Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015.
Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multi...
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ftdoajarticles:oai:doaj.org/article:068e202edd6b45cfa7af8fd95d4358c2 2023-05-15T15:16:30+02:00 Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. Kay M Tomashek Olga D Lorenzi Doris A Andújar-Pérez Brenda C Torres-Velásquez Elizabeth A Hunsperger Jorge Luis Munoz-Jordan Janice Perez-Padilla Aidsa Rivera Gladys E Gonzalez-Zeno Tyler M Sharp Renee L Galloway Mindy Glass Elrod Demetrius L Mathis M Steven Oberste W Allan Nix Elizabeth Henderson Jennifer McQuiston Joseph Singleton Cecilia Kato Carlos García Gubern William Santiago-Rivera Jesús Cruz-Correa Robert Muns-Sosa Juan D Ortiz-Rivera Gerson Jiménez Ivonne E Galarza Kalanthe Horiuchi Harold S Margolis Luisa I Alvarado 2017-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005859 https://doaj.org/article/068e202edd6b45cfa7af8fd95d4358c2 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5597097?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005859 https://doaj.org/article/068e202edd6b45cfa7af8fd95d4358c2 PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005859 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005859 2022-12-31T01:42:03Z Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, and clinical data and specimens were collected at enrollment and upon discharge or follow-up. Blood and oro-nasopharyngeal specimens were tested by RT-PCR and immunodiagnostic methods for infection with dengue viruses (DENV) 1-4, chikungunya virus (CHIKV), influenza A and B viruses (FLU A/B), 12 other respiratory viruses (ORV), enterovirus, Leptospira spp., and Burkholderia pseudomallei. Clinical presentation and laboratory findings of participants infected with DENV were compared to those infected with CHIKV, FLU A/B, and ORV. Clinical predictors of laboratory-positive dengue compared to all other AFI etiologies were determined by age and day post-illness onset (DPO) at presentation. Of 8,996 participants enrolled from May 7, 2012 through May 6, 2015, more than half (54.8%, 4,930) had a pathogen detected. Pathogens most frequently detected were CHIKV (1,635, 18.2%), FLU A/B (1,074, 11.9%), DENV 1-4 (970, 10.8%), and ORV (904, 10.3%). Participants with DENV infection presented later and a higher proportion were hospitalized than those with other diagnoses (46.7% versus 27.3% with ORV, 18.8% with FLU A/B, and 11.2% with CHIKV). Predictors of dengue in participants presenting <3 DPO included leukopenia, thrombocytopenia, headache, eye pain, nausea, and dizziness, while negative predictors were irritability and rhinorrhea. Predictors of dengue in participants presenting 3-5 DPO were leukopenia, thrombocytopenia, facial/neck erythema, nausea, eye pain, signs of poor circulation, and diarrhea; presence of rhinorrhea, cough, and red conjunctiva predicted non-dengue ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 9 e0005859 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Kay M Tomashek Olga D Lorenzi Doris A Andújar-Pérez Brenda C Torres-Velásquez Elizabeth A Hunsperger Jorge Luis Munoz-Jordan Janice Perez-Padilla Aidsa Rivera Gladys E Gonzalez-Zeno Tyler M Sharp Renee L Galloway Mindy Glass Elrod Demetrius L Mathis M Steven Oberste W Allan Nix Elizabeth Henderson Jennifer McQuiston Joseph Singleton Cecilia Kato Carlos García Gubern William Santiago-Rivera Jesús Cruz-Correa Robert Muns-Sosa Juan D Ortiz-Rivera Gerson Jiménez Ivonne E Galarza Kalanthe Horiuchi Harold S Margolis Luisa I Alvarado Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, and clinical data and specimens were collected at enrollment and upon discharge or follow-up. Blood and oro-nasopharyngeal specimens were tested by RT-PCR and immunodiagnostic methods for infection with dengue viruses (DENV) 1-4, chikungunya virus (CHIKV), influenza A and B viruses (FLU A/B), 12 other respiratory viruses (ORV), enterovirus, Leptospira spp., and Burkholderia pseudomallei. Clinical presentation and laboratory findings of participants infected with DENV were compared to those infected with CHIKV, FLU A/B, and ORV. Clinical predictors of laboratory-positive dengue compared to all other AFI etiologies were determined by age and day post-illness onset (DPO) at presentation. Of 8,996 participants enrolled from May 7, 2012 through May 6, 2015, more than half (54.8%, 4,930) had a pathogen detected. Pathogens most frequently detected were CHIKV (1,635, 18.2%), FLU A/B (1,074, 11.9%), DENV 1-4 (970, 10.8%), and ORV (904, 10.3%). Participants with DENV infection presented later and a higher proportion were hospitalized than those with other diagnoses (46.7% versus 27.3% with ORV, 18.8% with FLU A/B, and 11.2% with CHIKV). Predictors of dengue in participants presenting <3 DPO included leukopenia, thrombocytopenia, headache, eye pain, nausea, and dizziness, while negative predictors were irritability and rhinorrhea. Predictors of dengue in participants presenting 3-5 DPO were leukopenia, thrombocytopenia, facial/neck erythema, nausea, eye pain, signs of poor circulation, and diarrhea; presence of rhinorrhea, cough, and red conjunctiva predicted non-dengue ... |
format |
Article in Journal/Newspaper |
author |
Kay M Tomashek Olga D Lorenzi Doris A Andújar-Pérez Brenda C Torres-Velásquez Elizabeth A Hunsperger Jorge Luis Munoz-Jordan Janice Perez-Padilla Aidsa Rivera Gladys E Gonzalez-Zeno Tyler M Sharp Renee L Galloway Mindy Glass Elrod Demetrius L Mathis M Steven Oberste W Allan Nix Elizabeth Henderson Jennifer McQuiston Joseph Singleton Cecilia Kato Carlos García Gubern William Santiago-Rivera Jesús Cruz-Correa Robert Muns-Sosa Juan D Ortiz-Rivera Gerson Jiménez Ivonne E Galarza Kalanthe Horiuchi Harold S Margolis Luisa I Alvarado |
author_facet |
Kay M Tomashek Olga D Lorenzi Doris A Andújar-Pérez Brenda C Torres-Velásquez Elizabeth A Hunsperger Jorge Luis Munoz-Jordan Janice Perez-Padilla Aidsa Rivera Gladys E Gonzalez-Zeno Tyler M Sharp Renee L Galloway Mindy Glass Elrod Demetrius L Mathis M Steven Oberste W Allan Nix Elizabeth Henderson Jennifer McQuiston Joseph Singleton Cecilia Kato Carlos García Gubern William Santiago-Rivera Jesús Cruz-Correa Robert Muns-Sosa Juan D Ortiz-Rivera Gerson Jiménez Ivonne E Galarza Kalanthe Horiuchi Harold S Margolis Luisa I Alvarado |
author_sort |
Kay M Tomashek |
title |
Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
title_short |
Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
title_full |
Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
title_fullStr |
Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
title_full_unstemmed |
Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. |
title_sort |
clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, puerto rico, 2012-2015. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005859 https://doaj.org/article/068e202edd6b45cfa7af8fd95d4358c2 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005859 (2017) |
op_relation |
http://europepmc.org/articles/PMC5597097?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005859 https://doaj.org/article/068e202edd6b45cfa7af8fd95d4358c2 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005859 |
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PLOS Neglected Tropical Diseases |
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container_start_page |
e0005859 |
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