#Serological #evidence of #Zika virus #infection in febrile patients at Greater #Accra Regional Hospital, Accra #Ghana (BMC Res Notes, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMC Res Notes. 2019 Jun 10;12(1):326. doi: 10.1186/s13104-019-4371-4.

Serological evidence of Zika virus infection in febrile patients at Greater Accra Regional Hospital, Accra Ghana.

Ankrah GA1, Bonney JHK2, Agbosu EE3, Pratt D3, Adiku TK1,4.

Author information: 1 Department of Medical Microbiology, College of Health Sciences, University of Ghana, Korle Bu, Accra, Ghana. 2 Virology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana. Kbonney@noguchi.ug.edu.gh. 3 Virology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana. 4 Department of Biomedical Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana.

 

Abstract

OBJECTIVE:

Increase in the evidence of global occurrence of Zika viral infection suggests that in Africa the circulation of the virus which causes 80% of asymptomatic infection could be undetected and/or overlooked. We sought to serologically detect Zika virus infection in febrile patients at Greater Accra Regional Hospital, Ghana.

RESULTS:

Of the 160 patient serum samples analyzed, 33 were found to have antibodies against Zika virus infection. Among the sero-positives 30 (91%) of the cases were anti-Zika virus IgM with the 21-30-year age group recording the highest number of 8 (26%) and 2 (7%) cases being the least for the 61 years and above age group. All sero-positive febrile patients developed at least one symptom consistent with Zika virus infection: 33 (100%) fever, 25 (76%) muscle pain, 24 (73%) joint pain, and conjunctivitis 2 (6%). Digestive symptoms recorded include 16 (49%) nausea, 12 (36%) vomiting and diarrhea 18 (55%). In addition, 28 (85%) loss of appetite, 14 (75%) rapid respiration and chest pain 15 (42%) were reported by seropositive febrile patients. Our data indicates exposure to Zika virus which suggests the possible circulation of the virus among febrile patients in Ghana with a sero-prevalence rate of 20.6%.

KEYWORDS: Anti-Zika virus immunoglobulins M and G (IgM and IgG) antibodies; Enzyme linked immunosorbent assay (ELISA); Seroprevalence; Zika virus

PMID: 31182146 DOI: 10.1186/s13104-019-4371-4

Keywords: Zika Virus; Serology; Seroprevalence; Ghana.

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Potential Intermediate #Hosts for #Coronavirus Transmission: No Evidence of Clade 2c Coronaviruses in Domestic #Livestock from #Ghana (Trop Med Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Trop Med Infect Dis. 2019 Feb 10;4(1). pii: E34. doi: 10.3390/tropicalmed4010034.

Potential Intermediate Hosts for Coronavirus Transmission: No Evidence of Clade 2c Coronaviruses in Domestic Livestock from Ghana.

El-Duah P1,2, Sylverken A3,4, Owusu M5,6, Yeboah R7,8, Lamptey J9,10, Frimpong YO11,12, Burimuah V13,14, Antwi C15, Folitse R16, Agbenyega O17, Oppong S18, Adu-Sarkodie Y19.

Author information: 1 Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. elduahphilip9@gmail.com. 2 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. elduahphilip9@gmail.com. 3 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. annan@kccr.de. 4 Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. annan@kccr.de. 5 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. owusumichael-gh@hotmail.com. 6 Department of Medical Laboratory Technology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. owusumichael-gh@hotmail.com. 7 Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. Yeboahrichmond82@yahoo.com. 8 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. Yeboahrichmond82@yahoo.com. 9 Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. jlamptey80@gmail.com. 10 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. jlamptey80@gmail.com. 11 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. oppongfrimpong1@gmail.com. 12 Department of Animal Science, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. oppongfrimpong1@gmail.com. 13 Kumasi Centre for Collaborative Research in Tropical Medicine, PMB, UPO, Kumasi 00233, Ghana. vitus7uk@yahoo.co.uk. 14 School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. vitus7uk@yahoo.co.uk. 15 Department of Animal Science, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. cantwi@icloud.com. 16 School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. raphfolitse@yahoo.com. 17 Department of Agroforestry, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. olivia_agbenyega@yahoo.com. 18 Department of Wildlife and Range Management, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. kobbyoppong@yahoo.com. 19 Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi 00233, Ghana. yasax@hotmail.co.uk.

 

Abstract

The emergence of Middle East Respiratory Syndrome Coronavirus (MERS-CoV), nearly a decade ago with worldwide distribution, was believed to be of zoonotic origin from bats with dromedary camels as intermediate hosts. There is a likelihood of other domestic livestock serving as intermediate hosts for this virus. The presence of coronaviruses, closely related to MERS-CoV in Ghanaian bats, presented the opportunity to test the hypothesis of transmissibility of this virus through domestic livestock species. The possible interactions between livestock and bats in 31 household farms were accessed by observation and interviews with farmers. Rectal swabs and serum from cattle, sheep, goats, donkeys, and swine from commercial and household farms were tested for MERS-CoV and a Nycteris sp. bat coronavirus, previously detected in Ghana. A pan-PCR assay to detect clade 2c viruses and recombinant immunofluorescence assay to detect anti-spike IgG antibodies against the target viruses were used. Likely contact between livestock and bats was determined for 13 farms (41.9%) that reported confining their livestock and also observing bats in their homes. Livestock were left unconfined on eight farms (25.8%) that also observed bats roosting in trees close to their homes. No viral RNA or antibodies against the two coronaviruses were detected in any of the livestock species tested. Cattle, sheep, goats, donkeys, and swine are not likely hosts of clade 2c coronaviruses.

KEYWORDS: bats; coronavirus; intermediate host; livestock

PMID: 30744201 DOI: 10.3390/tropicalmed4010034 Free full text

Keywords: Coronavirus; MERS-CoV; Bats; Cattle; Pigs; Ghana.

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Molecular characterisation of the #NDM-1-encoding #plasmid p2189-NDM in an #Escherichia coli ST410 clinical isolate from #Ghana (PLoS One, abstract)

[Source: PLoS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Molecular characterisation of the NDM-1-encoding plasmid p2189-NDM in an Escherichia coli ST410 clinical isolate from Ghana

Alafate Ayibieke, Wakana Sato, Samiratu Mahazu, Isaac Prah, John Addow-Thompson, Mitsuko Ohashi, Toshihiko Suzuki, Shiroh Iwanaga, Anthony Ablordey, Ryoichi Saito

Published: December 21, 2018 / DOI: https://doi.org/10.1371/journal.pone.0209623

 

Abstract

Global dissemination of New Delhi metallo-β-lactamase (NDM)-producing bacteria has become a major health threat. However, there are few reports regarding the identification and characterisation of NDM-producing bacteria from West Africa, including Ghana. An Escherichia coli strain with resistance to meropenem was isolated from the Tamale Teaching Hospital in Ghana. Its identification and determination of antibiotic susceptibility profile were carried out using commercial systems. The antibiotic resistance mechanism was analysed by phenotypic detection kits, PCR, and DNA sequencing. Conjugation experiments, S1 nuclease pulsed field gel electrophoresis, and Southern blotting were performed. Finally, the NDM-1-harbouring plasmid was characterised using next-generation sequencing and phylogenetic analysis. The meropenem-resistant Escherichia coli strain EC2189 harboured blaNDM-1 and belonged to sequence type 410. blaNDM-1 was located on the IncHI type transferrable plasmid p2189-NDM (248,807 bp long), which co-carried multiple resistance genes, such as blaCTX-M-15, aadA1, aac(6′)-Ib, sul3, dfrA12, and cmlA1. p2189-NDM phylogenetically differed from previously identified blaNDM-1-positive IncHI type plasmids. A truncated Tn125 containing blaNDM-1 was bracketed by an ISSm-1-like insertion sequence upstream and by a site-specific integrase downstream. To the best of our knowledge, we have, for the first time identified and molecularly characterised an NDM-1-producing Enterobacteriaceae strain in Ghana with blaNDM-1 that had a novel genetic structure. Our findings indicate a possibility of NDM-1 dissemination in Ghana and underscore the need for constant monitoring of carbapenemase-producing bacteria.

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Citation: Ayibieke A, Sato W, Mahazu S, Prah I, Addow-Thompson J, Ohashi M, et al. (2018) Molecular characterisation of the NDM-1-encoding plasmid p2189-NDM in an Escherichia coli ST410 clinical isolate from Ghana. PLoS ONE 13(12): e0209623. https://doi.org/10.1371/journal.pone.0209623

Editor: Yung-Fu Chang, Cornell University, UNITED STATES

Received: September 26, 2018; Accepted: December 7, 2018; Published: December 21, 2018

Copyright: © 2018 Ayibieke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: This study was supported by the Japan Agency for Medical Research and Development (AMED, URL: http://www.amed.go.jp/en/) under Grant Number 17fm0108010h0003 (MO, TS, SI, RS). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Antibiotics; Drugs resistance; NMD1; Carbapene; Ghana.

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#Transmission of toxigenic #Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West #Africa, #UK, 2017 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017

David Edwards1, Dianne Kent1, Caroline Lester1, Colin Stewart Brown2, Michael E. Murphy3, Nicholas M. Brown4, Olajumoke Sule4,Alexandra Itani5, Meera Chand6, Amy Trindall7, Callum Pearson7, Iain Roddick7, Norman K. Fry2, Jorg Hoffmann1, Nalini Iyanger2,Laurence Kemp5, Joanne White2, Babak Javid8, Isobel D. Ramsay8, Dominik Zenner2, Aliko Ahmed1, Gayatri Amirthalingam9, Sultan Salimee1,David Litt2, Mark Reacher7

Affiliations: 1 East of England Health Protection Team, Public Health England, Thetford, United Kingdom; 2 National Infection Service, Public Health England, London, United Kingdom; 3 Department of Microbiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; 4 PHE Public Health Laboratory Cambridge, Public Health England, Cambridge, United Kingdom. 5 Granta Medical Practices, Cambridge, United Kingdom; 6 NIHR Health Protection Research Unit in Respiratory Infections, Public Health England, London, United Kingdom; 7 Field Epidemiology Service, Public Health England, Cambridge, United Kingdom; 8 Department of Medicine, University of Cambridge School of Clinical Medicine, University of Cambridge Hospitals Trust, Cambridge, United Kingdom; 9 Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, United Kingdom

Correspondence:  David Edwards

Citation style for this article: Edwards David, Kent Dianne, Lester Caroline, Brown Colin Stewart, Murphy Michael E., Brown Nicholas M., Sule Olajumoke, Itani Alexandra,Chand Meera, Trindall Amy, Pearson Callum, Roddick Iain, Fry Norman K., Hoffmann Jorg, Iyanger Nalini, Kemp Laurence, White Joanne, Javid Babak, Ramsay Isobel D.,Zenner Dominik, Ahmed Aliko, Amirthalingam Gayatri, Salimee Sultan, Litt David, Reacher Mark. Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017. Euro Surveill. 2018;23(39):pii=1700681. https://doi.org/10.2807/1560-7917.ES.2018.23.39.1700681

Received: 10 Oct 2017;   Accepted: 23 May 2018

 

Abstract

In early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium diphtheriae. Real-time PCR ascertained the species and presence of the diphtheria toxin gene. An Elek test confirmed toxigenicity. The isolate was macrolide sensitive and penicillin resistant. The local Public Health England (PHE) Health Protection Team obtained the patient’s clinical history and traced contacts to inform appropriate public health action. One close contact (in their early 80s with uncertain immunisation status who had not recently travelled) had a positive throat swab for toxigenic C. diphtheriae and reported a history of mild coryzal symptoms. Multilocus sequence typing revealed that strains from the index case and contact had Sequence Type 463. Diphtheria is extremely rare in the UK due to high vaccine coverage and this is the first documented transmission in 30 years. Clinicians and laboratory staff should remain highly suspicious of lesions in overseas travellers, even when patients are fully vaccinated. Older individuals who might not have completed a full immunisation course may have higher diphtheria susceptibility.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Diphtheria; UK; Ghana.

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#Zika Virus #Exposure in an #HIV-Infected Cohort in #Ghana (J Acquir Immune Defic Syndr., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract , edited.]

J Acquir Immune Defic Syndr. 2018 Apr 27. doi: 10.1097/QAI.0000000000001718. [Epub ahead of print]

Zika Virus Exposure in an HIV-Infected Cohort in Ghana.

Sherman KE1, Rouster SD1, Kong LX1, Shata TM1, Archampong T2, Kwara A3, Aliota MT4, Blackard JT1.

Author information: 1 University of Cincinnati College of Medicine, Cincinnati, OH, USA. 2 University of Ghana School of Medicine and Dentistry, College of Health Sciences, Accra, Ghana. 3 Warren Alpert Medical School of Brown University, Providence, RI, USA. 4 University of Wisconsin- Madison, WI.

 

Abstract

OBJECTIVE:

To determine the prevalence and epidemiologic associations of Zika Virus (ZIKV) in HIV-infected patients in Ghana, West Africa.

METHODS:

We examined the seroprevalence of ZIKV in HIV/HBV co-infected persons in Ghana from sera samples collected from 2012 to 2014 using ELISA assays and plaque reduction neutralization tests (PRNT).

RESULTS:

Overall, ZIKV antibody was detected in 12.9% of 236 tested samples, though the true estimate of exposure is probably less due cross-reactions with other related viruses. PRNTs were performed on a subset to provide an estimate of the frequency of false positive reaction. Dengue virus testing was also performed and antibody prevalence was 87.2%. The median CD4 count was 436 (range 2-1781 cell/mm) and did not affect antibody results. Regional geographic ethnicity was associated with ZIKV exposure.

DISCUSSION:

Overall, these data suggest that ZIKV infection is a relatively prevalent infection in HIV-positive persons in Ghana though not as common as dengue. Further evaluation of the effect of ZIKV and HIV co-infection is warranted given the large geographical overlap of populations exposed to both viruses.

PMID: 29771784 DOI: 10.1097/QAI.0000000000001718

Keywords: Zika Virus; HIV/AIDS; Ghana.

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#EVALUATION OF DOMESTIC #DUCKS AS POTENTIAL #RESERVOIR OF #AVIAN #INFLUENZA VIRUS IN POST HPAI #H5N1 #OUTBREAK AREA… #GHANA (Afr J Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Afr J Infect Dis. 2016 May 1;10(2):134-145. doi: 10.21010/ajid.v10i2.10. eCollection 2016.

THE EVALUATION OF DOMESTIC DUCKS AS POTENTIAL RESERVOIR OF AVIAN INFLUENZA VIRUS IN POST HPAI H5N1 OUTBREAK AREA, SUNYANI MUNICIPALITY, BRONG AHAFO REGION OF GHANA.

Burimuah V1, Ampofo WK2, Awumbila B3, Yebuah N4, Emikpe BO1, Tasiame W1, Folitse RD1.

Author information: 1 School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. 2 Noguchi Memorial Inst. for Medical Research, Accra, Ghana. 3 School of Veterinary Medicine, University of Ghana, Accra, Ghana. 4 School of Public Health, University of Ghana, Accra Ghana.

 

Abstract

BACKGROUND:

Avian influenza (AI) is an important zoonotic disease responsible for significant losses in most sub-Saharan countries. However, the role of poultry other than chicken in the epidemiology of the disease, especially after the first AI outbreak in Ghana, has not been fully elucidated. The obiective of this study is to determine whether the AI virus infection that was reported in the area in May 2007 was circulating silently in ducks in nine randomly selected farms in the Sunyani Municipality, Ghana.

MATERIALS AND METHODS:

The sample size was calculated using Epi info version 3.4.1 at 95% confidence level, absolute precision of 5% and assuming 0.5 prevalence of Avian Influenza A virus in ducks. Samples collection was done simultaneously with questionnaire administration to farmers. A total of 526 samples made up of 384 cloacal swabs and 142 feather tissues from ducks from a commercial duck farm, seven backyard holdings and one live birds market in six randomly selected communities in the Sunyani Municipality, Brong Ahafo region of Ghana. The samples were processed and subjected to Influenza Type A Matrix Gene analysis using RRT-PCR.

RESULTS:

All the 526 samples subiected to Influenza Type A Matrix Gene analysis using RRT-PCR were negative for Influenza Type A viruses. However, it was observed that bio-security practices which are keys to reintroduction of the virus in the area were not adhered to in 89 % of the sites investigated. Our finding also revealed that only the commercial farm investigated in this study complied with fifteen (78.9%) of the nineteen different farm practices observed.

CONCLUSION:

Though AI was not detected in the ducks sampled, there is the need for continuous surveillance and education of stakeholders on standard bio-security and farm management practices in the area.

KEYWORDS: Avian influenza type A viruses; RRT-PCR; Re-introduction; Sunyani Municipality; Surveillance; ducks

PMID: 28480449 PMCID: PMC5411989 DOI: 10.21010/ajid.v10i2.10

Keywords: Avian Influenza; H5N1; Poultry; Ghana.

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Highly Pathogenic #Avian #Influenza A(#H5N1) Virus among #Poultry, #Ghana, 2015 (@CDC_EIDjournal, extract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Extract.]

Volume 22, Number 12—December 2016 / Letter

Highly Pathogenic Avian Influenza A(H5N1) Virus among Poultry, Ghana, 2015

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To the Editor:

Outbreaks of highly pathogenic avian influenza (HPAI) A(H5N1) virus among poultry were first reported in Africa in 2006, with initial reports from Nigeria (1). The virus then spread to several countries (e.g., Egypt, Côte d’Ivoire, Burkina Faso, Niger) in Africa, leading to large economic losses (1,2). In 2007, Ghana reported the first HPAI H5N1 cases among poultry in 3 regions: Greater Accra, Volta, and Brong Ahafo (3,4). The outbreak was contained by measures such as destruction of all birds on affected farms, disinfection of affected farms, and restricted movement of poultry and poultry products. Soon after containment, active influenza surveillance was initiated among birds, domestic poultry, and the human population throughout the country (5). Until 2015, no influenza-positive samples among birds had been detected in Ghana since the 2006–2007 outbreak. In January 2015, Nigeria resumed reporting HPAI H5N1–positive samples among poultry (6). One month later, HPAI H5N1–positive samples among chickens were confirmed in Burkina Faso (7). Then, in April 2015, chicken farmers in the Greater Accra region in Ghana reported a large number of deaths among domestic chicken flocks. Tracheal swabs collected from dead chickens and tested at the laboratories of the Veterinary Services Directorate in Accra, Ghana, confirmed the presence of HPAI H5N1 virus infection. By June 2015, the poultry populations in 5 of Ghana’s 10 regions were affected, leading to the death or culling of ≈100,000 poultry (7). Affected farms in Ghana (in the Greater Accra, Volta, and Ashanti regions) included medium-scale commercial farms with ≈30,000 chickens (broilers and layers) ranging from day-old chicks to layers >21 weeks of age; small-scale commercial bird farms with 200–1,000 chickens; and free-range local poultry of mixed species raised with low levels of biosafety. The death rate for chickens during the period of sample collection (April 13–June 11, 2015) was 17.6% (6,919 of 39,281 poultry died) (7). No direct links among farms were evident at this time. However, further spread in the Greater Accra region has been attributed to movement of live poultry. Outbreaks have been documented in live bird markets and backyard poultry, leading to a ban on movement of live poultry, feed, and equipment from affected regions. These counter-measures resulted in reduced incidence among poultry. For a lower-middle–income country like Ghana, such outbreaks are a major threat to food security and human health. We describe the outbreak strain found in Ghana during 2015 and its zoonotic potential.

(…)

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Ivy Asantewaa Asante, Stephanie Bertram, Joseph Awuni, Abraham Nii Okai Commey, Ben Aniwa, William Kwabena Ampofo, and Gülsah Gabriel

Author affiliations: Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany (I.A. Asante, S. Bertram, G. Gabriel); Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana (I.A. Asante, W.K. Ampofo); Center for Structural and Cellular Biology in Medicine at the University of Lübeck, Lübeck, Germany (S. Bertram, G. Gabriel); Veterinary Services Directorate, Accra (J. Awuni, A.N.O. Commey, B. Aniwa)

Suggested citation for this article: Asante IA, Bertram S, Awuni J, Commey ANO, Aniwa B, Ampofo WK. Highly pathogenic avian influenza A(H5N1) virus among poultry, Ghana, 2015. Emerg Infect Dis. 2016 Dec [date cited]. http://dx.doi.org/10.3201/eid2212.160639

DOI: 10.3201/eid2212.160639

Keywords: Research; Avian Influenza, H5N1; Poultry; Ghana.

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