Clonal outbreak of Plasmodium falciparum infection in eastern Panama.

J Infect Dis
Authors
Keywords
Abstract

Identifying the source of resurgent parasites is paramount to a strategic, successful intervention for malaria elimination. Although the malaria incidence in Panama is low, a recent outbreak resulted in a 6-fold increase in reported cases. We hypothesized that parasites sampled from this epidemic might be related and exhibit a clonal population structure. We tested the genetic relatedness of parasites, using informative single-nucleotide polymorphisms and drug resistance loci. We found that parasites were clustered into 3 clonal subpopulations and were related to parasites from Colombia. Two clusters of Panamanian parasites shared identical drug resistance haplotypes, and all clusters shared a chloroquine-resistance genotype matching the pfcrt haplotype of Colombian origin. Our findings suggest these resurgent parasite populations are highly clonal and that the high clonality likely resulted from epidemic expansion of imported or vestigial cases. Malaria outbreak investigations that use genetic tools can illuminate potential sources of epidemic malaria and guide strategies to prevent further resurgence in areas where malaria has been eliminated.

Year of Publication
2015
Journal
J Infect Dis
Volume
211
Issue
7
Pages
1087-96
Date Published
2015 Apr 01
ISSN
1537-6613
URL
DOI
10.1093/infdis/jiu575
PubMed ID
25336725
PubMed Central ID
PMC4366603
Links
Grant list
R01A1077558 / PHS HHS / United States
R01 AI106734 / AI / NIAID NIH HHS / United States
T32 AI049928 / AI / NIAID NIH HHS / United States
U19 AI089702 / AI / NIAID NIH HHS / United States
5U19AI089702 / AI / NIAID NIH HHS / United States