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Hospital-Based Surveillance for Infectious Etiologies Among Patients with Acute Febrile Illness in Georgia, 2008–2011
Information on the infectious causes of undifferentiated acute febrile illness (AFI) in Georgia is essential for effective treatment and prevention. In May 2008, a hospital-based AFI surveillance was initiated at six hospitals in Georgia. Patients aged ≥ 4 years with fever ≥ 38°C for ≥ 48 hours were eligible for surveillance. Blood culture and serologic testing were conducted for Leptospira spp., Brucella spp., West Nile virus (WNV), Crimean–Congo hemorrhagic fever virus, Coxiella burnetii, tick-borne encephalitis virus (TBEV), hantavirus, Salmonella enterica serovar Typhi (S. Typhi), and Rickettsia typhi. Of 537 subjects enrolled, 70% were outpatients, 54% were males, and the mean age was 37 years. Patients reported having fatigue (89%), rigors (87%), sweating (83%), pain in joints (49%), and sleep disturbances (42%). Thirty-nine (7%) patients were seropositive for R. typhi, 37 (7%) for Brucella spp., 36 (7%) for TBEV, 12 (2%) for Leptospira spp., 10 (2%) for C. burnetii, and three (0.6%) for S. Typhi. None of the febrile patients tested positive for WNV antibodies. Of the patients, 73% were negative for all pathogens. Our results indicate that most of the targeted pathogens are present in Georgia, and highlight the importance of enhancing laboratory capacity for these infectious diseases.
Author Notes
Financial support: This study was funded by the Global Emerging Infections Surveillance Program (GEIS).
Authors' addresses: Tinatin Kuchuloria, Javakhishvili Tbilisi State University, Tbilisi, Georgia, E-mail: drkuchuloria@yahoo.com. Paata Imnadze, Javakhishvili Tbilisi State University, Tbilisi, Georgia, and National Center for Disease Control and Public Health, Tbilisi, Georgia, E-mail: pimnadze@ncdc.ge. Nana Mamuchishvili and Maiko Chokheli, National Center for Disease Control and Public Health, Tbilisi, Georgia, E-mails: nanamamuchishvili@yahoo.com and chokhelimaiko@yahoo.com. Tengiz Tsertsvadze, Javakhishvili Tbilisi State University, Tbilisi, Georgia, and Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia, E-mail: aids@gol.ge. Marina Endeladze, Ketevan Mshvidobadze, and Lana Gatserelia, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia, E-mails: marinaendeladze@ymail.com, katemshvidobadze@yahoo.com, and lgatserelia@yahoo.com. Manana Makhviladze, Marine Kanashvili, and Teona Mikautadze, V. Bochorishvili Sepsis Center, Tbilisi, Georgia, E-mails: makhviladze_manana@yahoo.com, mkanashvili@mail.ru, and mikautadze.teona@mail.ru. Alexander Nanuashvili and Khatuni Kiknavelidze, Sachkhere Hospital, Sachkhere, Georgia, E-mails: tamari.davitashvili@gmail.com and xatuna-kiknavelidze@rambler.ru. Nora Kokaia and Manana Makharadze, S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia, E-mails: irma_kokaia@yahoo.com and mananamaxaradze@yahoo.com. Danielle V. Clark and Christian T. Bautista, Walter Reed Army Institute of Research, Silver Spring, MD, E-mails: dvclark@gmail.com and marcos.c.bautista.ctr@mail.mil. Margaret Farrell, Moustafa Abdel Fadeel, Mohamed Abdel Maksoud, Guillermo Pimentel, and Brent House, Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt, E-mails: marleefar@gmail.com, moustafa.abdelfadeel.eg@med.navy.mil, mohamed.abdelmaksoud.eg@med.navy.mil, gpiment@gmail.com, and brent.l.house2.mil@mail.mil. Matthew J. Hepburn and Robert G. Rivard, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, E-mails: matthewhepburn@yahoo.com and robert.g.rivard.mil@mail.mil.