TY - JOUR
T1 - Flaviviruses as a cause of undifferentiated fever in sindh province, pakistan
T2 - A preliminary report
AU - Khan, Erum
AU - Farooqi, Joveria Q.
AU - Barr, Kelli L.
AU - Prakoso, Dhani
AU - Nasir, Amna
AU - Kanji, Akbar
AU - Shakoor, Sadia
AU - Malik, Faisal Riaz
AU - Hasan, Rumina
AU - Lednicky, John A.
AU - Long, Maureen T.
N1 - Funding Information:
This work was supported by the Defense Threat Reduction Agency, Basic Research Award # HDTRA1-14-1-0022, to the University of Florida. The contents do not necessarily reflect the position or the policy of the federal government, and no official endorsement should be inferred.
Publisher Copyright:
© 2016 Khan, Farooqi, Barr, Prakoso, Nasir, Kanji, Shakoor, Malik, Hasan, Lednicky and Long.
PY - 2016/2
Y1 - 2016/2
N2 - Arboviral diseases are expanding worldwide, yet global surveillance is often limited due to diplomatic and cultural barriers between nations. With human encroachment into new habitats, mosquito-borne viruses are also invading new areas. The actual prevalence of expanding arboviruses is unknown in Pakistan due to inappropriate diagnosis and poor testing for arboviral diseases. The primary objective of this study was to document evidence of flavivirus infections as the cause of undifferentiated fever in Pakistan. Through a cooperative effort between the USA and Pakistan, patient exposure to dengue virus (DENV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) was examined in Sindh Province for the first time in decades. Initial results from the 2015 arbovirus season consisting of a cross-sectional study of 467 patients in 5 sites, DENV NS1 antigen was identified in 63 of the screened subjects, WNV IgM antibodies in 16 patients, and JEV IgM antibodies in 32 patients. In addition, a number of practical findings were made including (1) in silico optimization of RT-PCR primers for flavivirus strains circulating in the Middle East, (2) shipping and storage of RT-PCR master mix and other reagents at ambient temperature, (3) Smart phone applications for the collection of data in areas with limited infrastructure, and (4) fast and reliable shipping for transport of reagents and specimens to and from the Middle East. Furthermore, this work is producing a group of highly trained local scientists and medical professionals disseminating modern scientific methods and more accurate diagnostic procedures to the community.
AB - Arboviral diseases are expanding worldwide, yet global surveillance is often limited due to diplomatic and cultural barriers between nations. With human encroachment into new habitats, mosquito-borne viruses are also invading new areas. The actual prevalence of expanding arboviruses is unknown in Pakistan due to inappropriate diagnosis and poor testing for arboviral diseases. The primary objective of this study was to document evidence of flavivirus infections as the cause of undifferentiated fever in Pakistan. Through a cooperative effort between the USA and Pakistan, patient exposure to dengue virus (DENV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) was examined in Sindh Province for the first time in decades. Initial results from the 2015 arbovirus season consisting of a cross-sectional study of 467 patients in 5 sites, DENV NS1 antigen was identified in 63 of the screened subjects, WNV IgM antibodies in 16 patients, and JEV IgM antibodies in 32 patients. In addition, a number of practical findings were made including (1) in silico optimization of RT-PCR primers for flavivirus strains circulating in the Middle East, (2) shipping and storage of RT-PCR master mix and other reagents at ambient temperature, (3) Smart phone applications for the collection of data in areas with limited infrastructure, and (4) fast and reliable shipping for transport of reagents and specimens to and from the Middle East. Furthermore, this work is producing a group of highly trained local scientists and medical professionals disseminating modern scientific methods and more accurate diagnostic procedures to the community.
KW - Arbovirus
KW - Dengue viruses
KW - Flavivirus
KW - Japanese encephalitis virus
KW - Transboundary diseases
KW - West Nile virus
UR - http://www.scopus.com/inward/record.url?scp=85050120561&partnerID=8YFLogxK
U2 - 10.3389/fpubh.2016.00008
DO - 10.3389/fpubh.2016.00008
M3 - Article
AN - SCOPUS:85050120561
SN - 2296-2565
VL - 4
JO - Frontiers in Public Health
JF - Frontiers in Public Health
M1 - 8
ER -
