Multiple circulating infections can mimic the early stages of viral hemorrhagic fevers and possible human exposure to filoviruses in sierra leone prior to the 2014 outbreak

Matthew L. Boisen, John S. Schieffelin, Augustine Goba, Darin Oottamasathien, Abigail B. Jones, Jeffrey G. Shaffer, Kathryn M. Hastie, Jessica N. Hartnett, Mambu Momoh, Mohammed Fullah, Michael Gabiki, Sidiki Safa, Michelle Zandonatti, Marnie Fusco, Zach Bornholdt, Dafna Abelson, Stephen K. Gire, Kristian G. Andersen, Ridhi Tariyal, Mathew StremlauRobert W. Cross, Joan B. Geisbert, Kelly R. Pitts, Thomas W. Geisbert, Peter Kulakoski, Russell B. Wilson, Lee Henderson, Pardis C. Sabeti, Donald S. Grant, Robert F. Garry, Erica O. Saphire, Luis M. Branco, Sheik Humarr Khan

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Lassa fever (LF) is a severe viral hemorrhagic fever caused by Lassa virus (LASV). The LF program at the Kenema Government Hospital (KGH) in Eastern Sierra Leone currently provides diagnostic services and clinical care for more than 500 suspected LF cases per year. Nearly two-thirds of suspected LF patients presenting to the LF Ward test negative for either LASV antigen or anti-LASV immunoglobulin M (IgM), and therefore are considered to have a non-Lassa febrile illness (NLFI). The NLFI patients in this study were generally severely ill, which accounts for their high case fatality rate of 36%. The current studies were aimed at determining possible causes of severe febrile illnesses in non-LF cases presenting to the KGH, including possible involvement of filoviruses. A seroprevalence survey employing commercial enzyme-linked immunosorbent assay tests revealed significant IgM and IgG reactivity against dengue virus, chikungunya virus, West Nile virus (WNV), Leptospira, and typhus. A polymerase chain reaction-based survey using sera from subjects with acute LF, evidence of prior LASV exposure, or NLFI revealed widespread infection with Plasmodium falciparum malaria in febrile patients. WNV RNA was detected in a subset of patients, and a 419 nt amplicon specific to filoviral L segment RNA was detected at low levels in a single patient. However, 22% of the patients presenting at the KGH between 2011 and 2014 who were included in this survey registered anti-Ebola virus (EBOV) IgG or IgM, suggesting prior exposure to this agent. The 2014 Ebola virus disease (EVD) outbreak is already the deadliest and most widely dispersed outbreak of its kind on record. Serological evidence reported here for possible human exposure to filoviruses in Sierra Leone prior to the current EVD outbreak supports genetic analysis that EBOV may have been present in West Africa for some time prior to the 2014 outbreak.

Original languageEnglish (US)
Pages (from-to)19-31
Number of pages13
JournalViral Immunology
Issue number1
StatePublished - Feb 1 2015

ASJC Scopus subject areas

  • Immunology
  • Molecular Medicine
  • Virology


Dive into the research topics of 'Multiple circulating infections can mimic the early stages of viral hemorrhagic fevers and possible human exposure to filoviruses in sierra leone prior to the 2014 outbreak'. Together they form a unique fingerprint.

Cite this