title: Emerging Viruses in the Republic of Suriname: Retrospective and Prospective Study into Chikungunya Circulation and Suspicion of Human Hantavirus Infections, 2008-2012 and 2014.
abstract: BACKGROUND
  Suriname is a country on the northeastern Atlantic coast of South America. It is unique in the sense that different ethnic cultures live together within the country, resulting in high levels of transport of both humans and products between the Asian, African, and European continents as well as the Caribbean. Travel is only one of the many factors present in Suriname contributing to the risk for the emergence or introduction of any infectious disease. Recently, circulation of both chikungunya virus (CHIKV) and hantavirus was reported in areas neighboring Suriname. Here we report a retrospective and prospective study into chikungunya and hantavirus circulation.
  
  
  METHODS
  A chikungunya and hantavirus retrospective serological study was conducted on samples submitted for dengue, leptospirosis, and/or influenza virus diagnostics between 2008 and 2012 to the Bureau of Public Health in Suriname. This was followed by a prospective CHIKV serological and molecular surveillance study until the detection of the first autochthonous CHIKV cases in Suriname in May and June of 2014.
  
  
  RESULTS
  None of the tested samples showed the presence of CHIKV antibodies in the retrospective serological study. Prospective testing of CHIKV-suspected patients resulted in the detection of the first autochthonous CHIKV cases in Suriname in May, 2015. In one sample, we were able to isolate and sequence the virus. Retrospective testing for the presence of hantavirus antibodies showed a relative high response in both pan-hantavirus enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). However, neutralization tests did not yield any evidence for infection with either Seoul or Andes hantavirus.
  
  
  CONCLUSIONS
  Here we report the presence of CHIKV in the republic of Suriname and the first serological indication of hantavirus infections in symptomatic patients.
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .
authors.forename: Marco
authors.initials: M
authors.lastname: Goeijenbier
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .
authors.forename: Georgina
authors.initials: G
authors.lastname: Aron
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .|2 Faculty of Medicine, University of Indonesia , Jakarta, Indonesia .
authors.forename: Fatih
authors.initials: F
authors.lastname: Anfasa
authors.affiliation: 3 Department of Medical Biochemistry and Microbiology, Zoonoses Science Centre, Uppsala University , Sweden .|4 Public Health Agency of Sweden , Solna, Sweden .
authors.forename: Åke
authors.initials: Å
authors.lastname: Lundkvist
authors.affiliation: 3 Department of Medical Biochemistry and Microbiology, Zoonoses Science Centre, Uppsala University , Sweden .|4 Public Health Agency of Sweden , Solna, Sweden .
authors.forename: Jenny
authors.initials: J
authors.lastname: Verner-Carlsson
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .
authors.forename: Chantal B E M
authors.initials: CB
authors.lastname: Reusken
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .|5 ARTEMIS One Health Research Institute , Utrecht, The Netherlands .
authors.forename: Byron E E
authors.initials: BE
authors.lastname: Martina
authors.affiliation: 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .
authors.forename: Eric C M
authors.initials: EC
authors.lastname: van Gorp
authors.affiliation: 6 Bureau of Public Health (BOG) , Paramaribo, Suriname .
authors.forename: Lesley
authors.initials: L
authors.lastname: Resida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology*; D065632:Chikungunya Fever / Q000453:epidemiology* / Q000821:virology; D002646:Chikungunya virus / Q000276:immunology* / Q000302:isolation & purification; D002648:Child; D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006476:Orthohantavirus / Q000276:immunology* / Q000302:isolation & purification; D018778:Hantavirus Infections / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013532:Suriname / Q000453:epidemiology; D014195:Travel; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
keywords: Chikungunya; Emerging infectious diseases; Hantavirus; Hemorrhagic fever; Suriname