title: Complex epidemiology of a zoonotic disease in a culturally diverse region: phylogeography of rabies virus in the Middle East.
abstract: The Middle East is a culturally and politically diverse region at the gateway between Europe, Africa and Asia. Spatial dynamics of the fatal zoonotic disease rabies among countries of the Middle East and surrounding regions is poorly understood. An improved understanding of virus distribution is necessary to direct control methods. Previous studies have suggested regular trans-boundary movement, but have been unable to infer direction. Here we address these issues, by investigating the evolution of 183 rabies virus isolates collected from over 20 countries between 1972 and 2014. We have undertaken a discrete phylogeographic analysis on a subset of 139 samples to infer where and when movements of rabies have occurred. We provide evidence for four genetically distinct clades with separate origins currently circulating in the Middle East and surrounding countries. Introductions of these viruses have been followed by regular and multidirectional trans-boundary movements in some parts of the region, but relative isolation in others. There is evidence for minimal regular incursion of rabies from Central and Eastern Asia. These data support current initiatives for regional collaboration that are essential for rabies elimination.
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom; School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom.
authors: Daniel L
authors: DL
authors: Horton
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
authors: Lorraine M
authors: LM
authors: McElhinney
authors: Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany.
authors: Conrad M
authors: CM
authors: Freuling
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom.
authors: Denise A
authors: DA
authors: Marston
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom.
authors: Ashley C
authors: AC
authors: Banyard
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom.
authors: Hooman
authors: H
authors: Goharrriz
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom.
authors: Emma
authors: E
authors: Wise
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom.
authors: Andrew C
authors: AC
authors: Breed
authors: Rocky Mountain Laboratories (NIAID, NIH), Hamilton, Montana, United States of America; Formerly USAPHCR-Europe Laboratory Sciences, Veterinary Pathology, Landstuhl, Germany.
authors: Greg
authors: G
authors: Saturday
authors: Institute of Virology, University of Veterinary Medicine Vienna, Vienna, Austria.
authors: Jolanta
authors: J
authors: Kolodziejek
authors: Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
authors: Erika
authors: E
authors: Zilahi
authors: Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
authors: Muhannad F
authors: MF
authors: Al-Kobaisi
authors: Institute of Virology, University of Veterinary Medicine Vienna, Vienna, Austria; Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
authors: Norbert
authors: N
authors: Nowotny
authors: Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany.
authors: Thomas
authors: T
authors: Mueller
authors: Animal and Plant Health Agency, New Haw, Addlestone, Surrey, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
authors: Anthony R
authors: AR
authors: Fooks
mesh_terms: D000818:Animals; D019143:Evolution, Molecular; D006801:Humans; D008877:Middle East / Q000453:epidemiology; D058974:Phylogeography; D011818:Rabies / Q000453:epidemiology*; D011820:Rabies virus / Q000235:genetics*; D015047:Zoonoses / Q000453:epidemiology*