Open AccessShort Report: Serological Evidence of Under-Reported Dengue Circulation in Sierra Leone
Author(s) -
Jaime M. de Araújo Lobo,
Christopher N. Mores,
Daniel G. Bausch,
Rebecca C. Christofferson
Publication year - 2016
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0004613
Subject(s) - dengue fever , sierra leone , ebola virus , dengue virus , medicine , lassa fever , outbreak , rift valley fever , malaria , transmission (telecommunications) , lassa virus , public health , serology , environmental health , virology , immunology , socioeconomics , virus , pathology , sociology , antibody , electrical engineering , engineering
Dengue virus (DENV) is thought to have emerged from a sylvatic cycle in Africa but has since become adapted to an urban-centric transmission cycle. These urban areas include villages in West Africa where DENV is not often routinely considered for patients presenting with febrile illnesses, as other endemic diseases (malaria, Lassa fever, e.g.) present with similar non-specific symptoms. Thus, dengue is likely under diagnosed in the region. These plaque reduction neutralization test-50 (PRNT50) screening results of patients presenting with fevers of unknown origin (FUO) at a clinic in Kenema, Sierra Leone indicate that all four serotypes of DENV likely circulate in areas surrounding Kenema. Using a more conservative PRNT80 cut-off value, our results still indicate the presence of antibody to all four serotypes in the region. Identifying alternate etiologies of FUOs in this region will assist clinicians in plan-of-care decisions as well as follow-up priorities. This is particularly relevant given the Ebola outbreak in the region, where diagnosis has a range of downstream effects ranging from correct allocation of medical resources, appropriate isolation of patients, and ultimately, a better informed public health sector.