ABSTRACT

Mayaro virus, which can often go undetected due to its clinical manifestations and intimate alignment with dengue and chikungunya viruses, is one of the most neglected arboviruses. The virus has been found in several outbreaks, where a moderate-to-severe and potentially incapacitating joint disease has been observed. MAYV usually circulates in a sylvan cycle of forest mosquitoes and vertebrates, causing sporadic sylvatic infections to humans, and some outbreaks in sub-urban areas. This study focuses on the demonstration of the possible co-circulation of Mayaro virus with chikungunya virus and Zika virus during the outbreaks that occurred in Trinidad and Tobago in 2014 and 2016, respectively. Acute samples from patients who previously tested negative for chikungunya, dengue, and Zika, and specifically exhibiting joint pain were selected and investigated for the presence of Mayaro virus genome using real-time RT-PCR techniques. Nine persons were shown to be positive for Mayaro virus during the chikungunya outbreak of 2014, while no one during the Zika outbreak in 2016. Five results correspond to persons living in highly urbanized areas across Trinidad. These findings provide evidence that multiple arboviral circulations are possible and could easily go undetected especially during outbreak situations. Our study is the first to demonstrate the possible co-circulation of Mayaro and chikungunya viruses and the occurrence of human cases for both diseases during an outbreak in the Caribbean. A possible change in the pattern of distribution of human cases to more urbanized areas is also discussed.

摘要

Mayaro 病毒由于其临床表现和与登革热和基孔肯雅病毒密切相关而经常未被发现，它是最被忽视的虫媒病毒之一。该病毒已在几次暴发中被发现，其中观察到中度至重度并可能导致失能的关节疾病。MAYV通常在森林蚊子和脊椎动物的森林循环中传播，对人类造成散发的森林感染，并在郊区爆发一些。本研究的重点是证明在 2014 年和 2016 年分别在特立尼达和多巴哥发生的暴发期间，Mayaro 病毒与基孔肯雅病毒和寨卡病毒可能共同传播。先前对基孔肯雅热、登革热和寨卡病毒检测呈阴性的患者的急性样本，使用实时 RT-PCR 技术选择并研究了特别表现出关节疼痛的 Mayaro 病毒基因组的存在。在 2014 年基孔肯雅热爆发期间，有 9 人对 Mayaro 病毒呈阳性反应，而在 2016 年寨卡病毒爆发期间则没有人呈阳性。五项结果与生活在特立尼达高度城市化地区的人相对应。这些发现提供了证据，证明多种虫媒病毒循环是可能的，并且很容易被发现，尤其是在爆发情况下。我们的研究首次证明了在加勒比地区爆发期间 Mayaro 和基孔肯雅病毒可能共同传播以及这两种疾病的人类病例的发生。还讨论了人类病例向更城市化地区的分布模式可能发生的变化。