Contact Investigation of Melioidosis Cases Reveals Regional Endemicity in Puerto Rico

Doker, Thomas J.; Sharp, Tyler M.; Rivera-García, Brenda; Pérez-Padilla, Janice; Benoit, Tina J.; Ellis, Esther M.; Elrod, Mindy G.; Gee, Jay E.; Shieh, Wun‐Ju; Beesley, Cari A.; Ryff, Kyle; Traxler, Rita M.; Galloway, Renee L.; Haberling, Dana L.; Waller, Lance A.; Shadomy, Sean V.; Bower, William A.; Hoffmaster, Alex R.; Walke, Henry; Blaney, David D.

doi:10.1093/cid/ciu764

Cited by 45 publications

(55 citation statements)

References 13 publications

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“…Third, although severe and potentially fatal manifestations of CHIKV infection [4–7] had been reported to occur most frequently in infants and the elderly [8–10], the expected incidence of such manifestations was unclear owing to differences in surveillance methods and potential population-specific differences (eg, underlying comorbidities, demographic age structure, and genetic predisposition). Fourth, multiple acute febrile illnesses (AFIs) are endemic in Puerto Rico, including dengue [11], influenza [12], leptospirosis [13], and melioidosis [14], all of which may be misdiagnosed as chikungunya and vice versa. Thus, accurate diagnosis of chikungunya was needed to enable appropriate and early initiation of clinical management of AFIs.…”

mentioning

confidence: 99%

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

Sharp¹,

Ryff

Alvarado

et al. 2016

J Infect Dis.

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After chikungunya virus (CHIKV) transmission was detected in Puerto Rico in May 2014, multiple surveillance systems were used to describe epidemiologic trends and CHIKV-associated disease. Of 28 327 cases reported via passive surveillance, 6472 were tested for evidence of CHIKV infection, and results for 4399 (68%) were positive. Of 250 participants in household cluster investigations, 70 (28%) had evidence of recent CHIKV infection. Enhanced surveillance for chikungunya at 2 hospitals identified 1566 patients who tested positive for CHIKV, of whom 10.9% were hospitalized. Enhanced surveillance for fatal cases enabled identification of 31 cases in which CHIKV was detected in blood or tissue specimens. All surveillance systems detected a peak incidence of chikungunya in September 2014 and continued circulation in 2015. Concomitant surveillance for dengue demonstrated low incidence, which had decreased before CHIKV was introduced. Multifaceted chikungunya surveillance in Puerto Rico resolved gaps in traditional passive surveillance and enabled a holistic description of the spectrum of disease associated with CHIKV infection.

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mentioning

confidence: 99%

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

Sharp¹,

Ryff

Alvarado

et al. 2016

J Infect Dis.

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“…The environmental conditions present in many of these countries, as well as environmental isolates of B. pseudomallei, support the possibility of endemicity in these areas. 26 A bit more puzzling are the three cases reported from the United States with no travel history outside the U.S. mainland. [35][36][37] One was reported as a chronic case.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19][20] Although human-to-human transmission is rare, one reported patient most likely acquired the infection through sexual transmission. 21 In addition, testing of soil samples or water in Peru, 22 Brazil, [22][23][24] Haiti, 22 Venezuela, 25 Ecuador, 25 and Puerto Rico 26 has revealed the presence of B. pseudomallei in the environment in these locations. In one study, B. pseudomallei was recovered from environmental specimens (soap, floor, and shower hose) in a burn unit of a hospital in Belo Horizonte, Brazil.…”

Section: Introductionmentioning

confidence: 99%

A Review of Melioidosis Cases in the Americas

Benoit¹,

Blaney²,

Doker³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a gram-negative saprophytic bacillus. Cases occur sporadically in the Americas with an increasing number of cases observed among people with no travel history to endemic countries. To better understand the incidence of the disease in the Americas, we reviewed the literature, including unpublished cases reported to the Centers for Disease Control and Prevention. Of 120 identified human cases, occurring between 1947 and June 2015, 95 cases (79%) were likely acquired in the Americas; the mortality rate was 39%. Burkholderia pseudomallei appears to be widespread in South, Central, and North America.

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“…10,11 Burkholderia pseudomallei, a saprophytic, gram-negative bacillus causes melioidosis, was recently shown to be in PR. 12,13 Excluding WNV, where mammals are dead-end hosts, it is unknown if free-ranging primates in PR are capable of being infected with any of these endemic pathogens or whether they might contribute to their transmission cycles in PR.…”

Section: Nonhuman Primates Are Not Native To the Caribbean Island Of mentioning

confidence: 99%

Serological Evidence of Infection with Endemic Human Pathogens Among Free-Ranging Old World Monkeys in Puerto Rico

Hemme¹,

Lopez-Ortiz²,

García³

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. Serum specimens from free-ranging but nonnative patas monkeys (Erythrocebus patas) and rhesus macaques (Macaca mulatta) in southwestern Puerto Rico (PR) were tested for antibodies to infection with dengue viruses (DENVs), West Nile virus (WNV), Leptospira species, and Burkholderia pseudomallei by microneutralization, plaque reduction neutralization, microscopic agglutination, and indirect hemagglutination, respectively. Of 23 animals (21 E. patas and two M. mulatta) tested, all had evidence of prior DENV infection, and of 17 animals tested for WNV, nine (53%) had evidence of prior infection. Of 24 (22 E. patas, two M. mulatta) tested for Leptospira spp., 10 (42%) had evidence of prior exposure, and one patas monkey had antibodies against B. pseudomallei. The acquisition of pathogens endemic among humans in PR by resident nonhuman primates merits further study to define modes of acquisition.

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Contact Investigation of Melioidosis Cases Reveals Regional Endemicity in Puerto Rico

Cited by 45 publications

References 13 publications

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

A Review of Melioidosis Cases in the Americas

Serological Evidence of Infection with Endemic Human Pathogens Among Free-Ranging Old World Monkeys in Puerto Rico

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