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1.
Microbiol Spectr ; 11(1): e0420722, 2023 Feb 14.
Article in English | MEDLINE | ID: covidwho-2241633

ABSTRACT

Backyard farming with limited biosecurity creates a massive potential for zoonotic spillover. Cambodia, a developing nation in Southeast Asia, is a hub for emerging and endemic infectious diseases. Due to pandemic-induced job losses in the tourism sector, rumors suggest that many former Cambodian tour guides have turned to backyard farming as a source of income and food security. A cross-sectional study including 331 tour guides and 69 poultry farmers in Cambodia before and during the novel coronavirus disease 2019 (COVID-19) pandemic was conducted. Participants were administered a survey to assess food security, income, and general farming practices. Survey data were collected to evaluate the risk perceptions for avian influenza virus (AIV), antimicrobial resistance (AMR), and general biosecurity management implemented on these poultry farms. Overall, food security decreased for 80.1% of the tour guides during the COVID-19 pandemic. Approximately 21% of the tour guides interviewed used backyard poultry farming to supplement losses of income and food insecurity during the COVID-19 pandemic, with a significantly higher risk than for traditional poultry farmers. Agricultural intensification in Cambodia due to the COVID-19 pandemic has caused an influx of makeshift farms with limited biosecurity. Inadequate biosecurity measures in animal farms can facilitate spillover and contribute to future pandemics. Improved biosecurity and robust viral surveillance systems are critical for reducing the risk of spillover from backyard farms. IMPORTANCE While this study highlights COVID-19-associated changes in poultry production at a small scale in Cambodia, poultry production is expected to expand due to an increase in the global demand for poultry protein during the pandemic, changes in urbanization, and the reduction of the global pork supply caused by African swine fever (ASF). The global demand and surge in poultry products, combined with inadequate biosecurity methods, can lead to an increased risk of domestic animal and human spillovers of zoonotic pathogens such as avian influenza. Countries in regions of endemicity are often plagued by complex emergency situations (i.e., food insecurity and economic fallouts) that hinder efforts to effectively address the emergence (or reemergence) of zoonotic diseases. Thus, novel surveillance strategies for endemic and emerging infectious diseases require robust surveillance systems and biosecurity training programs to prevent future global pandemics.


Subject(s)
African Swine Fever , COVID-19 , Influenza in Birds , Poultry Diseases , Humans , Animals , Swine , Influenza in Birds/epidemiology , Influenza in Birds/prevention & control , Pandemics/prevention & control , Cambodia/epidemiology , Farms , Biosecurity , African Swine Fever/epidemiology , Cross-Sectional Studies , Animal Husbandry/methods , COVID-19/epidemiology , Zoonoses/epidemiology , Zoonoses/prevention & control , Poultry
2.
Int J Environ Res Public Health ; 20(1)2022 12 23.
Article in English | MEDLINE | ID: covidwho-2240245

ABSTRACT

As a result of the COVID-19 pandemic, as well as other outbreaks, such as SARS and Ebola, bats are recognized as a critical species for mediating zoonotic infectious disease spillover events. While there is a growing concern of increased antimicrobial resistance (AMR) globally during this pandemic, knowledge of AMR circulating between bats and humans is limited. In this paper, we have reviewed the evidence of AMR in bats and discussed the planetary health aspect of AMR to elucidate how this is associated with the emergence, spread, and persistence of AMR at the human-animal interface. The presence of clinically significant resistant bacteria in bats and wildlife has important implications for zoonotic pandemic surveillance, disease transmission, and treatment modalities. We searched MEDLINE through PubMed and Google Scholar to retrieve relevant studies (n = 38) that provided data on resistant bacteria in bats prior to 30 September 2022. There is substantial variability in the results from studies measuring the prevalence of AMR based on geographic location, bat types, and time. We found all major groups of Gram-positive and Gram-negative bacteria in bats, which are resistant to commonly used antibiotics. The most alarming issue is that recent studies have increasingly identified clinically significant multi-drug resistant bacteria such as Methicillin Resistant Staphylococcus aureus (MRSA), ESBL producing, and Colistin resistant Enterobacterales in samples from bats. This evidence of superbugs abundant in both humans and wild mammals, such as bats, could facilitate a greater understanding of which specific pathways of exposure should be targeted. We believe that these data will also facilitate future pandemic preparedness as well as global AMR containment during pandemic events and beyond.


Subject(s)
COVID-19 , Chiroptera , Methicillin-Resistant Staphylococcus aureus , Animals , Humans , Anti-Bacterial Agents/pharmacology , Pandemics , COVID-19/epidemiology , Drug Resistance, Bacterial , Gram-Negative Bacteria , Gram-Positive Bacteria , Zoonoses/epidemiology , Bacteria
3.
S Afr Fam Pract (2004) ; 64(1): e1-e5, 2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2242036

ABSTRACT

The development of new zoonotic diseases such as coronavirus disease 2019 (COVID-19) and monkeypox that can cause epidemics and high mortality rates have significantly threatened global health security. However, the increasing number of people with no immunity to poxvirus because of the end of the smallpox vaccination programme has created a vulnerable population for the monkeypox outbreak. On 23 July 2022, it was announced that the World Health Organization's director-general has determined that the multicountry outbreak of monkeypox constitutes a Public Health Emergency of International Concern. The monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar to smallpox but less severe. Many unanswered questions remain regarding monkeypox's pathogenesis, transmission and host reservoir. There is currently no evidence that transmission by individuals can sustain zoonotic infections during human-to-human transmissions; the continued emergence of these pathogens highlights the interconnectedness of animals and humans. The increasing number of monkeypox cases outside the endemic region has highlighted the need for effective global capacity building to prevent the spread of the disease and its impact on global health security. The priority now is to stop the spread of the disease and protect frontline healthcare workers and the most vulnerable individuals. This article aims to comprehensively analyse the various aspects of the transmission and epidemiology of monkeypox. It also explores possible diagnostic techniques, therapeutics and prevention strategies. A key recommendation is that primary care and public health professionals are expected to increase their efforts to be vigilant and contain any potential outbreaks.


Subject(s)
COVID-19 , Monkeypox , Smallpox , Variola virus , Animals , Humans , Monkeypox/epidemiology , Monkeypox/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Disease Outbreaks/prevention & control , Monkeypox virus , Zoonoses/epidemiology , Zoonoses/prevention & control
4.
Cell ; 186(4): 688-690, 2023 02 16.
Article in English | MEDLINE | ID: covidwho-2243715

ABSTRACT

Trafficking of live mammals is considered a major risk for emergence of zoonotic viruses. SARS-CoV-2-related coronaviruses have previously been identified in pangolins, the world's most smuggled mammal. A new study identifies a MERS-related coronavirus in trafficked pangolins with broad mammalian tropism and a newly acquired furin cleavage site in Spike.


Subject(s)
Coronavirus , Pangolins , Animals , Humans , Chiroptera , COVID-19 , Middle East Respiratory Syndrome Coronavirus , Phylogeny , SARS-CoV-2 , Coronavirus/physiology , Zoonoses
5.
PLoS One ; 18(2): e0280154, 2023.
Article in English | MEDLINE | ID: covidwho-2227379

ABSTRACT

BACKGROUND: Babesiosis is a zoonosis caused by an intraerythrocytic protozoan of the genus Babesia and transmitted mainly by ticks of the Ixodes spp. complex. There is no comprehensive global incidence in the literature, although the United States, Europe and Asia are considered to be endemic areas. In Europe, the percentage of ticks infected with Babesia spp. ranges from 0.78% to 51.78%. The incidence of babesiosis in hospitalized patients in Spain is 2.35 cases per 10,000,000 inhabitants/year. The mortality rate is estimated to be approximately 9% in hospitalized patients but can reach 20% if the disease is transmitted by transfusion. OBJECTIVE: To analyze the epidemiological impact of inpatients diagnosed with babesiosis on the National Health System (NHS) of Spain between 1997 and 2019. METHODOLOGY: A retrospective longitudinal descriptive study that included inpatients diagnosed with babesiosis [ICD-9-CM code 088.82, ICD-10 code B60.0, cases ap2016-2019] in public Spanish NHS hospitals between 1 January 1997 and 31 December 2019 was developed. Data were obtained from the minimum basic dataset (CMBD in Spanish), which was provided by the Ministerio de Sanidad, Servicios Sociales e Igualdad after the receipt of a duly substantiated request and the signing of a confidentiality agreement. MAIN FINDINGS: Twenty-nine inpatients diagnosed with babesiosis were identified in Spain between 1997 and 2019 (IR: 0.28 cases/10,000,000 person-years). A total of 82.8% of the cases were men from urban areas who were approximately 46 years old. The rate of primary diagnoses was 55.2% and the number of readmissions was 79.3%. The mean hospital stay was 20.3±19.2 days, with an estimated cost of €186,925.66. Two patients, both with secondary diagnoses of babesiosis, died in our study. CONCLUSIONS: Human babesiosis is still a rare zoonosis in Spain, with an incidence rate that has been increasing over the years. Most cases occurred in middle-aged men from urban areas between summer and autumn. The Castilla-La-Mancha and Extremadura regions recorded the highest number of cases. Given the low rate of primary diagnoses (55.2%) and the high number of readmissions (79.3%), a low clinical suspicion is likely. There was a 6.9% mortality in our study. Both patients who died were patients with secondary diagnoses of the disease.


Subject(s)
Babesia , Babesiosis , Ixodes , Male , Animals , Middle Aged , Humans , United States , Female , Babesiosis/epidemiology , Spain/epidemiology , Retrospective Studies , Zoonoses/epidemiology
6.
Int J Environ Res Public Health ; 20(4)2023 Feb 13.
Article in English | MEDLINE | ID: covidwho-2235248

ABSTRACT

BACKGROUND: The COVID-19 pandemic is an epidemiological and psychological crisis; what it does to the body is quite well known by now, and more research is underway, but the syndemic impact of COVID-19 and mental health on underlying chronic illnesses among the general population is not completely understood. METHODS: We carried out a literature review to identify the potential impact of COVID-19 and related mental health issues on underlying comorbidities that could affect the overall health of the population. RESULTS: Many available studies have highlighted the impact of COVID-19 on mental health only, but how complex their interaction is in patients with comorbidities and COVID-19, the absolute risks, and how they connect with the interrelated risks in the general population, remain unknown. The COVID-19 pandemic can be recognized as a syndemic due to; synergistic interactions among different diseases and other health conditions, increasing overall illness burden, emergence, spread, and interactions between infectious zoonotic diseases leading to new infectious zoonotic diseases; this is together with social and health interactions leading to increased risks in vulnerable populations and exacerbating clustering of multiple diseases. CONCLUSION: There is a need to develop evidence to support appropriate and effective interventions for the overall improvement of health and psychosocial wellbeing of at-risk populations during this pandemic. The syndemic framework is an important framework that can be used to investigate and examine the potential benefits and impact of codesigning COVID-19/non-communicable diseases (NCDs)/mental health programming services which can tackle these epidemics concurrently.


Subject(s)
COVID-19 , Humans , Animals , Mental Health , Pandemics , Syndemic , Chronic Disease , Zoonoses
7.
BMJ ; 377: o1489, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-2236180
9.
Viruses ; 14(12)2022 12 10.
Article in English | MEDLINE | ID: covidwho-2171911

ABSTRACT

Southeast Asia is considered a global hotspot of emerging zoonotic diseases. There, wildlife is commonly traded under poor sanitary conditions in open markets; these markets have been considered 'the perfect storm' for zoonotic disease transmission. We assessed the potential of wildlife trade in spreading viral diseases by quantifying the number of wild animals of four mammalian orders (Rodentia, Chiroptera, Carnivora and Primates) on sale in 14 Indonesian wildlife markets and identifying zoonotic viruses potentially hosted by these animals. We constructed a network analysis to visualize the animals that are traded alongside each other that may carry similar viruses. We recorded 6725 wild animals of at least 15 species on sale. Cities and markets with larger human population and number of stalls, respectively, offered more individuals for sale. Eight out of 15 animal taxa recorded are hosts of 17 zoonotic virus species, nine of which can infect more than one species as a host. The network analysis showed that long-tailed macaque has the greatest potential for spreading viral diseases, since it is simultaneously the most traded species, sold in 13/14 markets, and a potential host for nine viruses. It is traded alongside pig-tailed macaques in three markets, with which it shares six viruses in common (Cowpox, Dengue, Hepatitis E, Herpes B, Simian foamy, and Simian retrovirus type D). Short-nosed fruit bats and large flying foxes are potential hosts of Nipah virus and are also sold in large quantities in 10/14 markets. This study highlights the need for better surveillance and sanitary conditions to avoid the negative health impacts of unregulated wildlife markets.


Subject(s)
Carnivora , Chiroptera , Communicable Diseases , Virus Diseases , Viruses , Animals , Humans , Animals, Wild , Rodentia , Indonesia/epidemiology , Primates , Zoonoses , Virus Diseases/epidemiology , Virus Diseases/veterinary
11.
Paediatr Respir Rev ; 43: 1, 2022 09.
Article in English | MEDLINE | ID: covidwho-2182468
12.
J Appl Microbiol ; 134(1)2023 Jan 23.
Article in English | MEDLINE | ID: covidwho-2189203

ABSTRACT

Omics research inevitably involves the collection and analysis of big data, which can only be handled by automated approaches. Here we point out that the analysis of big data in the field of genomics dictates certain requirements, such as specialized software, quality control of input data, and simplification for visualization of the results. The latter results in a loss of information, as is exemplified for phylogenetic trees. Clear communication of big data analyses can be enhanced by novel visualization strategies. The interpretation of findings is sometimes hampered when dedicated analytical tools are not fully understood by microbiologists, while the researchers performing these analyses may not have a full overview of the biology of the microbes under study. These issues are illustrated here, using SARS-Cov-2 and Salmonella enterica as zoonotic examples. Whereas in scientific communications jargon should be avoided or explained, nomenclature to group similar organisms and distinguish these from more distant relatives is not only essential, but also influences the interpretation of results. Unfortunately, changes in taxonomically accepted names are now so frequent that they hamper rather than assist research, as is illustrated with difficulties of microbiome studies. Nomenclature to group viral isolates, as is done for SARS-Cov2, is also not without difficulties. Some weaknesses in current omics research stem from poor quality of data or biased databases, and problems can be magnified by machine learning approaches. Moreover, the overall opus of scientific publications can now be considered "big data", as is illustrated by the avalanche of COVID-19-related publications. The peer-review model of scientific publishing is only barely coping with this novel situation, resulting in retractions and the publication of bogus works. The avalanche of scientific publications that originated from the current pandemic can obstruct literature searches, and this will unfortunately continue over time.


Subject(s)
COVID-19 , Animals , Humans , SARS-CoV-2/genetics , Phylogeny , RNA, Viral , Genomics , Zoonoses
13.
Emerg Microbes Infect ; 12(1): e2164218, 2023 Dec.
Article in English | MEDLINE | ID: covidwho-2187798

ABSTRACT

Middle East respiratory syndrome coronavirus (MERS-CoV) is enzootic in dromedary camels and causes zoonotic infection and disease in humans. Although over 80% of the global population of infected dromedary camels are found in Africa, zoonotic disease had only been reported in the Arabia Peninsula and travel-associated disease has been reported elsewhere. In this study, genetic diversity and molecular epidemiology of MERS-CoV in dromedary camels in Ethiopia were investigated during 2017-2020. Of 1766 nasal swab samples collected, 61 (3.5%) were detected positive for MERS-CoV RNA. Of 484 turbinate swab samples collected, 10 (2.1%) were detected positive for MERS-CoV RNA. Twenty-five whole genome sequences were obtained from these MERS-CoV positive samples. Phylogenetically, these Ethiopian camel-originated MERS-CoV belonged to clade C2, clustering with other East African camel strains. Virus sequences from camel herds clustered geographically while in an abattoir, two distinct phylogenetic clusters of MERS-CoVs were observed in two sequential sampling collections, which indicates the greater genetic diversity of MERS-CoV in abattoirs. In contrast to clade A and B viruses from the Arabian Peninsula, clade C camel-originated MERS-CoV from Ethiopia had various nucleotide insertions and deletions in non-structural gene nsp3, accessory genes ORF3 and ORF5 and structural gene N. This study demonstrates the genetic instability of MERS-CoV in dromedaries in East Africa, which indicates that the virus is still actively adapting to its camel host. The impact of the observed nucleotide insertions and deletions on virus evolution, viral fitness, and zoonotic potential deserves further study.


Subject(s)
Coronavirus Infections , Middle East Respiratory Syndrome Coronavirus , Animals , Humans , Middle East Respiratory Syndrome Coronavirus/genetics , Camelus , Phylogeny , Ethiopia/epidemiology , Molecular Epidemiology , Travel , Coronavirus Infections/epidemiology , Coronavirus Infections/veterinary , Zoonoses/epidemiology , Genetic Variation , RNA
14.
Med Sci (Paris) ; 38(12): 1039-1042, 2022 Dec.
Article in French | MEDLINE | ID: covidwho-2186231

ABSTRACT

Today, the emergence of zoonoses is one of the biggest concerns for human health. With the recent examples of the Ebola virus, avian flus or coronaviruses, this threat is intensifying and raising fears of pandemics of the same magnitude as Covid-19. In this article, we review the state of knowledge about the mechanisms involved in these emergences, especially the impact of human activities on ecosystems, the intensive breeding of domestic animals or wildlife trade. We conclude on the importance of adopting a real integrated "One Health" approach in order to implement solutions at the beginning of this process of emergence and thus prevent new catastrophes.


Title: Perte de biodiversité, prélude aux émergences virales. Abstract: Aujourd'hui, l'émergence de zoonoses est un phénomène des plus préoccupants. Avec les exemples récents du virus Ebola, des virus responsables des grippes aviaires, ou des coronavirus, cette menace s'intensifie et fait craindre des pandémies de la même ampleur que celle de la Covid-19. Dans cette synthèse, nous dressons l'état des connaissances sur les mécanismes impliqués dans ces émergences, que ce soit l'impact de l'homme sur les écosystèmes, l'élevage intensif d'animaux domestiques, ou encore le commerce de la faune sauvage. Nous concluons sur l'importance d'adopter une réelle approche intégrée « Une seule santé ¼ (One health) afin d'implémenter des solutions au début de ce processus d'émergence et ainsi de prévenir de nouvelles catastrophes.


Subject(s)
COVID-19 , Ecosystem , Animals , Humans , COVID-19/epidemiology , Zoonoses/epidemiology , Biodiversity , Animals, Wild
15.
Schweiz Arch Tierheilkd ; 165(1): 59-63, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2204330

ABSTRACT

INTRODUCTION: In a guinea pig herd with 26 breeding animals, several individuals of all age categories died (16/26) after three animals had been newly introduced from another herd. Furthermore, the population suffered of apathy, anorexia, severe weight loss and conjunctivitis, as well as abortions and stillbirths. At the same time, the owner experienced a SARS-CoV-2 infection with pneumonia, which was confirmed by taking a PCR test. Chlamydia caviae was detected from the conjunctiva and vagina/uterus in one juvenile animal together with an intestinal Cryptosporidium wrairi infection. Oocysts were found histologically in the small intestine, which was confirmed by PCR. C. wairi is a parasite adapted to guinea pigs with zoonotic potential, which causes diarrhoea with frequent deaths in larger guinea pig herds. C. caviae is also a zoonotic pathogen and often the cause of conjunctivitis, pneumonia and abortions in guinea pigs and can lead to upper respiratory tract disease, conjunctivitis but also severe pneumonia in humans. The increased death cases and the clinical signs could be traced back to an infection with Cryptosporidium wrairi, complicated by a co-infection of C. caviae. We suspect that the abortions were caused by C. caviae, but since the population was treated with various antibiotics effective against chlamydial infections, it was no longer possible to verify this by PCR testing. Unfortunately, more animals succumbed and finally only two animals of the originally 26 were left. With this case report, we would like to point out to veterinarians that guinea pigs can be an important source of zoonotic infections for various pathogens, especially since they are popular pets and often come into close contact with children where hygiene might not always be strictly followed.


INTRODUCTION: Dans un groupe de cobayes de 26 animaux reproducteurs, plusieurs individus de toutes les catégories d'âge sont morts (16/26) après l'introduction de trois animaux provenant d'un autre groupe. En outre, la population a souffert d'apathie, d'anorexie, de perte de poids sévère et de conjonctivite ainsi que d'avortements et de mortinatalité. La présence de Chlamydia caviae a pu être détectée dans la conjonctive et le vagin/utérus d'un animal juvénile, ainsi qu'une infection intestinale à Cryptosporidium wrairi. Des oocystes ont été trouvés histologiquement dans l'intestin grêle, ce qui a été confirmé par PCR. C. wairi est un parasite adapté aux cobayes avec un potentiel zoonotique, qui provoque des diarrhées avec des morts fréquentes dans les grands groupes de cobayes. C. caviae est également un agent pathogène zoonotique et est souvent à l'origine de conjonctivites, de pneumonies et d'avortements chez les cobayes ; il peut entraîner des maladies des voies respiratoires supérieures, des conjonctivites mais aussi des pneumonies graves chez l'homme. L'augmentation des cas de décès et les signes cliniques pourraient être attribués à une infection par Cryptosporidium wrairi, compliquée par une co-infection par C. caviae. Nous soupçonnons que les avortements ont été causés par C. caviae, mais comme la population a été traitée avec divers antibiotiques efficaces contre les infections à chlamydia, il n'était plus possible de le vérifier par des tests PCR. Malheureusement, d'autres animaux ont succombé et il ne restait finalement que deux animaux sur les 26 d'origine. Avec ce rapport de cas, nous aimerions attirer l'attention des vétérinaires sur le fait que les cochons d'Inde peuvent être une source importante d'infections zoonotiques pour divers pathogènes, d'autant plus qu'il s'agit d'animaux de compagnie populaires qui sont souvent en contact étroit avec des enfants avec lesquels l'hygiène n'est pas toujours strictement respectée.


Subject(s)
Chlamydia Infections , Conjunctivitis , Cryptosporidiosis , Guinea Pigs , Animals , Female , Humans , Conjunctivitis/epidemiology , Conjunctivitis/microbiology , Conjunctivitis/parasitology , Conjunctivitis/veterinary , Cryptosporidiosis/epidemiology , Cryptosporidium , Disease Outbreaks/veterinary , Chlamydia Infections/complications , Chlamydia Infections/epidemiology , Chlamydia Infections/veterinary , Zoonoses/epidemiology , Zoonoses/microbiology , Zoonoses/parasitology
17.
Front Cell Infect Microbiol ; 12: 1052082, 2022.
Article in English | MEDLINE | ID: covidwho-2162983
19.
Sci Rep ; 12(1): 20936, 2022 Dec 03.
Article in English | MEDLINE | ID: covidwho-2151090

ABSTRACT

The human-pathogenic Kasokero virus (KASV; genus Orthonairovirus) has been isolated from the sera of Egyptian rousette bats (ERBs; Rousettus aegyptiacus) captured in Uganda and unengorged Ornithodoros (Reticulinasus) faini ticks collected from the rock crevices of ERB colonies in South Africa and Uganda. Although evidence suggests that KASV is maintained in an enzootic transmission cycle between O. (R.) faini ticks and ERBs with potential for incidental virus spillover to humans through the bite of an infected tick, the vertebrate reservoir status of ERBs for KASV has never been experimentally evaluated. Furthermore, the potential for bat-to-bat and bat-to-human transmission of KASV is unknown. Herein, we inoculate two groups of ERBs with KASV; one group of bats is serially sampled to assess viremia, oral, fecal, and urinary shedding and the second group of bats is serially euthanized to assess virus-tissue tropism. Throughout the study, none of the bats exhibit overt signs of clinical disease. Following the detection of high KASV loads of long duration in blood, oral, fecal, and urine specimens collected from ERBs in the serial sampling group, all bats seroconvert to KASV. ERBs from the serial euthanasia group exhibit high KASV loads indicative of virus replication in the skin at the inoculation site, spleen, and inguinal lymph node tissue, and histopathology and in situ hybridization reveal virus replication in the liver and self-limiting, KASV-induced lymphohistiocytic hepatitis. The results of this study suggest that ERBs are competent, natural vertebrate reservoir hosts for KASV that can sustain viremias of appropriate magnitude and duration to support virus maintenance through bat-tick-bat transmission cycles. Viral shedding data suggests that KASV might also be transmitted bat-to-bat and highlights the potential for KASV spillover to humans through contact with infectious oral secretions, feces, or urine.


Subject(s)
Chiroptera , Nairovirus , Ornithodoros , Humans , Animals , Zoonoses , Feces , Viremia
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