# Detection and Characterization of Flavivirus and Alphavirus Infections in Acute Suspected Arboviral Cases or Neurological Disease, Central Department, Paraguay

> **NIH NIH R21** · EMORY UNIVERSITY · 2020 · $176,386

## Abstract

PROJECT ABSTRACT
Flaviviruses and alphaviruses are the two most common genera of arboviral pathogens, accounting for
hundreds of millions of infections annually and repeated epidemics over the past 20 years. In total, these large
genera include over a hundred potential human pathogens. Symptomatic infections with the flaviviruses (e.g.
dengue, Zika, West Nile) and alphaviruses (e.g. chikungunya, Mayaro) present with non-specific
manifestations and predominantly result in two overlapping acute clinical syndromes: a systemic illness with or
without fever and a neurological illness such as meningoencephalitis. However, it is costly and impractical to
test patients for more than a few common pathogens, and research protocols typically focus on one clinical
syndrome. These factors complicate the detection of arboviral infections, surveillance and control efforts, and
the calculation of accurate incidence estimates. Research in this proposal will utilize novel molecular methods
for pan-genus detection and new multiplex serological methods to simultaneously screen for antibodies against
eight arboviruses. The objective of the proposal is to evaluate new molecular and serological methods for the
characterization of the incidence, seroprevalence and diversity of flavivirus and alphavirus infections among
symptomatic patients. Research will be performed in Asunción and the Central Department of Paraguay,
where recent transmission of multiple arboviruses has been documented. Our central hypotheses are that 1)
these new methods will increase the breadth of arbovirus detection among symptomatic patients, 2) evidence
of exposure to multiple arboviruses will be common, and 3) broad, heterotypic antibody responses will protect
against severe disease. This research will first characterize flavivirus and alphavirus infections among patients
with an acute suspected arboviral illness or acute neurological disease (meningitis, encephalitis, Guillain-Barré
syndrome). Pan-flavivirus and pan-alphavirus detection will be performed with a novel molecular assay. Viral
epidemiology, clinical findings, and patient outcomes will be described among patients who meet the study
definitions. The incidence of symptomatic and severe disease will then be determined in relation to arboviral
antibodies at presentation. Multiplex serological testing will be performed to detect IgM and IgG against five
flaviviruses and three alphaviruses. Seroprevalence will be calculated, and the incidence of symptomatic and
severe disease will be evaluated in relation to the presence of pre-infection antibodies to heterotypic viruses.
Finally, whole-genome viral sequences will be obtained directly from clinical samples using a CRISPR/CAS9
depletion system to analyze viral phylogenetics and identify new/rare viral strains. The purpose of this research
is to improve laboratory methods for the most common human arbovirus families and identify patients at risk
for symptomatic or severe arboviral illnesses...

## Key facts

- **NIH application ID:** 9950981
- **Project number:** 5R21AI146443-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Jesse Waggoner
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $176,386
- **Award type:** 5
- **Project period:** 2019-06-12 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9950981

## Citation

> US National Institutes of Health, RePORTER application 9950981, Detection and Characterization of Flavivirus and Alphavirus Infections in Acute Suspected Arboviral Cases or Neurological Disease, Central Department, Paraguay (5R21AI146443-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9950981. Licensed CC0.

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