Spectrum of pathogens causing syndromes of fever and haemorrhage in Guangdong province, China

  Objective  To examine the distribution of pathogens among patients suffering from syndromes of fever and haemorrhage in Guangdong province and to provide evidences for clinic diagnosis and treatment of the syndromes.

  Methods  Totally 282 blood samples were collected from 282 patients with acute clinical symptoms of fever and haemorrhage at 6 sentinel hospitals in 3 prefectures of Guangdong province. Capture enzyme-linked immunosobent assay (ELISA), indirect ELISA and double-antibody sandwich ELISA were used for detections of imunoglobulin M/imunoglobulin G (IgM/IgG) antibody of dengue virus (DENV), Hantaan virus (HTNV), Leptospira (LS), and new bunyavirus (NBYV). Orientia tsutsugamushi (Ot) IgM/IgG antibody and nucleotide were tested with colloidal gold and nested-PCR. In addition, plaque reduction neutralization test and microscopic agglutination test were adopted to further confirm ELISA positive results of DENV and LS antibody.

  Results  The antibody positive rates of specimens were 4.61% (13/282) for DENV, 3.55% (10/282) for HTNV, 24.82% (70/282) for Ot, 32.66% (65/199) for LS, and 0.39% (1/254) for NBYV, respectively. Only one sample was positive for IgG of NBYV. Totally 6 DENV positive samples were confirmed with plaque reduction neutralization test and 6 LS positive samples were confirmed with microscopic agglutination test. PCR detection identified 11 Ot nucleotide positive samples, with 4 genotypes based on sequencing.

  Conclusion  Infection of dengue virus, Hantaan virus, Orientia tsutsugamushi, and Leptospira were not unusual, but the infection of new bunyavirus was rare among patients with syndromes of fever and haemorrhage in Guangdong province.