Trypanosoma brucei rhodesiense transmitted by a single tsetse fly bite in vervet monkeys as a model of human African trypanosomiasis

Abstract

We have investigated the pathogenicity of tsetse (Glossina pallidipes)-transmitted cloned strains of Trypanosoma brucei rhodesiense in vervet monkeys. Tsetse flies were confirmed to have mature trypanosome infections by xenodiagnosis, after which nine monkeys were infected via the bite of a single infected fly. Chancres developed in five of the nine (55.6%) monkeys within 4 to 8 days post infection (dpi). All nine individuals were successfully infected, with a median pre-patent period of 4 (range = 4-10) days, indicating that trypanosomes migrated from the site of fly bite to the systemic circulation rapidly and independently of the development of the chancre. The time lag to detection of parasites in cerebrospinal fluid (CSF) was a median 16 (range = 8-40) days, marking the onset of central nervous system (CNS, late) stage disease. Subsequently, CSF white cell numbers increased above the pre-infection median count of 2 (range = 0-9) cells/microl, with a positive linear association between their numbers and that of CSF trypanosomes. Haematological changes showed that the monkeys experienced an early microcytic-hypochromic anaemia and severe progressive thrombocytopaenia. Despite a 3-fold increase in granulocyte numbers by 4 dpi, leucopaenia occurred early (8 dpi) in the monkey infection, determined mainly by reductions in lymphocyte numbers. Terminally, leucocytosis was observed in three of nine (33%) individuals. The duration of infection was a median of 68 (range = 22-120) days. Strain and individual differences were observed in the severity of the clinical and clinical pathology findings, with two strains (KETRI 3741 and 3801) producing a more acute disease than the other two (KETRI 3804 and 3928). The study shows that the fly-transmitted model accurately mimics the human disease and is therefore a suitable gateway to understanding human African trypanosomiasis (HAT; sleeping sickness).

Figure 1. Parasitaemia curves generated by four T.b. rhodesiense cloned strains after experimental fly (Glossina pallidipes) infection of nine vervet monkeys (+-476, □-515, ♦-536, ◊-523, ▪-579, ▴-556, x-574, •-554, ▵-555).

After a variable pre-patent period, the parasitaemia tended to plateau but with more clearly defined waves of relapse and recrudescence in the individuals with longer disease duration.

Figure 2. Changes in the mean corpuscular volume (MCV) mean corpuscular haemoglobin (MCH) and Red cell distribution width (RDW) in two vervet monkeys (•-554 and ▵-555) that were infected with T.b. rhodesiense KETRI 3928.

Panel A: MCV; Panel B: MCH; and Panel C: RDW. Note that while both MCV and MCH decreased below pre-infection levels and remained low throughout; RDW increased throughout the infection.

Figure 3. Changes in total and differential white blood cell numbers in vervet 554 that was infected with T.b. rhodesiense KETRI 3928.

During the early part of the infection, granulocytes and lymphocytes are approximately equal while later in the infection, lymphocytes are clearly the predominant cell type. (X- Total WBC, ▴-lymphocytes, ▵-Granulocytes, ▪-Monocytes).

Figure 4. Changes in cerebrospinal fluid (CSF) trypanosomes (▪) and white cell (▴) during the course of infection of vervet 476 with T.b. rhodesiense KETRI 3741.

Phase 1: early stage infection; Phase 2: transition of intermediate stage infection and phase 3: late stage disease which at terminal point was marked by surge in trypanosome numbers and white cell counts.