RESEARCHthe potential for human infection. Macaques have adaptedto urbanized human environments, and contact betweenhumans and macaques can occur in a variety of contexts(e.g., feeding in public recreational areas, capture of wildmacaques for the pet trade or biomedical research colonies,consumption, or population management by wildlifeauthorities). Human–macaque contact can result in bites,scratches, and indirect exposure to macaque body fluids(16,17). Simian foamy virus, a nonpathogenic retrovirusfound in nonhuman primates including macaques, has beentransmitted during occupational exposure to macaques viabites and scratches in many of the aforementioned contextsand in agricultural, suburban, and urban environments (18–20). Zoonotic transmission of simian foamy virus to humanshas been demonstrated in Indonesia (18) and Bangladesh(19). Because exposure to MaHV1 can occur throughsimilar routes (8), its transmission under circumstancessimilar to those of transmission of simian foamy virus inAsia is plausible.In Peninsular Malaysia, conflict between humans andmacaques in residential and public areas results from lossof macaque habitat, successful macaque adaptation to humanenvironments, and subsequent macaque overpopulation.As a result, the Department of Wildlife and NationalParks (DWNP) in Peninsular Malaysia implemented a macaquepopulation management program, which includesthe removal or translocation of macaques from a conflictarea. The possibility of exposure to MaHV1 during macaquecapture and transport presents a potential occupationalhazard to wildlife personnel.Our aim with this study was to describe the prevalenceof MaHV1 shedding among wild-caught long-tailedmacaques after capture and transport in Peninsular Malaysia.This study represents a step toward understandingthe potential for zoonotic transmission of MaHV1 outsidethe laboratory.Materials and MethodsCapture and Sample CollectionIndependently of this study, DWNP, as part of their macaquemanagement program throughout Peninsular Malaysia,captured and transported macaques from 6 states(Johor, Perak, Pahang, Pulau Pinang, Selangor, and NegeriSembilan) to DWNP holding facilities. Capture and opportunisticblood sampling was performed by DWNP andEcoHealth Alliance during September–November 2009,July–October 2010, and July 2011. The macaques capturedhad been free ranging and lived in the peripheral vegetationof rural, suburban, and urban communities in severalstates of Peninsular Malaysia. Trapped animals were transferredinto transport cages and taken to the nearest localDWNP facility, where they were held up to 72 h beforebeing transported to the DWNP headquarters in KualaLumpur or relocated to a new area. Macaques were kept ingroups in cages and provided with food and water throughoutthe holding period. Animals were captured in accordancewith the protocols and guidelines of the Manual forHuman–Macaque Conflict Management in Peninsular Malaysia(21). This study was conducted under InstitutionalAnimal Care and Use Committee approval no. 18048 fromthe University of California (Davis, CA, USA). When handlingand sampling macaques, personnel involved with thisstudy wore personal protective equipment (PPE; e.g., eyeprotection, double-layered nitrile gloves, Tyvek coveralls,and P100 respirators) (22). Blood and swab samples werecollected from each animal at its arrival at the headquartersor at the local DWNP facility before relocation. Macaqueswere immobilized with an intramuscular injection of acombination of 5 mg/kg ketamine and 5 mg/kg xylazine(21). After immobilization, oropharyngeal swab and urogenitalswab samples were collected (when possible, urinewas also collected by cystocentesis). The samples wereplaced in 2 mL cryovials (Nalgene Nunc International,Rochester, NY, USA) with 500 μL NucliSens lysis buffer(bioMérieux, Marcy l’Étoile, France) and immediatelystored at -80°C. Macaque weight, body condition, sex, andapproximate age were recorded. The age of the animalswas determined by assessing their weight, body size, andthe development of their incisors and genitals (23). Macaqueswere categorized as adult (>7 years), subadult (3–6years), or juvenile (1–3 years). The sex and age of 2 animalsand the sex of 1 adult animal were not recorded.Molecular TestingThe samples were vigorously mixed; 100 μL of the samplewas used for mechanical nucleic acid extraction by use ofthe NucliSENS miniMAG system (bioMérieux). The extractednucleic acid was eluted with 60 μL of buffer. PCRwas performed as previously described and validated byScinicariello et al. (13). Briefly, MaHV1 primers (B virus1, 5′-ACCTCACGTACGACTCCGACT-3′; and B virus2, 5′-CTGCAGGACCGAGTAGAGGAT-3′; 2.5 μmol/L)were each added to the extraction product and HotStarTaqPlus Master Mix (QIAGEN, Hilden, Germany). The productwas placed in a thermocyler at 94°C for 5 min and thenunderwent 30 cycles as follows: 94°C for 1 min, 56°C for1 min, and 72°C for 1 min. The products (10 μL) were thenanalyzed by electrophoresis on 1% agarose gels. Of the≈10% of samples that were positive by PCR, 14 PCR productswere randomly selected and purified with a PCR purificationkit (QIAGEN) and sequenced by using the sameprimers to confirm identity. Sequences were 128 bp andwere analyzed by using a BLAST search of GenBank (24).Because PCR is reported to be highly specific (13) and all 14PCR products showed 93%–100% nucleotide homology to1108 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015
Macacine Herpesvirus 1 in Macaques, MalaysiaMaHV1, we considered the other PCR products with identicalamplicon size to also be positive for MaHV1. PCR ismore sensitive than culture for detecting HSV (25,26), andwe considered the detection of MaHV1 DNA in a sampleas an indication of virus shedding, although viral load wasnot obtained through culture or quantitative PCR.The positive control was produced in a BSL-4 facilityand removed from containment by use of inactivationprocedures approved by the Texas Biomedical ResearchInstitute Biohazard Committee. Briefly, macacine herpesvirus1 strain E2490 virion “mini-prep” DNA was generatedas previously described (27). With the same B virus1 and 2 primers, the region between nt 54886 and 54993was amplified by PCR from the viral genome (13) by usingthe FailSafe PCR Enzyme Mix (Epicenter, Madison, WI,USA). This region corresponded to a region in the UL28open reading frame. The resulting 128-nt fragment wascloned into pCR2.1-TOPO by using the TOPO TA kit (Invitrogen,Carlsbad, CA, USA) to generate the pMHUL28gene. The insert was sequenced and confirmed.PCR sensitivity (limit of detection) was determined byusing DNA from pMHUL28 and 2 confirmed-positive samplesby diluting the DNA to copy numbers of 2.71 × 10 4 forpMHUL28 and 1.59 × 10 11 for the samples. The sensitivitylimit for pMHUL28 by PCR was 9.13 × 10 2 molecules, andfor the swab samples it was ≈1 × 10 4 molecules. The PCRsensitivity was previously determined to be ≈100 gene copiesby using purified viral DNA, and specificity was determinedby SacII restriction enzyme analysis and Southernblot hybridization by using an MaHV1-specific internalprobe (5′-GGAGAAGACGTCGCGGTCGTAC-3′) thatdiscriminates MaHV1 from HSV (13).ImmunoassayA subset of 149 animals, randomly chosen to represent eachage group, were tested by the MaHV1 ELISA as describedby Ohsawa et al. (28). Although the exact specificity andsensitivity of the original MaHV1 ELISA was not determined,it had been validated by testing of known MaHV1-positive (n = 14) and negative (n = 6) serum, and the assaycorrectly detected 100% of the positive samples and providednegative results for 100% of the negative samples(R. Eberle, pers. comm., 2013). In brief, MaHV1-infectedand noninfected cell antigens were added to 96-well roundbottomplates and prepared as previously described (28).Wells were blocked with phosphate-buffered saline containing5% bovine serum albumin and 0.05% Tween 20(PBS-BSA-Tw) and were incubated at 37°C for 1 h, thenrinsed with PBS-Tw. Serum samples were diluted to 1:100with PBS-BSA-Tw, added to the plate (50 μL/well), andincubated at room temperature for 2 h. The wells werewashed 5 times with PBS-Tw. Biotinylated anti-humanIgG (Vector Laboratories, Burlingame, CA, USA) wasdiluted 1:5,000 with PBS-BSA-Tw (50 μL/well) and incubatedat room temperature for 1 h. The wells were washed 5times with PBS-Tw. A complex of avidin and biotinylatedperoxidase was prepared according to the manufacturer’sinstructions, diluted to 1:32, added to washed wells (50μL/well), and incubated at room temperature for 1 h. Thewells were washed 5 times with PBS-Tw. A 3,3′,5,5′-tetramethylbenzidinesubstrate solution was added (100 μL/well), and the plates were incubated without light for 8–12min. The reaction was stopped with 2 mol/L sulfuric acid(50 μL/well), and the optical density at 450 nm was measuredby using a microplate absorbance reader (Bio-RadLaboratories, Hercules, CA, USA). An ELISA result wasconsidered positive when the optical density was >0.1 (28).Statistical AnalysesWe calculated standard prevalence rates and 95% CIs (29)for differences in shedding prevalence based on macaquesample type, sex, and age. For pairwise analysis (2 parameters)of proportions, we conducted a z-test. A general linearmodel was used to investigate the effect of geographiclocation by state, sex, and age, and the Akaike InformationCriterion was used to select the best-fit model (with nosignificant interactions between the variables). An analysisof variance of the general linear model with a post hocTukey HSD (honest significant difference) test was used toassess the significance of each factor. Statistical analyseswere conducted by using the R Statistical package (R CoreTeam, Vienna, Austria). A p value of
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LETTERSInfluenza A(H5N6)Virus Reass
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