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Assessing Monkeypox Virus Prevalence in Small Mammals at the Human–Animal Interface in the Democratic Republic of the Congo

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Assessing Monkeypox Virus Prevalence in Small Mammals at the Human–Animal Interface in the Democratic Republic of the Congo viruses Article Assessing Monkeypox Virus Prevalence in Small Mammals at the Human–Animal Interface in the Democratic Republic of the Congo Jeffrey B. Doty 1,*, Jean M. Malekani 2, Lem’s N. Kalemba 2, William T. Stanley 3, Benjamin P. Monroe 1, Yoshinori U. Nakazawa 1, Matthew R. Mauldin 1 ID , Trésor L. Bakambana 2, Tobit Liyandja Dja Liyandja 2, Zachary H. Braden 1, Ryan M. Wallace 1, Divin V. Malekani 2, Andrea M. McCollum 1, Nadia Gallardo-Romero 1, Ashley Kondas 1, A. Townsend Peterson 4 ID , Jorge E. Osorio 5, Tonie E. Rocke 6, Kevin L. Karem 1, Ginny L. Emerson 1 and Darin S. Carroll 1 1 U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, 1600 Clifton Rd. NE, Atlanta, GA 30333, USA; [email protected] (B.P.M.); [email protected] (Y.U.N.); [email protected] (M.R.M.); [email protected] (Z.H.B.); [email protected] (R.M.W.); [email protected] (A.M.M.); [email protected] (N.G.-R.); [email protected] (A.K.); [email protected] (K.L.K.); [email protected] (G.L.E.); [email protected] (D.S.C.) 2 University of Kinshasa, Department of Biology, P.O. Box 218 Kinshasa XI, Democratic Republic of the Congo; [email protected] (J.M.M.); [email protected] (L.N.K.); [email protected] (T.L.B.); [email protected] (T.L.D.L.); [email protected] (D.V.M.) 3 Field Museum of Natural History, 1400 S. Lake Shore Dr., Chicago, IL 60605, USA; wstanley@fieldmuseum.org 4 Biodiversity Institute, University of Kansas, 1345 Jayhawk Blvd., Lawrence, KS 66045, USA; [email protected] 5 University of Wisconsin, School of Veterinary Medicine, 2015 Linden Dr., Madison, WI 53706, USA; [email protected] 6 U.S. Geological Survey, National Wildlife Health Center, 6006 Schroeder Rd., Madison, WI 53711, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-404-639-1466; Fax: +1-404-639-1060 Received: 7 August 2017; Accepted: 19 September 2017; Published: 3 October 2017 Abstract: During 2012, 2013 and 2015, we collected small mammals within 25 km of the town of Boende in Tshuapa Province, the Democratic Republic of the Congo. The prevalence of monkeypox virus (MPXV) in this area is unknown; however, cases of human infection were previously confirmed near these collection sites. Samples were collected from 353 mammals (rodents, shrews, pangolins, elephant shrews, a potamogale, and a hyrax). Some rodents and shrews were captured from houses where human monkeypox cases have recently been identified, but most were trapped in forests and agricultural areas near villages. Real-time PCR and ELISA were used to assess evidence of MPXV infection and other Orthopoxvirus (OPXV) infections in these small mammals. Seven (2.0%) of these animal samples were found to be anti-orthopoxvirus immunoglobulin G (IgG) antibody positive (six rodents: two Funisciurus spp.; one Graphiurus lorraineus; one Cricetomys emini; one Heliosciurus sp.; one Oenomys hypoxanthus, and one elephant shrew Petrodromus tetradactylus); no individuals were found positive in PCR-based assays. These results suggest that a variety of animals can be infected with OPXVs, and that epidemiology studies and educational campaigns should focus on animals that people are regularly contacting, including larger rodents used as protein sources. Keywords: habitat analysis; human–animal interface; monkeypox; orthopoxviruses; serology; small mammals; wildlife Viruses 2017, 9, 283; doi:10.3390/v9100283 www.mdpi.com/journal/viruses Viruses 2017, 9, 283 2 of 13 1. Introduction Monkeypox virus (MPXV), a member of the species Monkeypox virus, is a zoonotic virus endemic to Western and Central Africa, and is a member of the genus Orthopoxvirus (OPXV). MPXV was first detected and isolated from primates at the Statens Seruminstitut in Copenhagen, Denmark, in 1958, and was later observed in several zoos and laboratory primate colonies [1,2]. During the smallpox (Variola virus) eradication campaign of the 1970s, monkeypox (MPX) was recognized as a human disease in Western and Central Africa. After smallpox eradication, MPXV became the most pathogenic OPXV to humans. Based on genetic, geographic, and phenotypic (pathogenicity in humans and animal models) variation, MPXV is divided into two distinct clades, West African and Congo Basin, with viruses assigned to the latter being the most virulent [3]. Breman et al. [4] conducted a serosurvey of non-human primates in West Africa (Côte d’Ivoire, Mali and the Upper Volta Region), and found anti-OXPV antibodies in primates of the genera Cercopithecus (8%, n = 170) and Colobus (6%, n = 16). Since that report, several studies have attempted to identify the reservoir or natural hosts of MPXV; the results suggested that small mammals played a role in the maintenance and circulation of the virus in nature. Khodakevich et al. [5] conducted an extensive, multi-year ecological survey of rodents and non-human primates at four locations in the Democratic Republic of the Congo (DRC). They reported an anti-OPXV seroprevalence of 23.7% (n = 659) in rope squirrels (Funisciurus spp.), 14.9% (n = 101) in sun squirrels (Heliosciurus spp.), and 7.8% (n = 12) in non-human primates (primarily Cercopithecus ascanius). Hutin et al. [6] also found high OXPV seroprevalence in two species of rope squirrels, 50% (n = 4) in F. anerythrus and 38.9% (n = 18) in F. congicus. They also showed serologic evidence of previous OPXV infection in giant pouched rats (Cricetomys emini; 15.8%, n = 19), elephant shrews (Petrodromus tetradactylus; 33.3%, n = 3), sun squirrels (50%, n = 2), and domestic pigs (Sus scrofa; 100%, n = 1). In 2013, a MPXV outbreak investigation in Bokungu, Tshuapa Province, DRC, reported anti-OPXV antibodies in two of three (66.7%) rope squirrels collected along with 65 other terrestrial small mammals (rodents and shrews) [7]. Some of the serologic results from previous publications suggest MPXV-specific antibodies were detected in samples collected from small mammals [4,5]. However, the assays used at the time these investigations were reported (radioimmunoassay absorption and indirect immunofluorescence), were not designed to discriminate among the diversity of the genus as it is currently recognized, and this raises questions about the utility of these assays as compared to the OPXV generic immunoglobulin G (IgG) ELISA. Following the importation of MPXV to the United States through the pet trade in 2003, an ecological survey was conducted in Ghana at the source of the animals imported into the US [8]. Reynolds et al. [8] reported antibody positive dormice (Graphiurus sp., 10%, n = 90), giant pouched rats (2.6%, n = 38), rope squirrels (40%, n = 5), and sun squirrels (14.2%, n = 7). They also detected OPXV DNA via real-time PCR in dormice (6%, n = 100), giant pouched rats (5%, n = 40), and unstriped ground squirrels (Xerus sp., 100%, n = 1). Despite this serologic and PCR evidence, MPXV has been isolated from wild animals on only two occasions, once from a rope squirrel (F. anerythrus) and once from a sooty mangabey (Cercocebus atys)[9, 10]. The squirrel was killed by a local hunter in the DRC and was obviously ill with pox-like lesions present, while the sooty mangabey was found dead with pox-like lesions in Tai National Park, Côte d’Ivoire. Despite the identification of several species as potential hosts/reservoirs, the rarity of MPXV isolation from wildlife presents a barrier to understanding the transmission cycle of the virus and its maintenance in nature. Contact between humans and infected wildlife is believed to be the primary mode of transmission of MPXV into human populations [5,6]. Therefore, surveys for MPXV exposure in sylvatic species in endemic areas remain one of the best approaches to identifying zoonotic sources of infection and understanding the sylvatic cycle of this virus. The vast majority of MPX cases are reported from Central Africa, and the DRC in particular, which has an estimated incidence rate of 5.53 cases per 10,000 people [11]. MPX is endemic in the Tshuapa Province, DRC, where an average of 661 suspected human cases were reported per Viruses 2017, 9, 283 3 of 13 year from 2011 to 2014 (data provided by Ministry of Health, Kinshasa, DRC). In this study, we collected samples from sylvatic animals to assess MPXV prevalence in small mammal communities at the human–animal interface at several locations near Boende, the capital of Tshuapa Province. Additionally, genetic diversity of seropositive squirrels was examined through phylogenetic analyses, and potential associations between seropositive animals and major vegetation types were investigated. 2. MaterialsViruses and 2017 Methods, 9, 283 3 of 13 2.1. Studyseropositive Area squirrels was examined through phylogenetic analyses, and potential associations between seropositive animals and major vegetation types were investigated. The Boende Health Zone is one of 12 health zones within Tshuapa Province, DRC (Figure1). It has an area of2. 10,275 Materials km and2 and Methods an estimated population of 249,588 people (2014 Tshuapa demographic 2 data), with2.1. a Study population Area density of 24 persons per km . The vegetation of this health zone is typical of the lowlandThe Congo Boende Basin Health rainforest.Zone is one of A 12 totalhealth of zone eights within localities Tshuapa (Baleko,Province, DRC Boende, (Figure Bongoy, 1). It has Bosenge, Inganda, Lifomi,an area of Lomela, 10,275 km and2 and Tokumbu) an estimated within population 25 kmof 249,588 of the people town (2014 of Boende Tshuapa weredemographic sampled. data), All sample collection sessionswith a population were conducted density of 24 between persons per May km and2. The July vegetation of 2012, of this 2013, heal andth zone 2015. is typical These of sites the included seasonallylowland flooded Congo primary Basin forest,rainforest.
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