The perfect storm: Cutaneous leishmaniasis in troops deployed in the Atlantic forest of Argentina.

American cutaneous leishmaniasis (ACL) is the most prevalent form of leishmaniasis, associated with an ulcerative and stigmatizing mucocutaneous pathology. This study assessed the incidence of Leishmania (Viannia) braziliensis in members of the Argentine Army who were exposed to sandfly bites in Iguazú National Park (INP), northeastern Argentina, during an outbreak of ACL in 2019, and the presence of Leishmania in rodents, opossums and phlebotomine sandflies collected in the area of exposure. Samples from military personnel, wild animals and phlebotomine sandflies were analysed. A total of 20 (40%) patients among the Army personnel and two Akodon montensis rodents (11%) were positive for the presence of Leishmania sp. genes by PCR, while Nyssomyia whitmani and Migonemyia migonei, competent vectors of Leishmania, were also found at the same site. Sequences of hsp70 DNA fragments obtained from human samples confirmed the identity of L. (V.) braziliensis. The risk to which military personnel carrying out activities in the forest are exposed is highlighted, and this risk extends to any worker and visitor who circulates without protection in the INP, coming into contact with transmission "hot spots" due to the concentration of vectors, reservoirs and/or parasites.

Modelling relative abundance of Oligoryzomys flavescens, an Orthohantavirus reservoir, in an endemic hantavirus pulmonary syndrome zone.

Hantavirus pulmonary syndrome (HPS) is a zoonotic emerging infectious disease caused by New World orthohantaviruses (family Hantaviridae) hosted by rodents of the family Cricetidae. In Argentina, one of its main hosts is the sigmodontine rodent Oligoryzomys flavescens, a widely distributed mouse of the Pampas, Delta and Espinal ecoregions of central-east Argentina. Because the abundance of the reservoir and its proportion in the rodent community affects both virus prevalence and human exposure risk, its estimation throughout its known geographical distribution is of key importance for the design of public health strategies to prevent HPS. The aim of this study was therefore to model the relative abundance of O. flavescens in most of the Pampas ecoregion within Buenos Aires Province, Argentina, where hantavirus pulmonary syndrome is endemic. To do this we used owl-pellet samples collected between 2006 and 2008 from 51 sites distributed throughout most of Buenos Aires province. Mammalian prey in each pellet was identified to the lowest possible taxonomic level by examination of the skulls, dentaries and molars. We modelled the frequency of O. flavescens found in each sample as a function of climatic, environmental, and topographic data of each site. The two best models were applied to a Geo referential Information System to build maps of estimated frequency (as a proxy of relative abundance) within Buenos Aires province. Estimated relative abundance of O. flavescens in Buenos Aires province was significantly associated with annual mean temperature, annual precipitation and presence of freshwater bodies, and varied among sub-regions, with the Inland and Rolling Pampas being the regions with highest frequencies. Knowing in which areas O. flavescens abundance is expected to be higher can be used to concentrate limited sanitary efforts in those areas that are most needed in order to reduce transmission and increase detection.

Assessment of Environmental Hazards to Public Health in Temperate Urban Argentina.

Human health risk in urban areas depends on multiple environmental features. We performed a year-round survey in a highly urbanized district located in temperate Argentina (General San Martín, Buenos Aires) to establish baseline information about environmental hazards associated with health risks. Sampling was stratified into low and high hazardous zones according to estimated indexes previously developed for the area for four hazards: drinking water and air pollution, and mosquito and rodent infestation. Water from wells showed lower concentrations of aluminum, manganese and iron, and higher values of arsenic than tap samples, with the latter showing records above the maximum permitted for arsenic, aluminum and chromium. Benzene concentration in air was higher in summer than in winter, and in areas close to dumps and landfills, gas stations, high traffic pathways and industries with respect to low hazard areas. Adult mosquito collections were more abundant in high hazardous areas, three species from the genus Culex dominated the captures and the proportion of individuals from each species was variable seasonally and spatially. Rodent activity was recorded inside and outside dwellings, and its observed values did not differ between low and high hazardous areas. In the comparison between field data and estimated hazard maps, high accuracy was obtained for air pollution maps, intermediate accuracy for water pollution and mosquito infestation, and poor accuracy for rodent infestation. How to improve field surveys and estimated maps are both discussed, highlighting the need for dynamic feedback between GIS-based models and environmental monitoring.

Hantavirus infection and biodiversity in the Americas.

Species diversity has been proposed to decrease prevalence of disease in a wide variety of host-pathogen systems, in a phenomenon labeled the dilution effect. This phenomenon was first proposed and tested for vector-borne diseases but was later extended to directly transmitted parasite systems such as hantavirus. Though there seems to be clear evidence for the dilution effect in some hantavirus/rodent systems, the generality of this hypothesis remains debated. In the present meta-analysis, we examined the evidence supporting the dilution effect for hantavirus/rodent systems in the Americas. General linear models employed on data from 56 field studies identified the abundance of the reservoir rodent species and its relative proportion in the community as the only relevant variables explaining the prevalence of antibodies against hantavirus in the reservoir. Thus, we found no clear support for the dilution effect hypothesis for hantavirus/rodent systems in the Americas.

An interdisciplinary approach to assess human health risk in an urban environment: A case study in temperate Argentina.

Unplanned urbanization increases the exposure of people to environmental hazards. Within a landscape ecology framework, this study is a diagnosis of human health risk in San Martín, an urban district of Buenos Aires, Argentina. Risk was estimated by combining four hazard indexes (water and air pollution, and mosquito and rodent infestation) and a vulnerability index. Each index was obtained by integrating environmental and socio-demographic layers in a Geographic Information System. Spatial autocorrelation was assessed for each hazard, vulnerability and risk indexes using Moran's tests. Also, spatial associations between pairs of variables were addressed by means of Geographically Weighted Regressions. The robustness of hazard and vulnerability indexes was checked by a sensitivity analysis. In General San Martín district, 83.3% of the population is exposed to relatively high levels of at least one hazard; 7.4% is exposed to relatively high levels of all hazards (11.5% of the total area) and only 16.7% lives in areas of relatively low levels of all hazards (15.4% of the total area). Areas where hazard intensity was relatively high corresponded to those areas where the most vulnerable population lives, enhancing human health risk. The models for hazards and vulnerability were reasonably robust to changes in the weights of the variables considered. Our results highlight the spatially heterogeneous nature of human health risk in an urban landscape, and reveal the location of critical risk hotspots where reduction or mitigation actions should be focused.

Hantavirus Pulmonary Syndrome Risk in Entre Ríos, Argentina.

Hantavirus pulmonary syndrome (HPS) is a severe emerging endemic disease of the Americas. Because hantavirus reservoirs are sylvatic rodents, HPS risk has been associated with occupational and recreational activities in natural and rural environments. The aim of this study was to analyze the risk of HPS in an endemic province of Argentina. For this, we explored the relationship between HPS cases occurring in Entre Ríos province between 2004 and 2015 and climate, vegetation, landscape, reservoir population, and rodent community characteristics by means of generalized linear models. We modeled HPS occurrence at each site, and both the incidence and number of cases grouped by department. The resulting best model of each analysis was applied in a GIS to build HPS risk maps. Risk of occurrence of HPS increased with tree cover and decreased with distance to rivers. We identified the south of Entre Ríos as the area with higher HPS risk, and therefore, where HPS prevention measures should be more urgently applied. Risk maps based on data available in the public domain are a useful tool that should be used by decision makers to concentrate surveillance and control efforts in those areas with highest HPS risk.

Rodent Abundance and Hantavirus Infection in Protected Area, East-Central Argentina.

We captured 3 hantavirus rodent hosts in Otamendi Natural Reserve, Argentina, during 2007-2012. Hantavirus antibodies were found only in Akodon azarae grass mice, mainly in males and old animals. Higher abundance of this species was associated with warm and rainy weather and high water levels, which peaked after a strong El Niño event.

Evaluation of habitat requirements of small rodents and effectiveness of an ecologically-based management in a hantavirus-endemic natural protected area in Argentina.

Hantavirus pulmonary syndrome is a severe cardio pulmonary disease transmitted to humans by sylvan rodents found in natural and rural environments. Disease transmission is closely linked to the ecology of animal reservoirs and abiotic factors such as habitat characteristics, season or climatic conditions. The main goals of this research were: to determine the biotic and abiotic factors affecting richness and abundance of rodent species at different spatial scales, to evaluate different methodologies for studying population of small rodents, and to describe and analyze an ecologically-based rodent management experience in a highly touristic area. A 4-year study of small rodent ecology was conducted between April 2007 and August 2011 in the most relevant habitats of El Palmar National Park, Argentina. Management involved a wide range of control and prevention measures, including poisoning, culling and habitat modification. A total of 172 individuals of 5 species were captured with a trapping effort of 13 860 traps-nights (1.24 individuals/100 traps-nights). Five rodent species were captured, including 2 hantavirus-host species, Oligoryzomys nigripes and Akodon azarae. Oligoryzomys nigripes, host of a hantavirus that is pathogenic in humans, was the most abundant species and the only one found in all the studied habitats. Our results are inconsistent with the dilution effect hypothesis. The present study demonstrates that sylvan rodent species, including the hantavirus-host species, have distinct local habitat selection and temporal variation patterns in abundance, which may influence the risk of human exposure to hantavirus and may have practical implications for disease transmission as well as for reservoir management.

How much effort is required to accurately describe the complex ecology of a rodent-borne viral disease?

We use data collected on 18,1-ha live trapping grids monitored from 1994 through 2005 and on five of those grids through 2013 in the mesic northwestern US to illustrate the complexity of the deer mouse (Peromyscus maniculatus)/Sin Nombre virus (SNV) host-pathogen system. Important factors necessary to understand zoonotic disease ecology include those associated with distribution and population dynamics of reservoir species as well as infection dynamics. Results are based on more than 851,000 trap nights, 16,608 individual deer mice and 10,572 collected blood samples. Deer mice were distributed throughout every habitat we sampled and were present during every sampling period in all habitats except high altitude habitats over1900 m. Abundance varied greatly among locations with peak numbers occurring mostly during fall. However, peak rodent abundance occurred during fall, winter and spring during various years on three grids trapped 12 mo/yr. Prevalence of antibodies to SNV averaged 3.9% to 22.1% but no grids had mice with antibodies during every month. The maximum period without antibody-positive mice ranged from one month to 52 months, or even more at high altitude grids where deer mice were not always present. Months without antibody-positive mice were more prevalent during fall than spring. Population fluctuations were not synchronous over broad geographic areas and antibody prevalences were not well spatially consistent, differing greatly over short distances. We observed an apparently negative, but non-statistically significant relationship between average antibody prevalence and average deer mouse population abundance and a statistically significant positive relationship between the average number of antibody positive mice and average population abundance. We present data from which potential researchers can estimate the effort required to adequately describe the ecology of a rodent-borne viral system. We address different factors affecting population dynamics and hantavirus antibody prevalence and discuss the path to understanding a complex rodent-borne disease system as well as the obstacles in that path.

Environmental Variables Associated with Hantavirus Reservoirs and Other Small Rodent Species in Two National Parks in the Paraná Delta, Argentina: Implications for Disease Prevention.

Hantavirus pulmonary syndrome (HPS) is a severe zoonotic disease caused by hantaviruses hosted in various rodents species. In Argentina, its transmission to humans has been associated to exposure during activities such as farming, recreation, and tourism which are carried out in wild and rural areas. The aim of this study was to analyze the macro- and micro-habitat use and spatio-temporal variation of small sylvan rodents in Pre Delta and Islas de Santa Fe national parks, located in an HPS-endemic area of Argentina. Rodent communities were studied at six sites: two islands, a riparian forest, an inland forest, a marsh, and the margins of a pond. A total of 453 individuals of five species were captured with a trapping effort of 9471 trap-nights. Maximum species richness was found at the marsh and the pond margin sites. Abundance of rodents was influenced by flooding events. Two hantavirus reservoirs, Oligoryzomys flavescens and Akodon azarae, were identified in the area. O. flavescens was captured in every habitat, but it was dominant in Islas de Santa Fe National Park where its abundance was strongly influenced by flooding. A. azarae was captured in every habitat except on the islands. A. azarae behaved as a generalist species at a micro-habitat scale in every habitat of Pre Delta National Park except for the marsh where it selected patches with low vegetation height. Based on these results, several disease prevention measures, including the use of rodent-proof containers for food, and keeping the grass short in the camp site, are proposed in order to reduce the risk to visitors and residents of contracting HPS.

Daily Movements and Microhabitat Selection of Hantavirus Reservoirs and Other Sigmodontinae Rodent Species that Inhabit a Protected Natural Area of Argentina.

Abundance, distribution, movement patterns, and habitat selection of a reservoir species influence the dispersal of zoonotic pathogens, and hence, the risk for humans. Movements and microhabitat use of rodent species, and their potential role in the transmission of hantavirus were studied in Otamendi Natural Reserve, Buenos Aires, Argentina. Movement estimators and qualitative characteristics of rodent paths were determined by means of a spool and line device method. Sampling was conducted during November and December 2011, and March, April, June, October, and December 2012. Forty-six Oxymycterus rufus, 41 Akodon azarae, 10 Scapteromys aquaticus and 5 Oligoryzomys flavescens were captured. Movement patterns and distances varied according to sex, habitat type, reproductive season, and body size among species. O. flavescens, reservoir of the etiologic agent of hantavirus pulmonary syndrome in the region, moved short distances, had the most linear paths and did not share paths with other species. A. azarae had an intermediate linearity index, its movements were longer in the highland grassland than in the lowland marsh and the salty grassland, and larger individuals traveled longer distances. O. rufus had the most tortuous paths and the males moved more during the non-breeding season. S. aquaticus movements were associated with habitat type with longer distances traveled in the lowland marsh than in the salty grassland. Hantavirus antibodies were detected in 20% of A. azarae and were not detected in any other species. Seropositive individuals were captured during the breeding season and 85% of them were males. A. azarae moved randomly and shared paths with all the other species, which could promote hantavirus spillover events.