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Amman BR, Koroma AH, Schuh AJ, Conteh I, Sealy TK, Foday I, Johnny J, Bakarr IA, Whitmer SLM, Wright EA, Gbakima AA, Graziano J, Bangura C, Kamanda E, Osborne A, Saidu E, Musa JA, Bangura DF, Williams SMT, Fefegula GM, Sumaila C, Jabaty J, James FH, Jambai A, Garnett K, Kamara TF, Towner JS, Lebbie A. Sosuga Virus Detected in Egyptian Rousette Bats ( Rousettus aegyptiacus) in Sierra Leone. Viruses 2024; 16:648. [PMID: 38675988 PMCID: PMC11054331 DOI: 10.3390/v16040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Sosuga virus (SOSV), a rare human pathogenic paramyxovirus, was first discovered in 2012 when a person became ill after working in South Sudan and Uganda. During an ecological investigation, several species of bats were sampled and tested for SOSV RNA and only one species, the Egyptian rousette bat (ERBs; Rousettus aegyptiacus), tested positive. Since that time, multiple other species have been sampled and ERBs in Uganda have continued to be the only species of bat positive for SOSV infection. Subsequent studies of ERBs with SOSV demonstrated that ERBs are a competent host for SOSV and shed this infectious virus while exhibiting only minor infection-associated pathology. Following the 2014 Ebola outbreak in West Africa, surveillance efforts focused on discovering reservoirs for zoonotic pathogens resulted in the capture and testing of many bat species. Here, SOSV RNA was detected by qRT-PCR only in ERBs captured in the Moyamba District of Sierra Leone in the central region of the country. These findings represent a substantial range extension from East Africa to West Africa for SOSV, suggesting that this paramyxovirus may occur in ERB populations throughout its sub-Saharan African range.
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Affiliation(s)
- Brian R. Amman
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Alusine H. Koroma
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Amy J. Schuh
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Immah Conteh
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Tara K. Sealy
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Ibrahim Foday
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Jonathan Johnny
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Ibrahim A. Bakarr
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Shannon L. M. Whitmer
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Emily A. Wright
- Oak Ridge Institute Science and Education, Oak Ridge, TN 37830, USA;
| | - Aiah A. Gbakima
- National Public Health Agency, Wilberforce, 42A Main Mottor Road, Freetown, Sierra Leone;
| | - James Graziano
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Camilla Bangura
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Emmanuel Kamanda
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Augustus Osborne
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Emmanuel Saidu
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Jonathan A. Musa
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Doris F. Bangura
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Sammuel M. T. Williams
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - George M. Fefegula
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Christian Sumaila
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Juliet Jabaty
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Fatmata H. James
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
| | - Amara Jambai
- Ministry of Health and Sanitation, Brookfields, Youyi Building, Freetown, Sierra Leone;
| | - Kate Garnett
- Ministry of Agriculture and Forestry, Brookfields, Youyi Building, Freetown, Sierra Leone;
| | - Thomas F. Kamara
- National Protected Area Authority, 4-6 FA John Avenue, Main Congo Town Road, Freetown, Sierra Leone;
| | - Jonathan S. Towner
- Centers for Disease Control and Prevention, Viral Special Pathogens Branch, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA; (A.J.S.); (T.K.S.); (S.L.M.W.); (J.G.)
| | - Aiah Lebbie
- Department of Biological Sciences, Njala University, Njala, Sierra Leone; (A.H.K.); (I.C.); (I.F.); (J.J.); (I.A.B.); (C.B.); (E.K.); (A.O.); (E.S.); (J.A.M.); (D.F.B.); (S.M.T.W.); (G.M.F.); (C.S.); (J.J.); (F.H.J.)
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Guito JC, Arnold CE, Schuh AJ, Amman BR, Sealy TK, Spengler JR, Harmon JR, Coleman-McCray JD, Sanchez-Lockhart M, Palacios GF, Towner JS, Prescott JB. Peripheral immune responses to filoviruses in a reservoir versus spillover hosts reveal transcriptional correlates of disease. Front Immunol 2024; 14:1306501. [PMID: 38259437 PMCID: PMC10800976 DOI: 10.3389/fimmu.2023.1306501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/27/2023] [Indexed: 01/24/2024] Open
Abstract
Several filoviruses, including Marburg virus (MARV), cause severe disease in humans and nonhuman primates (NHPs). However, the Egyptian rousette bat (ERB, Rousettus aegyptiacus), the only known MARV reservoir, shows no overt illness upon natural or experimental infection, which, like other bat hosts of zoonoses, is due to well-adapted, likely species-specific immune features. Despite advances in understanding reservoir immune responses to filoviruses, ERB peripheral blood responses to MARV and how they compare to those of diseased filovirus-infected spillover hosts remain ill-defined. We thus conducted a longitudinal analysis of ERB blood gene responses during acute MARV infection. These data were then contrasted with a compilation of published primate blood response studies to elucidate gene correlates of filovirus protection versus disease. Our work expands on previous findings in MARV-infected ERBs by supporting both host resistance and disease tolerance mechanisms, offers insight into the peripheral immunocellular repertoire during infection, and provides the most direct known cross-examination between reservoir and spillover hosts of the most prevalently-regulated response genes, pathways and activities associated with differences in filovirus pathogenesis and pathogenicity.
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Affiliation(s)
- Jonathan C. Guito
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Catherine E. Arnold
- Biological Defense Research Directorate, Naval Medical Research Center, Frederick, MD, United States
- RD-CBR, Research and Development Directorate, Chemical and Biological Technologies Directorate, Research Center of Excellence, Defense Threat Reduction Agency, Fort Belvoir, VA, United States
| | - Amy J. Schuh
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Brian R. Amman
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tara K. Sealy
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jessica R. Spengler
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jessica R. Harmon
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Joann D. Coleman-McCray
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Mariano Sanchez-Lockhart
- Center for Genome Sciences, Molecular Biology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Gustavo F. Palacios
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jonathan S. Towner
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Joseph B. Prescott
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
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Burke B, Rocha SM, Zhan S, Eckley M, Reasoner C, Addetia A, Lewis J, Fagre A, Charley P, Richt JA, Weiss SR, Tjalkens RB, Veesler D, Aboellail T, Schountz T. Regulatory T Cell-like Response to SARS-CoV-2 in Jamaican Fruit Bats ( Artibeus jamaicensis ) Transduced with Human ACE2. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.13.528205. [PMID: 36824814 PMCID: PMC9949052 DOI: 10.1101/2023.02.13.528205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Insectivorous Old World horseshoe bats ( Rhinolophus spp.) are the likely source of the ancestral SARS-CoV-2 prior to its spillover into humans and causing the COVID-19 pandemic. Natural coronavirus infections of bats appear to be principally confined to the intestines, suggesting fecal-oral transmission; however, little is known about the biology of SARS-related coronaviruses in bats. Previous experimental challenges of Egyptian fruit bats ( Rousettus aegyptiacus ) resulted in limited infection restricted to the respiratory tract, whereas insectivorous North American big brown bats ( Eptesicus fuscus ) showed no evidence of infection. In the present study, we challenged Jamaican fruit bats ( Artibeus jamaicensis ) with SARS-CoV-2 to determine their susceptibility. Infection was confined to the intestine for only a few days with prominent viral nucleocapsid antigen in epithelial cells, and mononuclear cells of the lamina propria and Peyer's patches, but with no evidence of infection of other tissues; none of the bats showed visible signs of disease or seroconverted. Expression levels of ACE2 were low in the lungs, which may account for the lack of pulmonary infection. Bats were then intranasally inoculated with a replication-defective adenovirus encoding human ACE2 and 5 days later challenged with SARS-CoV-2. Viral antigen was prominent in lungs for up to 14 days, with loss of pulmonary cellularity during this time; however, the bats did not exhibit weight loss or visible signs of disease. From day 7, bats had low to moderate IgG antibody titers to spike protein by ELISA, and one bat on day 10 had low-titer neutralizing antibodies. CD4 + helper T cells became activated upon ex vivo recall stimulation with SARS-CoV-2 nucleocapsid peptide library and exhibited elevated mRNA expression of the regulatory T cell cytokines interleukin-10 and transforming growth factor-β, which may have limited inflammatory pathology. Collectively, these data show that Jamaican fruit bats are poorly susceptibility to SARS-CoV-2 but that expression of human ACE2 in their lungs leads to robust infection and an adaptive immune response with low-titer antibodies and a regulatory T cell-like response that may explain the lack of prominent inflammation in the lungs. This model will allow for insight of how SARS-CoV-2 infects bats and how bat innate and adaptive immune responses engage the virus without overt clinical disease. Author Summary Bats are reservoir hosts of many viruses that infect humans, yet little is known about how they host these viruses, principally because of a lack of relevant and susceptible bat experimental infection models. Although SARS-CoV-2 originated in bats, no robust infection models of bats have been established. We determined that Jamaican fruit bats are poorly susceptible to SARS-CoV-2; however, their lungs can be transduced with human ACE2, which renders them susceptible to SARS-CoV-2. Despite robust infection of the lungs and diminishment of pulmonary cellularity, the bats showed no overt signs of disease and cleared the infection after two weeks. Despite clearance of infection, only low-titer antibody responses occurred and only a single bat made neutralizing antibody. Assessment of the CD4 + helper T cell response showed that activated cells expressed the regulatory T cell cytokines IL-10 and TGFβ that may have tempered pulmonary inflammation.
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Haas GD, Lee B. Paramyxoviruses from bats: changes in receptor specificity and their role in host adaptation. Curr Opin Virol 2023; 58:101292. [PMID: 36508860 PMCID: PMC9974588 DOI: 10.1016/j.coviro.2022.101292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Global metagenomic surveys have revealed that bats host a diverse array of paramyxoviruses, including species from at least five major genera. An essential determinant of successful spillover is the entry of a virus into a new host. We evaluate the role of receptor usage in the zoonotic potential of bat-borne henipaviruses, morbilliviruses, pararubulaviruses, orthorubulaviruses, and jeilongviruses; successful spillover into humans depends upon compatibility of a respective viral attachment protein with its cognate receptor. We also emphasize the importance of postentry restrictions in preventing spillover. Metagenomics and characterization of newly identified paramyxoviruses have greatly improved our understanding of spillover determinants, allowing for better forecasts of which bat-borne viruses may pose the greatest risk for cross-species transmission into humans.
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Affiliation(s)
- Griffin D Haas
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Benhur Lee
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA.
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Welch SR, Ritter JM, Schuh AJ, Genzer SC, Sorvillo TE, Harmon JR, Coleman-McCray JD, Jain S, Shrivastava-Ranjan P, Seixas JN, Estetter LB, Fair PS, Towner JS, Montgomery JM, Albariño CG, Spiropoulou CF, Spengler JR. Tissue replication and mucosal swab detection of Sosuga virus in Syrian hamsters in the absence of overt tissue pathology and clinical disease. Antiviral Res 2023; 209:105490. [PMID: 36521633 PMCID: PMC10999129 DOI: 10.1016/j.antiviral.2022.105490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/29/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
Human infection with Sosuga virus (SOSV), a recently discovered pathogenic paramyxovirus, has been reported in one individual to date. No animal models of disease are currently available for SOSV. Here, we describe initial characterization of experimental infection in Syrian hamsters, including kinetics of virus dissemination and replication, and the corresponding clinical parameters, immunological responses, and histopathology. We demonstrate susceptibility of hamsters to infection in the absence of clinical signs or significant histopathologic findings in tissues.
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Affiliation(s)
- Stephen R Welch
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jana M Ritter
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Amy J Schuh
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Sarah C Genzer
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Teresa E Sorvillo
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jessica R Harmon
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - JoAnn D Coleman-McCray
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Shilpi Jain
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Punya Shrivastava-Ranjan
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Josilene Nascimento Seixas
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Lindsey B Estetter
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Pamela S Fair
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jonathan S Towner
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Joel M Montgomery
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - César G Albariño
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jessica R Spengler
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
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