Respiratory Viral Infections and Their Association with Acute Febrile Illness Within Nicaragua

Abstract

Acute febrile illness (AFI) is defined as a non-localized fever of ≥ 38oC and affects many individuals around the world. Due to many different diseases causing AFI, it can often be difficult to diagnose patients with the correct etiology. As such, it is hypothesized that a significant percentage of patients within Leon, Nicaragua are often misdiagnosed with ailments such as dengue fever when a respiratory virus is the etiologic agent causing the patient’s AFI. 262 Nasopharyngeal swabs from patients ≧ 1 year old were obtained between January 2021 and March 2022 at the Hospital Escuela Oscar Danilo Rosales Arguello (HEODRA) located in Leon, Nicaragua. The DNA and/or RNA of each sample was extracted using the Qiagen EZ1 Advanced XL alongside the EZ1 virus kit. After DNA/RNA extraction the samples were then sequenced via real-time polymerase chain reaction (RT-PCR) on the Luminex Integrated System NxTAG Respiratory Pathogen Panel (RPP) platform which detects a multitude of respiratory pathogens. The RPP panel results were then cross-referenced with each patient’s sociodemographics, clinical symptoms, and end diagnosis. Around 20% of patient samples tested positive on the RPP in which rhinovirus/enterovirus and influenza A were the most detected targets. These patients were often younger and more likely to be male, work in an office, have a shorter fever and rhinitis, and be diagnosed with dengue. These results support the hypothesis as well as show differences in symptoms that providers can use to better diagnose patients.