Afifi S, Earhart K, Azab MA, Youssef FG, El Sakka H, Wasfy M, Mansour H, El Oun S, Rakha M, Mahoney F, 2005. Hospital-based surveillance for acute febrile illness in Egypt: a focus on community-acquired blood stream infection. Am J Trop Med Hyg 73 :392–399.
Crump JA, Youseff FG, Luby SP, Wasfy MO, Rangel JM, Taalat M, Oun S, Mahoney FJ, 2003. Estimating the incidence of typhoid fever and other febrile illnesses in developing countries. Emerg Infect Dis 9 :539–544.
Ismail T, Wasfy M, Abdul-Rahman B, Murray C, Hospenthal D, Abdel-Fadeel M, Abdel-Maksoud M, Samir A, Hatem M, Klena J, Pimentel G, El-Sayed N, Hajjeh R, 2006. Retrospective serosurvey of leptospirosis among acute febrile illness and hepatitis patients in Egypt. Am Soc Trop Med Hyg 75 :1085–1089.
Wongsrichanalai C, Murray CK, Gray M, Miller RS, McDaniel P, Liao WJ, Pickard AL, Magill AJ, 2003. Co-infection with malaria and leptospirosis. Am J Trop Med Hyg 68 :583–585.
Ravindran B, Sahoo PK, Dash AP, 1998. Lymphatic filariasis and malaria: concomitant parasitism in Orissa, India. Trans R Soc Trop Med Hyg 94 :310–314.
Levi GC, 1998. Management of opportunistic infections in HIV(+) patients: contrast between Europe and South America. Braz J Infect Dis 2 :118–127.
Kudesia G, Christie P, Walker E, Pinkerton I, Lloyd G, 1988. Dual infection with leptospira and hantavirus. Lancet 18 :1397.
World Health Organization, 1999. Recommended Surveillance Standards. Second edition. WHO/CDS/CSR/ISR/99.2. Available at: http://www.who.int/csr/resources/publications/surveillance/whocdscsrisr992.pdf. Geneva: WHO.
Weyant RS, Bragg SL, Kaufmann AF, 1999. Leptospira and Leptonema. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Youlken RH, eds. Manual of Clinical Microbiology. Seventh edition. Washington, D.C.: American Society for Microbiology, 739–745.
Fadeel MA, Wasfy MO, Pimentel G, Klena JD, Mahoney F, Hajjeh R, 2006. Rapid enzyme-linked immunosorbent assay for the diagnosis of human brucellosis in surveillance and clinical settings in Egypt. Saudi Med J 27 :975–981.
Palaniappan RU, Chang YF, Chang CF, Pan MJ, Yang CW, Harpending P, McDonough SP, Dubovi E, Divers T, Ou J, Roe B, 2005. Evaluation of lig-based conventional and real-time PCR for the detection of pathogenic leptospires. Mol Cell Probes 2 :111–117.
Richards AL, Soeatmadji DW, Widodo MA, Sardjono TW, Yanuwiadi B, Hernowati TE, Baskoro AD, Roebiyoso HL, Soendoro M, Rahardjo E, Putri MP, Saragih JM, Strickman D, Kelly DJ, Dasch GA, Olson JG, Church CJ, Corwin AL, 1997. Seroepidemiological evidence for murine and scrub typhus in Malang, Indonesia. Am J Trop Med Hyg 57 :91–95.
Blair PJ, Jiang J, Schoeler GB, Moron C, Anaya E, Cespedes M, Cruz C, Felices V, Guevara C, Mendoza L, Villaseca P, Sumner JW, Richards AL, Olson JG, 2004. Characterization of spotted fever group rickettsiae in flea and tick specimens from northern Peru. J Clin Microbiol 42 :4961–4967.
Jennings GJ, Hajjeh RA, Girgis FY, Fadeel MA, Maksoud MA, Wasfy MO, El-Sayed N, Srikantiah P, Luby SP, Earhart K, Mahoney FJ, 2007. Brucellosis as a cause of acute febrile illness in Egypt. Trans R Soc Trop Med Hyg 101 :707–713.
Loftis AD, Reeves WK, Szumlas DE, Abbassy MM, Helmy IM, Moriarty JR, Dasch GA, 2006. Surveillance of Egyptian fleas for agents of public health significance: Anaplasma, Bartonella, Coxiella, Ehrlichia, Rickettsia and Yersinia pestis. Am J Trop Med Hyg 75 :41–48.
Loftis AD, Reeves WK, Szumlas DE, Abbassy MM, Helmy IM, Moriarity JR, Dasch GA, 2006. Rickettsial agents in Egyptian ticks collected from domestic animals. Exp Appl Acarol 40 :67–81.
Heymann DL, 2004. Control of Communicable Disease Manual. Eighteenth ed. Washington, D.C.: American Public Health Association, 75–78, 306–309, 469–473, 586.
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We report the occurrence of concurrent infections with multiple acute febrile illness (AFI) pathogens during an ongoing prospective laboratory-based surveillance in four infectious disease hospitals in urban and rural areas of Egypt from June 2005 to August 2006. Patients were screened for Leptospira, Rickettsia typhi, Brucella, or Salmonella enterica serogroup Typhi by various methods including serology, culture, and PCR. One hundred eighty-seven of 1,510 patients (12.4%) evaluated had supporting evidence for the presence of coinfections; 20 (1%) of these patients had 2 or more pathogens based upon confirmatory 4-fold rise in antibody titer, culture, and/or PCR. Most coinfected patients lived or worked in rural agricultural areas. The high coinfection rates suggest that defining the etiologies of AFI is imperative in guiding proper disease treatment, prevention, and control strategies in Egypt.