Surveillance and laboratory collaboration in response to an outbreak of Vibrio parahaemolyticus, Plesiomonas shigelloides, and Aeromonas hydrophila in Sekondi-Takoradi, Ghana: a case series

Michael Owusu,Solomon Asante Sefa,Bernard Nkrumah,Lucy Maryogo Robinson,Jones Lamptey,Kwame Asante,Eric Amoako,David Opare,David Sambian,Slyvester Chinbuah,Ebenezer Kofi Mensah,Augustina Sylverken,Irene Amedzro,Yaw Adu-Sarkodie,Godfred Acheampong,Shannon Emery

doi:10.1186/s13256-021-03243-0

Abstract

BackgroundThe detection of epidemic-prone pathogens is important in strengthening global health security. Effective public health laboratories are critical for reliable, accurate, and timely testing results in outbreak situations. Ghana received funding as one of the high-risk non-Ebola affected countries to build and strengthen public health infrastructure to meet International Health Regulation core capacities. A key objective was to build laboratory capacities to detect epidemic-prone diseases.Case presentationIn June 2018, a local hospital received eight patients who presented with acute diarrhea. A sample referral system for Ghana has not been established, but the Sekondi Zonal Public Health Laboratory staff and mentors collaborated with Disease Surveillance Officers (DSOs) to collect, package, and transport stool specimens from the outbreak hospital to the Public Health Laboratory for laboratory testing. The patients included seven females and one male, of Fante ethnicity from the Fijai township of Sekondi-Takoradi Municipality. The median age of the patients was 20 years (interquartile range: 20–29 years). Vibrio parahaemolyticus was identified within 48 hours from four patients, Plesiomonas shigelloides from one patient, and Aeromonas hydrophila from another patient. There was no bacteria growth from the samples from the two other patients. All patients were successfully treated and discharged.ConclusionThis is the first time these isolates have been identified at the Sekondi Zonal Public Health Laboratory, demonstrating how rapid response, specimen transportation, laboratory resourcing, and public health coordination are important in building capacity towards achieving health security. This capacity building was part of the United States Centers for Disease Control and Prevention engagement of international and local partners to support public health laboratories with supplies, diagnostic equipment, reagents, and logistics.

Highlights

Following the 2003 severe acute respiratory syndrome (SARS) outbreak, the World Health Organization (WHO) drafted the International Health Regulations 2005 (IHR), requiring member countries to prevent, rapidly detect, respond, and report outbreaks and public health emergencies [1, 2]
This is the first time these isolates have been identified at the Sekondi Zonal Public Health Laboratory, demonstrating how rapid response, specimen transportation, laboratory resourcing, and public health coordination are important in building capacity towards achieving health security
As part of strengthening the laboratory and epidemiologic surveillance of priority pathogens in Ghana, the United States Centers for Disease Control and Prevention (US CDC) engaged international [Association of Public Health Laboratories (APHL)] and local [Centre for Health System Strengthening (CfHSS)] partners to build the capacity of PHLs to detect epidemic-prone infectious diseases in Ghana

Summary

Conclusion

This report presents rare cases of diarrhea associated with V. parahaemolyticus, A. hydrophila, and P. shigelloides. These organisms might be widespread in Ghana, especially along the coastal towns, and may be significant causative agents of diarrheal outbreaks or might cause chronic diarrhea in immunocompromised patients. This report underscores the importance of laboratory analyses in outbreaks. Comprehensive investigation, including food microbiology for seafood, is recommended to map out sources of infection for better control measures. CDC: United States Centers for Disease Control and Prevention; WHO/AFRO: WHO Regional Office for Africa; WHO: World Health Organization; XLD: Xylose lysine deoxycholate

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