Metagenomic next-generation sequencing aids the diagnosis of viral infections in febrile returning travellers

Jerome, H. et al. (2019) Metagenomic next-generation sequencing aids the diagnosis of viral infections in febrile returning travellers. Journal of Infection, 79(4), pp. 383-388. (doi: 10.1016/j.jinf.2019.08.003) (PMID:31398374) (PMCID:PMC6859916)

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Objectives: Travel-associated infections are challenging to diagnose because of the broad spectrum of potential aetiologies. As a proof-of-principle study, we used MNGS to identify viral pathogens in clinical samples from returning travellers in a single center to explore its suitability as a diagnostic tool. Methods: Plasma samples from 40 returning travellers presenting with a fever of ≥38°C were sequenced using MNGS on the Illumina MiSeq platform and compared with standard-of-care diagnostic assays. Results: In total, 11/40 patients were diagnosed with a viral infection. Standard of care diagnostics revealed 5 viral infections using plasma samples; dengue virus 1 (n = 2), hepatitis E (n = 1), Ebola virus (n = 1) and hepatitis A (n = 1), all of which were detected by MNGS. Three additional patients with Chikungunya virus (n = 2) and mumps virus were diagnosed by MNGS only. Respiratory infections detected by nasal/throat swabs only were not detected by MNGS of plasma. One patient had infection with malaria and mumps virus during the same admission. Conclusions: MNGS analysis of plasma samples improves the sensitivity of diagnosis of viral infections and has potential as an all-in-one diagnostic test. It can be used to identify infections that have not been considered by the treating physician, co-infections and new or emerging pathogens. Summary: Next generation sequencing (NGS) has potential as an all-in-one diagnostic test. In this study we used NGS to diagnose returning travellers with acute febrile illness in the UK, highlighting cases where the diagnosis was missed using standard methods.

Item Type:Articles
Keywords:Diagnosis, NGS, returning travellers.
Glasgow Author(s) Enlighten ID:Harder, Miss Lisbeth and Davis, Dr Chris and Jesudason, Dr Natasha and Gunson, Dr Rory and Da Silva Filipe, Dr Ana and Vattipally, Dr Sreenu and Thomson, Professor Emma and Wilson-Davies, Dr Eleri and Ashraf, Dr Shirin
Authors: Jerome, H., Taylor, C., Sreenu, V. B., Klymenko, T., Da Silva Filipe, A., Jackson, C., Davis, C., Ashraf, S., Wilson-Davies, E., Jesudason, N., Devine, K., Harder, L., Aitken, C., Gunson, R., and Thomson, E. C.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
Journal Name:Journal of Infection
ISSN (Online):1532-2742
Published Online:06 August 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Journal of Infection 79(4): 383-388
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
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656341Virus-host interactions in hepatitis C virus infectionJohn McLauchlanMedical Research Council (MRC)MC_UU_12014/1MVLS III - CENTRE FOR VIRUS RESEARCH