11 HK Monkeys died from Melioidosis

[Torres, Alfredo G.]

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[Torres, Alfredo G.]

12 monkeys dead and counting

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On Oct 22, 2024, at 5:45 AM, Torres, Alfredo G. <alto...@utmb.edu> wrote:



[Bart Currie]

Thanks Alfredo

Colleagues from Hong Kong presenting the latest on this outbreak as a late late breaker at WMC this afternoon.

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From: melio...@googlegroups.com <melio...@googlegroups.com> on behalf of Torres, Alfredo G. <alto...@utmb.edu>
Sent: Wednesday, October 23, 2024 9:21:07 AM
To: melio...@googlegroups.com <melio...@googlegroups.com>
Subject: EXTERNAL: [Melioidosis] Re: 11 HK Monkeys died from Melioidosis

 

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[Torres, Alfredo G.]

Fantastic 

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On Oct 23, 2024, at 1:37 PM, Bart Currie <Bart....@menzies.edu.au> wrote:



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Thanks Alfredo

Colleagues from Hong Kong presenting the latest on this outbreak as a late late breaker at WMC this afternoon.

Get Outlook for iOS

---

From: melio...@googlegroups.com <melio...@googlegroups.com> on behalf of Torres, Alfredo G. <alto...@utmb.edu>
Sent: Wednesday, October 23, 2024 9:21:07 AM
To: melio...@googlegroups.com <melio...@googlegroups.com>
Subject: EXTERNAL: [Melioidosis] Re: 11 HK Monkeys died from Melioidosis

 

12 monkeys dead and counting

<image.png>

Sent from my iPhone

On Oct 22, 2024, at 5:45 AM, Torres, Alfredo G. <alto...@utmb.edu> wrote:



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[Ivan Wong]

Hi, this is Ivan from Hong Kong.

I wanted to provide an update on the recent melioidosis cases in monkeys in Hong Kong. Fortunately, the death toll has not risen beyond the initial 12 cases. All isolates obtained so far have been sequence type 46 (ST46).

Intriguingly, ST46 has not been identified in Hong Kong previously to my knowledge. However, it is frequently reported in Hainan province of China and Southeast Asian countries like Malaysia. ST46 has also emerged as a dominant sequence type in veterinary melioidosis cases, especially in Southeast Asia. Additionally, ST46 genomes uploaded to PubMLST from Australia and New Zealand were linked to travel to South/Southeast Asia.

This evidence suggests further investigation into food or products imported from Southeast Asia/South China for the park may be warranted. I will be sure to provide any updates as we learn more. For now, that is the extent of our information.

In closing, thank you to the organizers for arranging WMC2024 and fostering global melioidosis collaboration and knowledge exchange. I look forward to continuing to learn from all of you.

[David Dance]

Thanks for the update Ivan.  It is intriguing, and of course tragic.  I wish you luck in your search for the ‘smoking gun’.

 

Great to meet you all in Darwin.

 

David

To view this discussion visit https://groups.google.com/d/msgid/melioidosis/308cc937-9e00-47e5-a129-8de94570bb69n%40googlegroups.com.

[Lek]

Hi Ivan,

Thank you. It’s a relief that the death toll hasn’t increased beyond the initial 12 cases, though the emergence of ST46 in Hong Kong is indeed intriguing.

The frequent identification of ST46 in Hainan, Malaysia, and across Southeast Asia, along with its presence in veterinary cases, certainly supports the idea of investigating potential sources linked to imports from these regions. This could shed more light on possible exposure routes and contribute to understanding ST46’s spread patterns.

I appreciate your diligence in keeping us updated, and I agree that the recent WMC2024 provided an invaluable platform for fostering these important exchanges.

Looking forward to learning more as we continue this work together.

Best regards,
Lek

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From: melio...@googlegroups.com <melio...@googlegroups.com> on behalf of David Dance <Dav...@tropmedres.ac>
Sent: 31 October 2024 14:59
To: melio...@googlegroups.com <melio...@googlegroups.com>

To view this discussion visit https://groups.google.com/d/msgid/melioidosis/27E6878F-A9D2-4820-9243-3EB85ADB2E49%40tropmedres.ac.

[Ivan Wong]

Dear all,

For those who followed the discussion during the World Melioidosis Congress last October, I'm writing to provide a final update on the melioidosis outbreak that occurred in monkeys at a Hong Kong zoo.

I am pleased to share that our team's investigation has now been published as a Dispatch in Emerging Infectious Diseases. You can access the full paper here:
[https://wwwnc.cdc.gov/eid/article/31/9/25-0823_article]

The key findings from our investigation are:

• A Single, Clonal Source:
  The outbreak was caused by a single clonal strain of B. pseudomallei (with only 0–1 cgSNP difference between isolates), confirming a point-source exposure.
• Sequence Type 46:
  All isolates were ST46, a sequence type not previously reported in Hong Kong.
• Phylogenetic Links:
  The outbreak strain's closest relatives were from Hainan, China (18 cgSNPs), followed by strains from Australia (27 cgSNPs) and Thailand (31 cgSNPs).
• Unidentified Source:
  Despite extensive environmental sampling, the ultimate source of the infection remains unidentified.

The initial discussion and insights shared on this email loop were greatly appreciated as we began our investigation.
I look forward to continuing the conversation and hopefully seeing many of you at the upcoming South Asian Melioidosis Congress (SAMC 2025).

All the best,
Ivan

[Susie Dunachie]

Dear Ivan

Many thanks for your update on your thorough investigation and congratulations on the nice EID report

Very best wishes

Susie

 

To view this discussion visit https://groups.google.com/d/msgid/melioidosis/c76a8495-f5ff-4d2b-96a8-9888cee9b8f3n%40googlegroups.com.

[Lek]

Dear Ivan et al.,

 

Thank you for sharing this update, and congratulations to you and your team on the publication in EID. Very interesting findings!

I heard you have Super Typhoon Yagi on 5 – 6 September and Waterspout inside the Victoria Harbour on 28 September 2024, Do you think it might be the cause to make 12 monkeys sick?

 

I look forward to more discussions and to seeing you at JITMM 2025.

 

Best regards,
Lek

To view this discussion visit https://groups.google.com/d/msgid/melioidosis/CWXP265MB1384C83E9A56D08C76A56640F630A%40CWXP265MB1384.GBRP265.PROD.OUTLOOK.COM.

[Ivan Wong]

Dear Susie,

Thank you so much for your kind message and congratulations. It's very much appreciated.

Dear Lek,

Thank you for the kind words about the publication and for keeping up with the situation here in Hong Kong. Your email also reminds me to thank you again for visiting and sharing your valuable insights on melioidosis diagnosis with our team; it was very helpful.

Regarding your question about the monkey cases, while we can't confirm the exact cause, our current thinking leans towards ingestion rather than inhalation. This is mainly because the liver and spleen were the most severely affected organs, and the veterinarian suggested hematogenous spread to the lungs was also present. The rapid timeline, with all 12 monkeys succumbing within 10 days, also suggests a single, concentrated exposure event.

That said, we appreciate you raising the potential role of the recent extreme weather, as these events can certainly promote the risk of infection. Unfortunately, the actual source remains unconfirmed for now.

And yes, I am very much looking forward to seeing you at JITMM 2025 and continuing the discussion.

Best regards,

Ivan

[Fazle Rabbi Chowdhury]

This is wonderful. Congratulations on publishing in EID.

All the best wishes.

Regards

Rabbi

To view this discussion visit https://groups.google.com/d/msgid/melioidosis/c76a8495-f5ff-4d2b-96a8-9888cee9b8f3n%40googlegroups.com.

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Dr. Fazle Rabbi Chowdhury

FCPS, FRCP, MSc. (Infectious Disease), D.Phil (OXON)

Associate Professor, Dept. of Internal Medicine, BMU

Deputy Director, NIHR RIGHT4: Preventing Deaths from Acute Poisoning in LMIC 

Research Affiliate, Mahidol Oxford Research Unit (MORU), Thailand

https://scholar.google.co.uk/citations?user=j-8bDJcAAAAJ&hl=en

https://www.ndm.ox.ac.uk/fazle-rabbi-chowdhury

https://www.ed.ac.uk/cardiovascular-science/nihr-acute-poisoning/governance