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Shamier MC, Zaeck LM, Götz HM, Vieyra B, Verstrepen BE, Wijnans K, Welkers MR, Hoornenborg E, van Cleef BA, van Royen ME, Jonas KJ, Koopmans MP, de Vries RD, van de Vijver DA, GeurtsvanKessel CH. Scenarios of future mpox outbreaks among men who have sex with men: a modelling study based on cross-sectional seroprevalence data from the Netherlands, 2022. Euro Surveill 2024; 29:2300532. [PMID: 38666400 PMCID: PMC11063670 DOI: 10.2807/1560-7917.es.2024.29.17.2300532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/29/2024] [Indexed: 04/30/2024] Open
Abstract
BackgroundFollowing the 2022-2023 mpox outbreak, crucial knowledge gaps exist regarding orthopoxvirus-specific immunity in risk groups and its impact on future outbreaks.AimWe combined cross-sectional seroprevalence studies in two cities in the Netherlands with mathematical modelling to evaluate scenarios of future mpox outbreaks among men who have sex with men (MSM).MethodsSerum samples were obtained from 1,065 MSM attending Centres for Sexual Health (CSH) in Rotterdam or Amsterdam following the peak of the Dutch mpox outbreak and the introduction of vaccination. For MSM visiting the Rotterdam CSH, sera were linked to epidemiological and vaccination data. An in-house developed ELISA was used to detect vaccinia virus (VACV)-specific IgG. These observations were combined with published data on serial interval and vaccine effectiveness to inform a stochastic transmission model that estimates the risk of future mpox outbreaks.ResultsThe seroprevalence of VACV-specific antibodies was 45.4% and 47.1% in Rotterdam and Amsterdam, respectively. Transmission modelling showed that the impact of risk group vaccination on the original outbreak was likely small. However, assuming different scenarios, the number of mpox cases in a future outbreak would be markedly reduced because of vaccination. Simultaneously, the current level of immunity alone may not prevent future outbreaks. Maintaining a short time-to-diagnosis is a key component of any strategy to prevent new outbreaks.ConclusionOur findings indicate a reduced likelihood of large future mpox outbreaks among MSM in the Netherlands under current conditions, but emphasise the importance of maintaining population immunity, diagnostic capacities and disease awareness.
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Affiliation(s)
- Marc C Shamier
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Luca M Zaeck
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Bruno Vieyra
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Babs E Verstrepen
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Koen Wijnans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Matthijs Ra Welkers
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
| | - Elske Hoornenborg
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
| | - Brigitte Agl van Cleef
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Martin E van Royen
- Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kai J Jonas
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marion Pg Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Rory D de Vries
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
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4
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Besombes C, Mbrenga F, Schaeffer L, Malaka C, Gonofio E, Landier J, Vickos U, Konamna X, Selekon B, Dankpea JN, Von Platen C, Houndjahoue FG, Ouaïmon DS, Hassanin A, Berthet N, Manuguerra JC, Gessain A, Fontanet A, Nakouné-Yandoko E. National Monkeypox Surveillance, Central African Republic, 2001-2021. Emerg Infect Dis 2022; 28:2435-2445. [PMID: 36328951 PMCID: PMC9707566 DOI: 10.3201/eid2812.220897] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
We analyzed monkeypox disease surveillance in Central African Republic (CAR) during 2001-2021. Surveillance data show 95 suspected outbreaks, 40 of which were confirmed as monkeypox, comprising 99 confirmed and 61 suspected monkeypox cases. After 2018, CAR's annual rate of confirmed outbreaks increased, and 65% of outbreaks occurred in 2 forested regions bordering the Democratic Republic of the Congo. The median patient age for confirmed cases was 15.5 years. The overall case-fatality ratio was 7.5% (12/160) for confirmed and suspected cases, 9.6% (8/83) for children <16 years of age. Decreasing cross-protective immunity from smallpox vaccination and recent ecologic alterations likely contribute to increased monkeypox outbreaks in Central Africa. High fatality rates associated with monkeypox virus clade I also are a local and international concern. Ongoing investigations of zoonotic sources and environmental changes that increase human exposure could inform practices to prevent monkeypox expansion into local communities and beyond endemic areas.
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Affiliation(s)
- Camille Besombes
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Festus Mbrenga
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Laura Schaeffer
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Christian Malaka
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Ella Gonofio
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Jordi Landier
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Ulrich Vickos
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Xavier Konamna
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Benjamin Selekon
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Joella Namsenei Dankpea
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Cassandre Von Platen
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Franck Gislain Houndjahoue
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Daniel Sylver Ouaïmon
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Alexandre Hassanin
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Nicolas Berthet
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Jean-Claude Manuguerra
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Antoine Gessain
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
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Dupke S, Schubert G, Beudjé F, Barduhn A, Pauly M, Couacy-Hymann E, Grunow R, Akoua-Koffi C, Leendertz FH, Klee SR. Serological evidence for human exposure to Bacillus cereus biovar anthracis in the villages around Taï National Park, Côte d'Ivoire. PLoS Negl Trop Dis 2020; 14:e0008292. [PMID: 32407387 PMCID: PMC7224451 DOI: 10.1371/journal.pntd.0008292] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/14/2020] [Indexed: 02/06/2023] Open
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. Anthrax is a zoonotic disease transmitted from animals to humans and normally caused by B. anthracis mainly in savanna regions. However, untypical bacteria named Bacillus cereus biovar anthracis (Bcbva) were detected in a variety of wild animals in the rain forest region of the Taï National Park (TNP) in Côte d’Ivoire. No anthrax infections in humans living in the region around TNP were reported until now. Therefore, 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 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 TNP region, and around 10% possessed also 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. Although most people reported animal contacts, there was no statistically significant correlation with the presence of antibodies against Bcbva. Nevertheless, our study confirmed that Bcbva represents a danger for humans living in the affected area.
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Affiliation(s)
- Susann Dupke
- Robert Koch Institute, Centre for Biological Threats and Special Pathogens, ZBS 2: Highly Pathogenic Microorganisms, Berlin, Germany
| | - Grit Schubert
- Robert Koch Institute, P3: Epidemiology of Highly Pathogenic Microorganisms, Berlin, Germany
| | - Félicité Beudjé
- Laboratoire National d’Appui au Développement Agricole/Laboratoire central de Pathologie Animale, Bingerville, Côte d’Ivoire
| | - Anne Barduhn
- Robert Koch Institute, Centre for Biological Threats and Special Pathogens, ZBS 2: Highly Pathogenic Microorganisms, Berlin, Germany
| | - Maude Pauly
- Robert Koch Institute, P3: Epidemiology of Highly Pathogenic Microorganisms, Berlin, Germany
| | - Emmanuel Couacy-Hymann
- Laboratoire National d’Appui au Développement Agricole/Laboratoire central de Pathologie Animale, Bingerville, Côte d’Ivoire
| | - Roland Grunow
- Robert Koch Institute, Centre for Biological Threats and Special Pathogens, ZBS 2: Highly Pathogenic Microorganisms, Berlin, Germany
| | - Chantal Akoua-Koffi
- Centre de Recherche pour le Développement, Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Fabian H. Leendertz
- Robert Koch Institute, P3: Epidemiology of Highly Pathogenic Microorganisms, Berlin, Germany
- * E-mail:
| | - Silke R. Klee
- Robert Koch Institute, Centre for Biological Threats and Special Pathogens, ZBS 2: Highly Pathogenic Microorganisms, Berlin, Germany
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