Kwitonda silverback eats a stalk of bamboo.
A few months ago, I received an e-mail from Samantha Newport (then communications director at WildlifeDirect) with an offer of medical supplies from a woman in Switzerland, Jackie Sonderegger, who works for a company that makes medical diagnostic test kits.
Jackie was planning a stay in Mombasa, Kenya, and Samantha knew we'd save a bundle on shipping if we could coordinate getting the supplies to Kenya and from there to Rwanda. Jackie invited me to check out her company's Web site (http://www.doctorsdirect.md/Disease-Testing.html) and pick out what might be useful for the gorillas.
MGVP lab manager Jean Paul Lukusa
One of my goals has been to find tests we can run "in house" to screen the gorillas for diseases. For most samples, including those Jacques and Magda recently collected from Mapendo, we can do some tests in our regional lab — at least when the power is on! But we often wait weeks to months for other types of tests while permits are processed.
Various instant result lab tests have been developed for humans in recent years and I've been trying to learn more about them, especially those that screen for viruses and bacteria that cause respiratory infections. Our lab manager, Jean Paul, is more than willing to run new tests.
Jackie Sonderegger in the mail room at MD Doctors Direct in Switzerland,
preparing a box of supplies for MGVP.
To my surprise, the choices from Jackie's company included easy to use and instant result test kits for influenza, respiratory syncytial virus and streptococcus, all respiratory diseases that we worry about.
These tests use a Q-tip-like swab to take samples from the back of the throat or pharynx. The swab is placed in a special snap test chamber; the color change indicates a positive or negative similar to that of a pregnancy test (her company donated those, too!). I made a wish list and sent it back to Jackie, who responded immediately that she'd do her best to pull all the items together.
Grauer's gorilla Mapendo is bonded to her caretakers,
but even they can't place a swab up her nose.
Unfortunately, we won't be able to use these new tests on wide awake gorillas, even the orphans. Mapendo nearly bit a hole in my stethoscope the other day and I wasn't trying to put it anywhere near her mouth. But we can run the tests on samples taken from anesthetized gorillas. We can also use them for our employee health program. It's a long shot, but we might also be able to use these new test kits on other types of samples, like feces — the most easily collected gorilla sample.
Chimpanzee wadge of ficus fruit (fig) in Nyungwe Forest, Rwanda
The timing of Jackie's donation couldn't have been better for another reason. Recently, Mike and I accepted a summer student from Tufts veterinary school, Tierra Wilson, to work on a small research project on a technique for recovering saliva from uneaten bits of gorilla food. Tierra submitted a grant for her study and got it. She arrives in June.
If her study works, we could have a whole new type of sample to test. Though saliva is not a respiratory secretion, it does mix with fluids that come from the nasal passages and, if the patient is coughing, from the lungs.
The saliva recovery study is not a new idea and it may not work in gorillas. It's been successful in chimpanzees, but that species naturally leaves behind a perfect sample, a "wadge" (a word coined by Dr. Jane Goodall) of uneaten food. Chimps do this most commonly with fruits.
During my recent visit to Nyungwe Forest in Rwanda, we found fig wadges everywhere. By contrast, gorillas don't wadge their food at all and they have access to fewer fruits — and no figs. Until Tierra conducts her pilot study, we're not sure if gorillas leave enough saliva behind on a stalk of bamboo, for example, to recover as a sample.
Orphan Grauer's gorillas forage at the Interim Quarantine Facility.
When Tierra arrives, we'll ask the caretakers at Kinigi to collect uneaten bits of forest food from the orphaned gorillas for the first round of testing. She'll centrifuge it and run tests for the presence of saliva.
In preparation, Tierra has arranged through her mentors at Tufts to collaborate with the nearby New England Zoo that houses Western lowland gorillas. She'll test uneaten food samples collected from these animals and evaluate alternate methods of saliva sample collection, such as ropes or other objects for the gorillas to chew on that might retain bits of saliva. We may find these techniques don't work and/or that there's no way to apply them to free-living gorillas, but we won't know until we try.
An adult female mountain gorilla in Shinda Group
chews on a leaf she later dropped.
Though I'm excited about the possibilities of Tierra's study and Jackie's test kits, we have a number of hurdles to clear when it comes to verifying test results. Because gorillas and people are so closely related, we have good reason to believe the results are accurate. But to verify them would mean giving a rare creature a disease just to prove a test works, something we'd never do to a mountain gorilla. There's another challenge with the saliva recovery study in particular: Gorillas sick with respiratory disease often don't eat very well.
Letter of donation from Jackie's company sent in the hope
that officials would waive the customs fee; they didn't.
As it turned out, our first challenge was getting Jackie's test kits to Rwanda without paying exorbitant shipping. Because of the security problems in Kenya, Jackie never made it to Africa.
Instead, she offered to ship us the samples. Since FedEx turned out to be very expensive, Jackie suggested Danzas, a division of DHL. We said OK, not realizing that the shipment would arrive as freight and thus incur a customs fee. Even with a donation letter from her company, the Rwandan authorities would not waive the fee. Understandable, rules are rules. Jackie graciously offered to make a donation to MGVP equal to the amount we had to pay to get the box.
The tests arrived in time to run them on the little Grauer's gorilla orphan, Mapendo. Magda and Jacques had no trouble with the gorilla under anesthesia and all results were (thankfully) negative.
When Jackie offered to make a donation, little did she or her company know that the supplies would help get a small research study going and also give us new ideas about screening park staff and gorilla caretakers for respiratory diseases. As we learn more, we'll report back. Lots to do.
THANK YOU, Jackie and all at MD Doctors Direct. And thanks, too, to Samantha, for pointing Jackie in our direction.
[Rwanda, April 8, 2008. Pictures: Dr. Lucy Spelman/MGVP]
thats sooooooooooooooooooo cooooooooooooooooooooooooooooooooool dude i used to live in rwanda
Posted by: vanessa | March 10, 2009 at 12:33 PM