title: Murine typhus is a common cause of febrile illness in Bedouin children in Israel.
abstract: Murine typhus is known to be endemic among populations living in poverty and exposed to rats and their fleas. A prospective 2-y study was conducted to determine the contribution of murine typhus to undifferentiated febrile illnesses among Bedouin children attending an outpatient clinic in southern Israel. Children with fever > or = 38.5 degrees C lasting for > or = 3 d were enrolled in the study. Murine typhus was serologically confirmed by the microimmunofluorescence test. A total of 549 children met the inclusion criteria of whom 76 (13.8%) had serologically-confirmed murine typhus. The disease was diagnosed in 27 of 434 (6.2%) patients aged < 5 y and in 49 of 115 (42.6%) older children (p<0.001). Murine typhus was diagnosed in 54 of 288 (18.8%) patients between June and November and in 22 of 261 (8.4%) between December and May (p<0.001). Patients with murine typhus had significantly higher prevalence of anaemia, leukopenia, hyponatraemia, and elevated liver enzymes compared to children without the disease. A single child was hospitalized and all 76 patients recovered without complications. Murine typhus is an important cause of febrile illnesses among Bedouin children > or = 5 y of age living in southern Israel and usually runs a benign clinical course.
authors.affiliation: Rahat Childrens' Health Centre, Kupat Holim Clalit, Beer-Sheva, Israel.
authors.forename: Hanna
authors.initials: H
authors.lastname: Shalev
authors.forename: Rotkane
authors.initials: R
authors.lastname: Raissa
authors.forename: Zislin
authors.initials: Z
authors.lastname: Evgenia
authors.forename: Pablo
authors.initials: P
authors.lastname: Yagupsky
mesh_terms: D000818:Animals; D018912:Arabs / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D012281:Rickettsia / Q000276:immunology*; D012698:Serologic Tests; D014437:Typhus, Endemic Flea-Borne / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy