Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018

Area of Science:

• Infectious Diseases
• Virology
• Microbiology

Background:

• The 2018 Lassa fever outbreak in Nigeria presented diagnostic challenges.
• Patients with suspected Lassa fever often had negative Lassa virus PCR results.
• Identifying the causative agents in these cases is crucial for effective treatment and public health response.

Purpose of the Study:

• To investigate the etiology of febrile illnesses in patients with negative Lassa virus PCR results during the 2018 Nigerian outbreak.
• To identify potential bacterial and viral co-infections or alternative pathogens.

Main Methods:

• Utilized custom gene expression array cards for comprehensive pathogen detection.
• Employed metagenomic sequencing for unbiased identification of microbial agents.
• Analyzed samples from patients with suspected Lassa fever but negative Lassa virus PCR.

Main Results:

• No single causative agent was identified for all cases.
• A variety of bacterial and viral pathogens were detected.
• Evidence of mixed co-infections with multiple pathogens was observed.

Conclusions:

• Febrile illnesses in this cohort were not solely attributed to Lassa virus.
• Bacterial and viral co-infections represent a significant factor in disease presentation.
• Advanced molecular techniques are essential for uncovering complex infectious etiologies.