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Purpose: The Federal Republic of Sudan has experienced 13 outbreaks of undifferentiated febrile illness (UFI) associated with haemorrhage and high case fatality rates (CFR) since 2012. As a range of high consequence pathogens is endemic in Sudan, these outbreaks are of significant concern. We investigated a 2015-16 UFI outbreak in Darfur (469 cases, CFR 25.6%) to explore aetiologies, inform public health interventions and promote development of diagnostic capacity.

Methods & Materials: We extracted clinical and epidemiological data from Sudan Ministry of Health databases and matched available legacy samples at the National Public Health Laboratory. Serum samples were tested further at the Rare and Imported Pathogens Laboratory, Public Health England, using a bespoke panel of molecular and serological assays covering a broad range of likely pathogens, including haemorrhagic fever viruses …