Peter R. Moore

Imported zika virus infection from the cook islands into australia, 2014.

A female resident of Townsville, Queensland, Australia has been diagnosed with Zika virus infection following a recent trip to the Cook Islands. An initial serum sample collected in March, 2014 was positive by two separate Zika virus TaqMan real-time RT-PCRs and a pan-Flavivirus RT-PCR. Nucleotide sequencing and phylogenetics of the complete Cook Islands Zika virus envelope gene revealed 99.1% homology with a previous Cambodia 2010 sequence within the Asian lineage. In addition, IgG and IgM antibody seroconversions were detected between paired acute and convalescent phase sera using recombinant Zika virus serology assays. This is the first known imported case of Zika virus infection into northern Queensland where the potential mosquito vector Aedes aegypti is present and only the second such reported case diagnosed within Australia.

Assessment of local mosquito species incriminates Aedes aegypti as the potential vector of Zika virus in Australia

Background Within the last 10 years Zika virus (ZIKV) has caused unprecedented epidemics of human disease in the nations and territories of the western Pacific and South America, and continues to escalate in both endemic and non-endemic regions. We evaluated the vector competence of Australian mosquitoes for ZIKV to assess their potential role in virus transmission. Methodology/Principal Findings Mosquitoes were exposed to infectious blood meals containing the prototype African ZIKV strain. After 14 days incubation at 28°C and high relative humidity, infection, dissemination and transmission rates were assessed. Infection in Culex annulirostris and Cx. sitiens could not be detected. 8% of Cx. quinquefasciatus were infected, but the virus did not disseminate in this species. Despite having infection rates > 50%, Aedes notoscriptus and Ae. vigilax did not transmit ZIKV. In contrast, Ae. aegypti had infection and transmission rates of 57% and 27%, respectively. In susceptibility trials, the virus dose required to infect 50% (ID50) of Ae. aegypti was106.4 tissue culture infectious dose50 (TCID50)/mL. Additionally, a threshold viral load within the mosquito of at least 105.1 TCID50 equivalents/mL had to be reached before virus transmission occurred. Conclusions/Significance We confirmed Ae. aegypti to be the most likely mosquito vector of ZIKV in Australia, although the restricted distribution of this species will limit the receptive zone to northern Queensland where this species occurs. Importantly, the role in ZIKV transmission of Culex and other Aedes spp. tested will be negligible. Despite being the implicated vector, the relatively high ID50 and need for a high titer disseminated infection in Ae. aegypti suggest that high mosquito population densities will be required to facilitate epidemic ZIKV transmission among the currently immunologically naïve human population in Australia.

Infection and dissemination of dengue virus type 2 in Aedes aegypti, Aedes albopictus, and Aedes scutellaris from the Torres Strait, Australia

ABSTRACT To determine their relative roles in transmission of dengue virus (DENV) in the Torres Strait region of northern Australia, we examined infection and dissemination of a sympatric strain of dengue virus type 2 (DENV-2) in Aedes scutellaris, Ae. albopictus, and Ae. aegypti. In experiments using membrane feeders for virus exposure, infection rates were 83% and 43% for Ae. scutellaris and Ae. aegypti, respectively. Salivary gland infection rates for both species were 43%. In experiments using pledgets for virus exposure, infection rates for Ae. aegypti, Ae. scutellaris, and Ae. albopictus were 68%, 55%, and 37%, respectively. Aedes albopictus exhibited the greatest barriers to infection with only 7% tested developing a salivary gland infection, compared to 42% and 24% of Ae. aegypti and Ae. scutellaris, respectively. These results suggest that Ae. scutellaris may have been responsible for DENV transmission on Torres Strait islands, where Ae. aegypti does not occur. In contrast, Ae. albopictus may not be an important vector of DENV-2 from the Torres Strait.

Highly divergent dengue virus type 1 genotype sets a new distance record

Dengue viruses (DENVs) are the leading cause of mosquito-borne viral disease of humans. They exist in both endemic and sylvatic ecotypes. In 2014, a viremic patient who had recently visited the rainforests of Brunei returned to Australia displaying symptoms consistent with DENV infection. A unique DENV strain was subsequently isolated from the patient, which we propose belongs to a new genotype within DENV serotype 1 (DENV-1). Bayesian evolutionary phylogenetic analysis suggests that the putative sylvatic DENV-1 Brunei 2014 (Brun2014) is the most divergent DENV-1 yet recorded and increases the time to the most recent common ancestor (MRCA) for DENV-1 from ≈120 years to ≈315 years. DENV-1 classification of the Brun2014 strain was further supported by monoclonal antibody serotyping data. Phenotypic characterization demonstrated that Brun2014 replication rates in mosquito cells and infection rates in Aedes aegypti mosquitoes were not significantly different from an epidemic DENV-1 strain. Given its ability to cause human illness and infect Ae. aegypti, potential urban spillover and clinical disease from further Brun2014 transmission cannot be discounted.

Emerging tropical diseases in Australia. Part 5. Hendra virus

Abstract Hendra virus (HeV) was first isolated in 1994, from a disease outbreak involving at least 21 horses and two humans in the Brisbane suburb of Hendra, Australia. The affected horses and humans all developed a severe but unidentified respiratory disease that resulted in the deaths of one of the human cases and the deaths or putting down of 14 of the horses. The virus, isolated by culture from a horse and the kidney of the fatal human case, was initially characterised as a new member of the genus Morbillivirus in the family Paramyxoviridae. Comparative sequence analysis of part of the matrix protein gene of the virus and the discovery that the virus had an exceptionally large genome subsequently led to HeV being assigned to a new genus, Henipavirus, along with Nipah virus (a newly emergent virus in pigs). The regular outbreaks of HeV‐related disease that have occurred in Australia since 1994 have all been characterised by acute respiratory and neurological manifestations, with high levels of morbidity and mortality in the affected horses and humans. The modes of transmission of HeV remain largely unknown. Although fruit bats have been identified as natural hosts of the virus, direct bat–horse, bat–human or human–human transmission has not been reported. Human infection can occur via exposure to infectious urine, saliva or nasopharyngeal fluid from horses. The treatment options and efficacy are very limited and no vaccine exists. Reports on the outbreaks of HeV in Australia are collated in this review and the available data on the biology, transmission and detection of the pathogen are summarized and discussed.

Isolation of Zika Virus Imported from Tonga into Australia.

Introduction: The globally emergent Zika virus (ZIKV) is a threat to Australia, given the number of imported cases from epidemic regions and the presence of competent mosquito vectors. We report the isolation of ZIKV from a female traveler who recently returned from Tonga to Brisbane, Queensland, Australia in 2016. Methods: A specific TaqMan real-time reverse transcriptase polymerase chain reaction assay (RT-PCR) assay was used to detect ZIKV in serum and urine samples. Conventional cell culture techniques and suckling mice were employed in an attempt to isolate ZIKV from serum and urine. Results: A ZIKV isolate (TS17-2016) was recovered from the serum sample after one passage in suckling mouse brains and harvested 11 days post inoculation. Phylogenetic analysis of complete envelope (E) gene sequences demonstrated TS17-2016 shared 99.9% nucleotide identity with other contemporary sequences from Tonga 2016, Brazil 2015 and French Polynesia 2013 within the Asian lineage. Discussion: This is the first known report of successful isolation of ZIKV from a human clinical sample in Australia and the first from a traveler from Tonga. This study highlights the potential difficulties in isolating ZIKV from acute clinical samples using conventional cell culture techniques, particularly in non-endemic countries like Australia where access to samples of sufficient viral load is limited. The successful isolation of TS17-2016 will be essential for continued investigations of ZIKV transmission and pathogenicity and will enable the advancement of new preventative control measures extremely relevant to the Australian and Pacific region.

Dengue viruses in Papua New Guinea: Evidence of endemicity and phylogenetic variation, including the evolution of new genetic lineages

Dengue is the most common cause of mosquito-borne viral disease in humans, and is endemic in more than 100 tropical and subtropical countries. Periodic outbreaks of dengue have been reported in Papua New Guinea (PNG), but there is only limited knowledge of its endemicity and disease burden. To help elucidate the status of the dengue viruses (DENVs) in PNG, we performed envelope (E) gene sequencing of DENV serotypes 1–4 (DENV 1–4) obtained from infected patients who traveled to Australia or from patients diagnosed during local DENV transmission events between 2001 and 2016. Phylogenetic analysis and comparison with globally available DENV sequences revealed new endemic PNG lineages for DENV 1–3 which have emerged within the last decade. We also identified another possible PNG lineage for DENV-4 from 2016. The DENV-1 and 3 PNG lineages were most closely related to recent lineages circulating on Pacific island nations while the DENV-2 lineage and putative DENV-4 PNG lineage were most similar to Indonesian sequences. This study has demonstrated for the first time the co-circulation of DENV 1–4 strains in PNG and provided molecular evidence of endemic DENV transmission. Our results provide an important platform for improved surveillance and monitoring of DENVs in PNG and broaden the global understanding of DENV genetic diversity. Emerging Microbes & Infections (2017) 6, e114; doi:10.1038/emi.2017.103; published online 20 December 2017

Detection of Specific ZIKV IgM in Travelers Using a Multiplexed Flavivirus Microsphere Immunoassay

Zika virus (ZIKV) has spread widely in the Pacific and recently throughout the Americas. Unless detected by RT-PCR, confirming an acute ZIKV infection can be challenging. We developed and validated a multiplexed flavivirus immunoglobulin M (IgM) microsphere immunoassay (flaviMIA) which can differentiate ZIKV-specific IgM from that due to other flavivirus infections in humans. The flaviMIA bound 12 inactivated flavivirus antigens, including those from ZIKV and yellow fever virus (YFV), to distinct anti-flavivirus antibody coupled beads. These beads were used to interrogate sera from patients with suspected ZIKV infection following travel to relevant countries. FlaviMIA results were validated by comparison to the ZIKV plaque reduction neutralization test (PRNT). The results highlight the complexity of serological ZIKV diagnosis, particularly in patients previously exposed to, or vaccinated against, other flaviviruses. We confirmed 99 patients with ZIKV infection by a combination of RT-PCR and serology. Importantly, ZIKV antibodies could be discriminated from those ascribed to other flavivirus infections. Serological results were sometimes confounded by the presence of pre-existing antibodies attributed to previous flavivirus infection or vaccination. Where RT-PCR results were negative, testing of appropriately timed paired sera was necessary to demonstrate seroconversion or differentiation of recent from past infection with or exposure to ZIKV.

New insights into chikungunya virus emergence and spread from Southeast Asia

Chikungunya virus (CHIKV) is a mosquito-borne virus of the family Togaviridae, genus Alphavirus, which causes a debilitating polyarthritic disease syndrome characterised by fever, arthralgia, myalgia, headache and rash. Circulation of the virus predominantly occurs in urban transmission cycles between humans and mosquitoes and can rapidly escalate into large-scale epidemics causing high rates of morbidity. The virus was originally isolated in 1953 in Tanzania, however clinical descriptions of previous disease outbreaks in the Caribbean (St. Thomas) and southeast coastal regions of the United States, suggest CHIKV epidemics may have occurred earlier in the nineteenth century. Classified according to their original geographical associations, three evolutionary distinct CHIKV genotypes, namely, the Asian, the East/Central/South African (ECSA) and the West African have been defined. However, increased human travel, commercial trade and expanding habitats of the primary mosquito vectors Aedes aegypti and Ae. albopictus, have directly influenced genotype distribution and contributed to global spread and transmission in new locations. Exploding in the western Indian Ocean during 2005–2006, the ECSA genotype has caused autochthonous outbreaks in India, Italy (2007), Papua New Guinea (PNG) (2012) and several Southeast Asian countries. Outbreaks on La Réunion Island (2005–2006), in Italy (2007), and in PNG in 2012, were driven by Ae. albopictus mosquitoes and involved a highly adapted CHIKV strain containing a unique amino-acid change, A226V, in the fusion envelope glycoprotein, E1. An outbreak of the ECSA genotype has also been recorded in Brazil (2014) in the east-central region of Feira de Santana, possibly imported from Angola. CHIKV also re-emerged from Asia and rapidly spread to Pacific regions including New Caledonia (2007), Yap, Federated States of Micronesia (2013), Samoa, American Samoa and French Polynesia (2014), and Kiribati (2015). In December, 2013, the Asian lineage was detected on the Caribbean Island, Saint Martin and has since caused widespread epidemics, involving millions of cases, in North, Central and South America. Previous phylogenetic analyses suggested that reported Pacific and American Asian CHIKV strains were most closely related to 2012 strains from the Philippines and China, and that the Saint Martin, Caribbean 2013 strain may have originated from the South Pacific. However, the exact route of CHIKV introduction into the Americas is unknown and is largely influenced by the limited availability of whole-genome sequences, particularly from the Pacific region. We performed whole-genome sequencing of 11 CHIKV strains (GenBank accession numbers MF773559-MF773569) imported into Australia by patients with travel histories from Southeast Asia, the Pacific and the Americas between 2010 and 2017, and phylogenetically compared the coding regions with 546 globally available CHIKV sequences retrieved from GenBank (including sequences from humans, and mosquito vector Ae. aegypti and Ae. albopictus host species). The CHIKV isolates were recovered following inoculation of C6/36 cell monolayers with patient serum previously positive for CHIKV RNA using a real-time TaqMan RTPCR assay. Viral RNA was extracted from passage 1 or passage 2 cultures using the QIAamp viral RNA extraction kit (Qiagen) without carrier RNA and whole-genome sequencing was performed as previously described using the Illumina NextSeq 500 sequencing system (Illumina, San Diego). Sample sequence outputs ranged between

Archival Isolates Confirm a Single Topotype of West Nile Virus in Australia

West Nile virus is globally wide-spread and causes significant disease in humans and animals. The evolution of West Nile virus Kunjin subtype in Australia (WNVKUN) was investigated using archival samples collected over a period of 50 years. Based on the pattern of fixed amino acid substitutions and time-stamped molecular clock analyses, a single long-term lineage (or topotype) was inferred. This implies that a bottleneck exists such that regional strains eventually die out and are replaced with strains from a single source. This was consistent with current hypotheses regarding the distribution of WNVKUN, whereby the virus is enzootic in northern Australia and is disseminated to southern states by water-birds or mosquitoes after flooding associated with above average rainfall. In addition, two previous amino acid changes associated with pathogenicity, an N-Y-S glycosylation motif in the envelope protein and a phenylalanine at amino acid 653 in the RNA polymerase, were both detected in all isolates collected since the 1980s. Changes primarily occurred due to stochastic drift. One fixed substitution each in NS3 and NS5, subtly changed the chemical environment of important functional groups, and may be involved in fine-tuning RNA synthesis. Understanding these evolutionary changes will help us to better understand events such as the emergence of the virulent strain in 2011.