15th ICID Abstracts / International Journal of Infectious Diseases 16S (2012) e317–e473 e337 Type: Poster Presentation Final Abstract Number: 52.001 Session: Travel Medicine & Travel Health Date: Friday, June 15, 2012 Time: 12:45-14:15 Room: Poster & Exhibition Area Traveler’s rickettsioses and domestic rickettsioses in Japan in 2011 S. Ando ∗ , Y. Ogasawara National Institute of Infectious Diseases, Tokyo, Japan Background: Various rickettsioses distribute worldwide. Scrub typhus and Japanese spotted fever are known in Japan. Each rick- ettsiosis is reported about 400 cases and over 100 cases every year and has seasonal and geographical characteristics. In contrast, trav- eler’s rickettsioses are febris acute diseases to need attention for all season and nationwide. In 2011, we experienced a laboratory diagnosis of various rickettsioses. Methods: In many time, untypical cases and imported cases are requested to perform laboratory diagnosis for our laboratory. We performed several PCR tests, targeted different reckettsial sequence regions, and measure antibody titer. We detected a rickettsial spe- cific gene from acute phase samples (eschars, skin biopsy of rash and whole blood) and confirmed antibody titers elevation by paired sera. Results: Three African tick bite fever cases were diagnosed (case 1 traveled to Swaziland and case 2 to South Africa in January, and case 7 traveled to Zimbabwe and Botswana in December). Case 3 was forgrin traveler from South Africa, and diagnosed as Bou- tonnese fever. Case 5 was Scrub typhus who traveled to Malaysia in March. Case 6 was murine typhus, who stayed in Thailand and showed acute respiratory disorder syndrome in April. On the other hand, case 4 was suggested as the new spotted fever group Rick- ettsia by results of genetic sequence analysis of PCR products and showed antibody elevation against Rickettsia conorii. Conclusion: Antigenic cross-reactivity are high among spot- ted fever rickettsia group, there is a limit for differentiation of infected Rickettsia species by serologic diagnosis. In addition, mem- bers of spotted fever group Rickettsia have increased until now. Spotted fever rickettsioses show variety in clinical symptom, and have various outbreak situation and distribution. Therefore, history and episodes of the patients before onset are extremely impor- tant. In this presentation, we summarize traveler’s rickettsioses and domestic rickettsioses in 2011 in Japan. http://dx.doi.org/10.1016/j.ijid.2012.05.398 Type: Poster Presentation Final Abstract Number: 52.003 Session: Travel Medicine & Travel Health Date: Friday, June 15, 2012 Time: 12:45-14:15 Room: Poster & Exhibition Area Clinical study on efficacy and safety of piperamisinin (dihydroartemisinin-piperaquine) in uncomplicated falci- parum malaria T.M. Hlaing ∗ , K.Z. Oo, K.P. Pyar Directorate of Medical Services, Nay Pyi Taw, Myanmar Background: Dihydroartemisinin and piperaquine phosphate co-formulated tablets manufactured from Pharmaceutical Com- panies of Republic of China namely Artekin and Artepip had been studied in Clinical Research Unit (Malaria) No. (1) DSGH (1000-Beds) Mingalardon in 2006-2008 for the treatment of uncomplicated falciparum malaria and it was found to be safe and effective. Piperamisinin, a combined tablet, containing 50mg dihydroartemisinin and 350 mg piperaquine phosphate, is first pro- duced from Myanmar Pharmaceutical Factory (MPF) of Ministry of Industry in 2009. Methods: An hospital based clinical study following 28 days WHO standard therapeutic efficacy test was conducted at 1000 Bedded Hospital in Mingalardon, Yangon Division, 300 Bedded Hospital in Myitkyinar, Kachin State and 100 Bedded Hospital in Lashio, Shan State on a total of 23 patients with acute uncom- plicated falciparum malaria between March to October 2010, to study the effectiveness, tolerability and safety of piperamisinin. The patients who met the inclusion criteria were given Piperamisinin combined tablets with the dosage of 3 tablet at 0-Hr, 24-Hr & 48- Hr. The patients were thoroughly assessed and monitored clinically including ECG, parasitologically, haematologically, and biochemi- cally (Blood sugar, urea & serum creatinine) for side effects during the 28 days of confinement at the respective hospitals. Results: The participants were 29.52 years old on average and ranged from 14 to 57 years of age. Initial parasitaemia was 1983.16 ± 2685.45 per L whereas initial temperature was 37.8 ± 0.88 ◦ C. Fever clearance time (FCT) and parasite clearance time (PCT) were 14.63 ± 10.72 hours 27.18 ± 11.44 hours respectively. Nei- ther early treatment failure nor late treatment failure was observed. Adequate clinical and parasitological response (ACPR) was 100 percents.There were no serious clinical or laboratory side effects observed in the study. Conclusion: In general, Domestically manufactured Piperamisinin combined tablet is safe and effective for the treatment of uncomplicated falciparum malaria patients in three different states and divsion of Myanmar. http://dx.doi.org/10.1016/j.ijid.2012.05.399 Type: Poster Presentation Final Abstract Number: 52.004 Session: Travel Medicine & Travel Health Date: Friday, June 15, 2012 Time: 12:45-14:15 Room: Poster & Exhibition Area Malaria and co-infection among traveller in a refferal hospital: a case series H. Habib 1 , S. Lardo 2,∗ 1 University of Indonesia, Jakarta, Indonesia 2 Gatot Subroto Central Army Hospital, Jakarta, Indonesia Background: A referral hospital in tropical region often received referral malaria patient with many co infection undiagnosed and have no respon to the therapy from the local hospital. Because of the indaquate therapy before, the referral patient usually have atypical sign and symptoms.The epidemiology of infection from the region where patient stay should take into consideration because patient could have multiple infection. Methods: Here we report a case series of three refferal patients of Gatot Subroto Central Army Hospital Jakarta, Indonesia with mix falciparum and vivax infection, falciparum and H1N1, vivax and dengue. Results: Case 1 was a male patient with sudden onset of continu- ous high grade fever for three days. He was an army on duty referred