Prioritizing surveillance of Nipah virus in India
Prioritizing surveillance of Nipah virus in India
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DOI：
10.1371/journal.pntd.0007393
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发表时间：
2019-06-01
影响因子：
3.8
通讯作者：
Han, Barbara A.
中科院分区：
文献类型：
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作者：
Plowright, Raina K.;Becker, Daniel J.;Han, Barbara A.
2018年印度喀拉拉邦爆发尼帕病毒，突显了全球监测蝙蝠体内尼帕病毒的必要性，蝙蝠是这种病毒和其他病毒的宿主。尼帕病毒是亨尼帕病毒属中的一种新出现的副粘病毒，在人类中引起严重的疾病和口吃的传播链，被认为是潜在的大流行威胁。2018年5月，尼帕病毒在距离2001年和2007年印度东部前两次爆发地点1800公里的喀拉拉邦爆发。23人感染，21人死亡(16人死亡，18例实验室确诊)。最初的监测重点是食虫蝙蝠(Megaderma Spasma)，而喀拉拉邦的后续调查发现有证据表明果蝠(Pteropus Medius)中存在尼帕病毒。P.medius是孟加拉国的确认东道主，现在是印度的确认东道主。然而，其他种类的蝙蝠也可能是埃尼帕病毒的宿主。为了向蝙蝠监测尼帕病毒提供信息，我们回顾和分析了全球公布的尼帕病毒监测记录。我们将一种基于特征的机器学习方法应用于发生在亚洲、澳大利亚和大洋洲的物种子集。除了喀拉拉邦以前被鉴定为尼帕病毒血清阳性的七种蝙蝠外，我们还鉴定了至少四种蝙蝠，根据与已知尼帕病毒血清阳性物种的特征相似性，它们在印度接触尼帕或尼帕类似病毒的可能性相对较高。这些机器学习方法提供了评估尼帕病毒在印度蔓延的风险所需的一系列研究的第一步。尼帕病毒监测不仅在喀拉拉邦，而且在印度其他地方都将受益于一项研究管道，其中包括对已知和预测的水库进行调查，以寻找过去感染尼帕病毒(或交叉反应的埃尼帕病毒)的血清学证据。然后应在血清调查之后进行纵向的空间和时间研究，以检测脱落并从有感染证据的物种中分离出病毒。随后需要进行生态学研究，以了解蝙蝠的流行和脱落以及可能对公共健康构成威胁的接触者的动态。尼帕病毒是一种新出现的人畜共患病病毒，它从蝙蝠向人类蔓延，在人类中造成严重的疾病和传播链。2018年5月，在印度喀拉拉邦，尼帕病毒感染23人，造成21人死亡。我们回顾和分析了已发表的蝙蝠尼帕病毒监测记录，并确定了11种发生在印度并有埃尼帕病毒感染或接触证据的物种。然而，几乎所有这些蝙蝠物种都是在印度以外的地方采样的。使用基于特征的机器学习方法，我们识别了至少四种额外的印度蝙蝠物种，它们可能已经接触到尼帕病毒或交叉反应的埃尼帕病毒。我们建议对这些物种进行监测，并研究尼帕病毒的生态动态和向人类溢出传播的流行病学。这项工作将有助于确定应对最近在喀拉拉邦、印度和其他地方爆发的尼帕病毒的研究议程的优先顺序。
The 2018 outbreak of Nipah virus in Kerala, India, highlights the need for global surveillance of henipaviruses in bats, which are the reservoir hosts for this and other viruses. Nipah virus, an emerging paramyxovirus in the genus Henipavirus, causes severe disease and stuttering chains of transmission in humans and is considered a potential pandemic threat. In May 2018, an outbreak of Nipah virus began in Kerala, > 1800 km from the sites of previous outbreaks in eastern India in 2001 and 2007. Twenty-three people were infected and 21 people died (16 deaths and 18 cases were laboratory confirmed). Initial surveillance focused on insectivorous bats (Megaderma spasma), whereas follow-up surveys within Kerala found evidence of Nipah virus in fruit bats (Pteropus medius). P. medius is the confirmed host in Bangladesh and is now a confirmed host in India. However, other bat species may also serve as reservoir hosts of henipaviruses. To inform surveillance of Nipah virus in bats, we reviewed and analyzed the published records of Nipah virus surveillance globally. We applied a trait-based machine learning approach to a subset of species that occur in Asia, Australia, and Oceana. In addition to seven species in Kerala that were previously identified as Nipah virus seropositive, we identified at least four bat species that, on the basis of trait similarity with known Nipah virus-seropositive species, have a relatively high likelihood of exposure to Nipah or Nipah-like viruses in India. These machine-learning approaches provide the first step in the sequence of studies required to assess the risk of Nipah virus spillover in India. Nipah virus surveillance not only within Kerala but also elsewhere in India would benefit from a research pipeline that included surveys of known and predicted reservoirs for serological evidence of past infection with Nipah virus (or cross reacting henipaviruses). Serosurveys should then be followed by longitudinal spatial and temporal studies to detect shedding and isolate virus from species with evidence of infection. Ecological studies will then be required to understand the dynamics governing prevalence and shedding in bats and the contacts that could pose a risk to public health.Author summary Nipah virus is an emerging zoonotic virus that spills over from bats to humans causing severe disease and chains of transmission in humans. In May 2018, in Kerala, India, Nipah virus infected 23 people, killing 21. We reviewed and analyzed published records of Nipah virus surveillance in bats and identified eleven species that occur in India and have had evidence of henipavirus infection or exposure. However, almost all of these bat species were sampled outside of India. Using a trait-based machine learning approach, we identified at least four additional Indian bat species that are likely to have been exposed to Nipah virus or cross-reacting henipaviruses. We suggest surveillance of these species as well as studies on the ecological dynamics of Nipah virus and epidemiology of spillover transmission to humans. This work will help prioritize a research agenda for responding to the recent outbreak of Nipah virus in Kerala, India and elsewhere.