Molecular Investigation into a Malaria Outbreak in Cusco, Peru: Plasmodium falciparum BV1 Lineage is Linked to a Second Outbreak in Recent Times.
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.
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 jyo3@cdc.gov.
Sheila Akinyi
SA
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.
Stella M
SM
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.
Nancy
N
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.
Sonia
S
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.
Cesar
C
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.
Jose Antonio
JA
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.
Venkatachalam
V
Udhayakumar
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D002675:Child, Preschool; D004196:Disease Outbreaks; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D010568:Peru / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D013045:Species Specificity; D055815:Young Adult
D000962:Antimalarials