EVALUATION OF ARTHROPOD-BORNE VIRUSES AND OTHER INFECTIOUS-DISEASE PATHOGENS AS THE CAUSES OF FEBRILE ILLNESSES IN THE KHARTOUM PROVINCE OFSUDAN

The relative importance of arthropod-borne and other disease pathogens as the cause of an outbreak of febrile illnesses was assessed during August 1988, following severe flooding in Khartoum, Sudan. A total of 200 patients with acute febrile illness and 100 afebrile controls were enrolled in the study during October and November 1988, at the Omdurm an Military Hospital, Khartoum, Sudan. Sera were tested for IgM and Ig G antibodies to six arthropod-borne viruses by an enzyme-linked immuno absorbent assay, and for similar antibodies to Lassa fever, Crimean-Co ngo hemorrhagic fever, and Ebola and Marburg viruses by an indirect fl uorescence assay. Thick and thin blood smears were examined microscopi cally for malaria parasites, and fecal and blood specimens were tested for bacteria by standard culture methods. Among the acute and convale scent sera collected from 67 febrile patients, five cases were caused by sandfly fever Sicilian (SFS), six by sandfly fever Naples (SFN), an d 12 by unidentified phleboviruses. Of 233 remaining unpaired, acute-p hase sera collected from cases and controls, 49 (21%) had IgM antibodi es to SFS or SFN, RVF, West Nile (WN), and Chikungunya (CHIK) viruses. Forty-three (22%) of 192 febrile cases and two of the 100 afebrile co ntrols were positive for Plasmodium falciparum, and bacterial enteropa thogens were associated with 25 (13%) cases and four controls. These d ata indicated that phleboviruses and to a lesser extent, WN, P. falcip arum, and enterobacterial pathogens were causes of acute febrile illne sses following the 1988 flood in Khartoum, Sudan. (C) 1996 Wiley-Liss, Inc.