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Arboviral Surveillance among Pediatric Patients with Acute Febrile Illness in Houston, Texas

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  • 1 Immunization Project, Texas Children’s Hospital, Houston, Texas;
  • | 2 Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas;
  • | 3 National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 4 Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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We instituted active surveillance among febrile patients presenting to the largest Houston-area pediatric emergency department to identify acute infections of dengue virus (DENV), West Nile virus (WNV), and chikungunya virus (CHIKV). In 2014, 1,063 children were enrolled, and 1,015 (95%) had blood and/or cerebrospinal fluid specimens available for DENV, WNV, and CHIKV testing. Almost half (49%) reported recent mosquito bites, and 6% (N = 60) reported either recent international travel or contact with an international traveler. None were positive for acute WNV; three had false-positive CHIKV results; and two had evidence of DENV. One DENV-positive case was an acute infection associated with international travel, whereas the other was identified as a potential secondary acute infection, also likely travel-associated. Neither of the DENV-positive cases were clinically recognized, highlighting the need for education and awareness. Health-care professionals should consider the possibility of arboviral disease among children who have traveled to or from endemic areas.

Author Notes

Address correspondence to Leila C. Sahni, Immunization Project, Texas Children’s Hospital, 1102 Bates Ave., Suite 1550, Houston, TX 77030. E-mail: lcsahni@texaschildrens.org

Financial support: This work was funded through a cooperative agreement between Texas Children’s Hospital and the Centers for Disease Control and Prevention (federal award identification number U01IP000461: Enhanced surveillance for new vaccine preventable disease).

Disclosure: RG is a named inventor on patent applications related to alphaviruses and held by University of Texas Medical Branch. RG receives licensing fees from one of the patent applications. No other authors report significant financial conflicts of interest.

Authors’ addresses: Leila C. Sahni, Immunization Project, Texas Children’s Hospital, Houston, TX, E-mail: lcsahni@texaschildrens.org. Rebecca S. B. Fischer, Rodion Gorchakov, Rebecca M. Berry, and Kristy O. Murray, Department of Pediatrics, Section of Tropical Medicine, Baylor College of Medicine, Houston, TX, E-mails: rebecca.fischer@bcm.edu, rodion@bcm.edu, rebecca.berry@bcm.edu, and kmurray@bcm.edu. Daniel C. Payne, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: dvp6@cdc.gov. Julie A. Boom, Department of Pediatrics, Baylor College of Medicine, Houston, TX, and Immunization Project, Texas Children’s Hospital, Houston, TX, E-mail: jboom@bcm.edu.

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