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An Outbreak of Acute Febrile Illness Caused by Sandfly Fever Sicilian Virus in the Afar Region of Ethiopia, 2011

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  • Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention–Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia

In malaria-endemic regions, many medical facilities have limited capacity to diagnose non-malarial etiologies of acute febrile illness (AFI). As a result, the etiology of AFI is seldom determined, although AFI remains a major cause of morbidity in developing countries. An outbreak of AFI was reported in the Afar region of Ethiopia in August of 2011. Retrospectively, 12,816 suspected AFI cases were identified by review of medical records. Symptoms were mild and self-limiting within 3 days after the date of onset; no fatalities were identified. All initial test results of AFI patient specimens were negative for selected pathogens using standard microbiological and molecular techniques. High-throughput sequencing of nucleic acid extracts of serum specimens from 29 AFI cases identified 17 (59%) of 29 samples as positive for Sandfly Fever Sicilian Virus (SFSV). These results were further confirmed by specific reverse transcription polymerase chain reaction. This is the first study implicating SFSV as an etiological agent for AFI in Ethiopia.

Author Notes

* Address correspondence to David Wang, 660 South Euclid Avenue, Campus Box 8230, St. Louis, MO 63130. E-mail: davewang@borcim.wustl.edu

Financial support: This work was supported, in part, by National Institutes of Health Midwest Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research Grant U54 AI057160.

Authors' addresses: Abyot Bekele Woyessa, Workenesh Ayele, Abdi Ahmed, Negga Asamene Abera, and Daddi Jima, Ethiopian Health and Nutrition Research Institute, E-mails: sifanbashu@yahoo.com, wayele@gmail.com, abdiseid04@yahoo.com, negaasamene@gmail.com, and daddi_jima@yahoo.com. Victor Omballa, Lilian Waiboci, and Melvin Ochieng, Global Disease Detection Program, Centers for Disease Control and Prevention–Kenya, E-mails: VOmballa@kemricdc.org, waiboci@uonbi.ac.ke, and MOchieng@kemricdc.org. David Wang and Song Cao, Departments of Molecular Microbiology and Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, E-mails: davewang@borcim.wustl.edu and scao@wustl.edu. Amy Lambert, Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, E-mail: ahk7@cdc.gov. Joel M. Montgomery and Barry Fields, Global Disease Detection Program, Centers for Disease Control and Prevention–Kenya, and Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: ztq9@cdc.gov and bsf2@cdc.gov.

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