Differential Yellow Fever Susceptibility in New World Nonhuman Primates, Comparison with Humans, and Implications for Surveillance
Natália Coelho Couto de Azevedo Fernandes, Juliana Mariotti Guerra, Josué Díaz‐Delgado, Mariana Sequetin Cunha, Leila delC. Saad, Silvia D’Andretta Iglezias, Rodrigo Albergaria Réssio, Cinthya dos Santos Cirqueira, Cristina Takami Kanamura, Ísis Paixão de Jesus, Adriana Yurika Maeda, Fernanda Gisele Silva Vasami, Júlia de Carvalho, Leonardo José Tadeu de Araújo, Renato Pereira de Souza, Juliana Silva Nogueira, Roberta Maria Fernandes Spínola, José Luiz Catão‐Dias
Abstract
A major outbreak of yellow fever (YF) occurred in Brazil during 2016-2018. Epizootics in New World nonhuman primates are sentinel events for YF virus circulation. However, genus-specific susceptibilities and suitability for YF surveillance remain poorly understood. We obtained and compared epidemiologic, histopathologic, immunohistochemical, and molecular results from 93 human and 1,752 primate cases submitted during the recent YF outbreak in Brazil (2017), with the support of the Brazilian National YF Surveillance Program. We detected heterogeneous YF-associated profiles among the various genera of primates we analyzed. Alouatta primates were the most reliable sentinel; Sapajus and Callicebus primates had higher viral loads but lower proportional mortality rates. Callithrix primates were the least sensitive, showing lower viral loads, lower proportional mortality rates, and no demonstrable YF virus antigen or extensive lesions in liver, despite detectable viral RNA. These differences in susceptibility, viral load, and mortality rates should be considered in strategic surveillance of epizootics and control measures for YF.