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A hospital-based study was conducted along the Thai-Myanmar border to provide greater knowledge of the causes of febrile illness and to determine what zoonotic and vector-borne emerging infectious diseases might be present. A total of 613 adults were enrolled from June 1999 to March 2002. Cases were classified based on clinical findings and laboratory results. An etiologic diagnosis was made for 48% of subjects. Malaria was the most common diagnosis, accounting for 25% of subjects, with two-thirds Plasmodium falciparum. Serologic evidence for leptospirosis was found in 17% of subjects. Other etiologic diagnoses included rickettsial infections, dengue fever, and typhoid. The most frequent clinical diagnoses were nonspecific febrile illness, respiratory infections, and gastroenteritis. Clinical associations were generally not predictive of etiologic diagnosis. Apparent dual diagnoses were common, particularly for malaria and leptospirosis. Findings have been used to modify treatment of unspecified febrile illness in the area.
Received June 2, 2005. Accepted for publication July 14, 2005.
Acknowledgments: This study was supported by the Global Emerging Infectious Disease Program (GEIS) of the U.S. Department of Defense. We would like to thank the field team of the Department of Immunology, AFRIMS, and the many nurses, technicians, and support staff at KRCH, AFRIMS, and elsewhere who contributed to this project. Presented in part at the International Conference of Emerging Infectious Diseases, Atlanta, Georgia, July 16–19, 2000.
Disclaimer: The opinions reflected herein reflect those of the authors and do not necessarily reflect the official views of the U.S. Army or the U.S. Department of Defense.
* Address correspondence to Ruth D. Ellis, 2530 N. 24th Street, Arlington, VA 22207. E-mail: schwartzellis{at}hotmail.com
Authors’ addresses: Ruth D. Ellis, 2530 N. 24th Street, Arlington, VA 22207, Telephone: 703-350-1936, E-mail: schwartzellis{at}hotmail.com. Mark M. Fukuda, Nichapat Uthaimongkol, Nillawan Buathong, Sabaithip Sriwichai, Kritsanai Yingyuen, Chaiyawat Mathavarat, and Robert S. Miller, Department of Immunology and Medicine, Armed Forces Research Unit of Medical Sciences (AFRIMS), 315/6 Rajvithi Road, Bangkok 10400, Thailand. Ananda Nisalak, Department of Virology, AFRIMS, 315/6 Rajvithi Road, Bangkok 10400, Thailand. Rungnapha Phasuk, Department of Enterics, AFRIMS, 315/6 Rajvithi Road, Bangkok 10400, Thailand. Clinton K. Murray, Department of Medicine (MCHE-MDI), Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78216. Michael R. Gray, VETCOM Leptospirosis Reference Laboratory, Fort Sam Houston, TX 78216. Philip McDaniel and Katherine Welch, 2140 College Ave SE, Grand Rapids, MI 49507.
Reprint requests: Mark M. Fukuda, Department of Immunology and Medicine, Armed Forces Research Unit of Medical Sciences (AFRIMS), 315/6 Rajvithi Road, Bangkok 10400, Thailand, Telephone: 66-2-644-5775, Fax: 66-2-644-5775, E-mail: mark.fukuda{at}afrims.org.
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