Challenges of establishing the correct diagnosis of outbreaks of acute febrile illnesses in Africa: The case of a likely Brucella outbreak among nomadic pastoralists, Northeast Kenya, March-July 2005

Mary D. Ari, Argata Guracha, Moustafa Abdel Fadeel, Charles Njuguna, M. Kariuki Njenga, Rosalia Kalani, Hassan Abdi, Osman Warfu, Victor Omballa, Christopher Tetteh, Robert F. Breiman, Guillermo Pimentel, Daniel R. Feikin

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)909-912
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume85
Issue number5
DOIs
StatePublished - Nov 2011
Externally publishedYes

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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