Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-30 (of 34 Records) |
Query Trace: Recuenco S[original query] |
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The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era
Taylor E , Aguilar-Ancori EG , Banyard AC , Abel I , Mantini-Briggs C , Briggs CL , Carrillo C , Gavidia CM , Castillo-Neyra R , Parola AD , Villena FE , Prada JM , Petersen BW , FalconPerez N , CabezasSanchez C , Sihuincha M , Streicker DG , MaguinaVargas C , NavarroVela AM , Vigilato MAN , WenFan H , Willoughby R , Horton DL , Recuenco SE . Int Health 2022 15 (2) 216-223 BACKGROUND: Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS: The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS: The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS: The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena. |
Rabies post-exposure healthcare-seeking behaviors and perceptions: Results from a knowledge, attitudes, and practices survey, Uganda, 2013
Bonaparte SC , Adams L , Bakamutumaho B , Barbosa Costa G , Cleaton JM , Gilbert AT , Osinubi M , Pieracci EG , Recuenco S , Tugumizemu V , Wamala J , Wallace RM . PLoS One 2021 16 (6) e0251702 BACKGROUND: Rabies is a viral disease of animals and people causing fatal encephalomyelitis if left untreated. Although effective pre- and post-exposure vaccines exist, they are not widely available in many endemic countries within Africa. Since many individuals in these countries remain at risk of infection, post-exposure healthcare-seeking behaviors are crucial in preventing infection and warrant examination. METHODOLOGY: A rabies knowledge, attitudes, and practices survey was conducted at 24 geographically diverse sites in Uganda during 2013 to capture information on knowledge concerning the disease, response to potential exposure events, and vaccination practices. Characteristics of the surveyed population and of the canine-bite victim sub-population were described. Post-exposure healthcare-seeking behaviors of canine-bite victims were examined and compared to the related healthcare-seeking attitudes of non-bite victim respondents. Wealth scores were calculated for each household, rabies knowledge was scored for each non-bitten survey respondent, and rabies exposure risk was scored for each bite victim. Logistic regression was used to determine the independent associations between different variables and healthcare-seeking behaviors among canine-bite victims as well as attitudes of non-bitten study respondents. RESULTS: A total of 798 households were interviewed, capturing 100 canine-bite victims and a bite incidence of 2.3 per 100 person-years. Over half of bite victims actively sought medical treatment (56%), though very few received rabies post-exposure prophylaxis (3%). Bite victims who did not know or report the closest location where PEP could be received were less likely to seek medical care (p = 0.05). Respondents who did not report having been bitten by a dog with higher knowledge scores were more likely to respond that they would both seek medical care (p = 0.00) and receive PEP (p = 0.06) after a potential rabies exposure event. CONCLUSIONS: There was varying discordance between what respondents who did not report having been bitten by a dog said they would do if bitten by a dog when compared to the behaviors exhibited by canine-bite victims captured in the KAP survey. Bite victims seldom elected to wash their wound or receive PEP. Having lower rabies knowledge was a barrier to theoretically seeking care and receiving PEP among not bitten respondents, indicating a need for effective and robust educational programs in the country. |
Defining new pathways to manage the ongoing emergence of bat rabies in Latin America
Benavides JA , Valderrama W , Recuenco S , Uieda W , Suzán G , Avila-Flores R , Velasco-Villa A , Almeida M , Andrade FAG , Molina-Flores B , Vigilato MAN , Pompei JCA , Tizzani P , Carrera JE , Ibanez D , Streicker DG . Viruses 2020 12 (9) Rabies transmitted by common vampire bats (Desmodus rotundus) has been known since the early 1900s but continues to expand geographically and in the range of species and environments affected. In this review, we present current knowledge of the epidemiology and management of rabies in D. rotundus and argue that it can be reasonably considered an emerging public health threat. We identify knowledge gaps related to the landscape determinants of the bat reservoir, reduction in bites on humans and livestock, and social barriers to prevention. We discuss how new technologies including autonomously-spreading vaccines and reproductive suppressants targeting bats might manage both rabies and undesirable growth of D. rotundus populations. Finally, we highlight widespread under-reporting of human and animal mortality and the scarcity of studies that quantify the efficacy of control measures such as bat culling. Collaborations between researchers and managers will be crucial to implement the next generation of rabies management in Latin America. |
Bat and Lyssavirus exposure among humans in area that celebrates bat festival, Nigeria, 2010 and 2013
Vora NM , Osinubi MOV , Davis L , Abdurrahman M , Adedire EB , Akpan H , Aman-Oloniyo AF , Audu SW , Blau D , Dankoli RS , Ehimiyein AM , Ellison JA , Gbadegesin YH , Greenberg L , Haberling D , Hutson C , Idris JM , Kia GSN , Lawal M , Matthias SY , Mshelbwala PP , Niezgoda M , Ogunkoya AB , Ogunniyi AO , Okara GC , Olugasa BO , Ossai OP , Oyemakinde A , Person MK , Rupprecht CE , Saliman OA , Sani M , Sanni-Adeniyi OA , Satheshkumar PS , Smith TG , Soleye MO , Wallace RM , Yennan SK , Recuenco S . Emerg Infect Dis 2020 26 (7) 1399-1408 Using questionnaires and serologic testing, we evaluated bat and lyssavirus exposure among persons in an area of Nigeria that celebrates a bat festival. Bats from festival caves underwent serologic testing for phylogroup II lyssaviruses (Lagos bat virus, Shimoni bat virus, Mokola virus). The enrolled households consisted of 2,112 persons, among whom 213 (10%) were reported to have ever had bat contact (having touched a bat, having been bitten by a bat, or having been scratched by a bat) and 52 (2%) to have ever been bitten by a bat. Of 203 participants with bat contact, 3 (1%) had received rabies vaccination. No participant had neutralizing antibodies to phylogroup II lyssaviruses, but >50% of bats had neutralizing antibodies to these lyssaviruses. Even though we found no evidence of phylogroup II lyssavirus exposure among humans, persons interacting with bats in the area could benefit from practicing bat-related health precautions. |
Human exposure to novel Bartonella species from contact with fruit bats
Bai Y , Osinubi MOV , Osikowicz L , McKee C , Vora NM , Rizzo MR , Recuenco S , Davis L , Niezgoda M , Ehimiyein AM , Kia GSN , Oyemakinde A , Adeniyi OS , Gbadegesin YH , Saliman OA , Ogunniyi A , Ogunkoya AB , Kosoy MY . Emerg Infect Dis 2018 24 (12) 2317-2323 Twice a year in southwestern Nigeria, during a traditional bat festival, community participants enter designated caves to capture bats, which are then consumed for food or traded. We investigated the presence of Bartonella species in Egyptian fruit bats (Rousettus aegyptiacus) and bat flies (Eucampsipoda africana) from these caves and assessed whether Bartonella infections had occurred in persons from the surrounding communities. Our results indicate that these bats and flies harbor Bartonella strains, which multilocus sequence typing indicated probably represent a novel Bartonella species, proposed as Bartonella rousetti. In serum from 8 of 204 persons, we detected antibodies to B. rousetti without cross-reactivity to other Bartonella species. This work suggests that bat-associated Bartonella strains might be capable of infecting humans. |
The influence of poverty and rabies knowledge on healthcare seeking behaviors and dog ownership, Cameroon
Barbosa Costa G , Gilbert A , Monroe B , Blanton J , Ngam Ngam S , Recuenco S , Wallace R . PLoS One 2018 13 (6) e0197330 BACKGROUND: Rabies is a fatal encephalitis caused by lyssaviruses, with most human cases worldwide resulting from rabid dog bites. Although effective animal and human vaccines have been available for over 100 years, control efforts have not been adequately implemented on the global scale and rabies remains one of the greatest global zoonotic threats to human health. We conducted a knowledge, attitudes and practices survey in Northern Cameroon to describe dog ownership characteristics, rates of dog bites, and post-bite healthcare seeking behaviors. METHODS: The survey was performed in four rural Cameroonian communities. A structured community-based questionnaire was conducted over a 20-day period in April 2010, and focused on socio-economic factors correlated with gaps in rabies knowledge. Information pertaining to socio-demographics, as well as attitudes and practices with regard to animal bites and bite treatment practices were recorded. Characteristics of dog ownership such as dog confinement, resources provided to dogs, and dog vaccination status were examined. Human to dog ratios were compared on a linear scale to poverty scores by community. When applicable, 2-tailed Chi-square tests or Fisher's exact tests were calculated to determine relationships between variables. We also used One-way Analysis of Variance (ANOVA) to identify associations between rabies knowledge and wealth with dog ownership, dog vaccination, and human healthcare seeking behaviors. Independent variables were evaluated using multivariate logistic regression analysis. RESULTS: A total of 208 households were enrolled. Respondents were predominantly male (68.3%), with a median age of 43.6 years. Eighty-four households (39.9%) reported owning a total of 141 dogs (human dog ratio 10.4:1). The majority of dogs (61%) were allowed to roam freely. A history of rabies vaccination was reported for 30.8% of owned dogs. Respondents reported 11 bites during the two years preceding the survey (annual bite incidence was 2.6% [95% CI 1.4%- 4.6%]). Only one person (9.1%) received rabies post-exposure prophylaxis (PEP), and none described symptoms of clinical illness consistent with rabies. Respondents who indicated that they would seek medical care and PEP after a dog bite had higher average wealth and rabies knowledge index scores (p = 0.01 and 0.04, respectively). Respondents who indicated that they would seek care from a traditional healer had significantly lower wealth scores, but not significantly different knowledge scores (p < 0.01 and p = 0.49, respectively). CONCLUSIONS: In the communities evaluated, the majority of dogs were allowed to roam freely and had no history of rabies vaccination; factors that favor enzootic transmission of canine rabies virus. We also identified a strong relationship between poverty and dog ownership. Bite events were relatively common among respondents, and very few victims reported utilizing health services to treat wounds. Increased wealth and knowledge were significantly associated with increased likelihood that a respondent would seek medical care and post-exposure prophylaxis. These findings indicate the need for educational outreach to raise awareness of dog rabies and proper prevention measures. |
A single center, open label study of intradermal administration of an inactivated purified chick embryo cell culture rabies virus vaccine in adults
Recuenco S , Warnock E , Osinubi MOV , Rupprecht CE . Vaccine 2017 35 (34) 4315-4320 In the USA, rabies vaccines (RVs) are licensed for intramuscular (IM) use only, although RVs are licensed for use by the intradermal (ID) route in many other countries. Recent limitations in supplies of RV in the USA reopened discussions on the more efficient use of available biologics, including utilization of more stringent risk assessments, and potential ID RV administration. A clinical trial was designed to compare the immunogenic and adverse effects of a purified chicken embryo cell (PCEC) RV administered ID or IM. Enrollment was designed in four arms, ID Pre-Exposure Prophylaxis (Pre-EP), IM Pre-EP, ID Booster, and IM Booster vaccination. Enrollment included 130 adult volunteers. The arms with IM administration received vaccine according to the current ACIP recommendations: Pre-EP, three 1mL (2.5 I.U.) RV doses, each on day 0, 7, and 21; or a routine Booster, one 1ml dose. The ID groups received the same schedule, but doses administered were in a volume of 0.1mL (0.25 I.U.). The rate of increase in rabies virus neutralizing antibody titers 14-21days after vaccination were similar in the ID and correspondent IM groups. The GMT values for ID vaccination were slightly lower than those for IM vaccination, for both naive and booster groups, and these differences were statistically significant by t-test. Fourteen days after completing vaccination, all individuals developed RV neutralizing antibody titers over the minimum arbitrary value obtained with the rapid fluorescent focus inhibition test (RFFIT). Antibodies were over the set threshold until the end of the trial, 160days after completed vaccination. No serious adverse reactions were reported. Most frequent adverse reactions were erythema, induration and tenderness, localized at the site of injection. Multi use of 1mL rabies vaccine vials for ID doses of 0.1 was demonstrated to be both safe and inmunogenic. |
The impact of poverty on dog ownership and access to canine rabies vaccination: results from a knowledge, attitudes and practices survey, Uganda 2013
Wallace RM , Mehal J , Nakazawa Y , Recuenco S , Bakamutumaho B , Osinubi M , Tugumizemu V , Blanton JD , Gilbert A , Wamala J . Infect Dis Poverty 2017 6 (1) 97 BACKGROUND: Rabies is a neglected disease despite being responsible for more human deaths than any other zoonosis. A lack of adequate human and dog surveillance, resulting in low prioritization, is often blamed for this paradox. Estimation methods are often employed to describe the rabies burden when surveillance data are not available, however these figures are rarely based on country-specific data. METHODS: In 2013 a knowledge, attitudes, and practices survey was conducted in Uganda to understand dog population, rabies vaccination, and human rabies risk factors and improve in-country and regional rabies burden estimates. Poisson and multi-level logistic regression techniques were conducted to estimate the total dog population and vaccination coverage. RESULTS: Twenty-four villages were selected, of which 798 households completed the survey, representing 4 375 people. Dog owning households represented 12.9% of the population, for which 175 dogs were owned (25 people per dog). A history of vaccination was reported in 55.6% of owned dogs. Poverty and human population density highly correlated with dog ownership, and when accounted for in multi-level regression models, the human to dog ratio fell to 47:1 and the estimated national canine-rabies vaccination coverage fell to 36.1%. This study estimates there are 729 486 owned dogs in Uganda (95% CI: 719 919 - 739 053). Ten percent of survey respondents provided care to dogs they did not own, however unowned dog populations were not enumerated in this estimate. 89.8% of Uganda's human population was estimated to reside in a community that can support enzootic canine rabies transmission. CONCLUSIONS: This study is the first to comprehensively evaluate the effect of poverty on dog ownership in Africa. These results indicate that describing a dog population may not be as simple as applying a human: dog ratio, and factors such as poverty are likely to heavily influence dog ownership and vaccination coverage. These modelled estimates should be confirmed through further field studies, however, if validated, canine rabies elimination through mass vaccination may not be as difficult as previously considered in Uganda. Data derived from this study should be considered to improve models for estimating the in-country and regional rabies burden. |
Host-pathogen evolutionary signatures reveal dynamics and future invasions of vampire bat rabies.
Streicker DG , Winternitz JC , Satterfield DA , Condori-Condori RE , Broos A , Tello C , Recuenco S , Velasco-Villa A , Altizer S , Valderrama W . Proc Natl Acad Sci U S A 2016 113 (39) 10926-31 Anticipating how epidemics will spread across landscapes requires understanding host dispersal events that are notoriously difficult to measure. Here, we contrast host and virus genetic signatures to resolve the spatiotemporal dynamics underlying geographic expansions of vampire bat rabies virus (VBRV) in Peru. Phylogenetic analysis revealed recent viral spread between populations that, according to extreme geographic structure in maternally inherited host mitochondrial DNA, appeared completely isolated. In contrast, greater population connectivity in biparentally inherited nuclear microsatellites explained the historical limits of invasions, suggesting that dispersing male bats spread VBRV between genetically isolated female populations. Host nuclear DNA further indicated unanticipated gene flow through the Andes mountains connecting the VBRV-free Pacific coast to the VBRV-endemic Amazon rainforest. By combining Bayesian phylogeography with landscape resistance models, we projected invasion routes through northern Peru that were validated by real-time livestock rabies mortality data. The first outbreaks of VBRV on the Pacific coast of South America could occur by June 2020, which would have serious implications for agriculture, wildlife conservation, and human health. Our results show that combining host and pathogen genetic data can identify sex biases in pathogen spatial spread, which may be a widespread but underappreciated phenomenon, and demonstrate that genetic forecasting can aid preparedness for impending viral invasions. |
Willingness to pay for dog rabies vaccine and registration in Ilocos Norte, Philippines (2012)
Birhane MG , Miranda ME , Dyer JL , Blanton JD , Recuenco S . PLoS Negl Trop Dis 2016 10 (3) e0004486 BACKGROUND: The Philippines is one of the developing countries highly affected by rabies. Dog vaccination campaigns implemented through collaborative effort between the government and NGOs have played an important role in successfully reducing the burden of disease within the country. Nevertheless, rabies vaccination of the domestic animal population requires continuous commitment not only from governments and NGOs, but also from local communities that are directly affected by such efforts. To create such long-term sustained programs, the introduction of affordable dog vaccination and registration fees is essential and has been shown to be an important strategy in Bohol, Philippines. The aim of this study, therefore, was to estimate the average amount of money that individuals were willing to pay for dog vaccination and registration in Ilocos Norte, Philippines. This study also investigated some of the determinants of individuals' willingness to pay (WTP). METHODS: A cross-sectional questionnaire was administered to 300 households in 17 municipalities (out of a total of 21) selected through a multi-stage cluster survey technique. At the time of the survey, Ilocos Norte had a population of approximately 568,017 and was predominantly rural. The Contingent Valuation Method was used to elicit WTP for dog rabies vaccination and registration. A 'bidding game' elicitation strategy that aims to find the maximum amount of money individuals were willing to pay was also employed. Data were collected using paper-based questionnaires. Linear regression was used to examine factors influencing participants' WTP for dog rabies vaccination and registration. KEY RESULTS: On average, Ilocos Norte residents were willing to pay 69.65 Philippine Pesos (PHP) (equivalent to 1.67 USD in 2012) for dog vaccination and 29.13PHP (0.70 USD) for dog registration. Eighty-six per cent of respondents were willing to pay the stated amount to vaccinate each of their dogs, annually. This study also found that WTP was influenced by demographic and knowledge factors. Among these, we found that age, income, participants' willingness to commit to pay each year, municipality of residency, knowledge of the signs of rabies in dogs, and number of dogs owed significantly predicted WTP. |
Knowledge, attitudes and practices regarding rabies and exposure to bats in two rural communities in Guatemala
Moran D , Juliao P , Alvarez D , Lindblade KA , Ellison JA , Gilbert AT , Petersen B , Rupprecht C , Recuenco S . BMC Res Notes 2015 8 955 BACKGROUND: Rabies is a fatal encephalitis caused by rabies virus, of the genus Lyssavirus. The principal reservoir for rabies in Latin America is the common vampire bat (Desmodus rotundus), which feeds routinely on the blood of cattle, and when livestock are scarce, may prey on other mammals, including humans. Although rabies is endemic in common vampire bat populations in Guatemala, there is limited research on the extent of exposure to bats among human populations living near bat refuges. RESULTS: A random sample of 270 of 473 households (57%) in two communities located within 2 Km of a known bat roost was selected and one adult from each household was interviewed. Exposure to bats (bites, scratches or bare skin contact) was reported by 96 (6%) of the 1,721 residents among the selected households. Of those exposed, 40% received rabies post-exposure prophylaxis. Four percent of household respondents reported that they would seek rabies post exposure prophylaxis if they were bitten by a bat. CONCLUSIONS: These findings demonstrate that exposure to bats in communities near bat roosts is common but recognition of the potential for rabies transmission from bats is low. There is a need for educational outreach to raise awareness of bat-associated rabies, prevent exposures to bats and ensure appropriate health-seeking behaviours for bat-inflicted wounds, particularly among communities living near bat roosts in Guatemala. |
Clinical management and humoral immune responses to rabies post-exposure prophylaxis among three patients who received solid organs from a donor with rabies
Vora NM , Orciari L , Niezgoda M , Selvaggi G , Stosor V , Lyon GM 3rd , Wallace RM , Gabel J , Stanek DR , Jenkins P , Shiferaw M , Yager P , Jackson F , Hanlon CA , Damon I , Blanton J , Recuenco S , Franka R . Transpl Infect Dis 2015 17 (3) 389-95 BACKGROUND: The rabies virus causes a fatal encephalitis and can be transmitted through organ transplantation. In 2013, a man developed rabies 18 months after receiving a kidney from a donor with rabies, who was not known to have been infected when the organs were procured. Three additional persons who received organs from the same donor (liver, kidney, heart), all of whom were not vaccinated for rabies before transplantation, received rabies post-exposure prophylaxis (PEP) with rabies immune globulin and 5 doses of rabies vaccine as soon as the diagnosis of rabies was made in the donor (18 months after their transplant procedures). We describe their clinical management. METHODS: Because the 3 recipients were all on immunosuppressive medications, post-vaccination serologic testing was performed using the rapid fluorescent focus inhibition test to measure rabies virus neutralizing antibodies (RVNAs). An acceptable antibody response to administration of rabies vaccine was defined as detection of RVNAs at a concentration ≥0.1 IU/mL from a serum specimen collected ≥7 days after the fifth vaccine dose. RESULTS: All 3 recipients demonstrated an acceptable antibody response despite their immunosuppressed states. More than 36 months have passed since their transplant surgeries, and all 3 recipients have no evidence of rabies. CONCLUSIONS: The survival of 3 previously unvaccinated recipients of solid organs from a donor with rabies is unexpected. Although the precise factors that led to their survival remain unclear, our data suggest that PEP can possibly enhance transplant safety in settings in which donors are retrospectively diagnosed with rabies. |
Estimating the global burden of endemic canine rabies
Hampson K , Coudeville L , Lembo T , Sambo M , Kieffer A , Attlan M , Barrat J , Blanton JD , Briggs DJ , Cleaveland S , Costa P , Freuling CM , Hiby E , Knopf L , Leanes F , Meslin FX , Metlin A , Miranda ME , Muller T , Nel LH , Recuenco S , Rupprecht CE , Schumacher C , Taylor L , Vigilato MA , Zinsstag J , Dushoff J . PLoS Negl Trop Dis 2015 9 (4) e0003709 BACKGROUND: Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. METHODOLOGY/PRINCIPAL FINDINGS: We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). CONCLUSIONS/SIGNIFICANCE: This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts. |
Virology, immunology and pathology of human rabies during treatment.
Caicedo Y , Paez A , Kuzmin I , Niezgoda M , Orciari LA , Yager PA , Recuenco S , Franka R , Velasco-Villa A , Willoughby RE Jr . Pediatr Infect Dis J 2014 34 (5) 520-8 BACKGROUND: Rabies is an acute fatal encephalitis caused by all members of the Lyssavirus genus. The first human rabies survivor without benefit of prior vaccination was reported from Milwaukee in 2005. We report a second unvaccinated patient who showed early recovery from rabies and then died accidentally during convalescence, providing an unparalleled opportunity to examine the histopathology as well as immune and virological correlates of early recovery from human rabies. METHODS: Case report, rapid fluorescent focus inhibition test, enzyme-linked immunosorbent assay, indirect and direct fluorescent antibody assays, reverse-transcriptase polymerase chain reaction, phylogenetic reconstruction, isolation in tissue culture, pathology and immunohistochemistry. RESULTS: The 9 year old died 76 days after presenting with rabies of vampire bat phylogeny transmitted by cat bite. Antibody response in serum and CSF was robust and associated with severe cerebral edema. No rabies virus was cultured at autopsy. Rabies virus antigen was atypical in size and distribution. Rabies virus genome was present in neocortex but absent in brainstem. CONCLUSIONS:: Clinical recovery was associated with detection of neutralizing antibody and clearance of infectious rabies virus in the CNS by 76 days, but not clearance of detectable viral subcomponents such as nucleoprotein antigen or RNA in brain. |
Bat rabies in Guatemala
Ellison JA , Gilbert AT , Recuenco S , Moran D , Alvarez DA , Kuzmina N , Garcia DL , Peruski LF , Mendonca MT , Lindblade KA , Rupprecht CE . PLoS Negl Trop Dis 2014 8 (7) e3070 Rabies in bats is considered enzootic throughout the New World, but few comparative data are available for most countries in the region. As part of a larger pathogen detection program, enhanced bat rabies surveillance was conducted in Guatemala, between 2009 and 2011. A total of 672 bats of 31 species were sampled and tested for rabies. The prevalence of rabies virus (RABV) detection among all collected bats was low (0.3%). Viral antigens were detected and infectious virus was isolated from the brains of two common vampire bats (Desmodus rotundus). RABV was also isolated from oral swabs, lungs and kidneys of both bats, whereas viral RNA was detected in all of the tissues examined by hemi-nested RT-PCR except for the liver of one bat. Sequencing of the nucleoprotein gene showed that both viruses were 100% identical, whereas sequencing of the glycoprotein gene revealed one non-synonymous substitution (302T,S). The two vampire bat RABV isolates in this study were phylogenetically related to viruses associated with vampire bats in the eastern states of Mexico and El Salvador. Additionally, 7% of sera collected from 398 bats demonstrated RABV neutralizing antibody. The proportion of seropositive bats varied significantly across trophic guilds, suggestive of complex intraspecific compartmentalization of RABV perpetuation. |
Rabies death attributed to exposure in Central America with symptom onset in a U.S. Detention facility - Texas, 2013
Wallace RM , Bhavnani D , Russell J , Zaki S , Muehlenbachs A , Hayden-Pinneri K , Aplicano RM , Peruski L , Vora NM , Balter S , Elson D , Lederman E , Leeson B , McLaughlin T , Waterman S , Fonseca-Ford M , Blanton J , Franka R , Velasco-Villa A , Niezgoda M , Orciari L , Recuenco S , Damon I , Hanlon C , Jackson F , Dyer J , Wadhwa A , Robinson L . MMWR Morb Mortal Wkly Rep 2014 63 (20) 446-9 On June 7, 2013, a man was diagnosed in a Texas hospital with rabies. He had been detained in a U.S. detention facility during his infectious period. To identify persons exposed to rabies who might require rabies postexposure prophylaxis (PEP), CDC and the Texas Department of State Health Services (DSHS) conducted investigations at four detention facilities, one medical clinic, and two hospitals. In all, 25 of 742 persons assessed for rabies exposure were advised to receive PEP. Early diagnosis of rabies is essential for implementation of appropriate hospital infection control measures and for rapid assessment of potential contacts for PEP recommendations. |
Assessment of potential zoonotic disease exposure and illness related to an annual bat festival - Idanre, Nigeria
Vora NM , Osinubi M , Wallace RM , Aman-Oloniyo A , Gbadegesin YH , Sebastian YK , Saliman OA , Niezgoda M , Davis L , Recuenco S . MMWR Morb Mortal Wkly Rep 2014 63 (15) 334 Bats provide vital ecologic services that humans benefit from, such as seed dispersal and pest control, and are a food source for some human populations. However, bats also are reservoirs for a number of high-consequence zoonoses, including paramyxoviruses, filoviruses, and lyssaviruses. The variety of viruses that bats harbor might be related to their evolutionary diversity, ability to fly large distances, long lifespans, and gregarious roosting behaviors. Every year a festival takes place in Idanre, Nigeria, in which males of all ages enter designated caves to capture bats; persons are forbidden from entering the caves outside of these festivities. Festival participants use a variety of techniques to capture bats, but protective equipment rarely is used, placing hunters at risk for bat scratches and bites. Many captured bats are prepared as food, but some are transported to markets in other parts of the country for sale as bushmeat. Bats also are presented to dignitaries in elaborate rituals. The health consequences of contact with these bats are unknown, but a number of viruses have been previously identified among Nigerian bats, including lyssaviruses, pegiviruses, and coronaviruses. Furthermore, the caves are home to Rousettus aegyptiacus bats, which are reservoirs for Marburg virus in other parts of Africa. |
A large-scale, rapid public health response to rabies in an organ recipient and the previously undiagnosed organ donor
Wallace RM , Stanek D , Griese S , Krulak D , Vora NM , Pacha L , Kan V , Said M , Williams C , Burgess TH , Clausen SS , Austin C , Gabel J , Lehman M , Finelli LN , Selvaggi G , Joyce P , Gordin F , Benator D , Bettano A , Cersovsky S , Blackmore C , Jones SV , Buchanan BD , Fernandez AI , Dinelli D , Agnes K , Clark A , Gill J , Irmler M , Blythe D , Mitchell K , Whitman TJ , Zapor MJ , Zorich S , Witkop C , Jenkins P , Mora P , Droller D , Turner S , Dunn L , Williams P , Richards C , Ewing G , Chapman K , Corbitt C , Girimont T , Franka R , Recuenco S , Blanton JD , Feldman KA . Zoonoses Public Health 2014 61 (8) 560-70 This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation. |
Notes from the field: wildlife rabies on an island free from canine rabies for 52 years - Taiwan, 2013
Wu H , Chang SS , Tsai HJ , Wallace RM , Recuenco SE , Doty JB , Vora NM , Chang FY . MMWR Morb Mortal Wkly Rep 2014 63 (8) 178 Dog-to-dog transmission of rabies in Taiwan was eliminated in 1961; the island was considered canine rabies-free for 52 years. On July 16, 2013, three ferret-badgers (Melogale moschata) tested positive for rabies by fluorescent antibody testing at the Animal Health Research Institute, Council of Agriculture of Taiwan. This was the first time wild animals other than bats were tested. During 1999-2012, a total of 6,841 clinically healthy dogs and five apparently normal cats from shelters were tested and found negative for rabies. During 2009-2012, a total of 322 bats were tested and found negative for rabies. |
Raccoon rabies virus variant transmission through solid organ transplantation
Vora NM , Basavaraju SV , Feldman KA , Paddock CD , Orciari L , Gitterman S , Griese S , Wallace RM , Said M , Blau DM , Selvaggi G , Velasco-Villa A , Ritter J , Yager P , Kresch A , Niezgoda M , Blanton J , Stosor V , Falta EM , Lyon GM 3rd , Zembower T , Kuzmina N , Rohatgi PK , Recuenco S , Zaki S , Damon I , Franka R , Kuehnert MJ . JAMA 2013 310 (4) 398-407 IMPORTANCE: The rabies virus causes a fatal encephalitis and can be transmitted through tissue or organ transplantation. In February 2013, a kidney recipient with no reported exposures to potentially rabid animals died from rabies 18 months after transplantation. OBJECTIVES: To investigate whether organ transplantation was the source of rabies virus exposure in the kidney recipient, and to evaluate for and prevent rabies in other transplant recipients from the same donor. DESIGN: Organ donor and all transplant recipient medical records were reviewed. Laboratory tests to detect rabies virus-specific binding antibodies, rabies virus neutralizing antibodies, and rabies virus antigens were conducted on available specimens, including serum, cerebrospinal fluid, and tissues from the donor and the recipients. Viral ribonucleic acid was extracted from tissues and amplified for nucleoprotein gene sequencing for phylogenetic comparisons. MAIN OUTCOMES AND MEASURES: Determination of whether the donor died from undiagnosed rabies and whether other organ recipients developed rabies. RESULTS: In retrospect, the donor's clinical presentation (which began with vomiting and upper extremity paresthesias and progressed to fever, seizures, dysphagia, autonomic dysfunction, and brain death) was consistent with rabies. Rabies virus antigen was detected in archived autopsy brain tissue collected from the donor. The rabies viruses infecting the donor and the deceased kidney recipient were consistent with the raccoon rabies virus variant and were more than 99.9% identical across the entire N gene (1349/1350 nucleotides), thus confirming organ transplantation as the route of transmission. The 3 other organ recipients remained asymptomatic, with rabies virus neutralizing antibodies detected in their serum after completion of postexposure prophylaxis (range, 0.3-40.8 IU/mL). CONCLUSIONS AND RELEVANCE: Unlike the 2 previous clusters of rabies virus transmission through solid organ transplantation, there was a long incubation period in the recipient who developed rabies, and survival of 3 other recipients without pretransplant rabies vaccination. Rabies should be considered in patients with acute progressive encephalitis of unexplained etiology, especially for potential organ donors. A standard evaluation of potential donors who meet screening criteria for infectious encephalitis should be considered, and risks and benefits for recipients of organs from these donors should be evaluated. |
Bats are a major natural reservoir for hepaciviruses and pegiviruses
Quan PL , Firth C , Conte JM , Williams SH , Zambrana-Torrelio CM , Anthony SJ , Ellison JA , Gilbert AT , Kuzmin IV , Niezgoda M , Osinubi MO , Recuenco S , Markotter W , Breiman RF , Kalemba L , Malekani J , Lindblade KA , Rostal MK , Ojeda-Flores R , Suzan G , Davis LB , Blau DM , Ogunkoya AB , Alvarez Castillo DA , Moran D , Ngam S , Akaibe D , Agwanda B , Briese T , Epstein JH , Daszak P , Rupprecht CE , Holmes EC , Lipkin WI . Proc Natl Acad Sci U S A 2013 110 (20) 8194-9 Although there are over 1,150 bat species worldwide, the diversity of viruses harbored by bats has only recently come into focus as a result of expanded wildlife surveillance. Such surveys are of importance in determining the potential for novel viruses to emerge in humans, and for optimal management of bats and their habitats. To enhance our knowledge of the viral diversity present in bats, we initially surveyed 415 sera from African and Central American bats. Unbiased high-throughput sequencing revealed the presence of a highly diverse group of bat-derived viruses related to hepaciviruses and pegiviruses within the family Flaviridae. Subsequent PCR screening of 1,258 bat specimens collected worldwide indicated the presence of these viruses also in North America and Asia. A total of 83 bat-derived viruses were identified, representing an infection rate of nearly 5%. Evolutionary analyses revealed that all known hepaciviruses and pegiviruses, including those previously documented in humans and other primates, fall within the phylogenetic diversity of the bat-derived viruses described here. The prevalence, unprecedented viral biodiversity, phylogenetic divergence, and worldwide distribution of the bat-derived viruses suggest that bats are a major and ancient natural reservoir for both hepaciviruses and pegiviruses and provide insights into the evolutionary history of hepatitis C virus and the human GB viruses. |
Discovery of diverse polyomaviruses in bats and the evolutionary history of the Polyomaviridae
Tao Y , Shi M , Conrardy C , Kuzmin IV , Recuenco S , Agwanda B , Alvarez DA , Ellison JA , Gilbert AT , Moran D , Niezgoda M , Lindblade KA , Holmes EC , Breiman RF , Rupprecht CE , Tong S . J Gen Virol 2013 94 738-48 Polyomaviruses (PyVs) have been identified in a wide range of avian and mammalian species. However, little is known about their occurrence, genetic diversity and evolutionary history in bats, even though bats are important reservoirs for many emerging viral pathogens. This study screened 380 specimens from 35 bat species from Kenya and Guatemala for the presence of PyVs by semi-nested pan-PyV PCR assays. PyV DNA was detected in 24 of the 380 bat specimens. Phylogenetic analysis revealed that the bat PyV sequences formed 12 distinct lineages. Full-genome sequences were obtained for seven representative lineages and possessed similar genomic features to known PyVs. Strikingly, this evolutionary analysis revealed that the bat PyVs were paraphyletic, suggestive of multiple species jumps between bats and other mammalian species, such that the theory of virus-host co-divergence for mammalian PyVs as a whole could be rejected. In addition, evidence was found for strong heterogeneity in evolutionary rate and potential recombination in a number of PyV complete genomes, which complicates both phylogenetic analysis and virus classification. In summary, this study revealed that bats are important reservoirs of PyVs and that these viruses have a complex evolutionary history. |
Evidence of rabies virus exposure among humans in the Peruvian Amazon
Gilbert AT , Petersen BW , Recuenco S , Niezgoda M , Gomez J , Laguna-Torres VA , Rupprecht C . Am J Trop Med Hyg 2012 87 (2) 206-15 In May of 2010, two communities (Truenococha and Santa Marta) reported to be at risk of vampire bat depredation were surveyed in the Province Datem del Maranon in the Loreto Department of Peru. Risk factors for bat exposure included age less than or equal to 25 years and owning animals that had been bitten by bats. Rabies virus neutralizing antibodies (rVNAs) were detected in 11% (7 of 63) of human sera tested. Rabies virus ribonucleoprotein (RNP) immunoglobulin G (IgG) antibodies were detected in the sera of three individuals, two of whom were also seropositive for rVNA. Rabies virus RNP IgM antibodies were detected in one respondent with no evidence of rVNA or RNP IgG antibodies. Because one respondent with positive rVNA results reported prior vaccination and 86% (six of seven) of rVNA-positive respondents reported being bitten by bats, these data suggest nonfatal exposure of persons to rabies virus, which is likely associated with vampire bat depredation. |
Prevalence and diversity of Bartonella spp. in bats in Peru
Bai Y , Recuenco S , Gilbert AT , Osikowicz LM , Gomez J , Rupprecht C , Kosoy MY . Am J Trop Med Hyg 2012 87 (3) 518-23 Bartonella infections were investigated in bats in the Amazon part of Peru. A total of 112 bats belonging to 19 species were surveyed. Bartonella bacteria were cultured from 24.1% of the bats (27/112). Infection rates ranged from 0% to 100% per bat species. Phylogenetic analyses of gltA of the Bartonella isolates revealed 21 genetic variants clustering into 13 divergent phylogroups. Some Bartonella strains were shared by bats of multiple species, and bats of some species were infected with multiple Bartonella strains, showing no evident specific Bartonella sp.-bat relationships. Rarely found in other bat species, the Bartonella strains of phylogroups I and III discovered from the common vampire bats (Desmodus rotundus) were more specific to the host bat species, suggesting some level of host specificity. |
Genetic characterization of atypical Mansonella (Mansonella) ozzardi microfilariae in human blood samples from northeastern Peru.
Marcos LA , Arrospide N , Recuenco S , Cabezas C , Weil GJ , Fischer PU . Am J Trop Med Hyg 2012 87 (3) 491-4 DNA sequence comparisons are useful for characterizing proposed new parasite species or strains. Microfilariae with an atypical arrangement of nuclei behind the cephalic space have been recently described in human blood samples from the Amazon region of Peru. Three blood specimens containing atypical microfilariae were genetically characterized using three DNA markers (5S ribosomal DNA, 12S ribosomal DNA, and cytochrome oxidase I). All atypical microfilariae were clustered into the Mansonella group and indistinguishable from M. ozzardi based on these DNA markers. |
Evaluation of a new serological technique for detecting rabies virus antibodies following vaccination
Ma X , Niezgoda M , Blanton JD , Recuenco S , Rupprecht CE . Vaccine 2012 30 (36) 5358-62 Two major techniques are currently used to estimate rabies virus antibody values: neutralization assays, such as the rapid fluorescent focus inhibition test (RFFIT), and enzyme-linked immunosorbent assays (ELISAs). The RFFIT is considered the gold standard assay and has been used to assess the titer of rabies virus neutralizing antibodies for more than three decades. In the late 1970s, ELISA began to be used to estimate the level of rabies virus antibody and has recently been used by some laboratories as an alternate screening test for animal sera. Although the ELISA appears simpler, safer and more efficient, the assay is less sensitive in detecting low values of rabies virus neutralizing antibodies than neutralization tests. This study was designed to evaluate a new ELISA-based method for detecting rabies virus binding antibody. This new technique uses electro-chemi-luminescence labels and carbon electrode plates to detect binding events. In this comparative study, the RFFIT and the new ELISA-based technique were used to evaluate the level of rabies virus antibodies in human and animal serum samples. By using a conservative approximation of 0.15IU/ml as a cutoff point, the new ELISA-based technique demonstrated a sensitivity of 100% and a specificity of 95% for human samples and for experimental animal samples. The sensitivity and specificity for field animal samples was 96% and 95%, respectively. The preliminary results from this study appear promising and demonstrate a higher sensitivity than traditional ELISA methods. |
Ecological and anthropogenic drivers of rabies exposure in vampire bats: implications for transmission and control
Streicker DG , Recuenco S , Valderrama W , Gomez Benavides J , Vargas I , Pacheco V , Condori Condori RE , Montgomery J , Rupprecht CE , Rohani P , Altizer S . Proc Biol Sci 2012 279 (1742) 3384-92 Despite extensive culling of common vampire bats in Latin America, lethal human rabies outbreaks transmitted by this species are increasingly recognized, and livestock rabies occurs with striking frequency. To identify the individual and population-level factors driving rabies virus (RV) transmission in vampire bats, we conducted a longitudinal capture-recapture study in 20 vampire bat colonies spanning four regions of Peru. Serology demonstrated the circulation of RV in vampire bats from all regions in all years. Seroprevalence ranged from 3 to 28 per cent and was highest in juvenile and sub-adult bats. RV exposure was independent of bat colony size, consistent with an absence of population density thresholds for viral invasion and extinction. Culling campaigns implemented during our study failed to reduce seroprevalence and were perhaps counterproductive for disease control owing to the targeted removal of adults, but potentially greater importance of juvenile and sub-adult bats for transmission. These findings provide new insights into the mechanisms of RV maintenance in vampire bats and highlight the need for ecologically informed approaches to rabies prevention in Latin America. |
A distinct lineage of influenza A virus from bats.
Tong S , Li Y , Rivailler P , Conrardy C , Castillo DA , Chen LM , Recuenco S , Ellison JA , Davis CT , York IA , Turmelle AS , Moran D , Rogers S , Shi M , Tao Y , Weil MR , Tang K , Rowe LA , Sammons S , Xu X , Frace M , Lindblade KA , Cox NJ , Anderson LJ , Rupprecht CE , Donis RO . Proc Natl Acad Sci U S A 2012 109 (11) 4269-74 Influenza A virus reservoirs in animals have provided novel genetic elements leading to the emergence of global pandemics in humans. Most influenza A viruses circulate in waterfowl, but those that infect mammalian hosts are thought to pose the greatest risk for zoonotic spread to humans and the generation of pandemic or panzootic viruses. We have identified an influenza A virus from little yellow-shouldered bats captured at two locations in Guatemala. It is significantly divergent from known influenza A viruses. The HA of the bat virus was estimated to have diverged at roughly the same time as the known subtypes of HA and was designated as H17. The neuraminidase (NA) gene is highly divergent from all known influenza NAs, and the internal genes from the bat virus diverged from those of known influenza A viruses before the estimated divergence of the known influenza A internal gene lineages. Attempts to propagate this virus in cell cultures and chicken embryos were unsuccessful, suggesting distinct requirements compared with known influenza viruses. Despite its divergence from known influenza A viruses, the bat virus is compatible for genetic exchange with human influenza viruses in human cells, suggesting the potential capability for reassortment and contributions to new pandemic or panzootic influenza A viruses. |
A spatial model to forecast raccoon rabies emergence
Recuenco S , Blanton JD , Rupprecht CE . Vector Borne Zoonotic Dis 2011 12 (2) 126-37 Although raccoons are widely distributed throughout North America, the raccoon rabies virus variant is enzootic only in the eastern United States, based on current surveillance data. This variant of rabies virus is now responsible for >60% of all cases of animal rabies reported in the United States each year. Ongoing national efforts via an oral rabies vaccination (ORV) program are aimed at preventing the spread of raccoon rabies. However, from an epidemiologic perspective, the relative susceptibility of naive geographic localities, adjacent to defined enzootic areas, to support an outbreak, is unknown. In the current study, we tested the ability of a spatial risk model to forecast raccoon rabies spread in presumably rabies-free and enzootic areas. Demographic, environmental, and geographical features of three adjacent states (Ohio, West Virginia, and Pennsylvania), which include distinct raccoon rabies free, as well as enzootic areas, were modeled by using a Poisson Regression Model, which had been developed from previous studies of enzootic raccoon rabies in New York State. We estimated susceptibility to raccoon rabies emergence at the census tract level and compared the results with historical surveillance data. Approximately 70% of the disease-free region had moderate to very high susceptibility, compared with 23% in the enzootic region. Areas of high susceptibility for raccoon rabies lie west of current ORV intervention areas, especially in southern Ohio and western West Virginia. Predicted high susceptibility areas matched historical surveillance data. We discuss model implications to the spatial dynamics and spread of raccoon rabies, and its application for designing more efficient disease control interventions. |
Bartonella spp. in bats, Guatemala
Bai Y , Kosoy M , Recuenco S , Alvarez D , Moran D , Turmelle A , Ellison J , Garcia DL , Estevez A , Lindblade K , Rupprecht C . Emerg Infect Dis 2011 17 (7) 1269-1272 To better understand the role of bats as reservoirs of Bartonella spp., we estimated Bartonella spp. prevalence and genetic diversity in bats in Guatemala during 2009. We found prevalence of 33% and identified 21 genetic variants of 13 phylogroups. Vampire bat-associated Bartonella spp. may cause undiagnosed illnesses in humans. |
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