Abstract

Bacillus cereus biovar anthracis (Bcbva) is an untypical anthrax-causing pathogen responsible for high wildlife mortality in Taï National Park (TNP), Côte d’Ivoire. However, nothing is known about its effect on the rural population living in the region bordering TNP. Contact to bushmeat is a known risk factor for exposure to a variety of zoonotic pathogens, but no human infections with Bcbva were noted so far. Therefore, we performed a retrospective seroprevalence analysis with sera from 1,386 study volunteers. We used assays which detect antibodies against the protective antigen PA, which is synthesized by both Bcbva and classic B. anthracis, and against the recently described antigen pXO2-60, a 35-kDa protein only produced by Bcbva. We found a high seroprevalence (22.37%) of antibodies against PA, and approximately half of those sera (10.46%) were also positive for the Bcbva-specific antigen pXO2-60. All sera negative for PA were also negative for antibodies against pXO2-60, confirming specificity and suitability of the PA/pXO2-60 combined serological assay. The fact that a large fraction of sera was positive for PA but negative for pXO2-60 can most likely be explained by lower immunogenicity of pXO2-60, but exposure to classic B. anthracis cannot be excluded. As only Bcbva has been detected in the TNP area so far, exposure to Bcbva can be suspected from the presence of antibodies against PA alone. In a questionnaire, most study participants reported contact to bushmeat and livestock carcasses. Unfortunately, risk factor analysis indicated that neither animal contacts, sex, age, nor country of origin were significant predictors of Bcbva seroprevalence. Nevertheless, our study added to an assessment of the distribution of Bcbva and its impact on the human population, and our data can serve to raise awareness of anthrax in the affected regions.

Highlights

  • We assessed exposure to the pathogen by analysis of sera from human volunteers for the presence of antibodies against the protective antigen (PA), which is produced by B. anthracis and Bacillus cereus biovar anthracis (Bcbva), and against the Bcbva-specific protein pXO2-60

  • We found antibodies against PA in more than 20% of sera from humans living in the Taï National Park (TNP) region, and around 10% possessed antibodies against pXO2-60, confirming exposure to Bcbva

  • As only Bcbva, but not classic B. anthracis was found in TNP, we assume that the majority of humans had contact with Bcbva and that pXO2-60 is less immunogenic than PA

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Summary

Introduction

While the zoonotic potential and global importance of classic B. anthracis for human health is widely recognized [1, 2], little is known on the epidemiology of the “rainforest” anthrax-like disease caused by Bacillus cereus biovar anthracis (Bcbva). Most commonly humans contract classic anthrax from exposure through skin contact when handling infected animals or carcasses, their skins, wool, etc. Handling and consumption of bushmeat, either found dead in the forest or hunted, has previously been shown to play an important role for transmission of zoonotic pathogens to humans in the region near TNP and elsewhere [9,10,11]. While it is conceivable that bushmeat from animals infected with Bcbva is a source of infection with this pathogen for the local human population at Taï, to date there is no evidence for the occurrence of anthrax-like diseases caused by Bcbva among humans inhabiting this region

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