Ongoing surveillance in the area and neighboring regions is needed to help with prompt response to future outbreaks. Activities should include accurate and rapid diagnosis of new outbreaks, investigation of risk factors associated with spillover and virus transmission, implementation of control measures, and further characterization of the virus involved. Ms Ching is a hospital staff nurse and a second-year fellow in the Philippine Field Epidemiology Training Program; she works at the Dr.
Jose N. Her research interests are outbreak investigations associated with vaccine-preventable diseases; foodborne illnesses; adverse events associated with fireworks use; and posttyphoon survival.
In addition, we acknowledge Mariko Saito for performing the preliminary diagnostic analysis. Table of Contents — Volume 21, Number 2—February Please use the form below to submit correspondence to the authors or contact them at the following address:.
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Paola Katrina G. Malbas, Gilbert C. Marsh, Sam McCullough, and A. Ruth Foxwell. Ching, V. Sucaldito, E. Tayag, F. Malbas Jr. Sejvar, D. Eagles, G. Playford, E. Dueger, A. Sejvar, E. Marsh, S. Kaku, S. Morikawa, M. Abstract During , henipavirus infection caused severe illness among humans and horses in southern Philippines; fatality rates among humans were high.
The Study. Figure 1 Figure 1. Figure 2 Figure 2. Aljofan M. Hendra and Nipah infection: emerging paramyxoviruses. Virus Res. Henipaviruses: emerging paramyxoviruses associated with fruit bats. Curr Top Microbiol Immunol. A review of Nipah and Hendra viruses with an historical aside. Identifying receptors for alphaviruses shared across mosquitoes, humans, and animals 1 hour ago. Load comments 0. Let us know if there is a problem with our content. Your message to the editors.
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I'm OK with that Cookie options. E-mail newsletter. It appears that you are currently using Ad Blocking software. Temporal and geographic features of human and horse cases in 2 villages Midtungok, Tinalon and at the provincial referral hospital Isulan , Philippines, , by date of disease onset.
Full rectangles represent cases based on case description. The empty rectangle horse I represents the horse death that did not fit the case description. Of these, 2 were health care workers from Isulan who did not visit the villages, had no contact with sick horses, and did not consume horse meat Figure 1 ; they reportedly wore minimal personal protective equipment gloves, face mask during patient procedures, 2 cared for case-patients in their homes, and 1 helped transport a case-patient who was producing substantial respiratory secretions to a hospital.
During March 3—May 11, ten horse deaths were reported in the 2 villages Figure 1 ; 2 were found dead, and all but 1 of the others showed neurologic signs head tilting, circling, ataxia. Progression of clinical signs was rapid. A dog was found dead after eating horse meat, but the epidemiologic link is unknown. Blood was collected from surviving suspected case-patients, contacts of human or horse case-patients, and several domestic animals cats, buffalo, dogs, horses, pigs, goats.
No samples were available from affected horses. Test results were negative for all agents except henipaviruses. To detect neutralizing antibodies against HeV and NiV, we used neutralization assays with infectious HeV and NiV 14 and pseudotyped vesicular stomatitis virus possessing NiV envelope proteins 15 Table 2.
Neutralizing antibodies against NiV and correspondingly lower neutralizing antibody titers against HeV were found for 3 patients. IgM against NiV was also detectable in these same 3 patients.
The pattern of neutralizing antibodies and IgM in acute-phase and convalescent-phase serum samples is evidence of recent exposure to a henipavirus. Further attempts to amplify additional genome and isolate the virus were unsuccessful. All serum samples from 4 dogs were positive for neutralizing antibodies against NiV. NiV neutralizing antibodies were not detected in samples from animals of any other species. Alignment A and phylogenetic relationship B of partial phosphoprotein gene sequences 71 mer of henipaviruses, including the fragment obtained by next-generation sequencing from a patient in Philippines Philippines.
The optimal tree with sum of branch length equal to 0. The percentage of replicate trees in which the associated taxa clustered together in the bootstrap test 1, replicates are shown. The phylogenetic tree is drawn to scale; branch lengths in the same units as those of the evolutionary distances are used to infer the phylogenetic tree. The scale bar represents 0. The evolutionary distances were computed by using the Kimura 2-parameter method and are presented as number of base substitutions per site.
The analysis involved nt sequences. All positions containing gaps and missing data were eliminated. The final dataset contained 71 positions. The accession numbers of each sequence are shown for the viruses. HeV, Hendra virus. Clinical presentations, epidemiologic findings, and serologic results suggest that the virus causing this outbreak was a henipavirus. It was most likely NiV or a virus that is antigenically and genetically closely related to NiV.
However, for at least 5 cases, clinical and epidemiologic evidence suggest direct human-to-human virus transmission. No protective equipment was used by those who cared for case-patients in the home, and health care workers used gloves and a face mask but not eye protection.
The evidence of human-to-human transmission in this outbreak confirms the need for preventative measures in home care and health care settings. Although the source of the horse infections is unclear, on the basis of the known ecology of henipaviruses, the most likely source is fruit bats family Pteropodidae Bats belonging to this family were reported near at least 1 of the 2 villages. Ongoing surveillance in the area and neighboring regions is needed to help with prompt response to future outbreaks.
Activities should include accurate and rapid diagnosis of new outbreaks, investigation of risk factors associated with spillover and virus transmission, implementation of control measures, and further characterization of the virus involved.
In addition, we acknowledge Mariko Saito for performing the preliminary diagnostic analysis. Ms Ching is a hospital staff nurse and a second-year fellow in the Philippine Field Epidemiology Training Program; she works at the Dr.
Jose N. Her research interests are outbreak investigations associated with vaccine-preventable diseases; foodborne illnesses; adverse events associated with fireworks use; and posttyphoon survival. Outbreak of henipavirus infection, Philippines, Emerg Infect Dis [Internet]. National Center for Biotechnology Information , U. Journal List Emerg Infect Dis v. Emerg Infect Dis.
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