Bacillus cereus Biovar Anthracis Causing Anthrax in Sub-Saharan Africa—Chromosomal Monophyly and Broad Geographic Distribution

Through full genome analyses of four atypical Bacillus cereus isolates, designated B. cereus biovar anthracis, we describe a distinct clade within the B. cereus group that presents with anthrax-like disease, carrying virulence plasmids similar to those of classic Bacillus anthracis. We have isolated members of this clade from different mammals (wild chimpanzees, gorillas, an elephant and goats) in West and Central Africa (Côte d’Ivoire, Cameroon, Central African Republic and Democratic Republic of Congo). The isolates shared several phenotypic features of both B. anthracis and B. cereus, but differed amongst each other in motility and their resistance or sensitivity to penicillin. They all possessed the same mutation in the regulator gene plcR, different from the one found in B. anthracis, and in addition, carry genes which enable them to produce a second capsule composed of hyaluronic acid. Our findings show the existence of a discrete clade of the B. cereus group capable of causing anthrax-like disease, found in areas of high biodiversity, which are possibly also the origin of the worldwide distributed B. anthracis. Establishing the impact of these pathogenic bacteria on threatened wildlife species will require systematic investigation. Furthermore, the consumption of wildlife found dead by the local population and presence in a domestic animal reveal potential sources of exposure to humans

High prevalence and diversity of species D adenoviruses (HAdV-D) in human populations of four Sub-Saharan countries

Abstract. Background: Human adenoviruses of species D (HAdV-D) can be associated with acute respiratory illness, epidemic ker

Isolation of Trypanosoma brucei gambiense from Cured and Relapsed Sleeping Sickness Patients and Adaptation to Laboratory Mice

Human African trypanosomiasis, or sleeping sickness, is still a major public health problem in central Africa. Melarsoprol is widely used for treatment of patients where the parasite has already reached the brain. In some regions in Angola, Sudan, Uganda and Democratic Republic of the Congo, up to half of the patients cannot be cured with melarsoprol. From previous investigations it is not yet clear what causes these high relapse rates. Therefore we aimed to establish a parasite collection isolated from cured as well as relapsed patients for downstream comparative drug sensitivity profiling. From 360 sleeping sickness patients, blood and cerebrospinal fluid (CSF) was collected before treatment and along the prescribed 24 months follow-up. Blood and CSF were inoculated in thicket rats (Grammomys surdaster), Natal multimammate mice (Mastomys natalensis) and immunodeficient laboratory mice (Mus musculus). Thus, we established a unique collection of Trypanosoma brucei gambiense type I parasites, isolated in the same disease focus and within a limited period, including 12 matched strains isolated from the same patient before treatment and after relapse. This collection is now available for genotypic and phenotypic characterisation to investigate the mechanism behind abnormally high treatment failure rates in Mbuji-Mayi, Democratic Republic of the Congo

Influenza surveillance in 15 countries in Africa, 2006-2010

BACKGROUND: In response to the potential threat of an influenza pandemic, several international institutions and governments, in partnership with African countries, invested in the development of epidemiologic and laboratory influenza surveillance capacity in Africa. METHODS: We used a standardized form to collect information on influenza surveillance system characteristics, the number and percent of influenza-positive patients with influenza-like illness (ILI) or severe acute respiratory infections (SARI) and virologic data. RESULTS: Between 2006 and 2010, the number of ILI and SARI sites in 15 African countries increased from 21 to 127 and from 2 to 98, respectively. Influenza was detected in 22% of ILI cases and 10% of SARI cases. Children 0-4 years accounted for 48% all ILI and SARI cases of which 20% and 10 respectively were positive for influenza. Influenza peaks were generally discernible in North and South Africa. Substantial co-circulation of influenza A and B occurred most years. CONCLUSIONS: Influenza is a major cause of respiratory illness in Africa, especially in children. Further strengthening influenza surveillance, along with conducting special studies on influenza burden, cost of illness, and role of other respiratory pathogens will help detect novel influenza viruses and inform and develop targeted influenza prevention policy decisions in the region.The work presented in this manuscript was funded completely or in part by host governments, Institute Pasteur, and cooperative agreements with the U.S. Centers for Disease Control and Prevention and/or the U.S. Department of Defense.http://www.journals.uchicago.edu/toc/jid/currenthb2013ay201

Epidemiology of circulating human influenza viruses from the Democratic Republic of Congo, 2015.

INTRODUCTION:The establishment of the influenza sentinel surveillance system in Kinshasa, Bas Congo, Maniema, Katanga, and Kasai Provinces allowed generation of important data on the molecular epidemiology of human influenza viruses circulating in the Democratic Republic of Congo (DRC). However, some challenges still exist, including the need for extending the influenza surveillance to more provinces. This study describes the pattern of influenza virus circulating in DRC during 2015. METHODOLOGY:Nasopharyngeal swabs were collected from January to December 2015 from outpatients with influenza-like illness (ILI) and in all hospitalized patients with Severe Acute Respiratory Infection (SARI). Molecular analysis was done to determine influenza type and subtype at the National Reference Laboratory (NRL) in Kinshasa using real time reverse transcription-polymerase chain reaction (rRT-PCR). Analysis of antiviral resistance by enzyme inhibition assay and nucleotide sequencing was performed by the Collaborating center in the USA (CDC, Atlanta). RESULTS:Out of 2,376 nasopharyngeal swabs collected from patients, 218 (9.1%) were positive for influenza virus. Among the positive samples, 149 were characterized as influenza virus type A (Flu A), 67 as type B (Flu B) and 2 mixed infections (Flu A and B). Flu A subtypes detected were H3N2 and H1N1. The Yamagata strain of Flu B was detected among patients in the country. Individuals aged between 5 and 14 years accounted for the largest age group affected by influenza virus. All influenza viruses detected were found to be sensitive to antiviral drugs such as oseltamivar, zanamivir, peramivir and laninamivar. CONCLUSION:The present study documented the possible involvement of both circulation of Flu A and B viruses in human respiratory infection in certain DRC provinces during 2015. This study emphasises the need to extend the influenza surveillance to other provinces for a better understanding of the epidemiology of influenza in DRC. It is envisioned that such a system would lead to improved disease control and patient management

Melarsoprol Sensitivity Profile of <i>Trypanosoma brucei gambiense</i> Isolates from Cured and Relapsed Sleeping Sickness Patients from the Democratic Republic of the Congo

<div><p>Background</p><p>Sleeping sickness caused by <i>Trypanosoma brucei</i> (<i>T.b</i>.) <i>gambiense</i> constitutes a serious health problem in sub-Sahara Africa. In some foci, alarmingly high relapse rates were observed in patients treated with melarsoprol, which used to be the first line treatment for patients in the neurological disease stage. Particularly problematic was the situation in Mbuji-Mayi, East Kasai Province in the Democratic Republic of the Congo with a 57% relapse rate compared to a 5% relapse rate in Masi-Manimba, Bandundu Province. The present study aimed at investigating the mechanisms underlying the high relapse rate in Mbuji-Mayi using an extended collection of recently isolated <i>T.b. gambiense</i> strains from Mbuji-Mayi and from Masi-Manimba.</p><p>Methodology/Principal Findings</p><p>Forty five <i>T.b. gambiense</i> strains were used. Forty one were isolated from patients that were cured or relapsed after melarsoprol treatment in Mbuji-Mayi. <i>In vivo</i> drug sensitivity tests provide evidence of reduced melarsoprol sensitivity in these strains. This reduced melarsoprol sensitivity was not attributable to mutations in <i>TbAT1</i>. However, in all these strains, irrespective of the patient treatment outcome, the two aquaglyceroporin (<i>AQP</i>) 2 and 3 genes are replaced by chimeric <i>AQP2/3</i> genes that may be associated with resistance to pentamidine and melarsoprol. The 4 <i>T.b. gambiense</i> strains isolated in Masi-Manimba contain both wild-type <i>AQP2</i> and a different chimeric <i>AQP2</i>/3. These findings suggest that the reduced <i>in vivo</i> melarsoprol sensitivity of the Mbuji-Mayi strains and the high relapse rates in that sleeping sickness focus are caused by mutations in the <i>AQP2/AQP3</i> locus and not by mutations in <i>TbAT1</i>.</p><p>Conclusions/Significance</p><p>We conclude that mutations in the <i>TbAQP2/3</i> locus of the local <i>T.b. gambiense</i> strains may explain the high melarsoprol relapse rates in the Mbuji-Mayi focus but other factors must also be involved in the treatment outcome of individual patients.</p></div

Restriction digest profile generated with AvaI PCR-RFLP on DNA of the <i>T.b. gambiense</i> strains as listed in Table 1, including the four strains isolated from relapsed mice.

<p>Lanes 1, 26, 27 and 52 = GeneRuler 100 bp Plus DNA Ladder (Fermentas), lanes 2 to 44 = <i>T.b. gambiense</i> strains isolated from Mbuji-Mayi, lane 45 = <i>T.b. gambiense</i> 15BT relapse 10 mg/kg BW, lane 46 = <i>T.b. gambiense</i> 163AT relapse 10 mg/kg BW, lane 47 = <i>T.b. gambiense</i> 346AT relapse 10 mg/kg BW, lane 48 = <i>T.b. gambiense</i> 346AT relapse 12 mg/kg BW, lane 49 = <i>T.b. gambiense</i> MBA, lane 50 = <i>T.b. gambiense</i> MM01, lane 51 = negative PCR control.</p

Phenotype of melarsoprol resistant strains.

<p>Number of relapsing mice (out of 6 infected) and day post-infection that relapses were observed after treatment with melarsoprol at different dosages and repetitions. DPI: days post-infection, BW: body weight, rep: repetition, na: not applicable,</p><p>*: relapsing population used for AQP2/3 RFLP analysis.</p><p>Phenotype of melarsoprol resistant strains.</p