Infectious Causes of Acute Febrile Illness in Belize, 2020-2022

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Acute febrile illness (AFI) surveillance is crucial for global health security, particularly in low- and middle-income countries.
• Establishing robust surveillance networks aids in the early detection of emerging pathogens.

Purpose of the Study:

• To establish and evaluate the Belize AFI Surveillance network over its initial 3-year period.
• To identify and characterize common and emerging pathogens causing febrile illness in Belize.

Main Methods:

• Real-time PCR for vector-borne pathogens and BioFire® diagnostics for respiratory/gastrointestinal pathogens.
• Surveillance expanded to include SARS-CoV-2 testing in response to the COVID-19 pandemic.
• Analysis of data from 5,643 participants across 11 hospitals.

Main Results:

• One or more pathogens identified in 51% of participants, with 43 distinct pathogens detected.
• Identified the first acute Chagas disease case in Belize and eight Vibrio cholerae cases.
• Common pathogens included dengue (all serotypes), SARS-CoV-2, human rhinovirus/enterovirus, diarrheagenic E. coli, and norovirus.

Conclusions:

• The Belize AFI Surveillance network successfully identified a wide range of pathogens, enhancing disease monitoring.
• Surveillance data facilitated rapid responses to outbreaks and improved understanding of disease activity.
• The network provides valuable insights for public health interventions and global health security.