Venezuelan equine encephalitis, Mayaro and chikungunya viruses as causative agents of febrile syndrome in Colombian patients during 2013 and 2014

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Abstract
Introduction Colombia’s tropical climate and low-altitude cities create an ideal environment where mosquito-borne diseases can thrive. During 2013-2014, dengue was the most diagnosed cause of febrile syndrome. However, other viruses like Venezuelan equine encephalitis (VEEV), Mayaro (MAYV), and chikungunya viruses (CHIKV) were also present, and their true prevalence was likely underestimated due to limited surveillance. Methods We conducted a cross-sectional study involving 90 febrile patients from the Urabá region. For each patient, we collected both acute and convalescent serum samples, which were analyzed to detect antibodies against VEEV, CHIKV, and MAYV. Additionally, we attempted virus isolation from the acute-phase serum samples. Results We found that antibodies against VEEV were present in 28.3% of samples, CHIKV antibodies were detected in 5%, and MAYV antibodies in 1.7%. Notably, one patient tested positive for CHIKV even before the first outbreak was recognized in Colombia in 2014. Furthermore, we isolated and fully sequenced VEEV, and our analysis revealed a close phylogenetic relationship with subtype ID Panamanian strains. Conclusion This study highlights the need to consider arboviruses beyond just dengue (DENV), when evaluating febrile illness in Colombia. The detection of VEEV and CHIKV, even before they were officially recognized as significant public health threats in this region, underscores the need for enhanced surveillance and diagnostic capabilities.