Four rodent-borne arenaviruses are known to cause hemorrhagic fever in the New World. These include Junin, Machupo, Guanarito, and Sabia viruses, which are found in rural areas of Argentina, Bolivia, Venezuela, and Brazil, respectively. In December 2003 and January 2004, a small number of hemorrhagic fever cases were reported in rural Bolivia in an area outside the known Machupo HF endemic zone, and sera from one fatal case was available for laboratory testing. The man had symptoms similar to those seen with other arenaviral hemorrhagic fever cases acute febrile illness beginning with headache, joint and muscle pain, and vomiting and rapidly progressed to shock, bleeding, and death at 14 days post onset of illness. Virus was isolated from two of the patient’s serum samples and identified as an arenavirus by reaction of virus infected cells with arenavirus-specific antibodies and by genetic detection techniques (PCR).
A team consisting of Bolivian health authorities, U.S. Navy health experts based in Lima, Peru, and the U.S. Centers for Disease Control and Prevention has now characterized Chapare arenavirus, a previously unrecognized arenavirus, discovered in serum samples from this patient in rural Bolivia. Named after the Chapare River in the eastern foothills of the Andes, the new Chapare arenavirus produces clinical hemorrhagic symptoms similar to those associated with other New World arenaviruses, such as the Junin, Machupo, Guanarito, and Sabia viruses. Genetically, however, Chapare is different from each. Junin, Machupo and Guanarito viruses have been associated with large outbreaks of hemorrhagic fever. Initial symptoms often include fever, malaise, muscle aches, nausea, vomiting, and anorexia, followed later by hemorrhagic symptoms. Untreated, more severe neurologic and/or hemorrhagic symptoms may develop, and death occurs in up to 30%. In this study, the authors first tested for yellow fever and dengue hemorrhagic fevers, but results were negative. Tests for Machupo and other related viruses also were negative. Sequence analysis of specific segments of the virus later confirmed it as a unique member of the Clade B New World Arenaviruses. Due to the remote nature of the region where the case occurred, only a limited description of a possible cluster of cases in the area was determined.
Further surveillance and ecological investigations should clarify the nature of the health threat posed by the Chapare virus, and give us better information on the source of human infection, says CDC virologist Tom Ksiazek of the Special Pathogens Branch. We need to learn more about this virus: how it is related to the other arenaviruses, how it causes disease, where it lives in nature, says Ksiazek. Together with our colleagues in Bolivia and Peru, we’re anticipating a more intensive investigation that improves our understanding of the virus, the disease it causes, and its ecology.
Chapare Virus, a Newly Discovered Arenavirus Isolated from a Fatal Hemorrhagic Fever Case in Bolivia
PLoS Pathog 4(4): 2008 e100004
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