Mycobacterium tuberculosis whole genome sequencing provides insights into the Manila strain and drug-resistance mutations in the Philippines.

The Philippines has a high incidence of tuberculosis disease (TB), with an increasing prevalence of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) strains making its control difficult. Although the M. tuberculosis "Manila" ancient lineage 1 strain-type is thought to be prevalent in the country, with evidence of export to others, little is known about the genetic diversity of circulating strains. By whole genome sequencing (WGS) 178 isolates from the Philippines National Drug Resistance Survey, we found the majority (143/178; 80.3%) belonged to the lineage 1 Manila clade, with the minority belonging to lineages 4 (European-American; n = 33) and 2 (East Asian; n = 2). A high proportion were found to be multidrug-resistant (34/178; 19.1%), established through highly concordant laboratory drug susceptibility testing and in silico prediction methods. Some MDR-TB isolates had near identical genomic variation, providing potential evidence of transmission. By placing the Philippine isolates within a phylogeny of global M. tuberculosis (n > 17,000), we established that they are genetically similar to those observed outside the country, including a clade of Manila-like strain-types in Thailand. An analysis of the phylogeny revealed a set of ~200 SNPs that are specific for the Manila strain-type, and a subset can be used within a molecular barcode. Sixty-eight mutations known to be associated with 10 anti-TB drug resistance were identified in the Philippine strains, and all have been observed in other populations. Whilst nine putative streptomycin resistance conferring markers in gid (8) and rrs (1) genes appear to be novel and with functional consequences. Overall, this study provides an important baseline characterisation of M. tuberculosis genetic diversity for the Philippines, and will fill a gap in global datasets and aid the development of a nation-wide database for epidemiological studies and clinical decision making. Further, by establishing a molecular barcode for detecting Manila strains it will assist with the design of diagnostic tools for disease control activities

Vectors and Spatial Patterns of Angiostrongylus cantonensis

In the Philippines, rats and snails abound in agricultural areas as pests and source of food for some of the local people which poses risks of parasite transmission to humans such as Angiostrongylus cantonensis. This study was conducted to determine the extent of A. cantonensis infection among rats and snails collected from rice-farming villages of Muñoz, Nueva Ecija. A total of 209 rats, 781 freshwater snails, and 120 terrestrial snails were collected for the study. Heart and lungs of rats and snail tissues were examined and subjected to artificial digestion for parasite collection. Adult worms from rats were identified using SSU rDNA gene. Seven nematode sequences obtained matched A. cantonensis. Results revealed that 31% of the rats examined were positive with A. cantonensis. Rattus norvegicus and R. tanezumi showed prevalence of 46% and 29%, respectively. Furthermore, only Pomacea canaliculata (2%) and Melanoides maculata (1%) were found to be positive for A. cantonensis among the snails collected. Analysis of host distribution showed overlapping habitats of rats and snails as well as residential and agricultural areas indicating risks to public health. This study presents a possible route of human infection for A. cantonensis through handling and consumption of P. canaliculata and M. maculata or crops contaminated by these snails

Lineage BA.2 dominated the Omicron SARS-CoV-2 epidemic wave in the Philippines

The Omicron SARS-CoV-2 variant led to a dramatic global epidemic wave following detection in South Africa in November, 2021. The Omicron lineage BA.1 was dominant and responsible for most SARS-CoV-2 outbreaks in countries around the world during December 2021-January 2022, whilst other Omicron lineages including BA.2 accounted for the minority of global isolates. Here, we describe the Omicron wave in the Philippines by analysing genomic data. Our results identify the presence of both BA.1 and BA.2 lineages in the Philippines in December 2021, before cases surged in January 2022. We infer that only lineage BA.2 underwent sustained transmission in the country, with an estimated emergence around November 18th, 2021 [95% highest posterior density: November 6-28th], whilst despite multiple introductions BA.1 transmission remained limited. These results suggest the Philippines was one of the earliest areas affected by BA.2, and reiterate the importance of whole-genome sequencing for monitoring outbreaks