title: Case report: two human Streptococcus suis infections in Borneo, Sabah, Malaysia.
abstract: Streptococcus Suis (S.suis) is increasingly being recognised as a potentially preventable emerging zoonotic infection in humans with a global distribution. It is a major cause of meningitis especially among those in contact with pigs and has also been associated with a toxic shock syndrome.
  
  
  
  We report the first two human cases from Sabah, Borneo, Malaysia which expands the global reach of this important pathogen. Here, we illustrate their epidemiological risk factors, clinical presentation and resulting sequelae of both patients.
  
  
  
  The continued public health threat of zoonotic infections such as S.suis, highlights the need for accurate epidemiological surveillance, regulation of pig farming, slaughtering and continued advocacy of best practices for pork preparation and consumption.
authors.affiliation: Infectious Diseases Unit, Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia. gsrajahram@gmail.com.|Clinical Research Centre, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia. gsrajahram@gmail.com.
authors.forename: Giri Shan
authors.initials: GS
authors.lastname: Rajahram
authors.affiliation: Microbiology Unit, Department of Pathology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Ahneez Abdul
authors.initials: AA
authors.lastname: Hameed
authors.affiliation: Clinical Research Centre, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.|Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Jayaram
authors.initials: J
authors.lastname: Menon
authors.affiliation: Jesselton Medical Centre, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Timothy
authors.initials: T
authors.lastname: William
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore.
authors.forename: Paul Anantharajah
authors.initials: PA
authors.lastname: Tambyah
authors.affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.|Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.|Global Health Division, Menzies School of Health Research, Darwin, Australia.
authors.forename: Tsin Wen
authors.initials: TW
authors.lastname: Yeo
mesh_terms: D000328:Adult; D000818:Animals; D001893:Borneo; D006801:Humans; D008296:Malaysia; D008297:Male; D013290:Streptococcal Infections / Q000175:diagnosis*; D017011:Streptococcus suis / Q000302:isolation & purification*; D034421:Sus scrofa; D015047:Zoonoses / Q000175:diagnosis*
keywords: Case report; Meningitis; Sabah; Streptococcus suis