Molecular Investigation into a Malaria Outbreak in Cusco, Peru: Plasmodium falciparum BV1 Lineage is Linked to a Second Outbreak in Recent Times

Sheila Akinyi Okoth Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Stella M. Chenet Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Nancy Arrospide Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Sonia Gutierrez Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Cesar Cabezas Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Jose Antonio Matta Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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Venkatachalam Udhayakumar Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Atlanta Research and Education Foundation, Atlanta, Georgia; Instituto Nacional de Salud del Peru, Lima, Peru; Laboratorio de Referencia de La Convención, Cusco, Peru

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DOI:
https://doi.org/10.4269/ajtmh.15-0442
Volume/Issue:
Volume 94: Issue 1
Page(s):
128–131
Restricted access
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In November 2013, a Plasmodium falciparum malaria outbreak of 11 cases occurred in Cusco, southern Peru, where falciparum malaria had not been reported since 1946. Although initial microscopic diagnosis reported only Plasmodium vivax infection in each of the specimens, subsequent examination by the national reference laboratory confirmed P. falciparum infection in all samples. Molecular typing of four available isolates revealed identity as the B-variant (BV1) strain that was responsible for a malaria outbreak in Tumbes, northern Peru, between 2010 and 2012. The P. falciparum BV1 strain is multidrug resistant, can escape detection by PfHRP2-based rapid diagnostic tests, and has contributed to two malaria outbreaks in Peru. This investigation highlights the importance of accurate species diagnosis given the potential for P. falciparum to be reintroduced to regions where it may have been absent. Similar molecular epidemiological investigations can track the probable source(s) of outbreak parasite strains for malaria surveillance and control purposes.

Author Notes

* Address correspondence to Sheila Akinyi Okoth, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, MS D-67, Atlanta, GA 30329-4027. E-mail: jyo3@cdc.gov

Financial support: Sheila Akinyi Okoth was supported by the Atlanta Research and Education Foundation. Stella M. Chenet was supported by the American Society of Microbiology/CDC Postdoctoral Fellowship Program. We acknowledge the support of the CDC Antimicrobial Resistance Working Group and the Atlanta Research and Education Foundation for the investigation.

Authors' addresses: Sheila Akinyi Okoth and Stella M. Chenet, Division of Parasitic Diseases and Malaria, CDC, Atlanta, GA, E-mails: jyo3@cdc.gov and ynw0@cdc.gov. Nancy Arrospide, Sonia Gutierrez, and Cesar Cabezas, Instituto Nacional de Salud del Peru, Centro Nacional de Salud Publica, Lima, Peru, E-mails: narrospide@hotmail.com, scgg68@hotmail.com, and salljaruna@yahoo.com. Jose Antonio Matta, Laboratorio de Referencia de La Convención, Cusco, Peru, E-mail: antonio_matta@hotmail.com. Venkatachalam Udhayakumar, Division of Parasitic Diseases and Malaria, Atlanta, GA, E-mail: vxu0@cdc.gov.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2016
Received:
16 Jun 2015
|
Accepted:
29 Aug 2015
|
Published Online:
06 Jan 2016
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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