coyotes as a reservoir for the emerging zoonotic parasite ...€¦ · coyotes as a reservoir for...
TRANSCRIPT
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COYOTES AS A RESERVOIR FOR THE EMERGING ZOONOTIC PARASITE,
ONCHOCERCA LUPI, IN THE SOUTHWESTERN UNITED STATES
Chandler Roe, MS
Research Coordinator, PMI
Graduate Student, NAU
April 2018
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ONCHOCERCIASIS
• Filarial nematode
• Eye and skin disease
• O. volvulus: African River blindness
• Transmission: black fly bit, Simulium tribulatum
• 114 million treated in 2015
• Adult worms live ~15 years in host
• Female worms: 13-19 inches
• Male worms: 7-16 inches
• Wolbachia endosymbiont
WHO/TDR/stammers WHO/TDR/OCP
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ONCHOCERCA VOLVULUS DISTRIBUTION 2015
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Based on a figure from CDC
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Based on a figure from CDC
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Based on a figure from CDC
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Based on a figure from CDC
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Based on a figure from CDC
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Based on a figure from CDC
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ILLUSTRATIVE NUMBERS ON ONCHOCERCIASIS
Variable Value
Females per nodule 2 – 50 worms a
Males per nodule (constantly exchanging) 1 – 10 worms b
Microfilariae produced per day per adult female 1600
Total body daily microfilariae turnover (steady state) 10,000 – 300,000
Total body loads As high as 150 million microfilariae
a females remain incarcerated in nodulesb Males move in and out of nodules throughout lifespan
Udal 2007, CID
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Heartworm
Filarial nematodes
Lefoulon et al 2017
wolf
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WYATT EARPWyatt EarpRescue from Northern Arizona ReservationShotgun woundsVenereal diseasesEye infection in both eyesBroken tail
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ONCHOCERCA LUPI
• Found: Northern AZ reservation
• Adopted: January 17, 2009
• Traveled:
• Yuma: December 2009
• Lee’s Ferry: March 2010
• New eye infection symptoms:
August 2010
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Found single worm, sent off for morphological identification
Onchcocerca lupi
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TREATMENT
Surgical excision of nodules
Melarsomine: An organic arsenical compound injected into the dog’s lumbar muscles.
Doxycycline: Antibiotic targets Wolbachia endosymbiont, sterilizes adult worms
Ivermectin: Anti-parasite medication
Prednisone: Anti-inflammatory steroid
Lots of eye drops..
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May 2016
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REPORTED ZOONOTIC O. LUPI IN HUMANS IN THE UNITED STATES
Age Case 122 months
Case 210 ya
Case 350 ya
Case 413 ya
Case 55 ya
Case 610 ya
Case 711 ya
Residence Arizona New Mexico Arizona Arizona New Mexico Texas Arizona
Location of nodule
Cervical spine Scalp Forearm Cervical spine Cervical spine Superior rectus muscle
Ocular
Method confirming diagnosis
Histology Histology, PCR
Histology, PCR
Histology Histology Histology Histology, PCR
Histologic findings
Gravid adult Nongravidadult
Nongravidadult
Nongravidadult
Gravid adult Multiple nongravid
adults
Unknown
Management Biopsy,ivermectin
Noduleexcision
Nodule excision,
ivermectin, doxycycline
Partial excision,
ivermectin, doxycycline
Nodule excision,
ivermectin, doxycycline
Nodule excision,
ivermectin, doxycycline
Unknown
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ARIZONA CASE #1: 22 MONTH OLD FROM NORTHERN AZ
Eberhard et al, 2013
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ARIZONA CASE #2
• 50 year old female, Southern Arizona
• Nickel-sized subcutaneous nodule on right forearm (November 2013)
• Rubbery, nontender, non-erythematous, and non-pruritic
• Travel to Monument Valley in Moab, Utah (2008)
• Subcutaneous granulomatous cyst removed (May 2014)
• Cyst contained O. lupi
Cross-section of adult female worm.Cantey, P. et. al. 2016. Clinical Infectious Diseases.
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ARIZONA CASE #3
• 13 year old male, NE Arizona
• Week + worsening left-sided neck pain, sore throat, dysphagia, and headache
• Treatment with anti-inflammatories and antibiotics
• Worsening pain/headache 2 days later, with meningismus
• CSF evaluation revealed bacterial meningitis
• Treatment Improvement
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ARIZONA CASE #3 CONT’D
• Symptoms reoccurred 4 weeks later
• CT normal
• MRI showed intradural, extramedullary mass within upper cervical spinal canal
• O. lupi infection confirmed by CDC
• Ophthalmological examination normal
• Patient treated with 6-weeks of doxycycline
• Repeat MRI after showed decrease in size of mass
MRI cervical spine, Arizona case #3.Cantey, P. et. al. 2016. Clinical Infectious Diseases.
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May 201222 monthsApache County
April 201413 yearsApache County
May 201450 yearsMaricopa County
2015-2017Coyote Project Implementation
July 201711 yearsCoconino County
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Canines as suspected host and sentinels.
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STUDY OBJECTIVES
• Characterize the presence and geographic distribution patterns of O. lupi in Arizona coyote populations
• Identify the role of coyotes as potential hosts of O. lupi and as a potential reservoir for domestic dog or human infections
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• December 2015 - May 2017
• Sampling kits provided
• Skin tissue from base of ear
• Routine coyote removal operations
SAMPLE COLLECTION
603Coyotes
571Arizona
26New Mexico
6Nevada
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SAMPLING DISTRIBUTION
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0 100 200 300 400 500
Majority of coyotes sampled were adults.
Adult
Youth
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0 100 200 300 400
Majority of coyotes sampled were male.
Male
Female
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METHODS
• Tissue processing
• DNA extraction
• Real-Time PCR screening
• Amplicon sequencing
• Bioinformatics
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U.S. strains are closely related.
Fairly new introduction of O. lupi in the U.S.
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NEXT STEPS
• Surveillance
• Black flies• Humans
• Animals
• Expand study site
• Outreach
• Clinicians
• Veterinarians
• Diagnostic
• Collect blood from positive and negative canine samples
• Draft genome
• Sequence whole genome
• Better population genomics
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COLLABORATORS
Hayley Yaglom
Dr. David Engelthaler
Dr. Jennifer Urbanz
Veronica Harrison
Ted Lyons
Dr. Jolene Bowers
Wyatt Earp