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The symptomatic manifestations of these diseases bear clinical resemblance, complicating the accurate determination of their etiological origins. Furthermore, the diagnostic panels for respiratory pathogens used within local medical practices, may not encompass the full spectrum of viral agents responsible for such ailments. Consequently, a significant number of clinically important viral pathogens may remain undetected.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>In the light of this, we conducted a metagenomic examination of 66 nasopharyngeal swab specimens, obtained from patients presenting with acute respiratory conditions yet tested negative by the standard diagnostic panels available locally. These specimens were obtained from the Public Health Laboratory, Maceio, State of Alagoas. Our findings indicate a predominant diagnostic escape of rhinoviruses and notably enterovirus D68. Moreover, our study identified a substantial quantity of sequence reads attributed to human respirovirus 3 (human parainfluenza 3) along with various herpresviruses including human herpesvirus-1, Epstein-Barr virus (Human herpesvirus-4), Human herpesviruses 6 and 7 and human parvovirus B19 (B19V). Notably, the metagenomic analysis uncovered a widespread presence of the emerging human vientovirus FB in most of sample pools, though its clinical importance remains to be elucidated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The obtained results in this study underscore the invaluable role of viral metagenomics in the identification of underrecognized viruses bearing clinical relevance. Furthermore, it offers insights into the dissemination of these pathogens within the studied area, thereby informing public health strategies aimed at enhancing diagnostic accuracy and improving patient care.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012536","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T17:37:17Z","timestamp":1727113037000},"page":"e0012536","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unveiling viral pathogens in acute respiratory disease: Insights from viral metagenomics in patients from the State of Alagoas, Brazil"],"prefix":"10.1371","volume":"18","author":[{"given":"Gabriel Montenegro","family":"de Campos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazerral de Oliveira","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Ranieri Jer\u00f4nimo","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson Brand\u00e3o","family":"Leite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jardelina de Souza","family":"Tod\u00e3o Bernardino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Phellipe Marques","family":"do Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Vanessa Cavalcante","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loyze Paola Oliveira","family":"de Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlon Breno Zampieri","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mykaella Andrade","family":"de Ara\u00fajo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Giovanetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esper Georges","family":"Kallas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra Coccuzzo","family":"Sampaio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carolina","family":"Elias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0805-6140","authenticated-orcid":true,"given":"Svetoslav Nanev","family":"Slavov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"pntd.0012536.ref001","first-page":"284","article-title":"Viral Respiratory Infections","author":"HR van Doorn","year":"2020","journal-title":"Hunter\u2019s Tropical Medicine and Emerg Infect Dis"},{"key":"pntd.0012536.ref002","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3389\/fmed.2020.00257","article-title":"Editorial: Respiratory Virus Infection: Recent Advances","volume":"7","author":"V Peltola","year":"2020","journal-title":"Front Med"},{"key":"pntd.0012536.ref003","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/INF.0b013e318284b146","article-title":"Role of a respiratory viral panel in the clinical management of pediatric inpatients","volume":"32","author":"GS Schulert","year":"2013","journal-title":"Pediatr Infect Dis J"},{"key":"pntd.0012536.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-1-4939-1571-2_1","article-title":"Classification and evolution of human rhinoviruses","volume":"1221","author":"AC Palmenberg","year":"2015","journal-title":"Methods Mol Biol"},{"key":"pntd.0012536.ref005","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.3390\/v13102063","article-title":"High-Throughput Next-Generation Sequencing Respiratory Viral Panel: A Diagnostic and Epidemiologic Tool for SARS-CoV-2 and Other Viruses","volume":"13","author":"NS Sahajpal","year":"2021","journal-title":"Viruses"},{"issue":"1","key":"pntd.0012536.ref006","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1038\/s41598-021-03987-1","article-title":"Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya","volume":"12","author":"MVT Phan","year":"2022","journal-title":"Sci Rep"},{"key":"pntd.0012536.ref007","unstructured":"Andrews S. 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