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      Behavioral–biological surveillance of emerging infectious diseases among a dynamic cohort in Thailand

      research-article
      1 , 2 , 1 , 1 , 1 , 3 , 4 , 1 , 5 , 6 , 6 , 6 , 7 , 7 , 7 , 7 , 8 , 9 , 9 , 10 , 9 , 1 , 1 , , 11 ,
      BMC Infectious Diseases
      BioMed Central
      Surveillance, Behavioral surveillance, Zoonotic risk, Human–animal interaction, Risk perception, Coronavirus, Paramyxovirus, Flavivirus, Influenza, Enterovirus

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          Abstract

          Background

          Interactions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts.

          Objective

          This study employed an integrated behavioral–biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures.

          Method

          Participants were enrolled at two community-based sites (n = 472) in eastern and western Thailand and two hospital (clinical) sites (n = 206) in northeastern and central Thailand. A behavioral questionnaire was administered to understand participants’ demographics, living conditions, health history, and animal-contact behaviors and attitudes. Biological specimens were tested for coronaviruses, filoviruses, flaviviruses, influenza viruses, and paramyxoviruses using pan (consensus) RNA Virus assays.

          Results

          Overall 61/678 (9%) of participants tested positive for the viral families screened which included influenza viruses (75%), paramyxoviruses (15%), human coronaviruses (3%), flaviviruses (3%), and enteroviruses (3%). The most salient predictors of reporting unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) in the past year were having other household members who had unusual symptoms and being scratched or bitten by animals in the same year. Many participants reported raising and handling poultry (10.3% and 24.2%), swine (2%, 14.6%), and cattle (4.9%, 7.8%) and several participants also reported eating raw or undercooked meat of these animals (2.2%, 5.5%, 10.3% respectively). Twenty four participants (3.5%) reported handling bats or having bats in the house roof. Gender, age, and livelihood activities were shown to be significantly associated with participants’ interactions with animals. Participants’ knowledge of risks influenced their health-seeking behavior.

          Conclusion

          The results suggest that there is a high level of interaction between humans, livestock, and wild animals in communities at sites we investigated in Thailand. This study highlights important differences among demographic and occupational risk factors as they relate to animal contact and zoonotic disease risk, which can be used by policymakers and local public health programs to build more effective surveillance strategies and behavior-focused interventions.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12879-022-07439-7.

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          Most cited references83

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          A SARS-CoV-2 surrogate virus neutralization test based on antibody-mediated blockage of ACE2–spike protein–protein interaction

          A robust serological test to detect neutralizing antibodies to SARS-CoV-2 is urgently needed to determine not only the infection rate, herd immunity and predicted humoral protection, but also vaccine efficacy during clinical trials and after large-scale vaccination. The current gold standard is the conventional virus neutralization test requiring live pathogen and a biosafety level 3 laboratory. Here, we report a SARS-CoV-2 surrogate virus neutralization test that detects total immunodominant neutralizing antibodies targeting the viral spike (S) protein receptor-binding domain in an isotype- and species-independent manner. Our simple and rapid test is based on antibody-mediated blockage of the interaction between the angiotensin-converting enzyme 2 (ACE2) receptor protein and the receptor-binding domain. The test, which has been validated with two cohorts of patients with COVID-19 in two different countries, achieves 99.93% specificity and 95-100% sensitivity, and differentiates antibody responses to several human coronaviruses. The surrogate virus neutralization test does not require biosafety level 3 containment, making it broadly accessible to the wider community for both research and clinical applications.
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            Bats are natural reservoirs of SARS-like coronaviruses.

            Severe acute respiratory syndrome (SARS) emerged in 2002 to 2003 in southern China. The origin of its etiological agent, the SARS coronavirus (SARS-CoV), remains elusive. Here we report that species of bats are a natural host of coronaviruses closely related to those responsible for the SARS outbreak. These viruses, termed SARS-like coronaviruses (SL-CoVs), display greater genetic variation than SARS-CoV isolated from humans or from civets. The human and civet isolates of SARS-CoV nestle phylogenetically within the spectrum of SL-CoVs, indicating that the virus responsible for the SARS outbreak was a member of this coronavirus group.
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              Risk factors for human disease emergence.

              A comprehensive literature review identifies 1415 species of infectious organism known to be pathogenic to humans, including 217 viruses and prions, 538 bacteria and rickettsia, 307 fungi, 66 protozoa and 287 helminths. Out of these, 868 (61%) are zoonotic, that is, they can be transmitted between humans and animals, and 175 pathogenic species are associated with diseases considered to be 'emerging'. We test the hypothesis that zoonotic pathogens are more likely to be associated with emerging diseases than non-emerging ones. Out of the emerging pathogens, 132 (75%) are zoonotic, and overall, zoonotic pathogens are twice as likely to be associated with emerging diseases than non-zoonotic pathogens. However, the result varies among taxa, with protozoa and viruses particularly likely to emerge, and helminths particularly unlikely to do so, irrespective of their zoonotic status. No association between transmission route and emergence was found. This study represents the first quantitative analysis identifying risk factors for human disease emergence.
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                Author and article information

                Contributors
                olival@ecohealthalliance.org
                Journal
                BMC Infect Dis
                BMC Infect Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                16 May 2022
                16 May 2022
                2022
                : 22
                : 472
                Affiliations
                [1 ]GRID grid.420826.a, ISNI 0000 0004 0409 4702, EcoHealth Alliance, ; New York, NY USA
                [2 ]GRID grid.412660.7, ISNI 0000 0001 0723 0579, Department of Biology, Faculty of Science, , Ramkhamhaeng University, ; Bangkok, Thailand
                [3 ]Wildlife Conservation Society, Viet Nam Country Program, Ha Noi, Viet Nam
                [4 ]GRID grid.269823.4, ISNI 0000 0001 2164 6888, Wildlife Conservation Society, , Health Program, ; Bronx, NY USA
                [5 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Division of Infectious Diseases, Faculty of Medicine, , Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, Chulalongkorn University, ; Bangkok, Thailand
                [6 ]Loei Hospital, Loei, Thailand
                [7 ]The Office of Disease Prevention and Control 5, Ratchaburi, Thailand
                [8 ]Wat-Luang Health Promoting Hospital, Phanat Nikhom, Chonburi, Thailand
                [9 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Thai Red Cross Emerging Infectious Diseases-Health Science Centre, Faculty of Medicine, World Health Organization Collaborating Centre for Research and Training On Viral Zoonoses, Chulalongkorn Hospital, Chulalongkorn University, ; Bangkok, Thailand
                [10 ]GRID grid.201075.1, ISNI 0000 0004 0614 9826, The Henry M. Jackson Foundation for the Advancement of Military Medicine, ; Bethesda, MD USA
                [11 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, ; Bangkok, Thailand
                Article
                7439
                10.1186/s12879-022-07439-7
                9109443
                35578171
                36ac2557-8515-4237-92c6-652f10bfcdc2
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 12 August 2021
                : 27 April 2022
                Funding
                Funded by: National Institute of Allergy and Infectious Diseases
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award ID: U01AI151797
                Award Recipient :
                Funded by: United States Agency for International Development
                Award ID: AID-OAA-A-14-00102
                Award ID: AID-OAA-A-14-00102
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                Award ID: AID-OAA-A-14-00102
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                Award ID: AID-OAA-A-14-00102
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                Award ID: AID-OAA-A-14-00102
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                Award ID: AID-OAA-A-14-00102
                Award ID: AID-OAA-A-14-00102
                Award ID: AID-OAA-A-14-00102
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                Award ID: AID-OAA-A-14-00102
                Award Recipient :
                Categories
                Research
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                © The Author(s) 2022

                Infectious disease & Microbiology
                surveillance,behavioral surveillance,zoonotic risk,human–animal interaction,risk perception,coronavirus,paramyxovirus,flavivirus,influenza,enterovirus

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