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Human and Equine Infection with Alphaviruses and Flaviviruses in Panamá during 2010: A Cross-Sectional Study of Household Contacts during an Encephalitis Outbreak
Members of the genera Alphavirus (family Togaviridae) and Flavivirus (family Flaviridae) are important zoonotic human and equine etiologic agents of neurologic diseases in the New World. In 2010, an outbreak of Madariaga virus (MADV; formerly eastern equine encephalitis virus) and Venezuelan equine encephalitis virus (VEEV) infections was reported in eastern Panamá. We further characterized the epidemiology of the outbreak by studying household contacts of confirmed human cases and of equine cases with neurological disease signs. Serum samples were screened using a hemagglutination inhibition test, and human results were confirmed using plaque reduction neutralization tests. A generalized linear model was used to evaluate the human MADV and VEEV seroprevalence ratios by age (in tercile) and gender. Overall, antibody prevalence for human MADV infection was 19.4%, VEEV 33.3%, and Mayaro virus 1.4%. In comparison with individuals aged 2–20 years, people from older age groups (21–41 and > 41 years) were five times more likely to have antibodies against VEEV, whereas the MADV prevalence ratio was independent of age. The overall seroprevalence of MADV in equids was 26.3%, VEEV 29.4%, West Nile virus (WNV) 2.6%, and St. Louis encephalitis virus (SLEV) was 63.0%. Taken together, our results suggest that multiple arboviruses are circulating in human and equine populations in Panamá. Our findings of a lack of increase in the seroprevalence ratio with age support the hypothesis of recent MADV exposure to people living in the affected region.
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Author Notes
Financial support: This work was supported grants FID-09-103 from Secretaria Nacional de Ciencia y Tecnología Panamá to J-P. C.; US National Institutes of Health grants AI120942 and AI116030 to S. C. W. and T32 grant AI007536 support to A. Y. V., and neglected diseases grant 1.11.1.3.703.01.55.120, from the Ministry of Economy and Finance of Panamá to J. M. P. J. M. C. was also supported by Columbus University of Panamá, Research grant CU-VIP-P-003-2015.
Authors’ addresses: Jean-Paul Carrera, Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panamá, Panamá, E-mail: jean1450@gmail.com. Karoun H. Bagamian, Environmental and Global Health and Emerging Pathogens Institute, University of Florida, Gainesville, FL, and Bagamian Scientific Consulting, LLC, Gainesville, FL, E-mail: karoun11@gmail.com. Amelia P. Travassos da Rosa, Robert B. Tesh, Eryu Wang, and Scott C. Weaver, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, E-mails: aptravas@utmb.edu, rtesh@utmb.edu, erwang@utmb.edu, and sweaver@utmb.edu. Davis Beltran, Department of Virology and Biotechnology Research, Gorgas Memorial Institute of Health Studies, Panamá City, FL, and Department of Medical Entomology, Gorgas Memorial Institute of Health Studies, Panamá City, FL, E-mail: dbelt16@gmail.com. Nathan D. Gundaker, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, E-mail: ndgundacker@gmail.com. Blas Armien, Departamento de Investigacion de Enfermedades Emergentes y Zoonóticas, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá, E-mail: barmien@gorgas.gob.pa. Gianfranco Arroyo, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: arroyogianfranco@gmail.com. Néstor Sosa, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá, E-mail: drnsosa@gmail.com. Juan Miguel Pascale, Department of Microbiology, Gorgas Memorial Institute for Health Research, Panamá City, Panamá, E-mail: jmpascal@yahoo.com. Anayansi Valderrama, Department of Medical Entomology, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá, and Universidad de Panamá, Panamá City, Panamá, E-mail: avalderrama@gorgas.gob.pa. Amy Y. Vittor, Emerging Pathogens Institute, University of Florida, Gainesville, FL, E-mail: amy.vittor@medicine.ufl.edu.