#Clinical and x-ray #oral #evaluation in patients with #congenital #Zika Virus (J Appl Oral Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Appl Oral Sci. 2019 May 20;27:e20180276. doi: 10.1590/1678-7757-2018-0276.

Clinical and x-ray oral evaluation in patients with congenital Zika Virus.

Carvalho IF1, Alencar PNB1, Carvalho de Andrade MD1, Silva PGB1, Carvalho EDF1, Araújo LS1, Cavalcante MPM1, Sousa FB1.

Author information: 1 Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brasil.

 

Abstract

OBJECTIVE:

The aim of this study was to investigate possible malformations in the soft, bone and/or dental tissues in patients with congenital Zika Virus (ZIKV) by clinical and x-ray evaluation.

METHODOLOGY:

Thirty children born with ZIKV and 30 children born without ZIKV (control group) were included in the study. Patients were evaluated over 24 consecutive months according to the variables: sex, age, cleft palates, soft tissue lesions, alveolar ridge hyperplasia, short labial and lingual frenums, inadequate posture of the lingual and perioral muscles at rest, micrognathia, narrow palatine vaults, changes in the teeth shape and/or number, sequence eruption, spasms, seizures and eruption delay were evaluated. Chi-square test, Student’s t-test and nominal logistic regression were used (p<0.05).

RESULTS:

Among the 30 babies examined, the mean age of the first dental eruption was 10.8±3.8 with almost two-thirds of the children (n=18, 60%) experiencing eruptions of their first tooth after 9 months of age, nine children (30%) had inadequate lingual posture at rest, more than half of the children (n=18, 60%) had short labial or lingual frenums. ZIKV babies showed a high prevalence of clef palate (p<0.001), inadequate lingual posture at rest (p=0.004), micrognathia (p=0.002), changes in the shape and/or number of teeth (p=0.006), alteration in sequence of dental eruption (p<0.001) and muscles spasms (p=0.002). The delay eruption was associated with inadequate lingual posture at rest (p=0.047), micrognathia (p=0.002) and changes in the shape and/or number of teeth (p=0.021). The delayed eruption (p=0.006) and narrow palatine vaults (p=0.008) were independently associated with ZIKV. Moreover, female patients showed the most narrow palatine vaults (p=0.010).

CONCLUSIONS:

The children with ZIKV showed a greater tendency to have delayed eruption of the first deciduous tooth, inadequate lingual posture and short labial and lingual frenums.

PMID: 31116278 DOI: 10.1590/1678-7757-2018-0276

Keywords: Zika Virus; Zika Congenital Syndrome; Brazil.

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Use of #mosquito #repellents to protect against #Zika virus infection among #pregnant women in #Brazil (Public Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Public Health. 2019 May 17;171:89-96. doi: 10.1016/j.puhe.2019.04.002. [Epub ahead of print]

Use of mosquito repellents to protect against Zika virus infection among pregnant women in Brazil.

Dantas Melo VA1, Santos Silva JR2, La Corte R3.

Author information: 1 Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil. 2 Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil; Department of Statistics and Actuarial Sciences, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil. 3 Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil; Department of Morphology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil. Electronic address: rlacorte@ufs.br.

 

Abstract

OBJECTIVES:

To evaluate the use of repellents among pregnant women as a protective measure against infection with the Zika virus.

STUDY DESIGN:

Pregnant women (n = 177) were interviewed between November 2016 and February 2017 at Basic Health Units in the city of Propriá, state of Sergipe, Brazil. Two units were located in rural areas and eight in urban regions.

METHODS:

Data were analysed using descriptive statistical methods, the Chi-squared test or Fisher’s exact test and odds ratios. The independent variables were grouped by analysis of the main components, and adherence to the use of the repellent was analysed by the logistic regression method.

RESULTS:

A total of 100 women reported using repellents at the time of the interview (56%). The use of repellents was greater among women with higher levels of education (83%) than those with only high school (68%) or elementary school (36%) education. Women assisted by the income transfer programme (Bolsa Família) presented a 2.27 times greater chance of not using repellents compared with pregnant women who were not receiving benefits of the programme. Regarding the logistic regression model, we observed that low economic and social conditions of pregnant women, as well as their lack of advice, had a negative effect on the use of repellents.

CONCLUSIONS:

Repellents were generally used as a preventive measure in pregnant women with higher levels of schooling and fewer children. The relatively high cost of repellents was the main reason for non-use.

Copyright © 2019. Published by Elsevier Ltd.

KEYWORDS: Aedes aegypti; Pregnant women; Repellents; Vector control; Zika virus

PMID: 31112836 DOI: 10.1016/j.puhe.2019.04.002

Keywords: Zika Virus; Pregnancy; Society; Poverty; Mosquitoes repellents.

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#Predictors of #mortality in patients with #yellowfever: an observational cohort study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Predictors of mortality in patients with yellow fever: an observational cohort study

Prof Esper G Kallas, PhD, Luiz Gonzaga F A B D’Elia Zanella, MD, Carlos Henrique V Moreira, MD, Renata Buccheri, MD, Gabriela B F Diniz, MD, Anna Carla P Castiñeiras, MD, Priscilla R Costa, PhD, Juliana Z C Dias, PhD, Mariana P Marmorato, BSc, Alice T W Song, PhD, Alvino Maestri, PhD, Igor C Borges, PhD, Daniel Joelsons, MD, Natalia B Cerqueira, BSc, Nathália C Santiago e Souza, BSc, Ingra Morales Claro, BSc, Ester C Sabino, PhD, José Eduardo Levi, PhD, Vivian I Avelino-Silva, PhD, Yeh-Li Ho, PhD

Published: May 16, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30125-2

 

Summary

Background

Yellow fever virus infection results in death in around 30% of symptomatic individuals. The aim of this study was to identify predictors of death measured at hospital admission in a cohort of patients admitted to hospital during the 2018 outbreak of yellow fever in the outskirts of São Paulo city, Brazil.

Methods

In this observational cohort study, we enrolled patients with yellow fever virus from two hospitals in São Paolo—the Hospital das Clínicas, University of São Paulo and the Infectious Diseases Institute “Emilio Ribas”. Patients older than 18 years admitted to hospital with fever or myalgia, headache, arthralgia, oedema, rash, or conjunctivitis were consecutively screened for inclusion in the present study. Consenting patients were included if they had travelled to geographical areas in which yellow fever virus cases had been previously confirmed. Yellow fever infection was confirmed by real-time PCR in blood collected at admission or tissues at autopsy. We sequenced the complete genomes of yellow fever virus from infected individuals and evaluated demographic, clinical, and laboratory findings at admission and investigated whether any of these measurements correlated with patient outcome (death).

Findings

Between Jan 11, 2018, and May 10, 2018, 118 patients with suspected yellow fever were admitted to Hospital das Clínicas, and 113 patients with suspected yellow fever were admitted to Infectious Diseases Institute “Emilio Ribas”. 95 patients with suspected yellow fever were included in the study, and 136 patients were excluded. Three (3%) of 95 patients with suspected yellow fever who were included in the study were excluded because they received a different diagnosis, and 16 patients with undetectable yellow fever virus RNA were excluded. Therefore, 76 patients with confirmed yellow fever virus infection, based on detectable yellow fever virus RNA in blood (74 patients) or yellow fever virus confirmed only at the autopsy report (two patients), were included in our analysis. 27 (36%) of 76 patients died during the 60 day period after hospital admission. We generated 14 complete yellow fever virus genomes from the first 15 viral load-detectable samples. The genomes belonged to a single monophyletic clade of the South America I genotype, sub-genotype E. Older age, male sex, higher leukocyte and neutrophil counts, higher alanine aminotransferase, aspartate transaminase (AST), bilirubin, and creatinine, prolonged prothrombin time, and higher yellow fever virus RNA plasma viral load were associated with higher mortality. In a multivariate regression model, older age, elevated neutrophil count, increased AST, and higher viral load remained independently associated with death. All 11 (100%) patients with neutrophil counts of 4000 cells per mL or greater and viral loads of 5·1 log 10 copies/mL or greater died (95% CI 72–100), compared with only three (11%) of 27 (95% CI 2–29) among patients with neutrophil counts of less than 4000 cells per mL and viral loads of less than 5·1 log 10 copies/mL.

Interpretation

We identified clinical and laboratory predictors of mortality at hospital admission that could aid in the care of patients with yellow fever virus. Identification of these prognostic markers in patients could help clinicians prioritise admission to the intensive care unit, as patients often deteriorate rapidly. Moreover, resource allocation could be improved to prioritise key laboratory examinations that might be more useful in determining whether a patient could have a better outcome. Our findings support the important role of the virus in disease pathogenesis, suggesting that an effective antiviral could alter the clinical course for patients with the most severe forms of yellow fever.

Funding

São Paulo Research Foundation (FAPESP).

Keywords: Yellow Fever; Brazil.

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#Epidemiological and #clinical suspicion of #congenital #Zika virus #infection: #serological findings in #mothers and #children from #Brazil (J Med Virol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Med Virol. 2019 May 15. doi: 10.1002/jmv.25504. [Epub ahead of print]

Epidemiological and clinical suspicion of congenital Zika virus infection: serological findings in mothers and children from Brazil.

Venturi G1, Fortuna C1, Alves RM2, Passos do Prado Paschoal AG2, da Silva Júnior PJ3, Remoli ME1, Benedetti E1, Amendola A1, da Silva Batista E3, Gama DVN2, Barros DH3, Fiorentini C1, Rezza G1, Leite Primo Chagas JR2,3.

Author information: 1 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. 2 Pediatric Neurology Service, S. Antonio das Obras Sociais Irmã Dulce Hospital(HSA/OSID), Salvador, Bahia, Brazil. 3 Neurologia Pediátrica, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.

 

Abstract

The emergence of Zika virus in the Americas has caused an increase of babies born with microcephaly or other neurological malformations. The differential diagnosis of Zika infection, particularly serological diagnosis, is an important but complex issue. In this study, we describe clinical manifestations of 94 suspected cases of congenital Zika from Bahia state, Brazil, and the results of serological tests performed on children and/or their mothers at an average of 71 days after birth. Anti-Zika IgM antibodies were detected in 44.4% and in 7.1% of samples from mothers and children, respectively. Nearly all the IgM, and 92% of IgG positive results were confirmed by neutralization test. Zika specific neutralizing antibodies were detected in as much as 90.4 % of the cases. Moreover, dengue specific neutralizing antibodies were detected in 79.0% of Zika seropositive mothers. In conclusion, Zika IgM negative results should be considered with caution, due to a possible rapid loss of sensitivity after birth, while the NS1-based Zika IgM ELISA test we have used has demonstrated to be highly specific. In a high percentage of cases, Zika specific neutralizing antibodies were detected, which are indicative of a past Zika infection, probably occurred during pregnancy in this population.

This article is protected by copyright. All rights reserved.

KEYWORDS: Congenital infection; Flavivirus; diagnosis; microcephaly; neutralization test; serological tests

PMID: 31090222 DOI: 10.1002/jmv.25504

Keywords: Zika Virus; Zika  Congenital Infection; Serology; Pregnancy; Brazil.

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Detection of #YellowFever Virus in #Sylvatic #Mosquitoes during Disease #Outbreaks of 2017⁻2018 in Minas Gerais State, #Brazil (Insects, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Insects. 2019 May 10;10(5). pii: E136. doi: 10.3390/insects10050136.

Detection of Yellow Fever Virus in Sylvatic Mosquitoes during Disease Outbreaks of 2017⁻2018 in Minas Gerais State, Brazil.

Pinheiro GG1,2, Rocha MN3, de Oliveira MA4, Moreira LA5, Andrade Filho JD6.

Author information: 1 Coleção de Mosquitos Neotropicais, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. ggarciapinheiro@gmail.com. 2 Grupo de Estudos em Leishmanioses, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. ggarciapinheiro@gmail.com. 3 Mosquitos Vetores: Endossimbiontes e Interação Patógeno-Vetor, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. marcele.rocha@fiocruz.br. 4 Coleção de Mosquitos Neotropicais, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. angelica.oliveira@fiocruz.br. 5 Mosquitos Vetores: Endossimbiontes e Interação Patógeno-Vetor, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. luciano.andrade@fiocruz.br. 6 Grupo de Estudos em Leishmanioses, Instituto René Rachou, Avenida Augusto de Lima, 1715, Belo Horizonte 30190-002, Brazil. jose.andrade@fiocruz.br.

 

Abstract

Brazil has experienced several arbovirus outbreaks in recent years, among which yellow fever stands out. The state of Minas Gerais faced outbreaks of sylvatic yellow fever in 2017 and 2018, with 1002 confirmed cases and 340 deaths. This work presents the results of survey efforts to detect the yellow fever virus in mosquitoes from two conservation areas in the metropolitan region of Belo Horizonte, Brazil. A total of 867 mosquitoes of 20 species were collected between September 2017 and May 2018, the most abundant being Psorophora(Janthinosoma) ferox (von Humboldt, 1819) (31.3%), Limatus durhamii Theobald, 1901 (19.1%) and Haemagogus (Haemagogus) janthinomys Dyar, 1921 (18.2%). Total RNA was extracted from the mosquitoes for real-time PCR analysis for yellow fever, chikungunya, mayaro, Zika and dengue viruses. The yellow fever infection rate was 8.2% for Hg. janthinomys (13 mosquitoes), which is the main vector of sylvatic yellow fever in Brazil. In addition to surveying the mosquito fauna of these conservation units, this work demonstrates the importance of monitoring the circulation of viruses near large urban centers.

KEYWORDS: arboviruses; mosquitoes; yellow fever

PMID: 31083286 DOI: 10.3390/insects10050136

Keywords: Arbovirus; Mosquitoes; Yellow fever; Brazil.

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Cross- #Protection of #Dengue Virus #Infection against #Congenital #Zika #Syndrome, Northeastern #Brazil (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 8—August 2019 / Research

Cross-Protection of Dengue Virus Infection against Congenital Zika Syndrome, Northeastern Brazil

Celia Pedroso1, Carlo Fischer1, Marie Feldmann1, Manoel Sarno, Estela Luz, Andrés Moreira-Soto, Renata Cabral, Eduardo Martins Netto, Carlos Brites, Beate M. Kümmerer, and Jan Felix Drexler

Author affiliations: Universidade Federal de Bahia, Salvador, Brazil (C. Pedroso, M. Sarno, E. Luz, R. Cabral, E. Martins Netto, C. Brites); Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humbolt-Universität zu Berlin and Berlin Institute of Health, Institute of Virology, Berlin, Germany (C. Fischer, A. Moreira-Soto, J.F. Drexler); University of Bonn Medical Centre, Bonn, Germany (M. Feldmann, B.M. Kümmerer); German Centre for Infection Research (B.M. Kümmerer, J.F. Drexler)

 

Abstract

The Zika virus outbreak in Latin America resulted in congenital malformations, called congenital Zika syndrome (CZS). For unknown reasons, CZS incidence was highest in northeastern Brazil; one potential explanation is that dengue virus (DENV)–mediated immune enhancement may promote CZS development. In contrast, our analyses of historical DENV genomic data refuted the hypothesis that unique genome signatures for northeastern Brazil explain the uneven dispersion of CZS cases. To confirm our findings, we performed serotype-specific DENV neutralization tests in a case–control framework in northeastern Brazil among 29 Zika virus–seropositive mothers of neonates with CZS and 108 Zika virus–seropositive control mothers. Neutralization titers did not differ significantly between groups. In contrast, DENV seroprevalence and median number of neutralized serotypes were significantly lower among the mothers of neonates with CZS. Supported by model analyses, our results suggest that exposure to multitypic DENV infection may protect from, rather than enhance, development of CZS.

Keywords: Flavivirus; Dengue Fever; Zika Virus; A.D.E.; Congenital Zika Syndrome; Pregnancy; Brazil; Seroprevalence.

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#Aporé virus, a novel #mammarenavirus (#Bunyavirales: #Arenaviridae) related to highly pathogenic virus from South #America (Mem Inst Oswaldo Cruz, abstract)

[Source: Memoria do Institutos Oswaldo Cruz, full page: (LINK). Abstract, edited.]

Aporé virus, a novel mammarenavirus (Bunyavirales: Arenaviridae) related to highly pathogenic virus from South America

[ACCEPTED ARTICLES / PRELIMINARY VERSION]

Jorlan Fernandes1,+, Alexandro Guterres1, Renata Carvalho de Oliveira1, Rodrigo Jardim2, Alberto Martín Rivera Dávila2, Roger Hewson3, Elba Regina Sampaio de Lemos1

1 Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro – RJ, Brasil; 2 Laboratório de Biologia Computacional e Sistemas, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro – RJ, Brasil; 3 National Infection Service, Public Health England, Salisbury, United Kingdom

DOI: 10.1590/0074-02760180586

 

ABSTRACT

Here, we report the complete genome sequence of the Aporé virus (Bunyavirales: Arenaviridae), obtained from a wild rodent Oligoryzomys mattogrossae captured in Mato Grosso do Sul state, Brazil. The genome of this virus showed strong similarity to highly pathogenic mammarenavirus from South America.

key words: Oligoryzomys – mattogrossae rodent mammarenavirus – arenavirus – Aporé virus

Financial support: FIOCRUZ, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES and Conselho Nacional para o Desenvolvimento Científico e Tecnológico (CNPq), grant number 404762/2016-6.

+ Corresponding author: jorlan@ioc.fiocruz.br

Received 14 December 2018  – Accepted 29 April 2019

Keywords: Mammarenavirus; Bunyavirus; Arenavirus; Aporé virus; Brazil.

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