Outbreak of human malaria caused by Plasmodium simium in the Atlantic Forest in Rio de Janeiro: a molecular epidemiological investigation

dc.creatorBrasil, Patrícia
dc.creatorZalis, Mariano Gustavo
dc.creatorPina-Costa, Anielle
dc.creatorSiqueira, Andre Machado
dc.creatorBianco Junior, Cesare
dc.creatorSilva, Sidnei
dc.creatorAreas, André Luiz Lisboa
dc.creatorMachado, Marcelo Pelajo
dc.creatorAlvarenga, Denise Anete Madureira de
dc.creatorSantelli, Ana Carolina Faria da Silva
dc.creatorAlbuquerque, Hermano Gomes
dc.creatorCravo, Pedro
dc.creatorAbreu, Filipe Vieira Santos de
dc.creatorPeterka, Cassio Leonel
dc.creatorZanini, Graziela Maria
dc.creatorMutis, Martha Cecilia Suárez
dc.creatorPissinatti, Alcides
dc.creatorOliveira, Ricardo Lourenço de
dc.creatorBrito, Cristiana Ferreira Alves de
dc.creatorCruz, Maria de Fátima Ferreira da
dc.creatorColleton, Richard
dc.creatorDaniel-Ribeiro, Cláudio Tadeu
dc.date2018-02-22T16:10:10Z
dc.date2018-02-22T16:10:10Z
dc.date2017
dc.date.accessioned2023-09-26T22:52:04Z
dc.date.available2023-09-26T22:52:04Z
dc.identifierBRASIL, Patrícia et al. Outbreak of human malaria caused by Plasmodium simium in the Atlantic Forest in Rio de Janeiro: a molecular epidemiological investigation. Lancet Glob Health, v. 5, p. 1-9, Aug. 2017.
dc.identifier2214-109X
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/24917
dc.identifier10.1016/S2214-109X(17)30333-9
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8884148
dc.descriptionFundação Carlos Chagas Filho de Amparo à Pesquisa do Estado de Rio de Janeiro, The Brazilian National Council for Scientific and Technological Development (CNPq), JSPS Grant-in-Aid for scientific research, Secretary for Health Surveillance of the Brazilian Ministry of Health, Global Fund, Fundaçao de amparo à pesquisa do estado de Minas Gerais (Fapemig), and PRONEX Program of the CNPq.
dc.descriptionBackground Malaria was eliminated from southern and southeastern Brazil over 50 years ago. However, an increasing number of autochthonous episodes attributed to Plasmodium vivax have recently been reported from the Atlantic Forest region of Rio de Janeiro state. As the P vivax-like non-human primate malaria parasite species Plasmodium simium is locally enzootic, we performed a molecular epidemiological investigation to determine whether zoonotic malaria transmission is occurring. Methods We examined blood samples from patients presenting with signs or symptoms suggestive of malaria as well as from local howler monkeys by microscopy and PCR. Samples were included from individuals if they had a history of travel to or resided in areas within the Rio de Janeiro Atlantic Forest, but not if they had malaria prophylaxis, blood transfusion or tissue or organ transplantation, or had travelled to known malaria endemic areas in the preceding year. Additionally, we developed a molecular assay based on sequencing of the parasite mitochondrial genome to distinguish between P vivax and P simium, and applied this assay to 33 cases from outbreaks that occurred in 2015, and 2016. Findings A total of 49 autochthonous malaria cases were reported in 2015–16. Most patients were male, with a mean age of 44 years (SD 14·6), and 82% lived in urban areas of Rio de Janeiro state and had visited the Atlantic Forest for leisure or work-related activities. 33 cases were used for mitochondrial DNA sequencing. The assay was successfully performed for 28 samples, and all were shown to be P simium, indicative of zoonotic transmission of this species to human beings in this region. Sequencing of the whole mitochondrial genome of three of these cases showed that P simium is most closely related to P vivax parasites from South America. The malaria outbreaks in this region were caused by P simium, previously considered to be a monkey-specific malaria parasite, related to but distinct from P vivax, and which has never conclusively been shown to infect people before. Interpretation This unequivocal demonstration of zoonotic transmission, 50 years after the only previous report of P simium in people, leads to the possibility that this parasite has always infected people in this region, but that it has been consistently misdiagnosed as P vivax because of an absence of molecular typing techniques. Thorough screening of local non-human primates and mosquitoes (Anopheline) is required to evaluate the extent of this newly recognised zoonotic threat to public health and malaria elimination in Brazil.
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier
dc.rightsopen access
dc.subjectMalária
dc.subjectMata Atlântica
dc.subjectRio de Janeiro
dc.subjectinvestigação epidemiológica molecular
dc.subjectPlasmodium simium
dc.subjectPlasmodium simium
dc.subjectAtlantic Forest
dc.subjectMolecular epidemiological investigation
dc.subjectMalaria
dc.subjectRio de Janeiro
dc.titleOutbreak of human malaria caused by Plasmodium simium in the Atlantic Forest in Rio de Janeiro: a molecular epidemiological investigation
dc.typeArticle


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