Integrated surveillance resolves Darien paradox of Oropouche virus emergence in Panama migration corridor
Rodriguez, X.; Perez-Jimenez, J. G.; Alexander, L. W.; Lezcano-Coba, C.; Galue, J.; Juarez, Y.; Beltran, D.; Smith, D. R.; Kadir, M.; Ali, D. W.; Corrales, R.; Trujillo Rodriguez, L.; Valdiviezo, G. E.; Thomas, Q. K.; Cicalo, A.; Fitzpatrick, M. C.; Luquette, A. E.; Cameron Sayer, L.; Cer, R. Z.; Malagon, F.; Grajales, I. A.; Rivera, L. F.; Gonzalez-R, Z.; Antioco, J.; Walters-Valdes, E.; Meneghello-Ponce, N.; Vittor, A. Y.; Escobar-Lee, K.; Abouganem-Shaw, A.; Rodriguez, F.; Aguirre, E.; Loyola, S.; Tinoco, Y.; Moreno, B.; Chen-German, M.; Ampuero, S.; Gomez-Angelo, A.; Correa-Duarte, S.; Ace
Show abstract
Oropouche virus (OROV) spread across the Americas in 2024, yet Panama Darien migration corridor saw no outbreak until nearly a year after Brazil January 2024 peak, raising two hypotheses: cryptic circulation masked by diagnostic gaps, or recent introduction under permissive climatic conditions. Here we resolve this paradox using integrated clinical, genomic, and climate-informed surveillance. Among 1,040 individuals tested, 43% were OROV-positive and showed a clinical signature distinct from co-circulating arboviruses, including headache more frequent than in dengue (RR 2.38, 95% CI 1.74-3.24). The household secondary attack rate was 56%, and waste burning independently predicted infection. Phylogeographic reconstruction identified a single recent introduction in October 2024 with no evidence of adaptive evolution, excluding prolonged cryptic persistence. Climate-informed models indicate broad outbreak susceptibility across Panama, with Bocas del Toro and Los Santos as the next highest-risk provinces. These findings identify a Central American foothold for OROV with potential for further northward spread.
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