title: Hospital-Based Surveillance for Infectious Etiologies Among Patients with Acute Febrile Illness in Georgia, 2008-2011.
abstract: 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.
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland drkuchuloria@yahoo.com.
authors.forename: Tinatin
authors.initials: T
authors.lastname: Kuchuloria
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Paata
authors.initials: P
authors.lastname: Imnadze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Nana
authors.initials: N
authors.lastname: Mamuchishvili
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Maiko
authors.initials: M
authors.lastname: Chokheli
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Tengiz
authors.initials: T
authors.lastname: Tsertsvadze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Marina
authors.initials: M
authors.lastname: Endeladze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Ketevan
authors.initials: K
authors.lastname: Mshvidobadze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Lana
authors.initials: L
authors.lastname: Gatserelia
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Manana
authors.initials: M
authors.lastname: Makhviladze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Marine
authors.initials: M
authors.lastname: Kanashvili
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Teona
authors.initials: T
authors.lastname: Mikautadze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Nanuashvili
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Khatuni
authors.initials: K
authors.lastname: Kiknavelidze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Nora
authors.initials: N
authors.lastname: Kokaia
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Manana
authors.initials: M
authors.lastname: Makharadze
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Danielle V
authors.initials: DV
authors.lastname: Clark
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Margaret
authors.initials: M
authors.lastname: Farrell
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Moustafa Abdel
authors.initials: MA
authors.lastname: Fadeel
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Mohamed Abdel
authors.initials: MA
authors.lastname: Maksoud
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pimentel
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Brent
authors.initials: B
authors.lastname: House
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hepburn
authors.affiliation: Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Rivard
mesh_terms: D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005846:Georgia (Republic) / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D014777:Virus Diseases / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult