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Volume 30, Number 8—August 2024
Research

Metagenomic Detection of Bacterial Zoonotic Pathogens among Febrile Patients, Tanzania, 2007–20091

Robert J. Rolfe, Sarah W. Sheldon, Luke C. Kingry, Jeannine M. Petersen, Venance P. Maro, Grace D. Kinabo, Wilbrod Saganda, Michael J. Maze, Jo E.B. Halliday, William L. Nicholson, Renee L. Galloway, Matthew P. Rubach, and John A. CrumpComments to Author 
Author affiliations: Duke University Department of Medicine Division of Infectious Diseases and International Health, Durham, North Carolina, USA (R.J. Rolfe, M.P. Rubach, J.A. Crump); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (S.W. Sheldon, L.C. Kingry, J.M. Petersen); Kilimanjaro Christian Medical Centre, Moshi, Tanzania (V.P. Maro, G.D. Kinabo, M.P. Rubach, J.A. Crump); Kilimanjaro Christian Medical University College, Moshi (V.P. Maro, G.D. Kinabo, J.A. Crump); Mawenzi Regional Referral Hospital, Moshi (W. Saganda); University of Otago Department of Medicine, Christchurch, New Zealand (M.J. Maze); University of Glasgow School of Biodiversity, One Health and Veterinary Medicine, Glasgow, Scotland, UK (J.E.B. Halliday); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (W.L. Nicholson, R.L. Galloway); Duke-National University of Singapore Programme in Emerging Infectious Diseases, Singapore (M.P. Rubach); Duke University Global Health Institute, Durham (M.P. Rubach, J.A. Crump); Centre for International Health, University of Otago, Dunedin, New Zealand (J.A. Crump)

Main Article

Table 1

Organisms and patients characteristics in a study of metagenomic detection of bacterial zoonotic pathogens among febrile patients, Tanzania, 2007–2009*

Organism detected Patient age, y/sex Rural res. Illness onset, d Symptoms Serologic testing
 Results
Cell count, × 103/µL
 Leptospira MAT Q fever IFA Rickettsia IFA
WBC† Plat. ALC
Bartonella quintana
 10/M
 Y
 4
 Fever, dyspnea, convulsions
 11.9
 89
 2.59
Acute and convalescent
 ELISA screen negative
 Acute and convalescent
 Probable acute leptospirosis‡
B. quintana
 47/M§
 N
 40
 Fever, cough, hemoptysis, dyspnea, weight loss
 18.4
 124
 1.55
ND
 ND
 ND
 NA
Coxiella burnetii
 22/M
 Y
 2
 Fever, rigors
 4.6
 93
 1.92
Acute only
 ND
 Acute only
 Probable acute leptospirosis‡
Leptospira borgpetersenii
 43/F
 Y
 4
 Fever, rigors, emesis, headache
 4.2
 85
 0.33
Acute and convalescent
 ELISA screen negative
 Acute and convalescent
 Confirmed acute leptospirosis‡
L. kirschneri
 60/F
 N
 3
 Fever, emesis, headache
 5.4
 114
 0.52
Acute only
 ND
 Acute only
 NA
Rickettsia conorii
 70/M
 Y
 7
 Fever, rigors, dyspnea, diarrhea, headache
 15.1
 118
 1.77
ND
 ND
 ND
 NA
Rickettsia typhi
 36/M
 Y
 14
 Fever, rigors, headache, nuchal rigidity, dysuria
 6.6
 52
 0.92
Acute only
 ND
 Acute only
 Exposure to SFG Rickettsia and typhus group Rickettsia
R. typhi
 77/F
 N
 3
 Fever, rigors
 4.5
 97
 0.35
Acute and convalescent
 ELISA screen negative
 Acute and convalescent
 Confirmed acute SFGR
R. typhi
 31/F
 Y
 30
 Fever, rigors, emesis, headache
 7.2
 148
 0.66
Acute and convalescent
 ELISA screen negative
 Acute and convalescent
 Confirmed acute SFGR; exposure to typhus group
Rickettsia
Neoehrlichia spp. 40/F N 3 Fever, rigors, hemoptysis, diarrhea, emesis, headache 3.0 25 0.65 ND ND ND NA

*Most patients were HIV-negative; 1 patient with B. quintana was HIV-infected. ALC, absolute lymphocyte count; IFA, immunofluorescence assay; MAT, microscopic agglutination testing; NA, not applicable; ND, not done; Plat., platelets; res., resident; SFG, spotted fever group; SFGR, spotted fever group rickettsioses; WBC, white blood cells (leukocytes). †Based on MAT results. ‡Leptospira PCR was not performed for this sample. §HIV-positive patient.

Main Article

1Preliminary results of this study were presented at the 72nd American Society of Tropical Medicine and Hygiene Annual Meeting; October 18­–22, 2023; Chicago, Illinois, USA.

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Page updated: July 20, 2024
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