Retrospective study of Oestrus ovis larvae infestation in small ruminants in Grenada, West Indies.

Oestrosis is a nasal cavity myiasis caused by Oestrus ovis larvae from Oetrus ovis diptera flies in small ruminants. The presence of the larvae in the nasal cavity is known to cause rhinitis and sinusitis which can negatively impact the productivity of small ruminants. The aim of the present study was to estimate the prevalence of Oestrus ovis larvae infestation in sheep and goats presented for necropsy. We reviewed necropsy records of sheep and goats submitted to the Veterinary Pathology diagnostic laboratory at St. George's University from 2001 to 2017. Out of 104 goat necropsy cases, Oestrus ovis larvae were observed in 8 goats giving a prevalence of 7.7% (95% confidence interval (CI):3.38% to 14.6%). Similarly, from the 47 sheep necropsies, Oestus ovis larvae were observed in 4 sheep (8.5%) (95% CI: 2.83% to 20.46%). There was no significant difference in Oestrus ovis larvae infestation rates between sheep and goats (p = 1.000, Fisher's exact test). Oestrosis was an incidental finding in all the small ruminants examined at necropsy. This is the first report on Oestrus ovis larvae infestation in small ruminants in Grenada.

Spare the rod, spoil the child: measurement and learning from an intervention to shift corporal punishment attitudes and behaviors in Grenada, West Indies.

Childrearing practices in the Caribbean and other postcolonial states have long been associated with corporal punishment and are influenced by expectations of children for respectfulness and obedience. Evidence across settings shows that physical punishment of young children is both ineffective and detrimental. Saving Brains Grenada (SBG) implemented a pilot study of an intervention based on the Conscious Discipline curriculum that aimed to build adult caregivers' skills around non-violent child discipline. We hypothesized that attitudes towards corporal punishment would shift to be negative as adults learned more positive discipline methods, and that child neurodevelopment would correspondingly improve. This report reviews the impact of monitoring and evaluation on the design and implementation of the intervention. Study 1 presents findings from the pilot study. Despite positive gains in neurodevelopmental outcomes among children in the intervention compared to controls, attitudes towards corporal punishment and reported use of it did not change. Additionally, several internal conflicts in the measures used to assess corporal punishment behaviors and attitudes were identified. Study 2 is a response to learning from Study 1 and highlights the importance for monitoring and evaluation to be data-informed, adaptive, and culturally appropriate. In Study 2, the SBG research team conducted cognitive interviews and group discussions with stakeholders to assess the content and comprehensibility of the Attitudes Towards Corporal Punishment Scale (ACP). This yielded insights into the measurement of attitudes towards corporal punishment and related parenting behavior, and prompted several revisions to the ACP. To accurately evaluate the intervention's theory of change and its goal to reduce violence against children, reliable and appropriate measures of attitudes towards corporal punishment and punishment behaviors are needed. Together, these two studies emphasize the value of continuous monitoring, evaluation, and learning in the implementation, adaptation, evaluation, and scaling of SBG and similar early childhood development interventions.

Does Intra-Uterine Exposure to the Zika Virus Increase Risks of Cognitive Delay at Preschool Ages? Findings from a Zika-Exposed Cohort from Grenada, West Indies.

Maternal infection with Zika virus (ZIKV) is associated with a distinct pattern of birth defects, known as congenital Zika syndrome (CZS). In ZIKV-exposed children without CZS, it is often unclear whether they were protected from in utero infection and neurotropism. Early neurodevelopmental assessment is essential for detecting neurodevelopmental delays (NDDs) and prioritizing at-risk children for early intervention. We compared neurodevelopmental outcomes between ZIKV-exposed and unexposed children at 1, 3 and 4 years to assess exposure-associated NDD risk. A total of 384 mother-child dyads were enrolled during a period of active ZIKV transmission (2016-2017) in Grenada, West Indies. Exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. Neurodevelopment was assessed using the Oxford Neurodevelopment Assessment, the NEPSY® Second Edition and Cardiff Vision Tests, at 12 (n = 66), 36 (n = 58) and 48 (n = 59) months, respectively. There were no differences in NDD rates or vision scores between ZIKV-exposed and unexposed children. Rates of microcephaly at birth (0.88% vs. 0.83%, p = 0.81), and childhood stunting and wasting did not differ between groups. Our results show that Grenadian ZIKV-exposed children, the majority of whom were without microcephaly, had similar neurodevelopmental outcomes to unexposed controls up to at least an age of 4 years.

Zoonotic helminths of dogs and risk factors associated with polyparasitism in Grenada, West Indies.

Canine soil-transmitted helminths (STHs) cause important zoonoses in the tropics, with varying degrees of intensity of infection in humans and dogs. This study aimed to investigate the prevalence and associated risk factors for STHs in community dogs residing in Grenada, West Indies. In May 2021, 232 canine fecal samples were examined for zoonotic helminths by microscopy (following flotation), and genomic DNA from a subset of 211 of these samples were subjected to multiplex qPCR for the detection and specific identification of hookworms, Toxocara spp. and Strongyloides. Microscopic examination revealed that 46.5% (108/232, 95% CI 40­52.9), 9% (21/232, 95% CI 5.35­12.7) and 5.2% (12/232, 95% CI 2.3­8) of the samples contained eggs of Ancylostoma spp., Toxocara spp. and Trichuris vulpis, respectively. Multiplex qPCR revealed that, 42.2% (89/211, 95% CI 35.5­48.8) were positive for at least 1 zoonotic parasite. Of these, 40.8% (86/211, 95% CI 34.1­47.3) of samples tested positive for Ancylostoma spp., 36% (76/211, 95% CI 29.5­42.9) were positive for A. caninum, 13.3% (28/211, 95% CI 9­18.6) for A. ceylanicum, 5.7% for T. canis (12/211, 95% CI 2.97­8.81) and 1% (2/211, 95% CI 0­2.26) for Strongyloides spp. (identified as S. stercoralis and S. papillosus by conventional PCR-based Sanger sequencing). Using a multiple logistic regression model, a low body score and free-roaming behaviour were significant predictors of test-positivity for these parasitic nematodes in dogs (P < 0.05). Further studies of zoonotic STHs in humans should help elucidate the public health relevance of these parasites in Grenada.

Factors Associated with Chikungunya Infection among Pregnant Women in Grenada, West Indies.

Neonates are vulnerable to vector-borne diseases given the potential for mother-to-child congenital transmission. To determine factors associated with chikungunya virus (CHIKV) infection among pregnant women in Grenada, West Indies, a retrospective cohort study enrolled women who were pregnant during the 2014 CHIKV epidemic. In all, 520/688 women (75.5%) were CHIKV IgG positive. Low incomes, use of pit latrines, lack of home window screens, and subjective reporting of frequent mosquito bites were associated with increased risk of CHIKV infection in bivariate analyses. In the multivariate modified Poisson regression model, low income (adjusted relative risk [aRR]: 1.05 [95% CI: 1.01-1.10]) and frequent mosquito bites (aRR: 1.05 [95% CI: 1.01-1.10]) were linked to increased infection risk. In Grenada, markers of low socioeconomic status are associated with CHIKV infection among pregnant women. Given that Grenada will continue to face vector-borne outbreaks, interventions dedicated to improving living conditions of the most disadvantaged will help reduce the incidence of arboviral infections.

Temporal trends in ambient fine particulate matter and the impacts of COVID-19 on this pollutant in Grenada, West Indies.

Most Caribbean islands do not have air pollution surveillance programs. Those who live in these countries are exposed to ambient air pollution from a variety of sources including motor vehicles, ocean-going vessels, and Saharan dust. We conducted an air sampling exposure study in Grenada to describe daily changes in fine particulate matter (PM2.5) pollution, and during Saharan dust episodes. Further, we assessed the impacts of COVID-19 public health interventions on PM2.5 concentrations in 2020. Four fixed-site PurpleAir monitors were installed throughout Grenada, and one on the neighboring island of Carriacou. PM2.5 was measured between January 6 and December 31, 2020. We classified each of these days based on whether COVID-19 public health mitigation measures were in place or not. Descriptive analyses were performed to characterize fluctuations in PM2.5, and we assessed the impacts of public health restrictions on PM2.5 using multivariate regression. The mean daily PM2.5 concentration in 2020 was 4.4 µg/m3. During the study period, the minimum daily PM2.5 concentration was 0.7 µg/m3, and the maximum was 20.4 µg/m3. Daily mean PM2.5 concentrations more than doubled on Saharan dust days (8.5 vs 3.6 µg/m3; p < 0.05). The daily mean PM2.5 concentrations were estimated to be 1.2 µg/m3 lower when COVID-19 restrictions were in effect. Ambient PM2.5 concentrations in Grenada are relatively low compared to other countries; however, Saharan dust episodes represent an important source of exposure. Low-cost sensors provide an opportunity to increase surveillance of air pollution in the Caribbean, however their value could be enhanced with the development of correction algorithms that more closely approximate values from reference-grade monitors.Implications: This study describes daily fluctuations in ambient PM2.5 concentrations in Grenada in 2020. Overall, concentrations of PM2.5 were low; however, we found that Saharan dust events cause daily exceedances in PM2.5 above the current 24-hr limits of the World Health Organization. Moreover, the constructed models suggest that public health interventions to reduce the spread of COVID-19 reduced PM2.5 concentrations by 27%.

Ancylostoma ceylanicum Hookworms in Dogs, Grenada, West Indies.

Ancylostoma ceylanicum hookworms are recognized agents of human infection in the Asia-Pacific region. We investigated prevalence of zoonotic hookworm infections in dogs in Grenada in 2021; 40.8% were infected by hookworms, including Ancylostoma ceylanicum. Surveillance of this parasite in dogs and humans is needed in tropical/subtropical countries in the Americas.

Toxoplasma gondii clonal type III is the dominant genotype identified in Grenadian pigs.

BACKGROUND: Toxoplasma gondii is a widespread zoonotic protozoan parasite capable of infecting all warm-blooded animals. Although the genotypes of T. gondii in pigs have been reported worldwide, there is no information on the genotypes and diversity of T. gondii in pigs in Grenada, West Indies. OBJECTIVES: The aims of the present study were to isolate, genotype and determine the diversity of T. gondii genotypes in pigs. METHODS: We carried out a modified agglutination test (MAT) on blood from 149 pig hearts collected from a local meat market. Myocardial tissue homogenate from pigs that tested positive for T. gondii was homogenized and inoculated into mice for isolation of the parasite. We collected mouse tissues and extracted DNA for genotyping based on 11 polymerase chain reaction-restriction fragment length polymorphism markers (SAG1, SAG2, alt. SAG2, SAG 3, BTUB, GRA6, L358, PK1, C22-8, C 29-2 and Apico). RESULTS: Out of the 149 pig hearts, 31 (20.8%) tested positive for T. gondii on MAT. Bioassays in mice yielded 12 isolates designated TgpgGr1 to TgpgGr12. Molecular characterisation of T. gondii revealed four genotypes as follows: ToxoDB #2-clonal type III (seven isolates); ToxoDB #7 (three isolates); ToxoDB #13 (one isolate); ToxoDB #30 (1 isolate). Overall, ToxoDB #2 was the most common (58%). Toxo database (DB) # 13, which causes interstitial pneumonia in affected mice, has also been reported. CONCLUSION: The genetic diversity of T. gondii in pigs in Grenada is lower than that in other surrounding Caribbean areas.

Kudoa hypoepicardialis and associated cardiac lesions in invasive red lionfish Pterois volitans in Grenada, West Indies.

Invasive red lionfish Pterois volitans (Linnaeus, 1758) represent an ongoing ecological threat within temperate and tropical waters. Relatively little is known regarding the overall health of P. volitans and their potential for spreading pathogens in non-native regions. Lionfish collected from inshore reefs of Grenada, West Indies, in 2019 and 2021 were identified as P. volitans based on cytochrome c oxidase subunit 1 barcoding. Gross and microscopic examination of tissues revealed myxozoan plasmodia in the hearts of 24/76 (31.6%) lionfish by histopathology or wet mount cytology. Further histopathologic examination revealed severe granulomatous inflammation and myofiber necrosis associated with developing plasmodia and presporogonic life stages. Fresh myxospores were morphologically and molecularly consistent with Kudoa hypoepicardialis, being quadrate in apical view with 4 valves and 4 equal polar capsules. The spore body was 5.1-7.9 (mean: 6.0) µm long, 8.1-9.8 (8.7) µm wide, and 6.9-8.5 (7.7) µm thick. Polar capsules were 2.3-2.7 (2.5) µm long and 0.9-1.6 (1.3) µm wide. 18S small subunit rDNA sequences were 99.81-99.87% similar to sequence data from the original description of the species. Novel 28S large subunit rDNA and elongation factor 2 data, which did not match any previously reported species, were provided. This is the first account of a myxozoan parasite of P. volitans, a new host record and locality for K. hypoepicardialis, and one of few reports describing pathogen-associated lesions in invasive lionfish.

Improving neurodevelopment in Zika-exposed children: A randomized controlled trial.

BACKGROUND: While microcephaly is a significant adverse outcome of prenatal exposure to the Zika virus (ZIKV), subtle malformations of cortical development (MCD) have been observed in Zika-exposed children (ZEC), including delays in language, cognition, and motor domains, and visual acuity deficits. Interventions within the first 1,000 days of life can significantly improve developmental outcomes. This study examined a 12-week Responsive Caregiving Intervention on neurodevelopmental outcomes in 24-30-month-old ZEC. METHODOLOGY/PRINCIPAL FINDINGS: A randomized controlled trial was implemented in Grenada, West Indies using an existing ZIKV cohort surveillance study. When children in that study turned 24 months, baseline child neurodevelopmental measures and caregiver interviews were administered. Caregivers who agreed to participate in the 12-week Responsive Caregiving Intervention, implemented when children were 24-30 months of age, were randomly assigned to the Intervention or Waitlist Control group. Children in both groups were re-assessed on the neurodevelopmental measures post-intervention. CONCLUSIONS/SIGNIFICANCE: 233 children from the ZIKV surveillance study met inclusion criteria, of which n = 80 declined participation, n = 42 did not complete the Intervention, and n = 72 missed follow-up assessments given strict timelines in the study design. The final sample for analysis was N = 13 children in the Intervention group and N = 26 children in the Control group. A GEE model analysis showed significantly higher language (p = 0.021) and positive behaviour (p = 0.005) scores for children in the Intervention group compared to the Control group. The Intervention had a medium effect on child language (d = 0.66) and a large effect on positive behaviour (d = 0.83). A 12-week Responsive Caregiving Intervention Programme significantly improves language and positive behaviour scores in 30-month-old normocephalic children who were exposed to ZIKV in utero. The programme provides an option for mothers of ZIKV-exposed children who are seeking an evidence-based neurodevelopmental intervention regardless of known impact of the virus on cortical formation. TRIAL REGISTRATION: The study was registered with clinicaltrials.gov (NCT04697147).

A retrospective study of canine transmissible venereal tumour in Grenada, West Indies.

BACKGROUND: Canine transmissible venereal tumour (CTVT) is a naturally occurring neoplasia affecting dogs worldwide. Previous CTVT studies in Grenada were limited to case records of dogs with neoplastic conditions at a veterinary diagnostic laboratory. OBJECTIVES: The present retrospective study aimed to determine the occurrence and risk factors of CTVT in a wider population of owned dogs presented to a university-affiliated veterinary hospital between 2008 and 2018. METHODS: Data on the age, breed, gender, and gonadectomy status were retrieved from an electronic database and analyzed using logistic regression. RESULTS: Of the 7180 dogs presented during the period, 102 dogs (1.4%) were diagnosed with CTVT. A higher predisposition was observed in Grenadian pothounds (odds ratio [OR] = 22.8, 95% confidence interval [CI] 10.3-50.4; p < 0.001) and mixed-breed dogs (OR = 9.2, 95% CI 4.1-20.7; p < 0.001) in comparison to the purebreds. Neutered dogs (OR = 2.2, 95% CI 1.4-3.3; p < 0.001) were at an increased risk of CTVT than intact dogs. Age and gender were not identified as significant risk factors. CONCLUSIONS: The percentage of dogs with CTVT in this study represents a crude estimate of the CTVT prevalence in the owned dog population in Grenada. Further studies including both owned and free-roaming dogs are required for a more accurate estimation of the CTVT prevalence in the region. Our results indicate that breed and gonadectomy status are significant risk factors for the occurrence of CTVT in Grenada.

Environmental impact assessment of biomass supported electricity generation for sustainable rural energy systems - A case study of Grenada County, Mississippi, USA.

Fossil fuels have been the major source of electricity supply in the United States of America (USA) for many decades. While a significant shift has occurred from coal-dominated supply to natural gas and renewable source based supplies in recent decades, there is still large potential to improve biomass supported electricity contribution in rural communities, which depend majorly on forest-related activities. Wood waste, an underutilized renewable resource, has the potential for electricity generation in rural areas to reduce the contribution of electricity generated from fossil fuels and assist in greenhouse gas savings. In this study, a life cycle assessment approach was used to estimate the emissions of electricity generated by wood residues in a rural community (Grenada County, Mississippi (MS), USA) and compared with those emissions from the recent electricity mix (2018), a previous electricity mix (2010) supply, along with natural gas (NG) and coal (Bituminous Coal, BC) based electricity generation options. A significant reduction (85.9-94.6%) in global warming impact was observed when compared with BC, NG and grid supplied electricity for years 2010 and 2018. When compared to the current electricity mix at the grid (2018), acidification, eutrophication, respiratory effects and smog formation showed higher emissions ranging from 30.8% to 72.4%. The sensitivity analysis showed an improvement in emissions savings with increased biomass to power conversion efficiency (40%), lower moisture content of the biomass (0%, bone dry biomass), and reduced transportation distance (35 km). This study showed an improvement in the electricity mix supplied to Grenada county, MS, which implies sustainable development opportunities for promoting energy security in rural communities with forest-based industries.

New genus and species of apterous Carventinae from Costa Rica and Grenada (Hemiptera, Heteroptera, Aradidae).

Only three species assigned to two genera of the flat bug subfamily Carventinae Usinger, 1950 are recorded to date from Costa Rica and one genus and species from Grenada. Following apterous carventine taxa are described and illustrated in the present paper: Joceliaptera graziae gen. et sp. nov.; Peggicoris cahuitanus sp. nov.; Peggicoris grenadensis sp. nov. Joceliaptera gen. nov. is compared with most similar Neotropical genera. A key to species of Peggicoris is presented.

Extinct insular oryzomyine rice rats (Rodentia: Sigmodontinae) from the Grenada Bank, southern Caribbean.

The Lesser Antillean island chain in the eastern Caribbean formerly supported a diverse rodent fauna including multiple endemic genera of oryzomyine rice rats. The Caribbean rice rats are now all extinct, with most island populations known only from Holocene palaeontological and zooarchaeological material and with many remaining taxonomically undescribed. Rice rat material is reported from several pre-Columbian Ceramic Age (late Holocene) archaeological sites on the Grenada Bank, including sites on Grenada and Carriacou, but the taxonomic identity and diversity of the Grenada Bank rice rats has remained uncertain. We provide a morphology-based description of rice rats from Grenada and Carriacou, and analyze their phylogenetic and biogeographical affinities to other Caribbean and mainland Neotropical oryzomyines. We recognize two taxa from the Grenada Bank: we describe the new species Megalomys camerhogne from Pearls (Grenada), representing the largest-bodied member of the extinct endemic Caribbean genus Megalomys, and we refer smaller-bodied oryzomyine material from Pearls and Sabazan (Carriacou) to the widespread extant Neotropical species Zygodontomys brevicauda. Body size variation within Megalomys correlates with island bank area and might thus reflect historical rather than modern biogeography. Zygodontomys specimens from the Grenada Bank fall within the upper end of size variation in extant populations and may constitute an example of 'island gigantism', but it is possible that occurrence of this widespread species on the Grenada Bank might reflect prehistoric human-mediated translocation. We predict further endemic Caribbean rice rat taxa remain to be discovered, including a possible species of Megalomys on the neighbouring island of St. Vincent.

Molecular detection and characterization of Anaplasma platys and Ehrlichia canis in dogs from the Caribbean.

Anaplasma platys is a tick-transmitted rickettsial pathogen, which is known to be the etiologic agent for cyclic thrombocytopenia in its primary canine host. Infections with this pathogen are also reported in cats, cattle and people. Similarly, Ehrlichia canis is another tick-borne rickettsial pathogen responsible for canine monocytic ehrlichiosis and is also reported to cause infections in people. We describe infections in dogs with these two pathogens on the Caribbean island of Grenada, West Indies by detection using molecular methods. We utilized a 16S rRNA gene-based PCR assay to detect both Ehrlichia and Anaplasma species by screening 155 canine blood samples from asymptomatic dogs. We found 18.7 % of the dogs to be positive for A. platys and 16.8 % for E. canis. Samples that tested positive for A. platys were further assessed by sequence analysis targeting 16S rRNA, 23S rRNA, citrate synthase (gltA) and heat shock protein (groEL) genes. Phylogenetic analysis revealed high correlation of A. platys 16S rRNA and gltA gene sequences with the geographic origins, while 23S rRNA and groEL gene sequences clustered independent of the geographic origins. This study represents an important step in defining the widespread distribution of active rickettsial infections in Caribbean dogs with no apparent clinical signs, thus posing a high risk for canine health and to a lesser extent to humans, as most dogs in the Caribbean are free-roaming.

GENETIC AND MORPHOLOGIC CHARACTERIZATION OF DIASCHISTORCHIS PANDUS (DIGENEA: PRONOCEPHALIDAE) TREMATODES EXTRACTED FROM HAWKSBILL TURTLES, ERETMOCHELYS IMBRICATA (TESTUDINES: CHELONIIDAE), IN GRENADA, WEST INDIES.

The hawksbill turtle Eretmochelys imbricata is a critically endangered species with a worldwide distribution. Limited information is available about the naturally occurring intestinal parasites of this species and what impact these parasites may have on the health of the hawksbill turtle. Diaschistorchis pandus was identified postmortem in 5 hawksbill turtles from Grenada, West Indies, using morphologic characterization. Sanger sequencing was performed for conserved ribosomal regions (5.8S, ITS2, 28S) and the mitochondrial cytochrome c oxidase subunit 1 gene (COI). Phylogenetic analysis of the 28S rRNA gene sequence data shows D. pandus clustering with other trematodes in the family Pronocephalidae, corroborating morphological classification. No genetic sequences have been previously reported for this trematode species, which has limited the collection of objective epidemiological data about this parasite of marine turtles.

Omental wrap: Radiographic diagnosis confirmed surgically - Report of two cases in Grenada.

Omental wrapping is a common cause of peritoneal catheter malfunction. This diagnosis should be confirmed by radiography before proceeding with surgical omentectomy. We report two cases of peritoneal dialysis (PD) catheter outflow obstruction from our developing PD program in Grenada, in which contrast studies accurately diagnosed omental wrap, allowing for prompt surgical correction. In both cases, the contrast study indicated the presence of omental wrapping, confirmed at time of surgical correction. Radiographic features of omental wrap are distinctive, which allows for reliable differentiation from other causes of obstruction. Radiographic contrast study reliably diagnoses the cause of peritoneal catheter obstruction, permitting prompt diagnosis and treatment. This is vital for regions with limited access to haemodialysis.

Faculty Perceptions: A Qualitative Study of the Perceived Need, Opportunities, and Challenges of Developing "One Health-One Medicine" in the Medical, Veterinary, and Public Health Curricula.

INTRODUCTION: The conceptual framework of One Health (OH) provides a strategy for promoting collaboration across the nexus of animal, human, and environmental health, which is essential for tackling emerging disease threats, such as COVID-19. However, there is no accreditation requirement for OH to prepare students across the professions for collaborative practice. This study aimed to explore the perspectives of faculty across the medical, veterinary, and public health programs about the need, opportunities, and challenges of developing OH in the curricula. METHODS: In this qualitative study, faculty across the three disciplines were invited to participate in audio-recorded, focus group interviews. Recordings were transcribed verbatim and analyzed using inductive and deductive thematic analysis. RESULTS: All participants recognized the need for OH as a critical concept for preparing students for collaborative practice. Opportunities were identified for shared learning and research across the disciplines, particularly through the use of interprofessional education. The lack of an accreditation mandate for OH in the medical curriculum was perceived to be the greatest challenge, leading to an anticipation of significant resistance among medical educators and students. DISCUSSION: Successful development of OH in all three curricula is vital to prepare students for current and future threats to global health. The role of accreditation bodies in ensuring medical, veterinary, and public health curricula prepare students for these threats is crucial. Implications for practice include strategies for persuading medical educators and medical students to embrace OH in the curriculum and promote a culture of shared learning.

Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study.

OBJECTIVE: To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN: Retrospective observational study. SETTING: Grenada. POPULATION: Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS: This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES: Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS: Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (µ = 898 days, σ = 277 days) compared with infections outside of pregnancy (µ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION: CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT: Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.

Potential for Scombroid Poisoning from Ingestion of Selar crumenophthalmus Due to Increased Histamine Levels in Grenada, West Indies.

ABSTRACT: In scombroid poisoning, a seafood-associated disease, consumption of fish that contains high levels of histamine results in allergy-like symptoms that range from mild to occasionally severe. To date, there is no published information on scombroid poisoning from Selar crumenophthalmus on the Caribbean island of Grenada, West Indies. S. crumenophthalmus is of particular interest because it is a common and heavily consumed fish that has been implicated in scombroid poisoning in Hawaii. Preliminary data on S. crumenophthalmus in Grenada have demonstrated the presence of Photobacterium damselae, a bacterium associated with scombroid poisoning. The present study further tested S. crumenophthalmus purchased in Grenada for factors that would indicate the potential for scombroid poisoning, including increased histamine levels in fish muscle and DNA evidence of bacteria associated with scombroid poisoning. Histamine levels between 7,160 and 66,688 ppm were found after temperature abuse at 37°C for 19 h; this far exceeds the acceptable limit for the United States (50 ppm) and the European Union (100 to 200 ppm). Even after 4 h of incubation at ambient temperature (28.9°C) during a time-point study, histamine levels exceeded U.S. acceptable limits (>50 ppm), and five samples used for temperature-abuse studies had elevated histamine levels (ranging from 141 to 2,510 ppm) at 0 h. PCR and sequence analysis of bacteria in temperature-abused fish identified P. damselae and Morganella morganii, which are histamine-producing bacteria known to be implicated in scombroid poisoning. These results suggest the potential for scombroid poisoning in Grenada and the need for promoting awareness about this disease.