UNLABELLED: Singapore is a modern urban city and endemic typhus is thought to be a disease of the past. This may be due to lack of specific serological testing as indirect immunoperoxidase testing using specific rickettsial antigens (U.S. Army Medical Research Unit, Institute of Medical Research, Kuala Lumpur, Malaysia) has only recently become available. In the last fourteen months, twenty-one cases of endemic typhus were diagnosed in patients hospitalised for acute febrile illnesses at the National University Hospital. We conducted a case control study to define the clinical and laboratory features of endemic typhus in Singapore. METHOD: Demographic, clinical and laboratory data were reviewed for cases and twenty-one age and sex matched controls who had negative serologic tests as part of a work-up for fever of unknown origin. RESULTS: Apart from a higher initial temperature (39 degrees C vs 37.9 degrees C (p < 0.001)) and ALT(p = 0.002), cases and controls had similar presentations of fever, myalgia, headache, cough, normal WBC and platelet counts. Singapore residents and migrant workers were represented in both groups (p = ns). CONCLUSION: Endemic typhus remains an important cause of acute febrile illness in Singaporein both the local and migrant worker populations. The presentation is similar to other causes of acute febrile illnesses and the diagnosis will be missed unless it is specifically sought.
UNLABELLED: Singapore is a modern urban city and endemic typhus is thought to be a disease of the past. This may be due to lack of specific serological testing as indirect immunoperoxidase testing using specific rickettsial antigens (U.S. Army Medical Research Unit, Institute of Medical Research, Kuala Lumpur, Malaysia) has only recently become available. In the last fourteen months, twenty-one cases of endemic typhus were diagnosed in patients hospitalised for acute febrile illnesses at the National University Hospital. We conducted a case control study to define the clinical and laboratory features of endemic typhus in Singapore. METHOD: Demographic, clinical and laboratory data were reviewed for cases and twenty-one age and sex matched controls who had negative serologic tests as part of a work-up for fever of unknown origin. RESULTS: Apart from a higher initial temperature (39 degrees C vs 37.9 degrees C (p < 0.001)) and ALT(p = 0.002), cases and controls had similar presentations of fever, myalgia, headache, cough, normal WBC and platelet counts. Singapore residents and migrant workers were represented in both groups (p = ns). CONCLUSION: Endemic typhus remains an important cause of acute febrile illness in Singaporein both the local and migrant worker populations. The presentation is similar to other causes of acute febrile illnesses and the diagnosis will be missed unless it is specifically sought.
Authors: Rapeephan R Maude; Aniruddha Ghose; Rasheda Samad; Hanna K de Jong; Masako Fukushima; Lalith Wijedoru; Mahtab Uddin Hassan; Md Amir Hossain; Md Rezaul Karim; Abdullah Abu Sayeed; Stannie van den Ende; Sujat Pal; A S M Zahed; Wahid Rahman; Rifat Karnain; Rezina Islam; Dung Thi Ngoc Tran; Tuyen Thanh Ha; Anh Hong Pham; James I Campbell; H Rogier van Doorn; Richard J Maude; Tom van der Poll; W Joost Wiersinga; Nicholas P J Day; Stephen Baker; Arjen M Dondorp; Christopher M Parry; Md Abul Faiz Journal: BMC Infect Dis Date: 2016-10-13 Impact factor: 3.090
Authors: Rapeephan R Maude; Richard J Maude; Aniruddha Ghose; M Robed Amin; M Belalul Islam; Mohammad Ali; M Shafiqul Bari; M Ishaque Majumder; Ampai Tanganuchitcharnchai; Arjen M Dondorp; Daniel H Paris; Robin L Bailey; M Abul Faiz; Stuart D Blacksell; Nicholas P J Day Journal: Am J Trop Med Hyg Date: 2014-08-04 Impact factor: 2.345