Detection of Contagious Caprine Pleuropneumonia and Concurrent Diseases in Outbreaks Presenting with Respiratory Signs in Small Ruminants in Tanzania

Aims: To establish the prevalence and concurrent diseases in outbreaks presenting with respiratory signs, major associated clinical signs and postmortem lesions and proportions of those diseases in clinically and autopsied small ruminants for a proper diagnosis and control strategies.Study Design: Purposive outbreaks investigation.Place and Duration of Study: Department of Global Health, School of Life Science and Bio Engineering (LiSBE), Nelson Mandela Institution of Science and Technology (NM-AIST) between September 2016 and December 2018.Methodology:We included investigations of outbreaks of diseases presenting with respiratory signs in small ruminants reported from five agro-ecological zones in Tanzania. Small ruminats with clinical signs or postmortem lesions suggestive of respiratory involvement were subjected to clinical or postmortem examination. Samples from all examined animals were tested in the laboratory using conventional polymerase chain reaction (PCR) to confirm the tentative diagnosis.Results: A total of 205 small ruminats were examined and tested, of these 72.2% and 20.8% were goats and sheep respectively. In goats, 79.1% (117/148) and sheep, 28.1% (16/57) were confirmed to have concurrent infections, and pneumonic pasteurellosis and peste des petits ruminants (PPR) for goats, and PPR for sheep being mostly involved diseases. Contagious caprine pleuropneumonia (CCPP) was detected in 16.1% (n=205) of the animals, and was significantly high in goats (p=0.003, OR=7.3) than sheep. Pneumonic mannheimiosis (prevalence = 9.3%) was less likely toaffect goats than sheep (p=0.047, OR=0.38). In goats (n=148), detection of all diseases was significantly (p<0.05) low in clinically examined animals except pneumonic pasteurellosis and PPR, (p =0.056, OR=2.1) and (p=0.096, OR=2.15) respectively, though the difference was not significant. In sheep (n=57), CCPP was significantly (p=0.005, OR=0.17) more likely to be detected in clinically examined animals.Conclusion: In investigations of outbreaks presenting with respiratory signs in small ruminants, it is important to consider concurrent infections in the interventions and control strategies to be deployed, which may include development and use of multivalent vaccines.

Emergence of dengue virus 4 as the predominant serotype during the outbreak of 2017 in South India

Context: Dengue virus (DENV) causes acute febrile illness in tropical and subtropical countries. In India there is a steady increase in incidence since 1950s which could be attributed to emergence of new serotype or lineage\clade shifts in circulating DENV. Aims: We aimed to perform molecular characterisation and phylogenetic analysis on samples from the recent outbreak (August–October 2017). Settings and Design: Retrospective epidemiological analysis of dengue outbreak. Subjects and Methods: Samples positive for non-steroidal 1 antigen by enzyme-linked immunosorbent assay (n = 147) were included. The study was approved by our institute ethics committee (JIP/IEC/2018/496). Five hundred and eleven base pair of capsid and pre-membrane encoding genes (CprM) region was amplified using Lanciotti primers, followed by second round of polymerase chain reaction using serotype specific primers. Samples which were positive by second round (n = 68) were sequenced and genotyped using Basic Local Alignment Search Tool analysis and phylogenetic tree was constructed by MEGA7 software. Results: Phylogenetic analysis of CprM sequences identified all 4 serotypes in circulation during this outbreak. We observed both single (n = 50) and concurrent infections (n = 18), with DENV4 as the major contributor (64%). Within Genotype I of DENV4 we observed a distinct new clade (Clade E) which was 2.6% ± 0.9%–5.5% ± 1.1% divergent from the other clades. Among the concurrent infection, DENV 4 and DENV 2 combination was observed to form the majority (77.8%). Conclusions: Overall this study documents the emergence of DENV4 as the major serotype in circulation, replacing DENV1, 2 and 3 which had been previously reported from Tamil Nadu and Puducherry. This substantiates the need for continuous monitoring in endemic countries like India, where such data may impact the formulation of vaccine policy for dengue.

Concurrent infections of dengue viruses serotype 2 and 3 in patient with severe dengue from Jakarta, Indonesia

OBJECTIVE@#To describe the clinical manifestation of patient with severe dengue, to identify the serotypes and genotypes of dengue viruses (DENV) which concurrently infecting the patient, and to explore the possible relationship of severe dengue with the concurrent infection of DENV.@*METHODS@#Dengue diagnosis was performed using NS1 antigen detection and IgG/IgM ELISA. Standard clinical and laboratory examinations were performed to obtain the clinical and hematological data. DENV concurrent infections were detected and confirmed using RT-PCR and DENV Envelope gene sequencing. Phylogenetic analyses were performed to determine the genotypes of the viruses.@*RESULTS@#The patient was classified as having severe dengue characterized by severe plasma leakage, hemorrhage, and organ damage involving lung, liver, and kidney. Concurrent infection of DENV serotype 2 and 3 was observed. The infecting DENV-2 virus was grouped into Cosmopolitan genotype while DENV-3 virus was classified into Genotype I. Both viruses were closely related to isolates that were endemic in Jakarta. Viremia measurement was conducted and revealed a significantly higher virus titer of DENV-3 compared to DENV-2.@*CONCLUSIONS@#The occurrence of multi-serotype DENV infections was presented in a patient with severe clinical manifestation in Indonesia. The hyperendemicity of dengue in Indonesia may contribute to the DENV concurrent infections cases and may underlie the severity of the disease.

Concurrent infections of dengue viruses serotype 2 and 3 in patient with severe dengue from Jakarta, Indonesia

Objective: To describe the clinical manifestation of patient with severe dengue, to identify the serotypes and genotypes of dengue viruses (DENV) which concurrently infecting the patient, and to explore the possible relationship of severe dengue with the concurrent infection of DENV. Methods: Dengue diagnosis was performed using NS1 antigen detection and IgG/IgM ELISA. Standard clinical and laboratory examinations were performed to obtain the clinical and hematological data. DENV concurrent infections were detected and confirmed using RT-PCR and DENV Envelope gene sequencing. Phylogenetic analyses were performed to determine the genotypes of the viruses. Results: The patient was classified as having severe dengue characterized by severe plasma leakage, hemorrhage, and organ damage involving lung, liver, and kidney. Concurrent infection of DENV serotype 2 and 3 was observed. The infecting DENV-2 virus was grouped into Cosmopolitan genotype while DENV-3 virus was classified into Genotype I. Both viruses were closely related to isolates that were endemic in Jakarta. Viremia measurement was conducted and revealed a significantly higher virus titer of DENV-3 compared to DENV-2. Conclusions: The occurrence of multi-serotype DENV infections was presented in a patient with severe clinical manifestation in Indonesia. The hyperendemicity of dengue in Indonesia may contribute to the DENV concurrent infections cases and may underlie the severity of the disease.