Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Mar 6;358(10):991-8.
doi: 10.1056/NEJMoa073785. Epub 2008 Feb 6.

A new arenavirus in a cluster of fatal transplant-associated diseases

Gustavo Palacios  1 , Julian Druce, Lei Du, Thomas Tran, Chris Birch, Thomas Briese, Sean Conlan, Phenix-Lan Quan, Jeffrey Hui, John Marshall, Jan Fredrik Simons, Michael Egholm, Christopher D Paddock, Wun-Ju Shieh, Cynthia S Goldsmith, Sherif R Zaki, Mike Catton, W Ian Lipkin
Affiliations
Free article

A new arenavirus in a cluster of fatal transplant-associated diseases

Gustavo Palacios et al. N Engl J Med. .
Free article

Erratum in

  • N Engl J Med. 2008 Mar 13;358(11):1204

Abstract

Background: Three patients who received visceral-organ transplants from a single donor on the same day died of a febrile illness 4 to 6 weeks after transplantation. Culture, polymerase-chain-reaction (PCR) and serologic assays, and oligonucleotide microarray analysis for a wide range of infectious agents were not informative.

Methods: We evaluated RNA obtained from the liver and kidney transplant recipients. Unbiased high-throughput sequencing was used to identify microbial sequences not found by means of other methods. The specificity of sequences for a new candidate pathogen was confirmed by means of culture and by means of PCR, immunohistochemical, and serologic analyses.

Results: High-throughput sequencing yielded 103,632 sequences, of which 14 represented an Old World arenavirus. Additional sequence analysis showed that this new arenavirus was related to lymphocytic choriomeningitis viruses. Specific PCR assays based on a unique sequence confirmed the presence of the virus in the kidneys, liver, blood, and cerebrospinal fluid of the recipients. Immunohistochemical analysis revealed arenavirus antigen in the liver and kidney transplants in the recipients. IgM and IgG antiviral antibodies were detected in the serum of the donor. Seroconversion was evident in serum specimens obtained from one recipient at two time points.

Conclusions: Unbiased high-throughput sequencing is a powerful tool for the discovery of pathogens. The use of this method during an outbreak of disease facilitated the identification of a new arenavirus transmitted through solid-organ transplantation.

PubMed Disclaimer

Comment in

Similar articles

  • The new age of molecular diagnostics for microbial agents.
    Whitley R. Whitley R. N Engl J Med. 2008 Mar 6;358(10):988-9. doi: 10.1056/NEJMp0708085. Epub 2008 Feb 6. N Engl J Med. 2008. PMID: 18256386 No abstract available.
  • Transmission of lymphocytic choriomeningitis virus by organ transplantation.
    Fischer SA, Graham MB, Kuehnert MJ, Kotton CN, Srinivasan A, Marty FM, Comer JA, Guarner J, Paddock CD, DeMeo DL, Shieh WJ, Erickson BR, Bandy U, DeMaria A Jr, Davis JP, Delmonico FL, Pavlin B, Likos A, Vincent MJ, Sealy TK, Goldsmith CS, Jernigan DB, Rollin PE, Packard MM, Patel M, Rowland C, Helfand RF, Nichol ST, Fishman JA, Ksiazek T, Zaki SR; LCMV in Transplant Recipients Investigation Team. Fischer SA, et al. N Engl J Med. 2006 May 25;354(21):2235-49. doi: 10.1056/NEJMoa053240. N Engl J Med. 2006. PMID: 16723615
  • A new arenavirus in transplantation.
    Allander T, de Lamballerie X, Simmonds P. Allander T, et al. N Engl J Med. 2008 Jun 12;358(24):2638; author reply 2638-9. doi: 10.1056/NEJMc080743. N Engl J Med. 2008. PMID: 18550879 No abstract available.
  • Zoonotic aspects of arenavirus infections.
    Charrel RN, de Lamballerie X. Charrel RN, et al. Vet Microbiol. 2010 Jan 27;140(3-4):213-20. doi: 10.1016/j.vetmic.2009.08.027. Epub 2009 Aug 28. Vet Microbiol. 2010. PMID: 19748747 Review.
  • [The arenavirus in the New World: a virus in evolution and emerging diseases].
    Gonzales JP, Lechuga M, Yoksan S. Gonzales JP, et al. Med Trop (Mars). 2000;60(2 Suppl):42-9. Med Trop (Mars). 2000. PMID: 11100459 Review. French. No abstract available.
See all similar articles

Cited by

See all "Cited by" articles

Publication types

MeSH terms