An Epidemiological Approach to Uncover Comorbidities as Potential Risk Factors for Development of Viral Haemorrhagic Fever

Abstract

Viral haemorrhagic fevers form a distinctive category of illness in humans that is typically, but not definitively, characterized by internal bleeding and fever. Disease manifestations are attributed to an autoimmune disorder that is triggered by prior exposure to one of several RNA viruses. These include such well known viruses as Ebola and Lassa, the associated fevers for which are often lethal, even with medical intervention, to dengue and Zika, which do cause severe complications but that are also often subclinical. Aside from the pressing need to establish precisely the mechanism of VHF pathogenicity, screening of genetic markers for comorbidity, which are in close proximity on the same human chromosome and thus may be inherited together, should help to determine risk factors for unrelated inheritable diseases and metabolic disorders. An exemplar is the autoimmune condition type 1 diabetes, which has been identified as a risk factor for dengue haemorrhagic fever. Any correlations found between VHF and a disease with a known molecular basis, such as type 1 diabetes, may be investigated further by examining genomic regions close to those associated with the identified condition. This may reveal genes which encode proteins that play a putative role in the pathogenesis of VHF.