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

Abyot Bekele Woyessa 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

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Victor Omballa 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

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David Wang 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

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Amy Lambert 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

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Lilian Waiboci 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

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Workenesh Ayele 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

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Abdi Ahmed 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

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Negga Asamene Abera 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

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Song Cao 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

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Melvin Ochieng 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

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Joel M. Montgomery 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

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Daddi Jima 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

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Barry Fields 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

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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.

  • 1.

    Archibald LK, Reller LB, 2001. Clinical microbiology in developing countries. Emerg Infect Dis 7: 302–305.

  • 2.

    Crump JA, Youssef FG, Luby SP, Wasfy MO, Rangel JM, Taalat M, Oun SA, Mahoney FJ, 2003. Estimating the incidence of typhoid fever and other febrile illnesses in developing countries. Emerg Inf Dis 9: 539–544.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Animut A, Mekonnen Y, Shimelis D, Ephrahim E, 2009. Febrile illnesses of different etiology among outpatients in four health centers in northwestern Ethiopia. Jpn J Infect Dis 62: 107–110.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Depaquit J, Grandadam M, Fouque F, Andry PE, Peyrefitte C, 2010. Arthropod- borne viruses transmitted by Phlebotomine sandflies in Europe: a review. Euro Surveill 15: 19507.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Dionisio D, Esperti F, Vivarelli A, Valassina M, 2003. Epidemiological, clinical and laboratory aspects of sandfly fever. Curr Opin Infect Dis 16: 383–388.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Tesh RB, Saidi S, Gajdamovic SJ, Rodhain F, Vesenjak-Hirjan J, 1976. Serological studies on the epidemiology of sandfly fever in the old world. Bull World Health Organ 54: 663–674.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Drosten C, Göttig S, Schilling S, Asper M, Panning M, Schmitz H, Günther S, 2002. Rapid detection and quantification of RNA of Ebola and Marburg viruses, Lassa virus, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus, dengue virus, and yellow fever virus by real-time reverse transcription-PCR. J Clin Microbiol 40: 2323–2330.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Handley SA, Thackray LB, Zhao G, Presti R, Miller AD, Droit L, Abbink P, Maxfield LF, Kambal A, Duan E, Stanley K, Kramer J, Macri SC, Permar SR, Schmitz JE, Mansfield K, Brenchley JM, Veazey RS, Stappenbeck TS, Wang D, Barouch DH, Virgin HW, 2012. Pathogenic simian immunodeficiency virus infection is associated with expansion of the enteric virome. Cell 151: 253–266.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Zhao G, Krishnamurthy S, Cai Z, Popov VL, Travassos da Rosa AP, Guzman H, Cao S, Virgin HW, Tesh RB, Wang D, 2013. Identification of novel viruses using VirusHunter–an automated data analysis pipeline. PLoS ONE 8: e78470.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Lambert AJ, Lanciotti RS, 2009. Consensus amplification and novel multiplex sequencing method for s segment species identification of 47 viruses of the Orthobunyavirus, Phlebovirus, and Nairovirus genera of the family Bunyaviridae. J Clin Microbiol 47: 2398–2404.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Thompson JD, Higgins DG, Gibson TJ, 1994. CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res 22: 4673–4680.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Tamura K, Dudley J, Nei M, Kumar S, 2007. MEGA4: molecular Evolutionary Genetics Analysis (MEGA) software version 4.0. Mol Biol Evol 24: 1596–1599.

  • 13.

    Saitou N, Nei M, 1987. The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol 4: 406–425.

  • 14.

    Guler S, Guler E, Caglayik DY, Kokoglu OF, Ucmak H, Bayrakdar F, Uyar Y, 2012. A sandfly fever virus outbreak in the east Mediterranean region of Turkey. Int J Infect Dis 16: 244–246.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Moureau G, Bichaud L, Salez N, Ninove L, Hamrioui B, Belazzoug S, de Lamballerie X, Izri A, Charrel RN, 2010. Molecular and serological evidence for the presence of novel phleboviruses in sandflies from northern Algeria. Open Virol J 4: 15–21.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Zhioua E, Moureau G, Chelbi I, Ninove L, Bichaud L, Derbali M, Champs M, Cherni S, Salez N, Cook S, de Lamballerie X, Charrel RN, 2010. Punique virus, a novel phlebovirus, related to sandfly fever Naples virus, isolated from sandflies collected in Tunisia. J Gen Virol 91: 1275–1283.

    • PubMed
    • Search Google Scholar
    • Export Citation
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