000161982 001__ 161982
000161982 005__ 20251017144609.0
000161982 0247_ $$2doi$$a10.1016/j.cmi.2025.04.007
000161982 0248_ $$2sideral$$a144625
000161982 037__ $$aART-2025-144625
000161982 041__ $$aeng
000161982 100__ $$aPellejero-Sagastizábal, Galadriel
000161982 245__ $$aDelayed correct diagnoses in emerging disease outbreaks: historical patterns and lessons for contemporary responses
000161982 260__ $$c2025
000161982 5060_ $$aAccess copy available to the general public$$fUnrestricted
000161982 5203_ $$aBackground
The gap between early diagnostic assumptions and final diagnoses in disease outbreaks represents a persistent challenge in global health despite advancements in diagnostic and response capabilities.
Objectives
To analyse the unfolding 2025 outbreak in the Democratic Republic of Congo (DRC) through the lens of historical cases where initial misattributions contributed to delayed recognition of novel or unexpected threats with varying public health consequences; identifying patterns from past outbreaks that can inform current diagnostic approaches and response strategies.
Sources
We selected illustrative examples from peer-reviewed publications, focusing on cases with initial diagnostic uncertainties that highlight specific diagnostic patterns relevant to the current DRC outbreak. For the ongoing DRC outbreak, we analysed official World Health Organization Africa bulletins and communications from the DRC Ministry of Health through February and early March 2025.
Content
As of beginning of April 2025, health authorities continue investigating clusters of unexplained acute febrile illness in Équateur Province with clinical features that were initially being suggestive of a viral haemorrhagic fever. Primary viral haemorrhagic fever pathogens have now been excluded. From selected historical and recent outbreaks, it can be deduced that diagnostic challenges extend beyond individual cognition to include structural biases in global health systems, methodological limitations and sociocultural factors.
Implications
We identified five evidence-informed interventions to mitigate diagnostic delays: systematic consideration of multiple working hypotheses, development of sustainable local diagnostic capacity, enhancement of clinician-to-public-health communication networks, implementation of cognitive debiasing strategies, and strengthening of One Health surveillance platforms. Historical misdiagnoses offer crucial lessons for transforming outbreak response from reactive to anticipatory, potentially averting future epidemics through earlier, more accurate recognition of emerging pathogens within their complex ecological and social contexts.
000161982 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000161982 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000161982 700__ $$aBulescu, Casandra
000161982 700__ $$aGupta, Nitin
000161982 700__ $$aJokelainen, Pikka
000161982 700__ $$aGkrania-Klotsas, Effrossyni
000161982 700__ $$aBarac, Aleksandra
000161982 700__ $$aGoorhuis, Abraham
000161982 700__ $$aJacob, Shevin T.
000161982 700__ $$aAgnandji, Selidji T.
000161982 700__ $$aNtoumi, Francine
000161982 700__ $$aMora-Rillo, Marta
000161982 700__ $$0(orcid)0000-0002-9600-8116$$aPaño-Pardo, José Ramón$$uUniversidad de Zaragoza
000161982 700__ $$aLescure, F.-Xavier
000161982 700__ $$aGrobusch, Martin P.
000161982 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000161982 773__ $$g(2025), [9 p.]$$pClin. microbiol. infect.$$tClinical Microbiology and Infection$$x1198-743X
000161982 8564_ $$s359814$$uhttps://zaguan.unizar.es/record/161982/files/texto_completo.pdf$$yVersión publicada
000161982 8564_ $$s2791418$$uhttps://zaguan.unizar.es/record/161982/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000161982 909CO $$ooai:zaguan.unizar.es:161982$$particulos$$pdriver
000161982 951__ $$a2025-10-17-14:16:46
000161982 980__ $$aARTICLE