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Diaz JN, Iannotti LL, Louis Dulience SJ, Vie S, Jiang X, Grigura V, Boncy J, Pierre FJM, Kuhlmann FM. Prevalence of diarrheagenic Escherichia coli and impact on child health in Cap-Haitien, Haiti. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001863. [PMID: 37145992 PMCID: PMC10162540 DOI: 10.1371/journal.pgph.0001863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/06/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. METHODS We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6-36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was determined using multivariate linear regression. Lastly, we assessed the association between specific biomarkers, choline and docosahexaenoic acid (DHA) and diarrheal burden. RESULTS Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression, controlled for case or control status, demonstrated ETEC and EAEC were significantly associated with reduced weight-age z-score (WAZ) and height-age z-score (HAZ) after adjusting for confounders. An interaction between ETEC and EAEC was observed. Choline and DHA were not associated with diarrheal burden. CONCLUSIONS DEC are prevalent in north Haitian children. ETEC, EAEC, household environment, and diet are associated with unfavorable anthropometric measures, with possible synergistic interactions between ETEC and EAEC. Further studies with longer follow up may quantify the contribution of individual pathogens to adverse health outcomes.
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Affiliation(s)
- Jenna N. Diaz
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Lora L. Iannotti
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Sherlie Jean Louis Dulience
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Sydney Vie
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Xuntian Jiang
- Department of Medicine, Diabetic Cardiovascular Disease Center, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Vadim Grigura
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Jacques Boncy
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Francesca J. Marhône Pierre
- Unité de Coordination du Programme National d’Alimentation et de Nutrition, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - F. Matthew Kuhlmann
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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2
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Alam MM, Mavian C, Okech BA, White SK, Stephenson CJ, Elbadry MA, Blohm GM, Loeb JC, Louis R, Saleem C, Madsen Beau de Rochars VE, Salemi M, Lednicky JA, Morris JG. Analysis of Zika Virus Sequence Data Associated with a School Cohort in Haiti. Am J Trop Med Hyg 2022; 107:873-880. [PMID: 36096408 PMCID: PMC9651511 DOI: 10.4269/ajtmh.22-0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/11/2022] [Indexed: 11/07/2022] Open
Abstract
Zika virus (ZIKV) infections occurred in epidemic form in the Americas in 2014-2016, with some of the earliest isolates in the region coming from Haiti. We isolated ZIKV from 20 children with acute undifferentiated febrile illness who were part of a cohort of children seen at a school clinic in the Gressier region of Haiti. The virus was also isolated from three pools of Aedes aegypti mosquitoes collected at the same location. On phylogenetic analysis, three distinct ZIKV clades were identified. Strains from all three clades were present in Haiti in 2014, making them among the earliest isolates identified in the Western Hemisphere. Strains from all three clades were also isolated in 2016, indicative of their persistence across the time period of the epidemic. Mosquito isolates were collected in 2016 and included representatives from two of the three clades; in one instance, ZIKV was isolated from a pool of male mosquitoes, suggestive of vertical transmission of the virus. The identification of multiple ZIKV clades in Haiti at the beginning of the epidemic suggests that Haiti served as a nidus for transmission within the Caribbean.
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Affiliation(s)
- Md. Mahbubul Alam
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Carla Mavian
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida
| | - Bernard A. Okech
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Sarah K. White
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Caroline J. Stephenson
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Maha A. Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Gabriela M. Blohm
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Julia C. Loeb
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Rigan Louis
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- State University of Haiti Faculty of Medicine and Pharmacy, Port-au-Prince, Haiti
| | - Cyrus Saleem
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
| | - Valery E. Madsen Beau de Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida
| | - John A. Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida
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3
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Lednicky JA, Tagliamonte MS, White SK, Elbadry MA, Alam MM, Stephenson CJ, Bonny TS, Loeb JC, Telisma T, Chavannes S, Ostrov DA, Mavian C, De Rochars VMB, Salemi M, Morris JG. Emergence of porcine delta-coronavirus pathogenic infections among children in Haiti through independent zoonoses and convergent evolution. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33791709 PMCID: PMC8010738 DOI: 10.1101/2021.03.19.21253391] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Coronaviruses have caused three major epidemics since 2003, including the ongoing SARS-CoV-2 pandemic. In each case, coronavirus emergence in our species has been associated with zoonotic transmissions from animal reservoirs1,2, underscoring how prone such pathogens are to spill over and adapt to new species. Among the four recognized genera of the family Coronaviridae – Alphacoronavirus, Betacoronavirus, Deltacoronavirus, Gammacoronavirus, – human infections reported to date have been limited to alpha- and betacoronaviruses3. We identify, for the first time, porcine deltacoronavirus (PDCoV) strains in plasma samples of three Haitian children with acute undifferentiated febrile illness. Genomic and evolutionary analyses reveal that human infections were the result of at least two independent zoonoses of distinct viral lineages that acquired the same mutational signature in the nsp15 and the spike glycoprotein genes by convergent evolution. In particular, structural analysis predicts that one of the changes in the Spike S1 subunit, which contains the receptor-binding domain, may affect protein’s flexibility and binding to the host cell receptor. Our findings not only underscore the ability of deltacoronaviruses to adapt and potentially lead to human-to-human transmission, but also raise questions about the role of such transmissions in development of pre-existing immunity to other coronaviruses, such as SARS-CoV-2.
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4
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Lednicky JA, Tagliamonte MS, White SK, Elbadry MA, Alam MM, Stephenson CJ, Bonny TS, Loeb JC, Telisma T, Chavannes S, Ostrov DA, Mavian C, Beau De Rochars VM, Salemi M, Morris JG. Independent infections of porcine deltacoronavirus among Haitian children. Nature 2021; 600:133-137. [PMID: 34789872 PMCID: PMC8636265 DOI: 10.1038/s41586-021-04111-z] [Citation(s) in RCA: 152] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/07/2021] [Indexed: 01/07/2023]
Abstract
Coronaviruses have caused three major epidemics since 2003, including the ongoing SARS-CoV-2 pandemic. In each case, the emergence of coronavirus in our species has been associated with zoonotic transmissions from animal reservoirs1,2, underscoring how prone such pathogens are to spill over and adapt to new species. Among the four recognized genera of the family Coronaviridae, human infections reported so far have been limited to alphacoronaviruses and betacoronaviruses3-5. Here we identify porcine deltacoronavirus strains in plasma samples of three Haitian children with acute undifferentiated febrile illness. Genomic and evolutionary analyses reveal that human infections were the result of at least two independent zoonoses of distinct viral lineages that acquired the same mutational signature in the genes encoding Nsp15 and the spike glycoprotein. In particular, structural analysis predicts that one of the changes in the spike S1 subunit, which contains the receptor-binding domain, may affect the flexibility of the protein and its binding to the host cell receptor. Our findings highlight the potential for evolutionary change and adaptation leading to human infections by coronaviruses outside of the previously recognized human-associated coronavirus groups, particularly in settings where there may be close human-animal contact.
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Affiliation(s)
- John A. Lednicky
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Massimiliano S. Tagliamonte
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL USA
| | - Sarah K. White
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Maha A. Elbadry
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Md. Mahbubul Alam
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Caroline J. Stephenson
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Tania S. Bonny
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Julia C. Loeb
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | | | | | - David A. Ostrov
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL USA
| | - Carla Mavian
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL USA
| | - Valery Madsen Beau De Rochars
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA. .,Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
| | - J. Glenn Morris
- grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, FL USA ,grid.15276.370000 0004 1936 8091Department of Medicine, College of Medicine, University of Florida, Gainesville, FL USA
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Taborda RLM, Silva LAD, Orlandi PP, Batista FS, Rodrigues RS, Matos NB. CHARACTERIZATION OF ENTEROAGGREGATIVE ESCHERICHIA COLI AMONG DIARRHEAL CHILDRENIN WESTERN BRAZILIAN AMAZON. ARQUIVOS DE GASTROENTEROLOGIA 2019; 55:390-396. [PMID: 30785524 DOI: 10.1590/s0004-2803.201800000-84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/12/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Enteroaggregative Escherichia coli (EAEC) is one of the main acute and chronic diarrhea causes both in children and adults, mainly in developing countries. OBJECTIVE The aim of the present study is to characterize EAEC strains isolated from faecal samples and to identify genes potentially contributing to virulence, biofilm production and antimicrobial resistance in children admitted to a pediatric hospital in Porto Velho, Rondônia State. METHODS The total of 1,625 E. coli specimens were isolated from 591 children in the age group 6 years or younger who were hospitalized in Cosme and Damião Children Hospital in Porto Velho, between February 2010 and February 2012, with acute gastroenteritis. Colonies suggestive of E. coli were subjected to polymerase chain reaction testing in order to identify the virulence factors. The in vitro adhesion assays using HEp-2 adherence were tests. Biofilm detection through spectrophotometry and antimicrobial susceptibility tests were conducted in the disk diffusion method. RESULTS The mentioned study examined 591 stool samples from children with diarrhea. Diarrheogenic E. coli was found in 27.4% (162/591) of the children. EAEC was the diarreagenic E. coli most frequently associated with diarrhea 52.4% (85/162), which was followed by enteropathogenic E. coli 43.8% (71/162), enterotoxigenic E. coli 2.4% (4/162), and enterohemorrhagic E. coli 1.2% (2/162). The aggR gene was detected in 63.5% (54/85) of EAEC isolates; moreover, statistically significant correlation was observed among typical EAEC (aggR) and aatA (P<0.0001), irp2 (P=0.0357) and shf (P=0.0328). It was recorded that 69% (59/85) of the 85 analyzed EAEC strains were biofilm producers; 73% (43/59) of the biofilm producers carried the aggR gene versus 42.3% (11/26) of non-producers (P=0.0135). In addition, there was association between the aatA gene and biofilm production; 61% (36/59) of the samples presented producer strains, versus 19.2% (5/26) of non-producers (P<0.0004). Antibiotic sensitivity test evidenced that most EAEC were ampicillin 70.6% (60/85), sulfamethoxazole 60% (51/85), tetracycline 44.7% (38/85) and cefotaxime 22.4% (19/85) resistant. CONCLUSION As far as it is known, the present study is pioneer in Northern Brazil to investigate EAEC virulence factors and to show the antimicrobial susceptibility of EAEC strains isolated from children with diarrhea.
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Affiliation(s)
| | | | | | | | | | - Najla Benevides Matos
- Centro de Pesquisa em Medicina Tropical, Porto Velho, RO, Brasil.,Fundação Oswaldo Cruz, FIOCRUZ - Porto Velho, RO, Brasil
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6
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Ball JD, Elbadry MA, Telisma T, White SK, Chavannes S, Anilis MG, Prosperi M, Cummings DAT, Lednicky JA, Morris JG, Beau de Rochars M. Clinical and Epidemiologic Patterns of Chikungunya Virus Infection and Coincident Arboviral Disease in a School Cohort in Haiti, 2014-2015. Clin Infect Dis 2019; 68:919-926. [PMID: 30184178 PMCID: PMC6399436 DOI: 10.1093/cid/ciy582] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Beginning in December 2013, an epidemic of chikungunya virus (CHIKV) infection spread across the Caribbean and into virtually all countries in the Western hemisphere, with >2.4 million cases reported through the end of 2017. METHODS We monitored a cohort of school children in rural Haiti from May 2014, through February 2015, for occurrence of acute undifferentiated febrile illness, with clinical and laboratory data available for 252 illness episodes. RESULTS Our findings document passage of the major CHIKV epidemic between May and July 2014, with 82 laboratory-confirmed cases. Subsequent peaks of febrile illness were found to incorporate smaller outbreaks of dengue virus serotypes 1 and 4 and Zika virus, with identification of additional infections with Mayaro virus, enterovirus D68, and coronavirus NL63. CHIKV and dengue virus serotype 1 infections were more common in older children, with a complaint of arthralgia serving as a significant predictor for infection with CHIKV (odds ratio, 16.2; 95% confidence interval, 8.0-34.4; positive predictive value, 66%; negative predictive value, 80%). CONCLUSIONS Viral/arboviral infections were characterized by a pattern of recurrent outbreaks and case clusters, with the CHIKV epidemic representing just one of several arboviral agents moving through the population. Although clinical presentations of these agents are similar, arthralgias are highly suggestive of CHIKV infection.
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Affiliation(s)
- Jacob D Ball
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine
| | - Maha A Elbadry
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville
| | - Taina Telisma
- Christianville School Clinic, Christianville Foundation, Gressier, Haiti
| | - Sarah K White
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville
| | - Sonese Chavannes
- Christianville School Clinic, Christianville Foundation, Gressier, Haiti
| | - Marie Gina Anilis
- Christianville School Clinic, Christianville Foundation, Gressier, Haiti
| | - Mattia Prosperi
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine
| | - Derek A T Cummings
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Biology, College of Liberal Arts and Sciences
| | - John A Lednicky
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville
| | - J Glenn Morris
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Medicine, College of Medicine
| | - Madsen Beau de Rochars
- Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville
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7
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Acute Respiratory Illness in Rural Haiti. Int J Infect Dis 2019; 81:176-183. [PMID: 30772468 PMCID: PMC7173118 DOI: 10.1016/j.ijid.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 12/18/2022] Open
Abstract
Top viruses detected in Haitian children are Rhinovirus, Influenza A and Adenovirus. Top bacteria detected in Haitian children are S. pneumoniae and S. aureus. Younger children are more likely to have Influenza A and S. pneumoniae detected. Younger children are more likely to present with fever and diagnosed with pneumonia. These data support early use of Influenza A and S. pneumoniae vaccines in Haiti.
Objectives Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. Methods Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015. Results Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3–5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3–5 years old (71% 3–5yrs; 58% 6–15 years; 25% 16–20 years; p = 0.008). Children 3–10 years old presented with fever more than children 11–20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p < 0.001). Conclusions Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.
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8
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Lednicky JA, White SK, Mavian CN, El Badry MA, Telisma T, Salemi M, OKech BA, Beau De Rochars VM, Morris JG. Emergence of Madariaga virus as a cause of acute febrile illness in children, Haiti, 2015-2016. PLoS Negl Trop Dis 2019; 13:e0006972. [PMID: 30629592 PMCID: PMC6328082 DOI: 10.1371/journal.pntd.0006972] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 11/03/2018] [Indexed: 12/24/2022] Open
Abstract
Madariaga virus (MADV), also known as South American eastern equine encephalitis virus, has been identified in animals and humans in South and Central America, but not previously in Hispaniola or the northern Caribbean. MADV was isolated from virus cultures of plasma from an 8-year-old child in a school cohort in the Gressier/Leogane region of Haiti, who was seen in April, 2015, with acute febrile illness (AFI). The virus was subsequently cultured from an additional seven AFI case patients from this same cohort in February, April, and May 2016. Symptoms most closely resembled those seen with confirmed dengue virus infection. Sequence data were available for four isolates: all were within the same clade, with phylogenetic and molecular clock data suggesting recent introduction of the virus into Haiti from Panama sometime in the period from October 2012-January 2015. Our data document the movement of MADV into Haiti, and raise questions about the potential for further spread in the Caribbean or North America. Madariaga virus (MADV) is the name given to what used to be called South American eastern equine encephalitis virus (EEEV), based on recent studies suggesting that MADV is distinct genetically from the EEEV circulating in North America. Until now, MADV has been found primarily in animals in South and Central America, with a limited number of human cases reported (most of whom had encephalitis). Our group has been responsible for a series of studies assessing the etiology of acute febrile illness (AFI) among children in a school cohort in Haiti. Unexpectedly, in April, 2015, we identified MADV on viral culture of plasma from a student with AFI in this cohort; an additional seven cases were identified on culture of samples from children with AFI in this same cohort in February, April, and May 2016. On sequence analysis, all strains were very similar genetically, and appear to have come from a strain introduced into Haiti from Panama sometime in the period from October 2012- January 2015. Symptoms of children were similar to those seen with dengue; none had encephalitis. Our data indicate that this virus, which has the potential for causing serious illness, has been recently introduced into Haiti, and raises the possibility that it might move into other parts of the Caribbean or North America.
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MESH Headings
- Animals
- Antibodies, Viral/blood
- Child
- Child, Preschool
- Communicable Diseases, Imported/epidemiology
- Communicable Diseases, Imported/transmission
- Communicable Diseases, Imported/virology
- Culex/virology
- Disease Outbreaks
- Encephalitis Virus, Eastern Equine/classification
- Encephalitis Virus, Eastern Equine/genetics
- Encephalitis Virus, Eastern Equine/isolation & purification
- Encephalomyelitis, Eastern Equine/epidemiology
- Encephalomyelitis, Eastern Equine/transmission
- Encephalomyelitis, Eastern Equine/virology
- Female
- Haiti/epidemiology
- Humans
- Male
- Phylogeny
- RNA, Viral/blood
- Schools
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Affiliation(s)
- John A. Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America
| | - Sarah K. White
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America
| | - Carla N. Mavian
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Maha A. El Badry
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America
| | - Taina Telisma
- Christianville Foundation School Clinic, Gressier, Haiti
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Bernard A. OKech
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America
| | - V. Madsen Beau De Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, United States of America
- * E-mail:
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White SK, Mavian C, Salemi M, Morris JG, Elbadry MA, Okech BA, Lednicky JA, Dunford JC. A new "American" subgroup of African-lineage Chikungunya virus detected in and isolated from mosquitoes collected in Haiti, 2016. PLoS One 2018; 13:e0196857. [PMID: 29746539 PMCID: PMC5944945 DOI: 10.1371/journal.pone.0196857] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/20/2018] [Indexed: 01/06/2023] Open
Abstract
As part of on-going arboviral surveillance activity in a semi-rural region in Haiti, Chikungunya virus (CHIKV)-positive mosquito pools were identified in 2014 (the peak of the Caribbean Asian-clade epidemic), and again in 2016 by RT-PCR. In 2014, CHIKV was only identified in Aedes aegypti (11 positive pools/124 screened). In contrast, in sampling in 2016, CHIKV was not identified in Ae. aegypti, but, rather, in (a) a female Aedes albopictus pool, and (b) a female Culex quinquefasciatus pool. Genomic sequence analyses indicated that the CHIKV viruses in the 2016 mosquito pools were from the East-Central-South African (ECSA) lineage, rather than the Asian lineage. In phylogenetic studies, these ECSA lineage strains form a new ECSA subgroup (subgroup IIa) together with Brazilian ECSA lineage strains from an isolated human outbreak in 2014, and a mosquito pool in 2016. Additional analyses date the most recent common ancestor of the ECSA IIa subgroup around May 2007, and the 2016 Haitian CHIKV genomes around December 2015. Known CHIKV mutations associated with improved Ae. albopictus vector competence were not identified. Isolation of this newly identified lineage from Ae. albopictus is of concern, as this vector has a broader geographic range than Ae. aegypti, especially in temperate areas of North America, and stresses the importance for continued vector surveillance.
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Affiliation(s)
- Sarah Keller White
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
| | - Carla Mavian
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - John Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Maha A. Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Bernard A. Okech
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - John A. Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - James C. Dunford
- US Navy and Marine Corps Public Health Center, Portsmouth, Virginia, United States of America
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10
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White SK, Mavian C, Elbadry MA, Beau De Rochars VM, Paisie T, Telisma T, Salemi M, Lednicky JA, Morris JG. Detection and phylogenetic characterization of arbovirus dual-infections among persons during a chikungunya fever outbreak, Haiti 2014. PLoS Negl Trop Dis 2018; 12:e0006505. [PMID: 29851952 PMCID: PMC5997359 DOI: 10.1371/journal.pntd.0006505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/12/2018] [Accepted: 05/07/2018] [Indexed: 01/01/2023] Open
Abstract
In the context of recent arbovirus epidemics, questions about the frequency of simultaneous infection of patients with different arbovirus species have been raised. In 2014, a major Chikungunya virus (CHIKV) epidemic impacted the Caribbean and South America. As part of ongoing screening of schoolchildren presenting with acute undifferentiated febrile illness in rural Haiti, we used RT-PCR to identify CHIKV infections in 82 of 100 children with this diagnosis during May-August 2014. Among these, eight were infected with a second arbovirus: six with Zika virus (ZIKV), one with Dengue virus serotype 2, and one with Mayaro virus (MAYV). These dual infections were only detected following culture of the specimen, suggesting low viral loads of the co-infecting species. Phylogenetic analyses indicated that the ZIKV and MAYV strains differ from those detected later in 2014 and 2015, respectively. Moreover, CHIKV and ZIKV strains from co-infected patients clustered monophyletically in their respective phylogeny, and clock calibration traced back the common ancestor of each clade to an overlapping timeframe of introduction of these arboviruses onto the island.
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Affiliation(s)
- Sarah K. White
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Carla Mavian
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Maha A. Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Valery Madsen Beau De Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Taylor Paisie
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Taina Telisma
- Christianville Foundation School Clinic, Gressier, Haiti
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - John A. Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
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Lednicky J, De Rochars VMB, Elbadry M, Loeb J, Telisma T, Chavannes S, Anilis G, Cella E, Ciccozzi M, Okech B, Salemi M, Morris JG. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerg Infect Dis 2018; 22:2000-2002. [PMID: 27767924 PMCID: PMC5088037 DOI: 10.3201/eid2211.161015] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mayaro virus has been associated with small outbreaks in northern South America. We isolated this virus from a child with acute febrile illness in rural Haiti, confirming its role as a cause of mosquitoborne illness in the Caribbean region. The clinical presentation can mimic that of chikungunya, dengue, and Zika virus infections.
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12
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Abstract
BACKGROUND Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being. METHODS A literature search was conducted identifying articles published from January 2010 through May 2016 related to pediatric health outcomes in Haiti. Two reviewers screened articles independently. Included research articles described at least one physical health, psychological health, or socioeconomic outcome among children less than 18 years of age in Haiti since the January 2010 earthquake. RESULTS Fifty-eight full-length research articles were reviewed, covering infectious diseases (non-cholera [N=12] and cholera [N=7]), nutrition (N=11), traumatic injuries (N=11), mental health (N=9), anemia (N=4), abuse and violence (N=5), and other topics (N=3). Many children were injured in the 2010 earthquake, and care of their injuries is described in the literature. Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake, with cholera being one of the most important etiologies. The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder (PTSD), peri-traumatic stress, depression, and anxiety, and that food insecurity and malnutrition continue to be important issues. CONCLUSIONS Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long-term disabilities among children in Haiti is needed. Dube A , Moffatt M , Davison C , Bartels S . Health outcomes for children in Haiti since the 2010 earthquake: a systematic review. Prehosp Disaster Med. 2018;33(1):77-88.
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13
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Weppelmann TA, von Fricken ME, Masse R, Gelin G, Morris JG, Okech BA, De Rochars VMB. Indicators of anemia and physical growth in schoolchildren from the Ouest and Sud-Est Departments of Haiti: a cross-sectional study. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0107-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Weppelmann TA, Burne A, von Fricken ME, Elbadry MA, Beau De Rochars M, Boncy J, Okech BA. A Tale of Two Flaviviruses: A Seroepidemiological Study of Dengue Virus and West Nile Virus Transmission in the Ouest and Sud-Est Departments of Haiti. Am J Trop Med Hyg 2016; 96:135-140. [PMID: 27879463 DOI: 10.4269/ajtmh.16-0422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/12/2016] [Indexed: 11/07/2022] Open
Abstract
Though plans to eliminate malaria from the island of Hispaniola have recently received much attention, arbovirus surveillance continues to be largely neglected in Haiti. To support surveillance efforts and encourage vector-control strategies, a cross-sectional study of dengue virus (DENV) and West Nile virus (WNV) transmission was conducted using standard seroepidemiological methods. Blood samples (N = 673) were collected from 278 males and 395 females from three locations in the Ouest and Sud-Est Departments of Haiti. Serum was separated and tested for the presence of anti-DENV and anti-WNV immunoglobulin G (IgG) antibodies using an indirect enzyme-linked immunosorbent assay (ELISA). Anti-DENV IgG antibodies were detected in 72.1% (95% confidence interval [CI] = 68.7, 75.5) of the sample population; with no significant differences in seroprevalence by study location, participant gender, or age group (P > 0.1, in all tests). Anti-WNV IgG antibodies were detected in only 1% (95% CI = 0.3, 1.8) of the sample population, all which originated from participants located in Gressier. The high prevalence of anti-DENV IgG antibodies among all age groups, including those in the youngest age group (2-5 years of age), suggests hyperendemic transmission of DENV in the Ouest and Sud-Est Departments of Haiti. In contrast, the relative absence of anti-WNV IgG antibodies, even among older population members, further supports the notion that WNV transmission in this population is largely absent. These findings highlight the large burden of disease from DENV and the need for enhanced arbovirus surveillance and implementation of vector control strategies throughout Haiti.
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Affiliation(s)
- Thomas A Weppelmann
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.,Emerging Pathogens Institute, University of Florida, Gainesville, Florida
| | - Alexandra Burne
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Florida
| | - Michael E von Fricken
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia
| | - Maha A Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Madsen Beau De Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Health Services, Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Jacques Boncy
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia.,Laboratoire National de Santé Publique (LNSP), Ministère de la Santé et de la Population (MSPP), Port au Prince, Haiti
| | - Bernard A Okech
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida. .,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
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15
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Beau De Rochars VM, Lednicky J, White S, Loeb J, Elbadry MA, Telisma T, Chavannes S, Anilis MG, Cella E, Ciccozzi M, Okech BA, Salemi M, Morris JG. Isolation of Coronavirus NL63 from Blood from Children in Rural Haiti: Phylogenetic Similarities with Recent Isolates from Malaysia. Am J Trop Med Hyg 2016; 96:144-147. [PMID: 27799635 DOI: 10.4269/ajtmh.16-0585] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 09/16/2016] [Indexed: 12/28/2022] Open
Abstract
Human coronavirus (HCoV) NL63 is recognized as a common cause of upper respiratory infections and influenza-like illness. In screening children with acute undifferentiated febrile illness in a school cohort in rural Haiti, we identified HCoV-NL63 in blood samples from four children. Cases clustered over an 11-day period; children did not have respiratory symptoms, but two had gastrointestinal complaints. On phylogenetic analysis, the Haitian HCoV-NL63 strains cluster together in a highly supported monophyletic clade linked most closely with recently reported strains from Malaysia; two respiratory HCoV-NL63 strains identified in north Florida in the same general period form a separate clade, albeit again with close linkages with the Malaysian strains. Our data highlight the variety of presentations that may be seen with HCoV-NL63, and underscore the apparent ease with which CoV strains move among countries, with our data consistent with recurrent introduction of strains into the Caribbean (Haiti and Florida) from Asia.
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Affiliation(s)
- Valery Madsen Beau De Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - John Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Sarah White
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Julia Loeb
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Maha A Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Taina Telisma
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Christianville Foundation, School Clinic, Gressier, Haiti
| | - Sonese Chavannes
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Christianville Foundation, School Clinic, Gressier, Haiti
| | - Marie Gina Anilis
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Christianville Foundation, School Clinic, Gressier, Haiti
| | - Eleonora Cella
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Pathology, Immunology and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, Florida.,Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Massimo Ciccozzi
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Bernard A Okech
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida.,Department of Pathology, Immunology and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, Florida
| | - J Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida. .,Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida
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16
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Lednicky J, Beau De Rochars VM, El Badry M, Loeb J, Telisma T, Chavannes S, Anilis G, Cella E, Ciccozzi M, Rashid M, Okech B, Salemi M, Morris JG. Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data. PLoS Negl Trop Dis 2016; 10:e0004687. [PMID: 27111294 PMCID: PMC4844159 DOI: 10.1371/journal.pntd.0004687] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/13/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV), first isolated in Uganda in 1947, is currently spreading rapidly through South America and the Caribbean. In Brazil, infection has been linked with microcephaly and other serious complications, leading to declaration of a public health emergency of international concern; however, there currently are only limited data on the virus (and its possible sources and manifestations) in the Caribbean. METHODS From May, 2014-February, 2015, in conjunction with studies of chikungunya (CHIKV) and dengue (DENV) virus infections, blood samples were collected from children in the Gressier/Leogane region of Haiti who presented to a school clinic with undifferentiated febrile illness. Samples were initially screened by RT-PCR for CHIKV and DENV, with samples negative in these assays further screened by viral culture. FINDINGS Of 177 samples screened, three were positive for ZIKV, confirmed by viral sequencing; DENV-1 was also identified in culture from one of the three positive case patients. Patients were from two different schools and 3 different towns, with all three cases occurring within a single week, consistent with the occurrence of an outbreak in the region. Phylogenetic analysis of known full genome viral sequences demonstrated a close relationship with ZIKV from Brazil; additional analysis of the NS5 gene, for which more sequences are currently available, showed the Haitian strains clustering within a monophyletic clade distinct from Brazilian, Puerto Rican and Guatemalan sequences, with all part of a larger clade including isolates from Easter Island. Phylogeography also clarified that at least three major African sub-lineages exist, and confirmed that the South American epidemic is most likely to have originated from an initial ZIKV introduction from French Polynesia into Easter Island, and then to the remainder of the Americas. CONCLUSIONS ZIKV epidemics in South America, as well as in Africa, show complex dissemination patterns. The virus appears to have been circulating in Haiti prior to the first reported cases in Brazil. Factors contributing to transmission and the possible linkage of this early Haitian outbreak with microcephaly remain to be determined.
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Affiliation(s)
- John Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Valery Madsen Beau De Rochars
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Maha El Badry
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Julia Loeb
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Taina Telisma
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Christianville Foundation School Clinic, Gressier, Haiti
| | - Sonese Chavannes
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Christianville Foundation School Clinic, Gressier, Haiti
| | - Gina Anilis
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Christianville Foundation School Clinic, Gressier, Haiti
| | - Eleonora Cella
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, Immunology, and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, Florida, United States of America
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Massimo Ciccozzi
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Mohammed Rashid
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Bernard Okech
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Pathology, Immunology, and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
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