Abstract
To better understand the potential risks of Nipah virus emergence in Cambodia by studying different components of the interface between humans and bats. From 2012 to 2016, we conducted a study at two sites in Kandal and Battambang provinces where fruit bats (Pteropus lylei) roost. We combined research on: bat ecology (reproductive phenology, population dynamics and diet); human practices and perceptions (ethnographic research and a knowledge, attitude and practice study); and Nipah virus circulation in bat and human populations (virus monitoring in bat urine and anti-Nipah-virus antibody detection in human serum). Our results confirmed circulation of Nipah virus in fruit bats (28 of 3930 urine samples positive by polymerase chain reaction testing). We identified clear potential routes for virus transmission to humans through local practices, including fruit consumed by bats and harvested by humans when Nipah virus is circulating, and palm juice production. Nevertheless, in the serological survey of 418 potentially exposed people, none of them were seropositive to Nipah virus. Differences in agricultural practices among the regions where Nipah virus has emerged may explain the situation in Cambodia and point to actions to limit the risks of virus transmission to humans. Human practices are key to understanding transmission risks associated with emerging infectious diseases. Social science disciplines such as anthropology need to be integrated in health programmes targeting emerging infectious diseases. As bats are hosts of major zoonotic pathogens, such integrated studies would likely also help to reduce the risk of emergence of other bat-borne diseases.
Highlights
Infectious diseases remain an important threat to global health, as demonstrated by the recent emergence of coronavirus disease-2019 (COVID-19).[1]
The risk of such an emergence was known and in its 2018 list of priority diseases the World Health Organization (WHO) recognized that a serious international epidemic could be caused by a pathogen unknown.[2]
We interviewed residents in the primary study area in 2016 at the same time as a P. lylei global positioning system (GPS) telemetry study.[23]
Summary
Infectious diseases remain an important threat to global health, as demonstrated by the recent emergence of coronavirus disease-2019 (COVID-19).[1]. Since multiple factors including environmental and anthropological factors are often involved in the processes of disease emergence,[7] surveillance and control requires integrated (transdisciplinary and trans-sectoral) approaches in health management.[8]
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