Surveillance of Infectious Agents in Acute Febrile Illnesses in a Tertiary Care Hospital in Northern India

ABSTRACT
Background: Fever is a common presenting symptom in developing countries. Epidemics of acute febrile illness (AFI) have caused major public-health concerns in India and abroad. Dengue, Typhoid, acute viral hepatitis, Chikungunya, Scrub Typhus, and Malaria are frequent causes. Each year, particularly during and after the rainy season, the northern region experiences AFI outbreaks with undocumented aetiologies. Significant gaps remain in knowledge of the aetiological spectrum and risk factors. This study aimed to bridge these gaps and generate evidence for public-health action.
Materials and Methods: A prospective observational study was conducted in the Department of Microbiology over 18-month period (July 2023 – December 2024) at the Punjab Institute of Medical Sciences, Jalandhar. Samples of patients from OPDs and IPDs with acute fever were evaluated.
Serological tests for Dengue, Typhoid, Hepatitis A & E, Chikungunya, Scrub Typhus, and Malaria as prescribed by physician were performed.
Findings: A total of 8127 samples were evaluated. Typhoid and Dengue were the leading causes (10.02% and 9.75%, respectively), followed by Hepatitis A (5.2%), Chikungunya (2.5%), Hepatitis E (2.34%), and Malaria (0.3%). Mixed infections were detected in 351 (4.32 %) samples.
Conclusion: The similarity of AFI symptoms complicates diagnosis without laboratory confirmation. A detailed history, careful examination, and appropriate laboratory tests facilitate timely diagnosis, rational treatment, and prevention of fatal outcomes.
Keywords: Acute febrile illness; Dengue; Typhoid; Hepatitis A; Scrub typhus; Surveillance