The phylogeography of rabies in Grenada, West Indies, and implications for control.

Ulrike Zieger,Andrew C Breed,Dirk Werling,Daniel L Horton,Bowen Louison,Denise A Marston,Muzzamil Sayyid,Anthony R Fooks,Hooman Goharriz,Keshaw Tiwari,Katja Voller,Alfred Chikweto,Ravindra Sharma

doi:10.1371/journal.pntd.0003251

Abstract

In Grenada, West Indies, rabies is endemic, and is thought to be maintained in a wildlife host, the small Indian mongoose (Herpestes auropunctatus) with occasional spillover into other hosts. Therefore, the present study was undertaken to improve understanding of rabies epidemiology in Grenada and to inform rabies control policy. Mongooses were trapped island-wide between April 2011 and March 2013 and examined for the presence of Rabies virus (RABV) antigen using the direct fluorescent antibody test (dFAT) and PCR, and for serum neutralizing antibodies (SNA) using the fluorescent antibody virus neutralization test (FAVN). An additional cohort of brain samples from clinical rabies suspects submitted between April 2011 and March 2014 were also investigated for the presence of virus. Two of the 171 (1.7%) live-trapped mongooses were RABV positive by FAT and PCR, and 20 (11.7%) had SNAs. Rabies was diagnosed in 31 of the submitted animals with suspicious clinical signs: 16 mongooses, 12 dogs, 2 cats and 1 goat. Our investigation has revealed that rabies infection spread from the northeast to the southwest of Grenada within the study period. Phylogenetic analysis revealed that the viruses from Grenada formed a monophyletic clade within the cosmopolitan lineage with a common ancestor predicted to have occurred recently (6–23 years ago), and are distinct from those found in Cuba and Puerto Rico, where mongoose rabies is also endemic. These data suggest that it is likely that this specific strain of RABV was imported from European regions rather than the Americas. These data contribute essential information for any potential rabies control program in Grenada and demonstrate the importance of a sound evidence base for planning interventions.

Highlights

Rabies is a globally distributed zoonotic, almost always fatal, infectious disease of the central nervous system of mammals caused by members of the Lyssavirus genus
A fatal disease of animals and humans has been endemic in Grenada, West Indies, since the early 1900s
Post-exposure prophylaxis (PEP) in humans is routinely done and no human has died of rabies in Grenada since 1970

Summary

Introduction

Rabies is a globally distributed zoonotic, almost always fatal, infectious disease of the central nervous system of mammals caused by members of the Lyssavirus genus. Fourteen Lyssavirus species have been classified, including two described recently [1,2,3,4]. The majority of human rabies cases are caused by rabies virus (RABV), transmitted by the bite of infected animals, most commonly dogs and other carnivores [5]. Rabies caused by lyssaviruses of other species, which are geographically more restricted and circulate mostly in bats, is clinically indistinguishable [6]. Rabies virus strains that circulate in specific hosts or in specific geographic regions are known to undergo genetic adaptations forming distinct biotypes and variants, which can affect their pathogenicity [7,8]. Most human fatalities are seen in Asia, Africa and Latin

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