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Serologic Evidence of Hemorrhagic Fever Virus Spillover in Rural Liberia.

Adam M Schafer1 Emmanuel Kerkula2 Chanhwa Lee3 Alfred Flomo2 Amara Fofana2 Stanley Kerkula2 Thomas Sumo2 Alexander Sampson2 Samuel Vouh2 Fred Flomo2 McKenzie A Colt2 Katie R Mollan3 Taylor J Krajewski3 Eleanor Rose Watts4 Catherine Nimely2 Randal J Schoepp5 Keersten Ricks5 Minnie Ricks6 Jefferson Sibley6,7 Jacob A Dillard8 David A Wohl1 William A Fischer1
Affiliations 8 institutions
  1. Institute for Global Health and Infectious Diseases, The University of North Carolina, Chapel Hill, North Carolina, USA.
  2. Institute for Global Health and Infectious Diseases, Project Liberia, The University of North Carolina, Bong, Liberia.
  3. Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, North Carolina, USA.
  4. Vaccine Development and Evaluation Centre, UK Health Security Agency, Andover, England, UK.
  5. Diagnostic Systems Division, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA.
  6. Department of Pediatrics, Phebe Hospital, Bong, Liberia.
  7. Department of Surgery, Phebe Hospital, Bong, Liberia.
  8. Department of Microbiology and Immunology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
PMID 41884425 2026 Open Forum Infect Dis eng epublish
PubMed DOI Browse context

Article

Publication summary

Outbreaks of zoonotic emerging infectious diseases, including viral hemorrhagic fevers, are increasing in frequency. Clinical detection remains challenging due to the lack of pathognomonic signs or symptoms and limited access to diagnostics. To better understand the prevalence of prior exposure to viral hemorrhagic fever viruses, serum from community participants in rural Liberia was tested for immunoglobulin G antibodies. Serum collected from individuals enrolled in the ENABLE study, an observational study of Lassa fever virus incidence and seroprevalence, were analyzed for immunoglobulin G against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay. Associations with seropositivity were evaluated using questionnaires that included demographic, animal, and environmental exposure information. Eighty-eight percent of samples from 456 participants tested positive for ≥1 of the viral antibodies with a majority (63%) having antibodies to ≥2 viruses. Seropositivity was highest for Lassa virus (67%) followed by pan-flavivirus (51%), pan-alphavirus (35%), Crimean-Congo hemorrhagic fever virus (24%), Ebolavirus (13%), Rift Valley Fever virus (9%), and Marburg virus (8%). Older age, sex (variable by pathogen), and exposure to cats and rats were associated with seropositivity. These findings demonstrate a significant spillover of filoviruses, bunyaviruses, flaviviruses, and alphaviruses in rural Liberia in contrast with an absence of detected outbreaks. These data support the need for enhanced surveillance and understanding of the ecological and behavioral risk factors for zoonotic spillover events, across a spectrum of disease presentation, given their potential and ongoing threat to global public health.

ebolavirus flavivirus Lassa virus Liberia Marburg virus

Structured evidence records

Evidence records

11 total
Serological Evidence 7 records
Serological Evidence Extraction confidence 0.95
Key finding

High seropositivity for antibodies to several hemorrhagic fever viruses was detected in human serum from rural Liberia, indicating prior exposure and possible zoonotic spillover.

Virus
LASV
Location
Not specified
Supporting text

Serum collected from individuals enrolled in the ENABLE study were analyzed for immunoglobulin G against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay. Eighty-eight percent of samples from 456 participants tested positive for ≥1 of the viral antibodies with seropositivity highest for Lassa virus (67%), followed by pan-flavivirus (51%), pan-alphavirus (35%), Crimean-Congo hemorrhagic fever virus (24%), Ebolavirus (13%), Rift Valley Fever virus (9%), and Marburg virus (8%).

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Antibodies to Ebolavirus were detected in 13% of human serum samples from rural Liberia, indicating previous viral exposure.

Virus
EBOV
Location
Not specified
Supporting text

Serum collected from individuals enrolled in the ENABLE study were analyzed for immunoglobulin G against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay. Seropositivity was 13% for Ebolavirus.

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Low seropositivity (8%) to Marburg virus was found in human serum, indicating potential prior exposure without recent outbreaks.

Virus
MARV
Location
Not specified
Supporting text

Serum collected from individuals enrolled in the ENABLE study were analyzed for immunoglobulin G against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus. Seropositivity was 8% for Marburg virus.

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Antibodies to Rift Valley Fever virus were detected in 9% of human serum samples from rural Liberia.

Virus
RVFV
Location
Not specified
Supporting text

Serum samples were tested for immunoglobulin G against Rift Valley Fever virus; seropositivity was 9%.

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Crimean-Congo hemorrhagic fever virus antibodies were detected in 24% of human serum samples, suggesting frequent prior exposure.

Virus
CCHFV
Location
Not specified
Supporting text

Serum samples were tested for immunoglobulin G antibodies to Crimean-Congo hemorrhagic fever virus; seropositivity was 24%.

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Pan-flavivirus antibodies were detected in 51% of human serum samples from rural Liberia, indicating widespread previous flavivirus exposure.

Virus
Flaviviridae
Location
Not specified
Supporting text

Serum samples were tested for immunoglobulin G antibodies against pan-flavivirus, with seropositivity of 51%.

Method
MAGPIX multiplex immune assay
Sample type
serum
Serological Evidence Extraction confidence 0.95
Key finding

Pan-alphavirus antibodies were detected in 35% of human serum samples from rural Liberia, indicating substantial prior exposure to alphaviruses.

Virus
Alphavirus
Location
Not specified
Supporting text

Serum samples were tested for immunoglobulin G antibodies against pan-alphavirus, with seropositivity of 35%.

Method
MAGPIX multiplex immune assay
Sample type
serum
Zoonotic Surveillance 3 records
Zoonotic Surveillance Extraction confidence 0.78
Key finding

Serologic surveillance in rural Liberia detected antibodies to multiple hemorrhagic fever viruses, indicating widespread prior zoonotic exposure.

Virus
EBOV
Location
Liberia rural Liberia, Liberia
Supporting text

Serum from community participants in rural Liberia was tested for immunoglobulin G antibodies against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay.

Method
serology; MAGPIX multiplex immune assay
Sample type
serum
Geographic raw
rural Liberia
Country inferred
Liberia
Zoonotic Surveillance Extraction confidence 0.78
Key finding

High seropositivity for Lassa virus was observed, supporting continued zoonotic exposure in the region.

Virus
LASV
Location
Liberia rural Liberia, Liberia
Supporting text

Serum from community participants in rural Liberia was tested for immunoglobulin G antibodies against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay.

Method
serology; MAGPIX multiplex immune assay
Sample type
serum
Geographic raw
rural Liberia
Country inferred
Liberia
Zoonotic Surveillance Extraction confidence 0.78
Key finding

Seropositivity to Marburg virus was detected among participants, indicating undetected spillover exposure.

Virus
MARV
Location
Liberia rural Liberia, Liberia
Supporting text

Serum from community participants in rural Liberia was tested for immunoglobulin G antibodies against Ebola virus, Marburg virus, Lassa virus, Rift Valley Fever virus, Crimean-Congo hemorrhagic fever virus, pan-alphavirus, and pan-flavivirus by MAGPIX, a multiplex immune assay.

Method
serology; MAGPIX multiplex immune assay
Sample type
serum
Geographic raw
rural Liberia
Country inferred
Liberia
Spillover Event 1 records
Spillover Event Extraction confidence 0.92
Key finding

Human serological evidence indicates previous animal-to-human spillover infections with viral hemorrhagic fever viruses in rural Liberia.

Virus
LASV
Location
Liberia rural Liberia, Liberia
Supporting text

Serum from community participants in rural Liberia was tested for antibodies against multiple viral hemorrhagic fever viruses, and positive results indicated a significant spillover of filoviruses, bunyaviruses, flaviviruses, and alphaviruses in rural Liberia.

Method
MAGPIX multiplex immune assay
Study design
serological survey
Transmission direction
animal-to-human
Geographic raw
rural Liberia
Country inferred
Liberia