Broad investigation of causative pathogen responsible for fatal outbreak in captive primates in Brazil

The Brazilian epizootic surveillance system, under the regulation of the Ministry of Health, has been recently established to address a national list of compulsory notifiable diseases. However, the system focus primarily on diseases affecting humans has led to the neglect of other zoonotic diseases. In this report, we present an outbreak that affected eleven neotropical primates (NP) belonging to six different species. Within four days of exhibiting a range of non-specific clinical signs, including fever, prostration, inappetence, and abdominal pain, almost all the NPs died. Despite testing negative for pathogens included in the national surveillance policy, a collaborative group of researchers investigated the outbreak in more detail. Using advanced diagnostic techniques such as reverse transcription-quantitative polymerase chain reaction (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2), Enzyme-Linked Immunosorbent Assay (SARS-CoV-2), immunohistochemistry (SARS-CoV, Toxoplasma gondii and Escherichia coli), indirect fluorescent antibody test (T. gondii) and portable metagenomic sequencing utilizing nanopore technology, we successfully identified Toxoplasma gondii as the causative agent within a span of two weeks. This unified effort proved instrumental to swiftly containing the outbreak, and underscores the effectiveness of a multidisciplinary collaborative surveillance network in facilitating rapid and precise diagnoses.