#Routes for #COVID19 #importation in #Brazil (J Trav Med., abstract)

[Source: Journal of Travel Medicine, full page: (LINK). Abstract, edited.]

Routes for COVID-19 importation in Brazil 

Darlan Da S Candido, MSc, Alexander Watts, PhD, Leandro Abade, DPhil, Moritz U G Kraemer, DPhil, Oliver G Pybus, DPhil, Julio Croda, MD, PhD, Wanderson Oliveira, PhD, Kamran Khan, MD, MPH, Ester C Sabino, PhD, Nuno R Faria, PhD

Journal of Travel Medicine, taaa042, https://doi.org/10.1093/jtm/taaa042

Published: 23 March 2020



The global outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been declared a pandemic by the WHO. As the number of imported SARS-CoV-2 cases is on the rise in Brazil, we use incidence and historical air travel data to estimate the most important routes of importation into the country.

Topic: coronavirus – brazil – disease outbreaks – world health organization – severe acute respiratory syndrome – air travel – pandemics – sars-cov-2 – covid-19

Issue Section: Not Selected

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© International Society of Travel Medicine 2020.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: SARS-CoV-2; COVID-19; Brazil.


#Zika Virus and #Pregnancy: Association between Acute #Infection and #Microcephaly in #Newborns in the State of #Rio de Janeiro, #Brazil (Geburtshilfe Frauenheilkd, abstract)

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

Geburtshilfe Frauenheilkd. 2020 Jan;80(1):60-65. doi: 10.1055/a-0972-2052. Epub 2020 Jan 13.

Zika Virus and Pregnancy: Association between Acute Infection and Microcephaly in Newborns in the State of Rio de Janeiro, Brazil.

Pereira AM1, Araujo Júnior E2,3, Werner H4, Monteiro DLM1.

Author information: 1 Perinatal Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro-RJ, Brazil. 2 Department of Obstetrics, Paulista School of Medicine – Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil. 3 Medical course, Municipal University of São Caetano do Sul (USCS), São Paulo-SP, Brazil. 4 Department of Radiology, Clínica de Diagnóstico por Imagem (CPDI), Rio de Janeiro-RJ, Brazil.


Abstract in English, German

Introduction Aim of the study was to evaluate the association between microcephaly and acute infection with Zika virus (ZIKV) in pregnant women in the state of Rio de Janeiro, Brazil. Infection was confirmed by laboratory testing. Materials and Methods A cross-sectional retrospective study of pregnant women with symptoms occurring between 2015 and 2016 suggestive of acute ZIKV infection was carried out, with confirmation of infection done by blood or urine RT-PCR. The relative proportions of categorical variables were calculated for two distinct groups: pregnant women whose newborns had microcephaly and pregnant women who gave birth to infants without microcephaly. Confidence intervals with a 95% level of agreement were estimated for the relative ratios. Results A total of 1609 pregnant women with a mean age of 26.4 ± 6.5 years were evaluated. As regards the time of acute infection, 19.6% (316) of cases occurred in the first trimester of pregnancy. Nineteen (76%) of the 25 cases with microcephaly (1.5%) were associated with an infection contracted in the first trimester of pregnancy (p < 0.001, OR = 13.7, 95% CI: 5.6 - 37.7). 48% (12/25) of the newborns with microcephaly had a birth weight of < 2500 grams, while only 7% (116/1597) of the group of newborns without microcephaly had a similarly low birth weight (p < 0.001, OR = 11.7, 95% CI: 5.2 - 26.2). Logistic regression showed that a birth weight of < 2500 g (OR = 12.54) and ZIKV infection in the first trimester of pregnancy (OR = 14.05) were associated with microcephaly (area under ROC curve = 0.86). Conclusion Acute ZIKV infection in the first trimester of pregnancy and low birth weight are associated with microcephaly.

KEYWORDS: Zika virus; congenital infection; first trimester of pregnancy; low birth weight; microcephaly

PMID: 31949320 PMCID: PMC6957353 DOI: 10.1055/a-0972-2052

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


#Sequencing of #ZIKV #genomes directly from Ae. aegypti and Cx. quinquefasciatus #mosquitoes collected during the 2015-16 #epidemics in #Recife (Infect Genet Evol., abstract)

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

Infect Genet Evol. 2020 Jan 6:104180. doi: 10.1016/j.meegid.2020.104180. [Epub ahead of print]

Sequencing of ZIKV genomes directly from Ae. aegypti and Cx. quinquefasciatus mosquitoes collected during the 2015-16 epidemics in Recife.

Paiva MHS1, Guedes DRD2, Krokovsky L2, Machado LC2, Rezende TMT2, de Morais Sobral MC2, Ayres CFJ2, Wallau GL3.

Author information: 1 Universidade Federal de Pernambuco, Caruaru, Brazil. 2 Entomology Department of the Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil. 3 Entomology Department of the Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil. Electronic address: gabriel.wallau@cpqam.fiocruz.br.



Zika virus (ZIKV) is a negative sense RNA virus from the Flaviviridae family, which was relatively unknown until the first human epidemic in Micronesia, in 2007. Since its spread to French Polynesia and the Americas. Recife, the capital of Pernambuco state and epicenter of the Zika epidemic in Brazil, experienced a large number of microcephaly cases and other congenital abnormalities associated to the ZIKV infection from, 2015 to 16. Evidences suggest that both Aedes aegypti and Culex quinquefasciatus mosquitoes from Recife are capable of replicating and transmitting the virus. Here, we conducted high throughput sequencing of ZIKV genomes directly from Ae. aegypti and Cx. quinquefasciatus mosquitoes collected during the ZIKV epidemics in Recife, in order to investigate the variability and evolution of the virus. We obtained 11 draft ZIKV genomes derived from 5 pools from each Ae. aegypti and Cx. quinquefasciatus species. Genome coverage breadth ranged from 16 to 100% and average depth from 45 to 46,584×. Two of these genomes were obtained from pools of unfed Cx. quinquefasciatus females. Amino acid substitutions found here were not species-specific, which could indicate species specific virus adaptation. In addition, molecular clock dating estimated that ZIKV draft genomes obtained here were co-circulating in the region during the epidemics. Overall results highlight that viral mutations and even minor variants can be detected in genomes directly sequenced from mosquito samples and insights about natural viral genomic variability and viral evolution can be useful when designing tools for mosquito control programs.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS: Aedes aegypti; Arboviruses; Culex quinquefasciatus; Surveillance; ZIKV

PMID: 31918041 DOI: 10.1016/j.meegid.2020.104180

Keywords: Zika Virus; Aedes aegypti; Culex quinquefascitus; Mosquitoes; Brazil.


#Zika Virus #Surveillance at the #Human – #Animal #Interface in West-Central #Brazil, 2017-2018 (Viruses, abstract)

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

Viruses. 2019 Dec 16;11(12). pii: E1164. doi: 10.3390/v11121164.

Zika Virus Surveillance at the Human-Animal Interface in West-Central Brazil, 2017-2018.

Pauvolid-Corrêa A1, Gonçalves Dias H2, Marina Siqueira Maia L3, Porfírio G4, Oliveira Morgado T5, Sabino-Santos G6, Helena Santa Rita P7, Teixeira Gomes Barreto W8, Carvalho de Macedo G4, Marinho Torres J4, Arruda Gimenes Nantes W4, Martins Santos F4, Oliveira de Assis W4, Castro Rucco A4, Mamoru Dos Santos Yui R4, Bosco Vilela Campos J4, Rodrigues Leandro E Silva R4, da Silva Ferreira R3, Aparecido da Silva Neves N3, Charlles de Souza Costa M3, Ramos Martins L3, Marques de Souza E3, Dos Santos Carvalho M3, Gonçalves Lima M7, de Cássia Gonçalves Alves F7, Humberto Guimarães Riquelme-Junior L7, Luiz Batista Figueiró L7, Fernandes Gomes de Santana M7, Gustavo Rodrigues Oliveira Santos L8, Serra Medeiros S8, Lopes Seino L8, Hime Miranda E9, Henrique Rezende Linhares J9, de Oliveira Santos V9, Almeida da Silva S9, Araújo Lúcio K9, Silva Gomes V9, de Araújo Oliveira A10, Dos Santos Silva J10, de Almeida Marques W10, Schafer Marques M6, Junior França de Barros J11, Campos L11, Couto-Lima D12, Coutinho Netto C13, Strüssmann C14, Panella N15, Hannon E15, Cristina de Macedo B16, Ramos de Almeida J14, Ramos Ribeiro K14, Carolina Barros de Castro M14, Pratta Campos L14, Paula Rosa Dos Santos A14, Marino de Souza I14, de Assis Bianchini M5, Helena Ramiro Correa S5, Ordones Baptista Luz R5, Dos Santos Vieira A5, Maria de Oliveira Pinto L2, Azeredo E2, Tadeu Moraes Figueiredo L6, Augusto Fonseca Alencar J10, Maria Barbosa de Lima S9, Miraglia Herrera H4, Dezengrini Shlessarenko R3, Barreto Dos Santos F2, Maria Bispo de Filippis A1, Salyer S17, Montgomery J17, Komar N15.

Author information: 1 Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil. 2 Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil. 3 Laboratório de Virologia, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, Brazil. 4 Laboratório de Biologia Parasitária, Programa de Pós-Graduação em Ciências Ambientais e Sustentabilidade Agropecuária, Universidade Católica Dom Bosco (UCDB), Campo Grande 79117-010, Brazil. 5 Hospital Veterinário, Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, Brazil. 6 Centro de Pesquisa em Virologia, Faculdade de Medicina, Universidade de São Paulo (USP), Ribeirão Preto 14025-099, Brazil. 7 Biotério, Universidade Católica Dom Bosco (UCDB), Campo Grande 79117-010, Brazil. 8 Laboratório de Ecologia de Populações e do Movimento, Programa de Ecologia e Conservação, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande 79070-900, Brazil. 9 Laboratório de Tecnologia Virológica, Bio-Manguinhos, Fiocruz, Rio de Janeiro 21040-900, Brazil. 10 Laboratório de Diptera, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil. 11 Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil. 12 Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil. 13 Centro de Reabilitação de Animais Silvestres (CRAS), Campo Grande 79037-109, Brazil. 14 Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso (UFMT), Cuiabá 78060-900, Brazil. 15 Laboratory of Arbovirus Ecology, Arboviral Diseases Branch, U.S. Centers for Disease Control and Prevention (CDC), Fort Collins, CO 80521, USA. 16 Faculdade de Medicina Veterinária da Universidade de Cuiabá (UNIC), Cuiabá 78065-900, Brazil. 17 Global Epidemiology, Laboratory, and Surveillance Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA 30333, USA.



Zika virus (ZIKV) was first discovered in 1947 in Uganda but was not considered a public health threat until 2007 when it found to be the source of epidemic activity in Asia. Epidemic activity spread to Brazil in 2014 and continued to spread throughout the tropical and subtropical regions of the Americas. Despite ZIKV being zoonotic in origin, information about transmission, or even exposure of non-human vertebrates and mosquitoes to ZIKV in the Americas, is lacking. Accordingly, from February 2017 to March 2018, we sought evidence of sylvatic ZIKV transmission by sampling whole blood from approximately 2000 domestic and wild vertebrates of over 100 species in West-Central Brazil within the active human ZIKV transmission area. In addition, we collected over 24,300 mosquitoes of at least 17 genera and 62 species. We screened whole blood samples and mosquito pools for ZIKV RNA using pan-flavivirus primers in a real-time reverse-transcription polymerase chain reaction (RT-PCR) in a SYBR Green platform. Positives were confirmed using ZIKV-specific envelope gene real-time RT-PCR and nucleotide sequencing. Of the 2068 vertebrates tested, none were ZIKV positive. Of the 23,315 non-engorged mosquitoes consolidated into 1503 pools tested, 22 (1.5%) with full data available showed some degree of homology to insect-specific flaviviruses. To identify previous exposure to ZIKV, 1498 plasma samples representing 62 species of domestic and sylvatic vertebrates were tested for ZIKV-neutralizing antibodies by plaque reduction neutralization test (PRNT90). From these, 23 (1.5%) of seven species were seropositive for ZIKV and negative for dengue virus serotype 2, yellow fever virus, and West Nile virus, suggesting potential monotypic reaction for ZIKV. Results presented here suggest no active transmission of ZIKV in non-human vertebrate populations or in alternative vector candidates, but suggest that vertebrates around human populations have indeed been exposed to ZIKV in West-Central Brazil.

KEYWORDS: Brazil; Zika; enzootic cycle; plaque reduction neutralization test (PRNT); zoonotic

PMID: 31888285 DOI: 10.3390/v11121164

Keywords: Zika Virus; Wildlife; Brazil.


#Risk of #yellowfever virus #importation into the #USA from #Brazil, #outbreak years 2016–2017 and 2017–2018 (Sci Rep., abstract)

[Source: Scientific Reports, full page: (LINK). Abstract, edited.]

Risk of yellow fever virus importation into the United States from Brazil, outbreak years 2016–2017 and 2017–2018

Ilaria Dorigatti,  Stephanie Morrison,  Christl A. Donnelly,  Tini Garske,  Sarah Bowden &  Ardath Grills

Scientific Reports volume 9, Article number: 20420 (2019)



Southeast Brazil has experienced two large yellow fever (YF) outbreaks since 2016. While the 2016–2017 outbreak mainly affected the states of Espírito Santo and Minas Gerais, the 2017–2018 YF outbreak primarily involved the states of Minas Gerais, São Paulo, and Rio de Janeiro, the latter two of which are highly populated and popular destinations for international travelers. This analysis quantifies the risk of YF virus (YFV) infected travelers arriving in the United States via air travel from Brazil, including both incoming Brazilian travelers and returning US travelers. We assumed that US travelers were subject to the same daily risk of YF infection as Brazilian residents. During both YF outbreaks in Southeast Brazil, three international airports—Miami, New York-John F. Kennedy, and Orlando—had the highest risk of receiving a traveler infected with YFV. Most of the risk was observed among incoming Brazilian travelers. Overall, we found low risk of YFV introduction into the United States during the 2016–2017 and 2017–2018 outbreaks. Decision makers can use these results to employ the most efficient and least restrictive actions and interventions.

Keywords: Yellow fever; USA; Brazil.


#ALS-like #Syndrome after #Chikungunya (Cureus, abstract)

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

Cureus. 2019 Oct 9;11(10):e5876. doi: 10.7759/cureus.5876.

Amyotrophic Lateral Sclerosis-like Syndrome after Chikungunya.

Andrade FC1, Vergetti V1, Cozza G2, Falcao MC1, Azevedo G3.

Author information: 1 Medicine, Faculdade Pernambucana De Saude, Recife, BRA. 2 Medicine, Faculdade Pernambuca De Saude, Recife, BRA. 3 Neurosurgery, Hospital Getulio Vargas, Recife, BRA.



Amyotrophic lateral sclerosis (ALS)-like syndrome refers to a group of conditions whose outcome is similar to that of amyotrophic lateral sclerosis, but with different characteristics in the initial phase and response to therapy. The involvement of an earlier age group, the subacute course, and the stabilization or improvement of the clinical condition during the treatment are most important. There is still no evidence of an association between amyotrophic lateral sclerosis-like syndrome and chikungunya (CHK) infection in the literature. This report was intended to review this syndrome and present a case that occurred after the epidemic of CHK in Pernambuco in 2016. CHK is a fast-onset febrile illness characterized by intense asthenia, arthralgia, myalgia, headache, and skin rash. Reports range from encephalitis, optic neuritis, myeloradiculitis to Guillain-Barré syndrome, generating drastic sequelae such as mental deficiency, blindness, and persistent paralysis. This is the first case report of a possible association of ALS-like syndrome and chikungunya infection. CHK infection may cause ALS-like syndrome. There is a need for further research in this field to develop therapies for neurological complications such as that of CHK.

Copyright © 2019, Andrade et al.

KEYWORDS: amyotrophic lateral sclerosis; arbovirus; chikungunya fever; critically ill; diagnostic techniques

PMID: 31763099 PMCID: PMC6834095 DOI: 10.7759/cureus.5876

Keywords: Chikungunya fever; Amyotrophic Lateral Scleroris; Neurology.


#Diagnosis and #Treatment of #GBS During The #Zika Virus #Epidemic In #Brazil: A National Survey Study (J Periph Nerv Syst., abstract)

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

J Peripher Nerv Syst. 2019 Nov 20. doi: 10.1111/jns.12358. [Epub ahead of print]

Diagnosis and Treatment of Guillain-Barré Syndrome During The Zika Virus Epidemic In Brazil: A National Survey Study.

Leonhard SE1, Conde RM2, de Assis Aquino Gondim F3, Jacobs BC1,4.

Author information: 1 Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands. 2 Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil. 3 Department of Internal Medicine, Neurology Division, Federal University of Ceará, Fortaleza, CE, Brazil. 4 Department of Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.




The Zika virus (ZIKV) epidemic in Brazil in 2015-2016 was followed by an increase in the incidence of patients with Guillain-Barré syndrome (GBS). With this national survey study, we aimed to gain a better understanding of how neurologists in Brazil are currently diagnosing and treating patients with GBS, and how this increase in incidence has impacted the management of the disease.


The questionnaire consisted of 52 questions covering: personal profile of the neurologist, practice of managing GBS during and outside of the ZIKV epidemic, and limitations in managing GBS. All 3264 neurologists that were member of the Brazilian Academy of Neurology at the time of the study were invited to participate.


The questionnaire was fully answered by 171 (5%) neurologists. Sixty-one percent of neurologists noticed an increase in patients with GBS during the ZIKV epidemic, and 30% experienced an increase in problems in managing GBS during this time. The most important limitations in the diagnosis and management of GBS included the availability of nerve conduction studies (NCS), beds in the Intensive Care Unit (ICU) and referral to rehabilitation centers. Most neurologists did not use a protocol for treating patients with GBS and the treatment practice varied.


Increasing availability of NCS and beds in the ICU and rehabilitation centers, and the implementation of (inter)national guidelines, are critical in supporting Brazilian neurologist in their management of GBS, and are especially important in preparing for future outbreaks.

This article is protected by copyright. All rights reserved.

KEYWORDS: Guillain-Barré syndrome; Zika virus; clinical practice; management; survey

PMID: 31746070 DOI: 10.1111/jns.12358

Keywords: Zika Virus; GBS; Neurology; Brazil.