TY - JOUR
T1 - Challenges of establishing the correct diagnosis of outbreaks of acute febrile illnesses in Africa
T2 - The case of a likely Brucella outbreak among nomadic pastoralists, Northeast Kenya, March-July 2005
AU - Ari, Mary D.
AU - Guracha, Argata
AU - Fadeel, Moustafa Abdel
AU - Njuguna, Charles
AU - Njenga, M. Kariuki
AU - Kalani, Rosalia
AU - Abdi, Hassan
AU - Warfu, Osman
AU - Omballa, Victor
AU - Tetteh, Christopher
AU - Breiman, Robert F.
AU - Pimentel, Guillermo
AU - Feikin, Daniel R.
PY - 2011/11
Y1 - 2011/11
N2 - An outbreak of acute febrile illness was reported among Somali pastoralists in remote, arid Northeast Kenya, where drinking raw milk is common. Blood specimens from 12 patients, collected mostly in the late convalescent phase, were tested for viral, bacterial, and parasitic pathogens. All were negative for viral and typhoid serology. Nine patients had Brucella antibodies present by at least one of the tests, four of whom had evidence suggestive of acute infection by the reference serologic microscopic agglutination test. Three patients were positive for leptospiral antibody by immunoglobulin M enzyme-linked immunosorbent assay, and two were positive for malaria. Although sensitive and specific point-of-care testing methods will improve diagnosis of acute febrile illness in developing countries, challenges of interpretation still remain when the outbreaks are remote, specimens collected too late, and positive results for multiple diseases are obtained. Better diagnostics and tools that can decipher overlapping signs and symptoms in such settings are needed.
AB - An outbreak of acute febrile illness was reported among Somali pastoralists in remote, arid Northeast Kenya, where drinking raw milk is common. Blood specimens from 12 patients, collected mostly in the late convalescent phase, were tested for viral, bacterial, and parasitic pathogens. All were negative for viral and typhoid serology. Nine patients had Brucella antibodies present by at least one of the tests, four of whom had evidence suggestive of acute infection by the reference serologic microscopic agglutination test. Three patients were positive for leptospiral antibody by immunoglobulin M enzyme-linked immunosorbent assay, and two were positive for malaria. Although sensitive and specific point-of-care testing methods will improve diagnosis of acute febrile illness in developing countries, challenges of interpretation still remain when the outbreaks are remote, specimens collected too late, and positive results for multiple diseases are obtained. Better diagnostics and tools that can decipher overlapping signs and symptoms in such settings are needed.
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U2 - 10.4269/ajtmh.2011.11-0030
DO - 10.4269/ajtmh.2011.11-0030
M3 - Article
C2 - 22049048
AN - SCOPUS:81155137289
SN - 0002-9637
VL - 85
SP - 909
EP - 912
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 5
ER -