Abstract
Using a metagenomic approach, we identified hepatitis A virus among cases of acute febrile illnesses that occurred in 2008-2012 in Brazil suspected as yellow fever. These findings reinforce the challenge facing routine clinical diagnosis in complex epidemiological scenarios.
Highlights
In tropical countries, acute febrile illnesses (AFIs) have a broad spectrum of possible aetiologies
In Brazil, Dengue virus (DENV), Chikungunya virus (CHIKV), Zika virus (ZIKV), and Yellow fever virus (YFV) are currently the major arbovirus infections associated with AFIs
Negative cases represent an additional threat to public health, since they can be due to unsuspected infectious agents with the potential to disseminate silently, as was the case in the early stage of the recent ZIKV epidemic in Brazil (Campos et al 2015)
Summary
Acute febrile illnesses (AFIs) have a broad spectrum of possible aetiologies. In Brazil, Dengue virus (DENV), Chikungunya virus (CHIKV), Zika virus (ZIKV), and Yellow fever virus (YFV) are currently the major arbovirus infections associated with AFIs. DENV became endemic following its re-emergence in 1986, and CHIKV and ZIKV were introduced in the region in the last three years (Figueiredo 2015). Given such a complex situation, establishment of an AFI laboratory-confirmed diagnosis is fundamental to determine the accurate epidemiological scenario as well as initiate effective and timely control measures and treatment.
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