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Metagenomic surveillance uncovers diverse and novel viral taxa in febrile patients from Nigeria

Abstract:
Effective infectious disease surveillance in high-risk regions is critical for clinical care and pandemic preemption; however, few clinical diagnostics are available for the wide range of potential human pathogens. Here, we conduct unbiased metagenomic sequencing of 593 samples from febrile Nigerian patients collected in three settings: i) population-level surveillance of individuals presenting with symptoms consistent with Lassa Fever (LF); ii) real-time investigations of outbreaks with suspected infectious etiologies; and iii) undiagnosed clinically challenging cases. We identify 13 distinct viruses, including the second and third documented cases of human blood-associated dicistrovirus, and a highly divergent, unclassified dicistrovirus that we name human blood-associated dicistrovirus 2. We show that pegivirus C is a common co-infection in individuals with LF and is associated with lower Lassa viral loads and favorable outcomes. We help uncover the causes of three outbreaks as yellow fever virus, monkeypox virus, and a noninfectious cause, the latter ultimately determined to be pesticide poisoning. We demonstrate that a local, Nigerian-driven metagenomics response to complex public health scenarios generates accurate, real-time differential diagnoses, yielding insights that inform policy.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41467-023-40247-4

Authors

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Role:
Author
ORCID:
0000-0003-0592-6905
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Role:
Author
ORCID:
0000-0003-2110-7475
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Role:
Author
ORCID:
0000-0002-2651-2149


Publisher:
Springer Nature
Journal:
Nature Communications More from this journal
Volume:
14
Issue:
1
Article number:
4693
Publication date:
2023-08-04
Acceptance date:
2023-07-10
DOI:
EISSN:
2041-1723


Language:
English
Pubs id:
2071991
Local pid:
pubs:2071991
Deposit date:
2024-12-21
ARK identifier:

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