Poster Presentation First Malaria World Congress 2018

Outbreak of human malaria caused by Plasmodium simium in the Atlantic Forest of Rio de Janeiro (#266)

Patrícia Brasil 1 2 , Mariano G Zalis 3 , Anielle de Pina-Costa 1 2 4 5 , Andre M Siqueira 1 2 , Cesare B Júnior 2 4 , Sidnei Silva 6 , André LL Areas 3 , Marcelo Pelajo-Machado 7 , Denise A Madureira de Alvarenga 8 , Ana Carolina F da Silva Santelli 9 , Hermano G Albuquerque 10 , Pedro VL Cravo 11 12 , Filipe Vieira S de Abreu 13 , Cassio L Peterka 9 , Graziela M Zanini 6 , Martha Cecilia S Mutis 10 , Alcides Pissinatti 5 14 , Ricardo Lourenço-de-Oliveira 2 13 , Cristiana FA de Brito 8 , Maria De Fatima Ferreira Da Cruz 2 4 , Richard Culleton 15 , Cláudio Tadeu Daniel-Ribeiro 2 4
  1. Laboratório de Doenças Febris Agudas , Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
  2. Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz, Rio de Janeiro, Brazil
  3. Laboratório de Infectologia e Parasitologia Molecular, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
  4. Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
  5. Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Rio de Janeiro, Brazil
  6. Laboratório de Parasitologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
  7. Laboratório de Patologia, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
  8. Laboratório de Malária, Centro de Pesquisas René Rachou por Institute René Rachou (IRR), Fiocruz, Belo Horizonte, Brazil
  9. Programa Nacional de Prevenção e Controle da Malária, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
  10. Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
  11. Laboratório de Genoma e Biotecnologia (GenoBio), Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
  12. Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
  13. Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
  14. Centro de Primatologia do Rio de Janeiro (CPRJ/INEA), Rio de Janeiro, Brazil
  15. Malaria Unit, Department of Pathology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan

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 Plasmodium simium is locally enzootic, we performed a molecular epidemiological investigation to determine whether zoonotic malaria transmission is occurring. We examined blood samples from patients presenting with malaria and 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, 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. 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.