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A Clinical and Epidemiological Investigation of the First Reported Human Infection With the Zoonotic Parasite Trypanosoma evansi in Southeast Asia

Title: A Clinical and Epidemiological Investigation of the First Reported Human Infection With the Zoonotic Parasite Trypanosoma evansi in Southeast Asia
Author(s): Nguyen, VVC
Le, BC
Desquesnes, M
Herder, S
Nguyen, PHL
Campbell, JI
Nguyen, VC
Yimming, B
Chalermwong, P
Jittapalapong, S
Franco, JR
Ngo, TT
Rabaa, MA
Carrique-Mas, J
Tam, PTT
Nga, TVT
Berto, A
Ngo, TH
Nguyen, VMH
Nguyen, CT
Nguyen, KC
Wills, B
Tran, TH
Thwaites, GE
Yacoub, S
Baker, S
Item Type: Journal Article
Abstract: Background. Trypanosoma is a genus of unicellular parasitic flagellate protozoa. Trypanosoma brucei species and Trypanosoma cruzi are the major agents of human trypanosomiasis; other Trypanosoma species can cause human disease, but are rare. In March 2015, a 38-year-old woman presented to a healthcare facility in southern Vietnam with fever, headache, and arthralgia. Microscopic examination of blood revealed infection with Trypanosoma. Methods. Microscopic observation, polymerase chain reaction (PCR) amplification of blood samples, and serological testing were performed to identify the infecting species. The patient's blood was screened for the trypanocidal protein apolipoprotein L1 (APOL1), and a field investigation was performed to identify the zoonotic source. Results. PCR amplification and serological testing identified the infecting species as Trypanosoma evansi. Despite relapsing 6 weeks after completing amphotericin B therapy, the patient made a complete recovery after 5 weeks of suramin. The patient was found to have 2 wild-type APOL1 alleles and a normal serum APOL1 concentration. After responsive animal sampling in the presumed location of exposure, cattle and/or buffalo were determined to be the most likely source of the infection, with 14 of 30 (47%) animal blood samples testing PCR positive for T. evansi. Conclusions. We report the first laboratory-confirmed case of T. evansi in a previously healthy individual without APOL1 deficiency, potentially contracted via a wound while butchering raw beef, and successfully treated with suramin. A linked epidemiological investigation revealed widespread and previously unidentified burden of T. evansi in local cattle, highlighting the need for surveillance of this infection in animals and the possibility of further human cases.
Publication Date: 7-Feb-2016
Date of Acceptance: 27-Jan-2016
URI: http://hdl.handle.net/10044/1/40524
DOI: http://dx.doi.org/10.1093/cid/ciw052
ISSN: 1537-6591
Publisher: Oxford University Press
Start Page: 1002
End Page: 1008
Journal / Book Title: Clinical Infectious Diseases
Volume: 62
Issue: 8
Copyright Statement: © The Author 2016. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
Vietnam
zoonosis
Trypanosoma evansi
case investigation
emerging infections
ANIMAL TRYPANOSOMES
BRUCEI
CRUZI
SUSCEPTIBILITY
IDENTIFICATION
RESISTANCE
REVEALS
MICE
PCR
Trypanosoma evansi
Vietnam
case investigation
emerging infections
zoonosis
Microbiology
06 Biological Sciences
11 Medical And Health Sciences
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine



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