Oropouche virus as an emerging cause of acute febrile illness in Colombia

ABSTRACT

Arbovirus infections are frequent causes of acute febrile illness (AFI) in tropical countries. We conducted health facility-based AFI surveillance at four sites in Colombia (Cucuta, Cali, Villavicencio, Leticia) during 2019-2022. Demographic, clinical and risk factor data were collected from persons with AFI that consented to participate in the study (n = 2,967). Serologic specimens were obtained and tested for multiple pathogens by RT–PCR and rapid test (Antigen/IgM), with 20.7% identified as dengue positive from combined testing. Oropouche virus (OROV) was initially detected in serum by metagenomic next-generation sequencing (mNGS) and virus target capture in a patient from Cúcuta. Three additional infections from Leticia were confirmed by conventional PCR, sequenced, and isolated in tissue culture. Phylogenetic analysis determined there have been at least two independent OROV introductions into Colombia. To assess OROV spread, a RT-qPCR dual-target assay was developed which identified 87/791 (10.9%) viremic cases in AFI specimens from Cali (3/53), Cucuta (3/19), Villavicencio (38/566), and Leticia (43/153). In parallel, an automated anti-nucleocapsid antibody assay detected IgM in 27/503 (5.4%) and IgG in 92/568 (16.2%) patients screened, for which 24/68 (35.3%) of PCR positives had antibodies. Dengue was found primarily in people aged <18 years and linked to several clinical manifestations (weakness, skin rash and petechiae), whereas Oropouche cases were associated with the location, climate phase, and odynophagia symptom. Our results confirm OROV as an emerging pathogen and recommend increased surveillance to determine its burden as a cause of AFI in Colombia.

GRAPHICAL ABSTRACT

KEYWORDS:

• Oropouche
• bunyavirus
• acute febrile illness
• fever
• Colombia
• RT–PCR
• NGS
• serology

Acknowledgements

The authors would like to thank the Directors and the medical staff from the participating study sites, including Hospital Erasmo Meoz, Hospital Departamental de Villavicencio, Red de Salud Ladera and Clinica de Leticia for their contribution during the field work of our study. We thank Dean Veronica Botero Dean of Faculty of Mines of Universidad Nacional de Colombia-Medellin for her instittutional support to this work. We sincerely thank to Monica Palma, Claudia Chia, Denny Cardenas, Diana Florez, Ana Maria Hurtado, Julian Rodriguez and Corporacion Corpotropica for their assistance and coordination of field work activities in the study sites. Many thanks to the staff of One Health lab and auxiliary personnel at all the study sites for their assistance in the study. MGB, LJP, AH, KF, JY, SW, XQ, FA, GAC are all Abbott employees and shareholders. Concept and design: All authors; Acquisition, analysis, or interpretation of data: All authors; Drafting of the manuscript: KC, FA, MB, JO. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: KC, LP, AH, FA, MB. Experiments design, samples processing, data analysis: KC, MB, LP, LC, LP, AH, KF, JY, SW, XQ; Obtained funding: JO, JPH, GC; Administrative, technical, or material support: JO, JPH, GC; Supervision: JO, JPH, GC.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. Raw data and other additional information are available from the corresponding author upon request.

Additional information

Funding

This work was supported by the Global Health Institute of the University of Wisconsin–Madison, the Universidad Nacional de Colombia (Medellín) and Abbott Diagnostics.