title: A retrospective chart review study to describe selected zoonotic and arboviral etiologies in hospitalized febrile patients in the Republic of Armenia.
abstract: Scant information is available on the infectious causes of febrile illnesses in Armenia. The goal of this study was to describe the most common causes, with a focus on zoonotic and arboviral infections and related epidemiological and clinical patterns for hospitalized patients with febrile illnesses of infectious origin admitted to Nork Infectious Diseases Clinical Hospital, the referral center for infectious diseases in the capital city, Yerevan.
  
  
  
  A chart review study was conducted in 2014. Data were abstracted from medical charts of adults (≥18 years) with a fever (≥38 °C), who were hospitalized (for ≥24 h) in 2010-2012.
  
  
  
  Of the 600 patients whose charts were analyzed, 76 % were from Yerevan and 51 % were male; the mean age (± standard deviation) was 35.5 (±16) years. Livestock exposure was recorded in 5 % of charts. Consumption of undercooked meat and unpasteurized dairy products were reported in 11 and 8 % of charts, respectively. Intestinal infections (51 %) were the most frequently reported final medical diagnoses, followed by diseases of the respiratory system (11 %), infectious mononucleosis (9.5 %), chickenpox (8.3 %), brucellosis (8.3 %), viral hepatitis (3.2 %), and erysipelas (1.5 %). Reviewed medical charts included two cases of fever of unknown origin (FUO), two cutaneous anthrax cases, two leptospirosis cases, three imported malaria cases, one case of rickettsiosis, and one case of rabies. Engagement in agricultural activities, exposure to animals, consumption of raw or unpasteurized milk, and male gender were significantly associated with brucellosis.
  
  
  
  Our analysis indicated that brucellosis was the most frequently reported zoonotic disease among hospitalized febrile patients. Overall, these study results suggest that zoonotic and arboviral infections were not common etiologies among febrile adult patients admitted to the Nork Infectious Diseases Clinical Hospital in Armenia.
authors.affiliation: National Center for Disease Control and Prevention, Ministry of Health of Armenia, Yerevan, Armenia. lusineparonyan@yahoo.com.
authors.forename: Lusine
authors.initials: L
authors.lastname: Paronyan
authors.affiliation: Nork Infectious Diseases Clinical Hospital, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Eduard
authors.initials: E
authors.lastname: Zardaryan
authors.affiliation: National Center for Disease Control and Prevention, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Vahe
authors.initials: V
authors.lastname: Bakunts
authors.affiliation: Nork Infectious Diseases Clinical Hospital, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Zaruhi
authors.initials: Z
authors.lastname: Gevorgyan
authors.affiliation: Nork Infectious Diseases Clinical Hospital, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Vigen
authors.initials: V
authors.lastname: Asoyan
authors.affiliation: Nork Infectious Diseases Clinical Hospital, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Hripsime
authors.initials: H
authors.lastname: Apresyan
authors.affiliation: Nork Infectious Diseases Clinical Hospital, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Alvard
authors.initials: A
authors.lastname: Hovhannisyan
authors.affiliation: National Center for Disease Control and Prevention, Ministry of Health of Armenia, Yerevan, Armenia.
authors.forename: Karo
authors.initials: K
authors.lastname: Palayan
authors.affiliation: Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.affiliation: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors.forename: Tinatin
authors.initials: T
authors.lastname: Kuchuloria
authors.affiliation: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Rivard
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001102:Arbovirus Infections / Q000209:etiology; D001136:Armenia / Q000453:epidemiology; D002006:Brucellosis / Q000453:epidemiology / Q000209:etiology; D003141:Communicable Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007922:Leptospirosis / Q000453:epidemiology / Q000209:etiology; D058751:Livestock; D008288:Malaria / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012282:Rickettsia Infections / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology / Q000209:etiology
keywords: Armenia; Epidemiology; Febrile; Hospital; Zoonotic