A Peer-Reviewed Journal Tracking and Analyzing Disease Trends Vol.8, No.5, May 2002 Simian immunodeficiency virus Nasopharyngeal Carriage of Streptococcus pneumoniae in Healthy Children: Implications for the Use of Heptavalent Pneumococcal Conjugate Vaccine.......................................479 P. Marchisio et al. Hospital-Based Diagnosis of Hemorrhagic Fever, Encephalitis, and Hepatitis in Cambodian Children...................................485 Y.M. Chhour et al. Excess Mortality Associated with Antimicrobial Drug-Resistant Salmonella Typhimurium......................................................490 On the Cover: Domenikos Theodokopoulos (known as El Greco, M. Helms et al. 1541–1614); Fable, c. 1600 (oil on canvas, 50 cm x 64 cm). Courtesy of The Prado, Madrid, Spain. Sentinel Surveillance: A Reliable Page 541 Way To Track Antibiotic Resistance in Communities? .................................................................496 Research S.J. Schrag et al. Risk to Human Health from a Plethora of Simian Immunodeficiency Perspective Viruses in Primate Bushmeat...............................................451 M. Peeters et al. Evaluation in Nonhuman Primates of Vaccines against Ebola Virus...............................................503 Epidemiology of Urban Canine Rabies, T.W. Geisbert et al. Santa Cruz, Bolivia, 1972–1997...........................................458 M.-A. Widdowson et al. Synopsis Clonal Groupings in Serogroup X Typical and Atypical Enteropathogenic Neisseria meningitidis ..........................................................462 Escherichia coli ...................................................................508 S. Gagneux et al. L.R. Trabulsi et al. Genetic Variants of Ehrlichia phagocytophila, Rhode Island and Connecticut .............................................467 Dispatches R. F. Massung et al. Increasing Quinolone Resistance in Salmonella enterica Serotype Enteritidis .............................514 Trends in Fluoroquinolone K. Mølbak et al. (Ciprofloxacin) Resistance in Enterobacteriaceae from Bacteremias, Molecular Characterization of England and Wales, 1990–1999 ..........................................473 Corynebacterium diphtheriae Isolates, D.M. Livermore et al. Russia, 1957–1987 ..............................................................516 V. Skogen et al. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the Centers for Disease Control and Prevention or the institutions with which the authors are affiliated. Outbreak of Neisseria meningitidis in Letters Edmonton, Alberta, Canada.................................................519 G.J. Tyrrell et al. First Shiga Toxin-Producing Escherichia coli Isolate from a Patient with Hemolytic Cefepime MIC as a Predictor of the Uremic Syndrome, Brazil..................................................... 535 Extended-Spectrum ß-Lactamase Type B.E.C. Guth et al. in Klebsiella pneumoniae, Taiwan........................................522 W.L. Yu et al. Emergence of Vancomycin-Intermediate Staphylococcus aureus and S. sciuri, Greece..................... 536 Deer Meat as the Source for a Sporadic A. Tsakris et al. Case of Escherichia coli O157:H7 Infection, Connecticut...........................................................525 T. Rabatsky-Ehr et al. News & Notes CD Review: Acute Respiratory Infection Phylogenetic Analysis of a Human Isolate CD Module (The Wellcome Trust, Publisher) ...................... 538 from the 2000 Israel West Nile virus Epidemic ....................528 P.L. Riley et al. T. Briese et al. Corrections .......................................................................... 540 Knowledge of Bat Rabies and Human Exposure among United States Cavers ...............................532 About the Cover .................................................................. 541 R.V. Gibbons et al. Full text free online at www.cdc.gov/eid The print journal is available at no charge to public health professionals YES, I would like to receive Emerging Infectious Diseases. Please print your name and business address in the box and return by fax to 404-371-5449 or mail to EID Editor CDC/NCID/MS D61 1600 Clifton Road, NE Atlanta, GA 30333 Moving? Please give us your new address (in the box) and print the number of your old mailing label here______________ RESEARCH Risk to Human Health from a Plethora of Simian Immunodeficiency Viruses in Primate Bushmeat Martine Peeters,* Valerie Courgnaud,* Bernadette Abela,† Philippe Auzel,†‡ Xavier Pourrut,* Frederic Bibollet-Ruche,§ Severin Loul,† Florian Liegeois,* Cristelle Butel,* Denis Koulagna,¶ Eitel Mpoudi-Ngole,† George M. Shaw,§ Beatrice H. Hahn,§ and Eric Delaporte* To assess human exposure to Simian immunodeficiency virus (SIV) in west central Africa, we looked for SIV infection in 788 monkeys that were hunted in the rainforests of Cameroon for bushmeat or kept as pets. Serologic reactivity suggesting SIV infection was found in 13 of 16 primate species, including 4 not previously known to harbor SIV. Overall, 131 sera (16.6%) reacted strongly and an additional 34 (4.3%) reacted weakly with HIV antigens. Molecular analysis identified five new phylogenetic SIV lineages. These data document for the first time that a substantial proportion of wild monkeys in Cameroon are SIV infected and that humans who hunt and handle bushmeat are exposed to a plethora of genetically highly divergent viruses. irst recognized in the early 1980s, AIDS represents the diverse primate species that are extensively hunted for food F endstage of infection with one of two lentiviruses, termed and trade (12). Much of the primate meat sold for consumption Human immunodeficiency virus type 1 (HIV-1) or type 2 (HIV- derives from infected monkeys, and a comparable number of 2) (1,2). HIV-1 has spread to most parts of the world, while pet monkeys also carry SIV. These data thus provide a first HIV-2 has remained largely restricted to West Africa (3,4). approximation of the magnitude and variety of SIVs to which More than 40 million persons are estimated to have HIV infec- humans are exposed through contact with nonhuman primates. tion or AIDS (4). Both HIV-1 and HIV-2 are of zoonotic origin (5). The clos- Materials and Methods est simian relatives of HIV-1 and HIV-2 have been found in the common chimpanzee (Pan troglodytes) and the sooty man- Collection of Primate Tissue and Blood Samples gabey (Cercocebus atys), respectively (6-8), and phylogenetic Blood was obtained from 788 monkeys wild-caught in evidence indicates that lentiviruses from these species (SIVcpz Cameroon from January 1999 to April 2001. Species were and SIVsm, respectively) have been transmitted to humans on determined by visual inspection according to the Kingdon Field at least eight occasions (5,9). Serologic evidence of SIV infec- Guide to African Mammals (13) and the taxonomy described tion has so far been documented in 26 primate species, and 20 by Colin Groves (14). We sampled 573 animals as bushmeat at of these viruses have been at least partially molecularly char- markets in Yaounde (n=157), surrounding villages (n=111), or acterized (5,10,11). Because humans come in frequent contact logging concessions in southeastern Cameroon (n=305), as with primates in many parts of sub-Saharan Africa, additional well as 215 pet animals from these same areas (Table 1). All zoonotic transfers of primate lentiviruses from species other primate samples were obtained with government approval from than chimpanzees and sooty mangabeys are possible. The risk the Cameroonian Ministry of Environment and Forestry. Bush- for acquiring SIV infection would be expected to be highest in meat samples were obtained through a strategy specifically persons who hunt primates and prepare their meat for con- designed not to increase demand: women preparing and pre- sumption, as well as in persons who keep primates as pets. serving the meat for subsequent sale and hunters already However, this risk cannot be assessed since the prevalence, involved in the trade were asked for permission to sample diversity, and geographic distribution of SIV infections in wild blood and tissues from carcasses, which were then returned. primate populations are unknown. We report the first compre- For the bushmeat animals, blood was collected by cardiac hensive survey of wild-caught primates in Cameroon, home to puncture, and lymph node and spleen tissues were collected whenever possible. The owners indicated that most of the ani- *Institut de Recherche pour le Développement (IRD), Montpellier, mals had died 12 to 72 hours before sampling. For pet mon- France; †Projet Prevention du Sida au Cameroun (PRESICA), keys, blood was drawn by peripheral venipuncture after the Yaounde, Cameroon; ‡Faculté Universitaire des Sciences animals were tranquilized with ketamine (10 mg/kg). Plasma Agronomiques de Gembloux, Gembloux, Belgium; §University of Ala- and cells were separated on site by Ficoll gradient centrifuga- bama at Birmingham, Birmingham, Alabama, USA; and ¶Ministry of Environment and Forestry, Yaounde, Cameroon tion. All samples, including peripheral blood mononuclear Emerging Infectious Diseases • Vol. 8, No. 5, May 2002 451 RESEARCH Table 1. Wild-born primates surveyed, by species, age, and status, Cameroon Pet animals Primate bushmeat Genus Species Common name Adults Juveniles/infants Adults Juveniles/infants Total Cercocebus agilis Agile mangabey 4 15 30 3 52 torquatus Red-capped mangabey 1 – – 1 2 Lophocebus albigena Grey-cheeked