Retrospective meta-transcriptomic identification of severe dengue in a traveller returning from Africa to Sweden, 1990

Kristian Alfsnes; Nina Lagerqvist; Sirkka Vene; Jon Bohlin; Jenny Verner-Carlsson; David Ekqvist; Andreas Bråve; Edward C Holmes; Weifeng Shi; John H-O Pettersson

doi:10.1016/j.onehlt.2021.100217

Retrospective meta-transcriptomic identification of severe dengue in a traveller returning from Africa to Sweden, 1990

One Health. 2021 Jan 22:12:100217. doi: 10.1016/j.onehlt.2021.100217. eCollection 2021 Jun.

Authors

Affiliations

¹ Infectious Disease Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
² Public Health Agency of Sweden, Nobels väg 18, SE-171 82 Solna, Sweden.
³ Department of Infectious Diseases, University Hospital Linköping, Sweden.
⁴ Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, the University of Sydney, Sydney, New South Wales 2006, Australia.
⁵ School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271016, China.
⁶ Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Sweden.

Abstract

Pathogens associated with haemorrhagic fever commonly have zoonotic origins. The first documented imported case of likely viral severe haemorrhagic fever in Sweden occurred in 1990. Despite extensive study, no aetiological agent was identified. Following retrospective investigation with total RNA-sequencing of samples collected between 7 and 36 days from onset of symptoms we identified dengue virus 3 (DENV-3) and a human pegivirus (HPgV). We conclude that the patient likely suffered from haemorrhagic symptoms due to an atypical severe and undiagnosed dengue infection.

Keywords: Dengue haemorrhagic fever; Dengue virus; Human pegivirus; Meta-transcriptomics; RNA-sequencing; Viral haemorrhagic fever.