Abstract
Although potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections. Serum samples from 234 acutely febrile patients at clinics in Tiko and Buea, Cameroon, were examined for antibodies to Rickettsia africae and African alphaviruses and flaviviruses. These serum samples did not contain antibodies against typhoid, and blood malarial parasites were not detected. Serum samples of 32% contained immunoglobulin M antibodies reactive with R. africae by immunofluorescence assay and were reactive with outer membrane proteins A and B of R. africae by immunoblotting. These findings established a diagnosis of acute rickettsiosis, most likely African tick-bite fever. Hemagglutination inhibition testing of the serum samples also detected antibodies to Chikungunya virus (47%) and flaviviruses (47%). High prevalence of antibodies to arboviruses may represent a major, previously unrecognized public health problem in an area where endemic malaria and typhoid fever have been the principal diagnostic considerations.
Highlights
Potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections
Vector-borne bacterial and viral diseases are rarely considered by local clinicians, whose primary diagnostic focus is on endemic malaria and typhoid fever
Chikungunya fever is an arboviral disease transmitted by mosquitoes of the genus Aedes; it occurs in neighboring Nigeria; and epidemics have been reported in Angola, Burundi, the Central African Republic, Kenya, Namibia, Senegal, South Africa, Tanzania, Uganda, and Zimbabwe [1,2,3]
Summary
Potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections. Serum samples from 234 acutely febrile patients at clinics in Tiko and Buea, Cameroon, were examined for antibodies to Rickettsia africae and African alphaviruses and flaviviruses. Serologic surveys in Angola, Burkina Faso, Central African Republic, Congo, Ivory Coast, Mali, and Zimbabwe have previously detected antibodies to spotted fever group rickettsiae, the first human case of R. africae infection was not reported until 1992 [13,14,15]. We sought to detect antibodies to spotted fever group rickettsiae, CHIKV, yellow fever, dengue, West Nile, and Spondweni viruses in serum samples collected from patients with symptoms of an acute febrile illness seen at clinics in the South West
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