Uncovering the viral aetiology of undiagnosed acute febrile illness in Uganda using metagenomic sequencing
Abstract
Abstract Viruses associated with acute febrile illness in Africa cause a spectrum of clinical disease from mild to life-threatening. Routine diagnostic methods are insufficient to identify all viral pathogens in this region. In this study, 1281 febrile Ugandan patients were prospectively recruited as part of the CDC-UVRI Acute Febrile Illness Study and pre-screened for common pathogens. 210/1281 undiagnosed samples, and 20 additional samples from viral outbreaks were subjected to metagenomic sequencing. Viral pathogens were identified in 44/230 (19%), including respiratory, hepatitis, blood-borne, gastrointestinal and vector-borne viruses. Importantly, one case of Crimean-Congo haemorrhagic fever and two cases each of Rift Valley fever, dengue and yellow fever were detected in 7/230 (3%) of cases. Le Dantec virus, last reported in 1969, was also identified in one patient. The presence of high-consequence and (re-)emerging viruses of public health concern highlights the need for enhanced population-based diagnostic surveillance in the African region.
Article Details
Authors (27)
Shirin Ashraf
Hanna Jerome
Daniel Lule Bugembe
Deogratius Ssemwanga
Timothy Byaruhanga
John Timothy Kayiwa
Robert Downing
Jesus F. Salazar-Gonzalez
Maria G. Salazar
James G. Shepherd
Craig Wilkie
Chris Davis
Nicola Logan
Sreenu B. Vattipally
Gavin S. Wilkie
Ana da Silva Filipe
Alfred Ssekagiri
Prossy Namuwulya
Henry Bukenya
Brian K. Kigozi
Weronika Witkowska McConnell
Brian J. Willett
Stephen Balinandi
Julius Lutwama
Pontiano Kaleebu
Josephine Bwogi
Emma C. Thomson