Convergence of Humans, Bats, Trees, and Culture in Nipah Virus Transmission, Bangladesh

Résumé fourni par la source

Preventing emergence of new zoonotic viruses depends on understanding determinants for human risk.Nipah virus (NiV) is a lethal zoonotic pathogen that has spilled over from bats into human populations, with limited person-to-person transmission.We examined ecologic and human behavioral drivers of geographic variation for risk of NiV infection in Bangladesh.We visited 60 villages during 2011-2013 where cases of infection with NiV were identified and 147 control villages.We compared case villages with control villages for most likely drivers for risk of infection, including number of bats, persons, and date palm sap trees, and human date palm sap consumption behavior.Case villages were similar to control villages in many ways, including number of bats, persons, and date palm sap trees, but had a higher proportion of households in which someone drank sap.Reducing human consumption of sap could reduce virus transmission and risk for emergence of a more highly transmissible NiV strain.E merging zoonoses pose a substantial threat to human health and well-being (1).Some of the most devastating human disease pandemics have been caused by diseases originating in livestock or wildlife, including HIV infection, influenza, bubonic plague, and a large Ebola outbreak in West Africa (1,2).For this reason, there is considerable scientific and public health interest in predicting which emerging pathogens have the potential to cause pandemics so that these pandemics can be prevented.Emerging lethal zoonotic pathogens that have crossed the species barrier and can be transmitted from 1 person to another, albeit without sustained person-to-person transmission, are particularly concerning because they could evolve to become more highly transmissible and cause large outbreaks or pandemics (3).It is therefore critical to focus resources on limiting the opportunity of these pathogens to spillover from wildlife and livestock to infect persons and to better adapt to human hosts.Effectively preventing cross-species transmission of zoonotic pathogens depends on our ability to determine how transmission occurs, including transmission pathways and determinants of human risk.Efforts to identify and predict risky geographic areas for emerging zoonoses have focused primarily on publicly available data, remote sensing of species habitat, and other large-scale population measures (4,5).A major limitation of these risk mapping approaches is that they typically rely on crude measures of spatial risk, including presence or absence of species or population densities.Human behavior patterns are rarely taken into account, although the risk for transmission probably involves complex, time-varying interactions between humans and their environment that are often driven by culture, climate, and economic development (1,6,7).Infection with Nipah virus (NiV), an emerging zoonotic pathogen, can cause encephalitis in humans; the virus can also be transmitted between humans, although somewhat inefficiently (8).NiV was first identified as the etiologic agent causing outbreaks in pigs and encephalitis in humans in Malaysia and Singapore during 1998-1999 (9).Shortly thereafter, this virus was identified as the cause of outbreaks of human encephalitis in Bangladesh and India Convergence of Humans, Bats, Trees, and Culture in Nipah VirusTransmission, Bangladesh

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