Surveillance and Etiological Insights into Vector-Borne and Febrile Illnesses (VIBES)

Vector-borne and febrile illnesses (VIBES) are a persistent public health challenge in tropical regions where diverse vector-borne and respiratory pathogens co-circulate. This study reports preliminary findings from ongoing VIBES surveillance at Klinik Kesihatan Kota Bharu, Bandar Botanik, and Kelana Jaya, targeting patients presenting with fever. A total of 857 samples were collected and analysed using BioFire® Respiratory Panel, Fast-Track Diagnostics Respiratory Pathogen 33 (FTD-RP33), and FTD Tropical Fever Core (FTD-TFC). FTD-TFC detected vector-borne pathogens in 5.69% (30/527) of cases, primarily Rickettsia spp. (14; 2.66%), dengue virus (13; 2.47%), and Salmonella spp. (11; 2.09%). BioFire® identified respiratory pathogens in 42.4% (70/165) of cases, with influenza B (26; 15.8%), SARS-CoV-2 (19; 11.6%), rhinovirus/enterovirus (15; 9.1%), adenovirus (11; 6.7%), and RSV (5; 3.0%). FTD-RP33 yielded 27.9% (114/409) positivity, predominantly rhinovirus (26; 6.36%) and influenza A (20; 4.89%). Clinical correlations showed influenza B was associated with chills/rigors, sore throat, cough, and loss of taste, RSV with sputum production, and adenovirus with joint pain. Conventional PCR assays for Rickettsia, Leptospira, and Orientia tsutsugamushi on blood clots were negative. Further work is optimising DNA extraction from serum and using indirect immunofluorescence assay (IFA) for Rickettsia serology. These findings highlight the varied etiology of febrile illness in Malaysia and the need for integrated molecular and serological surveillance to enhance early detection, outbreak prevention, and targeted public health interventions. By bridging laboratory diagnostics with clinical insights, this approach strengthens Malaysia’s preparedness against future multi-pathogen outbreaks.