BACKGROUND: Seasonal outbreaks of dengue often result in hundreds of dengue-suspected cases where a clinical diagnosis cannot be confirmed. Usually, during large outbreaks of dengue and other pathogens that can cause acute febrile illnesses, the search for secondary pathogens with similar disease outcomes is rare. METHODS: Using total RNA sequencing and targeted diagnostic assays, we discovered an outbreak of parvovirus B19 in dengue-suspected patients that occurred from November 2013 to February 2014. RESULTS: Of the 182 cases investigated, 63% were viremic for the B19 virus. Moreover, we found that >43% of infected patients had no serological evidence of prior infection. Parvovirus B19 is a typical childhood infection, yet we observed that 82% of the infected patients were adults. Additionally, we perceived that infected adults had significantly higher presentations of myalgia than in children. We also obtained viral protein (VP) 1/VP2 gene nucleotide sequences from 43 patients. CONCLUSIONS: Our results support the utility of next-generation sequencing for symptomatic patients with unknown etiologies during seasonal outbreaks of dengue and other arborviruses. Our findings could improve the vigilance of hospitals and laboratories by raising awareness of co-circulating pathogens such as parvovirus B19 that may be hidden in plain sight.
BACKGROUND: Seasonal outbreaks of dengue often result in hundreds of dengue-suspected cases where a clinical diagnosis cannot be confirmed. Usually, during large outbreaks of dengue and other pathogens that can cause acute febrile illnesses, the search for secondary pathogens with similar disease outcomes is rare. METHODS: Using total RNA sequencing and targeted diagnostic assays, we discovered an outbreak of parvovirus B19 in dengue-suspected patients that occurred from November 2013 to February 2014. RESULTS: Of the 182 cases investigated, 63% were viremic for the B19 virus. Moreover, we found that >43% of infectedpatients had no serological evidence of prior infection. Parvovirus B19 is a typical childhood infection, yet we observed that 82% of the infectedpatients were adults. Additionally, we perceived that infected adults had significantly higher presentations of myalgia than in children. We also obtained viral protein (VP) 1/VP2 gene nucleotide sequences from 43 patients. CONCLUSIONS: Our results support the utility of next-generation sequencing for symptomatic patients with unknown etiologies during seasonal outbreaks of dengue and other arborviruses. Our findings could improve the vigilance of hospitals and laboratories by raising awareness of co-circulating pathogens such as parvovirus B19 that may be hidden in plain sight.
Authors: Christina Yek; Andrea R Pacheco; Manu Vanaerschot; Jennifer A Bohl; Elizabeth Fahsbender; Andrés Aranda-Díaz; Sreyngim Lay; Sophana Chea; Meng Heng Oum; Chanthap Lon; Cristina M Tato; Jessica E Manning Journal: Front Epidemiol Date: 2022-08-15
Authors: Elizabeth Fahsbender; Antonio Charlys da-Costa; Danielle Elise Gill; Flavio Augusto de Padua Milagres; Rafael Brustulin; Fred Julio Costa Monteiro; Marlisson Octavio da Silva Rego; Edcelha Soares D'Athaide Ribeiro; Ester Cerdeira Sabino; Eric Delwart Journal: PLoS One Date: 2020-03-05 Impact factor: 3.240