On January 31, 2024 Gorilla Doctors welcomed guests from around the world to celebrate the official opening of their state-of-the-art diagnostics laboratory at Gorilla Doctors regional headquarters in Musanze, Rwanda.

Gorilla Doctors veterinarians can now get a report from a tracker about a coughing gorilla, collect a non-invasive sample, and identify the infectious respiratory pathogen in that sample that very same day.

From Field to Lab

Gorilla Doctors is the only organization in the world dedicated to saving wild eastern gorillas one gorilla patient at a time using veterinary medicine and science with a One Health approach. Their international veterinary team provides hands-on medical care to ill and injured mountain and Grauer's gorillas living in the national parks of Rwanda, Uganda, and the Democratic Republic of the Congo (D. R. Congo). With only 1,063 mountain gorillas, and an ever-decreasing number of Grauer's gorillas left in the world today, the health and well-being of every individual gorilla is vital to the species' survival.

Not surprisingly, given their close genetic similarity to humans, eastern gorillas are susceptible to human pathogens. Second to trauma, respiratory disease is the second most common cause of morbidity and mortality in habituated mountain gorillas, and outbreaks occur annually. As far back as the initial days of mountain gorilla tourism in the 1980s, human measles was assumed to be the cause of a widespread respiratory illness outbreak in habituated mountain gorillas in Volcanoes National Park, Rwanda in 1988, based on clinical signs and histopathology (Hastings et al. 1991). Human metapneumovirus was determined to be the primary cause of fatal pneumonia in an adult female mountain gorilla and her infant in 2009 in Volcanoes National Park, Rwanda, during a respiratory disease outbreak that affected most individuals in the group (Palacios et al. 2011). Respiratory illness in mountain gorillas in Volcanoes National Park in 2012 and 2013 was determined to be caused by human respiratory syncytial virus (Mazet et al. 2020).

Historically, identification and confirmation of these types of infectious disease cases have required Gorilla Doctors to collect specimens and undergo lengthy shipping processes to conduct confirmatory diagnostics in international reference laboratories. This approach has enabled advancement in scientific understanding of disease and overall population health of the gorillas but has done little to impact clinical case management in real time. With the support of the Rwanda Development Board, IGCP and other founding donors, Gorilla Doctors has established a world-class diagnostics laboratory at the base of the Virunga Massif in Rwanda to serve this very important and timely function.

The Gorilla Doctors Michael Cranfield Regional One Health Laboratory enables comprehensive diagnostic testing on biological specimens from gorillas and other wildlife to support optimal clinical case management and scientific research. The laboratory is equipped to perform hematology, serology, virology, bacteriology, parasitology, and histopathology and is located in a brand-new building engineered for optimal biosafety and biobanking of specimens. As the largest and only gorilla health diagnostic laboratory in the region it facilitates the work of Gorilla Doctors and its partners in Rwanda, Uganda, and D. R. Congo.

The laboratory is fully equipped to perform molecular diagnostics and genetic sequencing of viruses, bacteria, and parasites that impact the health of the gorillas. Gorilla Doctors monitors all suspected outbreaks of infectious disease that are observed among habituated eastern gorillas through daily health observations and the collection of non-invasive specimens such as feces and chewed plant samples. If a gorilla becomes ill enough to warrant a clinical intervention with full chemical immobilization, additional specimen types are collected including swabs and blood samples. All specimens collected can now be analyzed using quantitative PCR for a suite of pathogens using molecular PCR techniques and results can be obtained in time to guide outbreak response or individual case management.

The laboratory also features a comprehensive histopathology suite which facilitates processing and analysis of clinical diagnostic as well as post-mortem tissues. Gorilla Doctors maintains the largest database of histopathological cases of any free-living great ape species in the world. Historical cases in this database were generated through collaborations with the University of California Davis School of Veterinary Medicine and other collaborating regional veterinary schools. While these important consulting partnerships will continue, Gorilla Doctors has recently hired our first regional diagnostic pathologist and will now be conducting all histopathology analyses at the Gorilla Doctors Michael Cranfield Regional One Health Laboratory. This will greatly reduce the time required to obtain diagnostic information while also increasing the volume of cases that can be examined. It also builds critically needed capacity for pathology in the region.

Cutting Edge Research

Gorilla Doctors has recently launched a new project to investigate the microbiome of the mountain gorilla and to investigate microbiome abnormalities associated with different observed clinical diseases in the gorillas. Located in the bacteriology wing, this research project will help advance our understanding of the connections between the gut-microbiome and systemic diseases as well as build capacity for microbiology techniques that are critical to Gorilla Doctors' clinical cases. To best serve the scientific community, Gorilla Doctors has curated the largest clinical database and biobank of biological specimens for any free-living great ape species in the world. Every time Gorilla Doctors saves an individual gorilla, the health data and specimens are archived for future scientific research. The new facility now enables us to house the majority of this biobank in the region, with the biosecurity and power backup protections required to keep this critical resource safe for today's as well as tomorrow's wildlife health scientists.

One Health for All

While the laboratory is focused on providing timely clinical diagnostics for gorilla cases it is also designed to be a resource for broader wildlife and One Health research in the region. Gorilla Doctors has been the lead implementing partner for several global emerging disease surveillance projects in the region including the USAID-funded PREDICT project (2009-2020) and the ongoing National Institutes of Health-funded Centers for Research in Emerging Infectious Diseases. With the addition of this laboratory, Gorilla Doctors now has both the veterinary surveillance as well as laboratory capacity to conduct laboratory screening needed for these kinds of global One Health projects. A One Health approach understands that animal, human, and environmental health are inextricably linked (e.g., Zinsstag et al. 2011). The health of one group impacts the health of all and is foundational to Gorilla Doctors contributions to mountain gorilla conservation.

Saving a Species One Gorilla at a Time

Gorilla Doctors clinical care and research of individual gorilla cases help advance the health of the entire population. Research has shown that up to 40 % of the annual population growth rate can be attributed to veterinary care (Robbins et al. 2011). For a long-lived, slow to reproduce animal, every individual counts towards saving the entire species.

Tierra Smiley Evans

References
Hastings, B. E. et al. (1991): Mountain gorillas and measles: ontogeny of a wildlife vaccination program. Annual Conference Proceedings of the American Association of Zoo Veterinarians, 198-205
Palacios, G. et al. (2011): Human metapneumovirus infection in wild mountain gorillas, Rwanda. Emerging infectious diseases 17 (4), 711
Mazet, J. A. K. et al. (2020): Human respiratory syncytial virus detected in mountain gorilla respiratory outbreaks. EcoHealth 17, 449-460
Zinsstag, J. et al. (2011): From "one medicine" to "one health" and systemic approaches to health and well-being. Preventive veterinary medicine 101 (3-4), 148-156