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Meta-analysis finds 30.7% molecular prevalence of yellow fever virus in non-human primatesYellow fever virus found in many monkeys in the Americas, study shows

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Key Takeaway
Consider NHPs as sentinel indicators in yellow fever surveillance, but note substantial data heterogeneity and geographical gaps.

This systematic review and meta-analysis examined the prevalence and characteristics of yellow fever virus (YFV) infection in non-human primates (NHPs). The analysis included 39 studies assessing 7,183 NHPs globally, with most data originating from the Americas, particularly Brazil, and limited representation from African endemic regions. Twenty-eight studies contributed to meta-analyses, and 10 provided 19 individual case reports.

The pooled molecular prevalence of YFV infection by RT-PCR was 30.7%, while prevalence by immunohistochemistry was 43.4%. Seroprevalence estimates varied widely, ranging from 5.0% to 36.4% across different assays and settings. Higher infection metrics were observed in howler monkeys and titi monkeys. Notably, all 19 reported individual cases were fatal and predominantly associated with severe hepatic and multisystemic pathology.

Key limitations include substantial between-study heterogeneity and the geographical bias, with most data from the Americas and limited representation from African endemic regions. The evidence is observational, reporting associations rather than establishing causation. Safety and tolerability data were not reported in the available studies.

The findings underscore the critical sentinel role of NHPs in YFV surveillance. For clinical practice, this analysis highlights the need to strengthen integrated One Health surveillance systems to better inform prevention and control strategies. However, the substantial heterogeneity and geographical data gaps warrant cautious interpretation of the pooled estimates.

Researchers reviewed 39 existing studies to understand how common yellow fever virus is in monkeys and other non-human primates. They looked at data from over 7,000 animals, mostly from the Americas, particularly Brazil. The goal was to see how often the virus was detected in these animals, which can act as early warning signs for human outbreaks.

The review found the virus was present in many of the animals tested. When using a test called RT-PCR, about 31% of samples were positive. When using a different test on tissue samples, about 43% were positive. Howler monkeys and titi monkeys seemed to have the highest rates of infection. In the 19 individual cases described in detail, all of the infected animals died, with severe liver and other organ damage.

It's important to be careful with these results. The studies included were very different from each other, which makes it hard to get a single, precise number. Also, most of the data came from the Americas, with very little from Africa, where yellow fever is also common. This means the findings might not apply everywhere. The study shows that monitoring monkeys is a key part of a 'One Health' approach to tracking diseases that can spread between animals and people.

What this means for you:
Yellow fever virus is widespread in some monkey populations, highlighting the importance of animal surveillance for public health.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMar 2026
View Original Abstract ↓
Yellow fever remains a major mosquito-borne viral disease of global public health and ecological concern. Non-human primates (NHPs) are central to the sylvatic transmission cycle and serve as key sentinels of viral circulation. Yet, evidence on yellow fever virus (YFV) infection in NHPs is dispersed and has not been synthesized comprehensively. To systematically review and meta-analyze global data on the prevalence and seroprevalence of YFV infection in NHP, and to summarize molecular, clinical, and pathological findings from reported epizootic cases. We conducted a systematic search of Scopus, PubMed, Web of Science, and SciELO for studies published between 1950 and 2025, following PRISMA guidelines. Observational studies reporting YFV prevalence or seroprevalence in NHPs were included in the quantitative syntheses, and individual case reports were analyzed separately. Random-effects meta-analyses were performed, with subgroup analyses by geographic region, diagnostic method, and primate genus. Thirty-nine articles assessing 7,183 NHP met the inclusion criteria; 28 contributed to meta-analyses, and 10 provided 19 individual case reports. Pooled molecular prevalence by RT-PCR was 30.7%, and prevalence by immunohistochemistry was 43.4%, both with substantial between-study heterogeneity. Seroprevalence estimates ranged from 5.0 to 36.4% across assays and settings. Higher infection metrics were observed in howler monkeys and titi monkeys. All reported individual cases were fatal and predominantly associated with severe hepatic and multisystemic pathology. Most data originated from the Americas, particularly Brazil, with limited representation from African endemic regions. YFV infection in NHP is widespread, often severe, and epidemiologically significant. Our findings underscore the critical sentinel role of NHPs and highlight the need to strengthen integrated One Health surveillance systems to inform prevention and control strategies, particularly in the context of the current resurgence of yellow fever in Latin America and persistent data gaps in Africa.
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