Climate determines transmission hotspots of Polycystic Echinococcosis, a life-threatening zoonotic disease, across Pan-Amazonia

San-José, Adrià; Mayor, Pedro; Carvalho, Bruno; El Bizri, Hani R; Antunes, André Pinassi; Antunez Correa, Miguel; Aquino, Rolando; Bodmer, Richard E; Boubli, Jean P; Carvalho, Elildo A R; Campos-Silva, João Vitor; Constantino, Pedro A L; de Paula, Milton José; Desbiez, Arnauld L J; Fang, Tula; Gómez-Puerta, Luis A; Knoop, Simon B.; Longin, Guillaume; Morcatty, Thais Q.; Maranhão, Louise; Massocato, Gabriel Favero; Munari, Daniel P.; Nunes, André Valle; Puertas, Pablo; Oliveira, Marcela A; Pezzuti, Juarez C B; Richard-Hansen, Cécile; Santos, Geovanna; Valsecchi, João; von Mühlen, Eduardo M; Bosmediano, John; Rodó, Xavier; Knoop, Simon B; Morcatty, Thais Q; Munari, Daniel P

Abstract

Polycystic Echinococcosis (PE), a neglected life-threatening zoonotic disease caused by the cestode is endemic in the Amazon. Despite being treatable, PE reaches a case fatality rate of around 29% due to late or missed diagnosis. PE is sustained in Pan-Amazonia by a complex sylvatic cycle. The hunting of its infected intermediate hosts (especially the lowland paca ) enables the disease to further transmit to humans, when their viscera are improperly handled. In this study, we compiled a unique dataset of host occurrences (~86000 records) and disease infections (~400 cases) covering the entire Pan-Amazonia and employed different modeling and statistical tools to unveil the spatial distribution of PE's key animal hosts. Subsequently, we derived a set of ecological, environmental, climatic, and hunting covariates that potentially act as transmission risk factors and used them as predictors of two independent Maximum Entropy models, one for animal infections and one for human infections. Our findings indicate that temperature stability promotes the sylvatic circulation of the disease. Additionally, we show how El Niño-Southern Oscillation (ENSO) extreme events disrupt hunting patterns throughout Pan-Amazonia, ultimately affecting the probability of spillover. In a scenario where climate extremes are projected to intensify, climate change at regional level appears to be indirectly driving the spillover of . These results hold substantial implications for a wide range of zoonoses acquired at the wildlife-human interface for which transmission is related to the manipulation and consumption of wild meat, underscoring the pressing need for enhanced awareness and intervention strategies.

• Journal Article Type: Article
• Acceptance Date: Jun 28, 2023
• Online Publication Date: Aug 7, 2023
• Publication Date: Aug 15, 2023
• Deposit Date: Aug 31, 2023
• Publicly Available Date: Aug 31, 2023
• Journal: Proceedings of the National Academy of Sciences of the United States of America
• Print ISSN: 1091-6490
• Publisher: National Academy of Sciences
• Peer Reviewed: Peer Reviewed
• Volume: 120
• Issue: 33
• Pages: e2302661120
• DOI: https://doi.org/10.1073/pnas.2302661120
• Keywords: Zoonoses - epidemiology, zoonotic diseases, Humans, ENSO, Risk Factors, climate change, modeling, Echinococcosis - epidemiology, Echinococcus, El Nino-Southern Oscillation, Disease Hotspot, Animals, zoonotic spillover