Seoul Virus Infection and Spread in United States Home-Based Ratteries: Rat and Human Testing Results From a Multistate Outbreak Investigation
Barbara Knust, Shelley Brown, Annabelle de St. Maurice, Shannon Whitmer, Sarah E Koske, Elizabeth Ervin, Ketan Patel, James Graziano, Maria Morales-Betoulle, Jennifer House, Deborah Cannon, Janna L. Kerins, Stacy Holzbauer, Connie Austin, Suzanne Gibbons-Burgener, Leah Colton, John R. Dunn, Sara Zufan, Mary Joung Choi, William R. Davis, Cheng‐Feng Chiang, Craig Manning, Linda Roesch, Trevor Shoemaker, Lawrence J. Purpura, Jennifer H. McQuiston, Dallin Peterson, Rachel Radcliffe, Ann Garvey, Ellen Christel, Laura Morgan, Joni Scheftel, James J. Kazmierczak, John D. Klena, Stuart T. Nichol, Pierre E. Rollin, the Multistate Seoul Virus Outbreak Investigation Team, Dee Jones, Susan P. Weinstein, Peter Buck, Casey Barton Behravesh, Sarah C. Genzer, Eddie Jackson, Jenks M. Harley, Gregory Langham, George D. Lathrop, Nishi Patel, Nathaniel Powell, Anne Straily, Ute Ströher, Natalie S. Marzec, Nhiem Luong, Danielle Stanek, Julie Gabel, Kris Carter, Jodi Lovejoy, Jennifer L. Brown, Betsy Schroeder, Jennifer E. Layden, Gary Balsamo, David Blythe, Caroline Castillo, Jennifer L. Sidge, Mary Grace Stobierski, Victoria Hall, Malia Ireland, Kimberly Signs, Howard Pue, Colin Campbell, Jill Baber, Laura Cronquist, Michelle Feist, Susan Keller, Amber Singh, Karen Gowdy, Dean Middleton, J. D. Achenbach, Drew D. Dycus, Aaron Smee, André Weltman, Mary Margaret Fill, Heather Henderson, Timothy B. Jones, Andrew Stephen May, Heather Mullins, Tom Sidwa, Allyn K. Nakashima, Dennis Foelker, Jordan L Dieckman, Rachel Klos, Anna Kocharian
Abstract
BACKGROUND: During 2017, a multistate outbreak investigation occurred after the confirmation of Seoul virus (SEOV) infections in people and pet rats. A total of 147 humans and 897 rats were tested. METHODS: In addition to immunoglobulin (Ig)G and IgM serology and traditional reverse-transcription polymerase chain reaction (RT-PCR), novel quantitative RT-PCR primers/probe were developed, and whole genome sequencing was performed. RESULTS: Seventeen people had SEOV IgM, indicating recent infection; 7 reported symptoms and 3 were hospitalized. All patients recovered. Thirty-one facilities in 11 US states had SEOV infection, and among those with ≥10 rats tested, rat IgG prevalence ranged 2%-70% and SEOV RT-PCR positivity ranged 0%-70%. Human laboratory-confirmed cases were significantly associated with rat IgG positivity and RT-PCR positivity (P = .03 and P = .006, respectively). Genomic sequencing identified >99.5% homology between SEOV sequences in this outbreak, and these were >99% identical to SEOV associated with previous pet rat infections in England, the Netherlands, and France. Frequent trade of rats between home-based ratteries contributed to transmission of SEOV between facilities. CONCLUSIONS: Pet rat owners, breeders, and the healthcare and public health community should be aware and take steps to prevent SEOV transmission in pet rats and to humans. Biosecurity measures and diagnostic testing can prevent further infections.