sciences ; Surveillance ; Tropical diseases ; Vector-borne diseases ; Viral infections ; Viruses ; Zika virus</subject><ispartof>PloS one, 2022-06, Vol.17 (6), p.e0270586-e0270586</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>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 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c618t-d209abecb3b278ee0da5b5973452986339a45dd31cee06ca956ee7dc42217b73</cites><orcidid>0000-0002-3175-8784 ; 0000-0003-3104-5685</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239456/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239456/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2930,23873,27931,27932,53798,53800</link.rule.ids></links><search><contributor>Lin, Baochuan</contributor><creatorcontrib>Rainey, Jeanette J</creatorcontrib><creatorcontrib>Siesel, Casey</creatorcontrib><creatorcontrib>Guo, Xiafang</creatorcontrib><creatorcontrib>Yi, Lina</creatorcontrib><creatorcontrib>Zhang, Yuzhi</creatorcontrib><creatorcontrib>Wu, Shuyu</creatorcontrib><creatorcontrib>Cohen, Adam L</creatorcontrib><creatorcontrib>Liu, Jie</creatorcontrib><creatorcontrib>Houpt, Eric</creatorcontrib><creatorcontrib>Fields, Barry</creatorcontrib><creatorcontrib>Yang, Zhonghua</creatorcontrib><creatorcontrib>Ke, Changwen</creatorcontrib><title>Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019</title><title>PloS one</title><description>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. 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 [greater than or equal to] 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. 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. 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.</description><subject>Acids</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Dengue</subject><subject>Dengue fever</subject><subject>Diagnosis</subject><subject>Diagnostic tests</subject><subject>Diarrhea</subject><subject>Differential diagnosis</subject><subject>Disease control</subject><subject>Disease susceptibility</subject><subject>Disease transmission</subject><subject>Enrollments</subject><subject>Epidemiology</subject><subject>Etiology</subject><subject>Fever</subject><subject>Health care</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Illnesses</subject><subject>Malaria</subject><subject>Medical diagnosis</subject><subject>Medical laboratories</subject><subject>Medicine and Health Sciences</subject><subject>Mosquitoes</subject><subject>Pathogens</subject><subject>Patients</subject><subject>Polymerase chain 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of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019</title><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></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c618t-d209abecb3b278ee0da5b5973452986339a45dd31cee06ca956ee7dc42217b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acids</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Dengue</topic><topic>Dengue fever</topic><topic>Diagnosis</topic><topic>Diagnostic tests</topic><topic>Diarrhea</topic><topic>Differential diagnosis</topic><topic>Disease control</topic><topic>Disease susceptibility</topic><topic>Disease 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Yuzhi</au><au>Wu, Shuyu</au><au>Cohen, Adam L</au><au>Liu, Jie</au><au>Houpt, Eric</au><au>Fields, Barry</au><au>Yang, Zhonghua</au><au>Ke, Changwen</au><au>Lin, Baochuan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019</atitle><jtitle>PloS one</jtitle><date>2022-06-28</date><risdate>2022</risdate><volume>17</volume><issue>6</issue><spage>e0270586</spage><epage>e0270586</epage><pages>e0270586-e0270586</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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. 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 [greater than or equal to] 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. 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. 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>35763515</pmid><doi>10.1371/journal.pone.0270586</doi><tpages>e0270586</tpages><orcidid>https://orcid.org/0000-0002-3175-8784</orcidid><orcidid>https://orcid.org/0000-0003-3104-5685</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2686270172 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acids Analysis Biology and Life Sciences Dengue Dengue fever Diagnosis Diagnostic tests Diarrhea Differential diagnosis Disease control Disease susceptibility Disease transmission Enrollments Epidemiology Etiology Fever Health care Health risks Hospitals Illnesses Malaria Medical diagnosis Medical laboratories Medicine and Health Sciences Mosquitoes Pathogens Patients Polymerase chain reaction Public health Risk factors Signs and symptoms Social Sciences Surveillance Tropical diseases Vector-borne diseases Viral infections Viruses Zika virus |
| title | Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-05T05%3A42%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Etiology%20of%20acute%20febrile%20illnesses%20in%20Southern%20China:%20Findings%20from%20a%20two-year%20sentinel%20surveillance%20project,%202017%E2%80%932019&rft.jtitle=PloS%20one&rft.au=Rainey,%20Jeanette%20J&rft.date=2022-06-28&rft.volume=17&rft.issue=6&rft.spage=e0270586&rft.epage=e0270586&rft.pages=e0270586-e0270586&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0270586&rft_dat=%3Cgale_plos_%3EA708505549%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2686270172&rft_id=info:pmid/35763515&rft_galeid=A708505549&rft_doaj_id=oai_doaj_org_article_094e01ed05424dbea702b57db945da46&rfr_iscdi=true |