Acquisition of cross- #resistance to #Bedaquiline and #Clofazimine following #treatment for #Tuberculosis in #Pakistan (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Acquisition of cross-resistance to Bedaquiline and Clofazimine following treatment for Tuberculosis in Pakistan

Arash Ghodousi, Alamdar Hussain Rizvi, Aurangzaib Quadir Baloch, Abdul Ghafoor, Faisal Masood Khanzada, Mehmood Qadir, Emanuele Borroni, Alberto Trovato, Sabira Tahseen,Daniela Maria Cirillo

DOI: 10.1128/AAC.00915-19



We report on the first six cases of acquired-resistance to bedaquiline in Pakistan. Seventy sequential isolates from 30 drug-resistant tuberculosis patients on bedaquiline-containing regimens were retrospectively tested for bedaquiline resistance by MIC test and by detection of mutations in relevant genes. We documented cases failing therapy developed specific mutations in Rv0678 and increased MICs associated with cross-resistance to clofazimine during treatment. This study underlines the relevance of surveillance programs following the introduction of new drugs.

Copyright © 2019 Ghodousi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

Keywords: Antibiotics; Drugs Resistance; Tuberculosis; Pakistan; Bedaquiline; Clofazimine.



#Prevalence and #Phylogenetics of #H9N2 in Backyard and Commercial #Poultry in #Pakistan (Avian Dis., abstract)

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

Avian Dis. 2018 Dec;62(4):416-424. doi: 10.1637/11690-062117-ResNote.1.

Prevalence and Phylogenetics of H9n2 in Backyard and Commercial Poultry in Pakistan.

Ali M1, Yaqub T2, Mukhtar N3, Imran M4, Ghafoor A5, Shahid MF1, Yaqub S1, Smith GJD6,7, Su YCF6, Naeem M8.

Author information: 1 Department of Microbiology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 2 Department of Microbiology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan, 3 Primary and Secondary, Health Care Department, Government of Punjab, Lahore 54000, Pakistan. 4 Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 5 University Diagnostic Laboratory, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 6 Duke-NUS Medical School, 8 College Road, 169857 Singapore. 7 Duke Global Health Institute, Duke University, Durham, NC 27710. 8 Institute of Pure and Applied Biology, Bahauddin Zakariya University, Multan 60800, Pakistan.


Abstract in English, Spanish

Surveillance of H9N2 is currently focused on areas central to the commercial poultry industry. This study determined the prevalence of H9N2 virus in commercial and backyard poultry flocks in Punjab Province, Pakistan. Oral and tracheal swabs were collected from commercial and backyard poultry from January 2015 through June 2016. Antisera against H5, H7, H9, and Newcastle disease viruses were used for virus identification. Molecular confirmation was made by reverse transcription PCR. Avian influenza virus subtypes H5 and H7 were not detected. The H9N2 virus was isolated in 5.7% of 905 tested flocks (5-10 birds/flock). Prevalence in commercial and backyard poultry was 6.7% of 687 flocks and 2.7% of 218 flocks, respectively. Hemagglutinin and neuraminidase-gene-based phylogenetic analysis of commercial and backyard poultry isolates showed 100% homology. Within sublineage B2 of Pakistan, identity among most recent isolates (2015) was 100%, compared to 75%-99% identity with previously isolated viruses (2010-12), indicating continued virus evolution. Most of the previously reported and currently studied viruses were isolated near the Pakistan-India border. Phylogenetic analysis showed that Pakistani and Indian isolates were closely related, indicating that avian influenza virus transmission may occur across this border.

KEYWORDS: H9N2; Punjab; commercial poultry; hemagglutinin; neuraminidase; phylogenetic analysis; prevalence

PMID: 31119926 DOI: 10.1637/11690-062117-ResNote.1

Keywords: Avian Influenza; H9N2; Poultry; Pakistan; India.


#Epidemiological #trend of #chikungunya #outbreak in #Pakistan: 2016–2018 (PLoS Negl Trop Dis., summary)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Summary, edited.]


Epidemiological trend of chikungunya outbreak in Pakistan: 2016–2018

Nazish Badar, Muhammad Salman, Jamil Ansari, Aamer Ikram, Javaria Qazi, Muhammad Masroor Alam

Published: April 18, 2019 / DOI:


Citation: Badar N, Salman M, Ansari J, Ikram A, Qazi J, Alam MM (2019) Epidemiological trend of chikungunya outbreak in Pakistan: 2016–2018. PLoS Negl Trop Dis 13(4): e0007118.

Editor: Maya Williams, Naval Medical Research Center, UNITED STATES

Published: April 18, 2019

Copyright: © 2019 Badar 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.

Funding: The authors received no specific funding for this work.

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


An unprecedented expansion of vector-borne diseases, especially those caused by viruses transmitted through mosquitoes, has posed a serious public health challenge worldwide. Chikungunya virus (CHIKV), which mainly invades tropical and subtropical regions, is one of the recently emerging pathogens associated with severe morbidity in humans. Although Pakistan is known to be endemic for arboviral infections, only Crimean-Congo hemorrhagic fever (CCHF) and dengue have been officially recognized over the last three decades, despite a recent trend of increasingly frequent chikungunya cases, first detected in December 2016.


Keywords: Arbovirus; Chikungunya Fever; Pakistan.


#Avian #Influenza A(#H9N2) Virus in #Poultry #Worker, #Pakistan, 2015 (Emerg Infect Dis., abstract)

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

Volume 25, Number 1—January 2019 / Dispatch

Avian Influenza A(H9N2) Virus in Poultry Worker, Pakistan, 2015

Muzaffar Ali, Tahir Yaqub, Nadia Mukhtar, Muhammad Imran, Aamir Ghafoor, Muhammad Furqan Shahid, Muhammad Naeem, Munir Iqbal, Gavin J.D. Smith  , and Yvonne C.F. Su

Author affiliations: University of Veterinary and Animal Sciences, Lahore, Pakistan (M. Ali, T. Yaqub, M. Imran, A. Ghafoor, M.F. Shahid); Health Care Department, Government of Punjab, Lahore (N. Mukhtar); Bahauddin Zakariya University, Multan, Pakistan (M. Naeem); The Pirbright Institute, Compton Laboratory, Newbury, UK (M. Iqbal); Duke University, Durham, North Carolina, USA (G.J.D. Smith); Duke-National University Singapore Medical School, Singapore (G.J.D. Smith, Y.C.F. Su)



Avian influenza A(H9N2) virus isolated from a poultry worker in Pakistan in 2015 was closely related to viruses detected in poultry farms. Observed mutations in the hemagglutinin related to receptor-binding affinity and antigenicity could affect cross-reactivity with prepandemic H9N2 vaccine strains.

Keywords: Avian Influenza; H9N2; Human; Pakistan.


Association of Increased #Receptor-Binding Avidity of #Influenza A(#H9N2) Viruses with Escape from #Antibody-Based Immunity and Enhanced #Zoonotic Potential (Emerg Infect Dis., abstract)

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

Volume 25, Number 1—January 2019 / Research

Association of Increased Receptor-Binding Avidity of Influenza A(H9N2) Viruses with Escape from Antibody-Based Immunity and Enhanced Zoonotic Potential

Joshua E. Sealy, Tahir Yaqub, Thomas P. Peacock1, Pengxiang Chang, Burcu Ermetal, Anabel Clements, Jean-Remy Sadeyen, Arslan Mehboob2, Holly Shelton, Juliet E. Bryant, Rod S. Daniels, John W. McCauley, Munir Iqbal, and Jean-Remy

Author affiliations: The Pirbright Institute, Pirbright, UK (J.E. Sealy, T.P. Peacock, P. Chang, A. Clements, J.-R. Sadeyen, H. Shelton, M. Iqbal); University of Veterinary and Animal Sciences, Lahore, Pakistan (T. Yaqub, A. Mehboob); The Francis Crick Institute, London (B. Ermetal, R.S. Daniels, J.W. McCauley); Fondation Mérieux, Lyon, France (J.E. Bryant)


We characterized 55 influenza A(H9N2) viruses isolated in Pakistan during 2014–2016 and found that the hemagglutinin gene is of the G1 lineage and that internal genes have differentiated into a variety of novel genotypes. Some isolates had up to 4-fold reduction in hemagglutination inhibition titers compared with older viruses. Viruses with hemagglutinin A180T/V substitutions conveyed this antigenic diversity and also caused up to 3,500-fold greater binding to avian-like and >20-fold greater binding to human-like sialic acid receptor analogs. This enhanced binding avidity led to reduced virus replication in primary and continuous cell culture. We confirmed that altered receptor-binding avidity of H9N2 viruses, including enhanced binding to human-like receptors, results in antigenic variation in avian influenza viruses. Consequently, current vaccine formulations might not induce adequate protective immunity in poultry, and emergence of isolates with marked avidity for human-like receptors increases the zoonotic risk.

Keywords: Avian Influenza; H9N2; Pakistan.


#History of #ZIKV #Infections in #India and Management of Disease #Outbreaks (Front Microbiol., abstract)

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

Front Microbiol. 2018 Sep 12;9:2126. doi: 10.3389/fmicb.2018.02126. eCollection 2018.

History of ZIKV Infections in India and Management of Disease Outbreaks.

Khaiboullina S1,2, Uppal T1, Martynova E2, Rizvanov A2, Baranwal M3, Verma SC1.

Author information: 1 Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV, United States. 2 Department of Exploratory Research, Scientific and Educational Center of Pharmaceutics, Kazan Federal University, Kazan, Russia. 3 Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, India.



Zika virus (ZIKV) is an emerging arbovirus infection endemic in multiple countries spread from Asia, Africa to the Americas and Europe. Previously known to cause rare and fairly benign human infections, ZIKV has become a major international public health emergency after being linked to unexpected neurological complications, that includes fetal brain damage/death and microcephaly in babies born to infected mothers and Guillain-Barre syndrome (GBS) in adults. It appears that a single genetic mutation in the ZIKV genome, likely acquired during explosive ZIKV outbreak in French Polynesia (2013), made virus causing mild disease to target fetus brain. The Aedes mosquitoes are found to be the main carrier of ZIKV, passing the virus to humans. Originally isolated from patients in Africa in 1954 (African lineage), virus disseminated to Southeast Asia (Asian lineage), establishing new endemic foci, including one in India. Numerous cases of ZIKV infection have been reported in several locations in India and neighboring countries like Pakistan and Bangladesh since mid of the last century, suggesting that the virus reached this part of Asia soon after it was first discovered in Uganda in 1947. Although, the exact means by which ZIKV was introduced to India remains unknown, it appears that the ZIKV strain circulating in India possibly belongs to the “Asian lineage,” which has not yet been associated with microcephaly and other neurological disorders. However, there still exists a threat that the contemporary ZIKV virulent strain from South America, carrying a mutation can return to Asia, posing a potential crisis to newborns and adult patients. Currently there is no specific vaccine or antiviral medication to combat ZIKV infection, thus, vector control and continuous monitoring of potential ZIKV exposure is essential to prevent the devastating consequences similar to the ones experienced in Brazil. However, the major obstacle faced by Indian healthcare agencies is that most cases of ZIKV infection have been reported in rural areas that lack access to rapid diagnosis of infection. In this review, we attempt to present a comprehensive analysis of what is currently known about the ZIKV infection in India and the neighboring countries.

KEYWORDS: ADEs; Aedes aegypti; India; Zika virus (ZIKV); emerging infections; epidemiology

PMID: 30258421 PMCID: PMC6145147 DOI: 10.3389/fmicb.2018.02126

Keywords: Zika Virus; India.


The 2016-2017 #Chikungunya #Outbreak in #Karachi (PLoS Curr., abstract)

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

The 2016-2017 Chikungunya Outbreak in Karachi


REVISIONS: This article is either a revised version or has previous revisions  Edition 1 – August 7, 2018

AUTHORS: Darakhshan Guhar, Shoukat Jahan Talpur, Nadia Jamil, Gulzar Ahmed Channa, Maliha Wajeeh, Muhammad Zohaib Khan, Saifullah Khan




Chikungunya is an incipient disease, caused by Chikungunya virus (CHKV) that belongs to genus alphavirus of the family Togaviridae.

Materials and Methods:

In this study, during an outbreak of CHKV in Dec 2016 in Karachi, Pakistan, samples were collected from patients presenting with fever, tiredness and pain in muscles and joints. Total 126 sera were tested for the presence of Chikungunya infection through ELISA and Real-time Reverse Transcriptase PCR assay.

Results and Discussion:

This study showed that approx 79.4% samples were positive for CHKV. To our knowledge, this is the first reported outbreak from last decades in which the presence of CHKV is confirmed in Karachi while affecting such large no. of individuals..


CHKV diagnosis should be considered by the scientists and clinicians as a differential diagnosis in febrile patients, and appropriate control strategies must be adopted for its surveillance.


The author(s) received no specific funding for this work.

Keywords: Alphavirus; Togavirus; Chikungunya Fever; Pakistan.