Hugh W. KingstonMosharraf HossainStije LeopoldTippawan AnantatatAmpai TanganuchitcharnchaiIpsita SinhaKatherine PlewesRichard J. MaudeM. A. Hassan ChowdhurySujat PaulRabiul Alam Mohammed Erfan UddinMohammed Abu Naser SiddiquiAbu Shahed Md ZahedAbdullah Abu SayeedMohammed Habibur RahmanAnupam BaruaMohammed Jasim UddinMohammed Abdus SattarArjen M. DondorpStuart D. BlacksellNicholas P.J. DayAniruddha GhoseAmir HossainDaniel H. ParisUniversity of OxfordUniversitat BaselSwiss Tropical and Public Health Institute (Swiss TPH)Mahidol UniversityChittagong Medical College HospitalHarvard UniversityCharles Darwin University2019-08-282019-08-282018-04-01Emerging Infectious Diseases. Vol.24, No.4 (2018), 638-64510806059108060402-s2.0-85044246696https://repository.li.mahidol.ac.th/handle/123456789/46804© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved. We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies.Mahidol UniversityMedicineArticleSCOPUS10.3201/eid2404.170190