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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#RVF Virus and #YellowFever Virus in #Urine: A Potential #Source of #Infection (Virol Sin., summary)

[Source: Virologica Sinica, full page: (LINK). Summary, edited.]

Rift Valley Fever Virus and Yellow Fever Virus in Urine: A Potential Source of Infection

Authors: Meng Li, Beibei Wang, Liqiang Li, Gary Wong, Yingxia Liu, Jinmin Ma, Jiandong Li, Hongzhou Lu, Mifang Liang, Ang Li, Xiuqing Zhang, Yuhai Bi, Hui Zeng

Letter / First Online: 19 March 2019

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Dear Editor,

In recent years, the incidence of human infections caused by emerging or re-emerging pathogens has rapidly increased. Diseases that were once regional now have the ability to spread globally in a short amount of time and pose a wider threat to public health (Weaver et al.2018). Yellow fever virus (YFV, family Flaviviridae, genus Flavivirus) is a mosquito-borne flavivirus that causes yellow fever in humans and has been endemic in Africa and Latin America for many years (Domingo et al. 2018). The most recent large-scale outbreak of YFV occurred in Brazil in which the mortality rate as of February 28, 2018 is 32.78% (WHO 2018). Rift Valley fever virus (RVFV, family Bunyaviridae, genus Phlebovirus) is another mosquito-borne virus and primarily circulates in Africa and the Middle East, and in recent years in Europe (Mansfield et al. 2015). During the initial stage of infection, most patients infected with YFV or RVFV present nonspecific symptoms such as fever, headache, and…

(…)

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Meng Li, Beibei Wang and Liqiang Li have contributed equally to this work.

Electronic supplementary material

The online version of this article ( https://doi.org/10.1007/s12250-019-00096-2) contains supplementary material, which is available to authorized users.

 

Notes

Acknowledgements

This work is supported by grants from the National Science and Technology Major Project of China (2016ZX10004222 and 2016YFC1200800), Strategic Priority Research Program of the Chinese Academy of Sciences (XDB29010102), Sanming Project of Medicine in Shenzhen (SZSM201412003), Shenzhen Municipal Government of China (JCYJ20160427151920801) and Beijing Municipal Science & Technology Commission (Z161100000116049), and the National Natural Science Foundation of China (NSFC) International Cooperation and Exchange Program (816110193). Y.B. is supported by the NSFC Outstanding Young Scholars (31822055) and Youth Innovation Promotion Association of Chinese Academy of Sciences (CAS) (2017122).

 

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Animal and Human Rights Statement

Informed consent was obtained from all patients for the collection and use of all clinical specimens. This article does not contain any studies with animal subjects performed by any of the authors.

Keywords: Flavivirus; Phlebovirus; Yellow Fever; Rift Valley Fever.

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#Yellowfever virus is susceptible to #sofosbuvir both in vitro and in vivo (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Yellow fever virus is susceptible to sofosbuvir both in vitroand in vivo

Caroline S. de Freitas , Luiza M. Higa , Carolina Q. Sacramento, André C. Ferreira, Patrícia A. Reis, Rodrigo Delvecchio, Fabio L. Monteiro, Giselle Barbosa-Lima, Harrison James Westgarth, Yasmine Rangel Vieira, Mayara Mattos, Natasha Rocha, Lucas Villas Bôas Hoelz,  [ … ], Thiago Moreno L. Souza

Published: January 30, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007072 / This is an uncorrected proof.

 

Abstract

Yellow fever virus (YFV) is a member of the Flaviviridae family. In Brazil, yellow fever (YF) cases have increased dramatically in sylvatic areas neighboring urban zones in the last few years. Because of the high lethality rates associated with infection and absence of any antiviral treatments, it is essential to identify therapeutic options to respond to YFV outbreaks. Repurposing of clinically approved drugs represents the fastest alternative to discover antivirals for public health emergencies. Other Flaviviruses, such as Zika (ZIKV) and dengue (DENV) viruses, are susceptible to sofosbuvir, a clinically approved drug against hepatitis C virus (HCV). Our data showed that sofosbuvir docks onto YFV RNA polymerase using conserved amino acid residues for nucleotide binding. This drug inhibited the replication of both vaccine and wild-type strains of YFV on human hepatoma cells, with EC50 values around 5 μM. Sofosbuvir protected YFV-infected neonatal Swiss mice and adult type I interferon receptor knockout mice (A129-/-) from mortality and weight loss. Because of its safety profile in humans and significant antiviral effects in vitro and in mice, Sofosbuvir may represent a novel therapeutic option for the treatment of YF.

Key-words: Yellow fever virus; Yellow fever, antiviral; sofosbuvir

 

Author summary

Yellow fever virus is transmitted by mosquitoes and its infection may be asymptomatic or lead to a wide clinical spectrum ranging from a mild febrile illness to a potentially lethal viral hemorrhagic fever characterized by liver damage. Although a yellow fever vaccine is available, low coverage allows 80,000–200,000 cases and 30,000–60,000 deaths annually worldwide. There are no specific therapy and treatment relies on supportive care, reinforcing an urgent need for antiviral repourposing. Here, we showed that sofosbuvir, clinically approved against hepatitis C, inhibits yellow fever virus replication in liver cell lines and animal models. In vitro, sofosbuvir inhibits viral RNA replication, decreases the number of infected cells and the production of infectious virus particles. These data is particularly relevante since the liver is the main target of yellow fever infection. Sofosbuvir also protected infected animals from mortality, weight loss and liver injury, especially prophylatically. Our pre-clinical results supports a second use of sofosbuvir against yellow fever.

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Citation: de Freitas CS, Higa LM, Sacramento CQ, Ferreira AC, Reis PA, Delvecchio R, et al. (2019) Yellow fever virus is susceptible to sofosbuvir both in vitro and in vivo. PLoS Negl Trop Dis 13(1): e0007072. https://doi.org/10.1371/journal.pntd.0007072

Editor: Samuel V. Scarpino, Northeastern University, UNITED STATES

Received: March 25, 2018; Accepted: December 12, 2018; Published: January 30, 2019

Copyright: © 2019 de Freitas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The financial support was provided by Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ – http://www.faperj.br/ – Grant Number E-26/201.573/2014) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq – http://cnpq.br/ – Grant Numbers 306389/2014-2 and 425636/2016-0). TMLS received the funds. This work has received financial support from the National Institute of Science and Technology in Dengue (INCT dengue), a scheme funded by the Brazilian National Science Council (CNPq, Brazil) and Minas Gerais Foundation for Science (FAPEMIG, Brazil). Funding was also provided by National Council for Scientific and Technological Development (CNPq), Ministry of Science, Technology, Information and Communications (no. 465313/2014-0); Ministry of Education/CAPES (no. 465313/2014-0); Research Foundation of the State of Rio de Janeiro/FAPERJ (no. 465313/2014-0) and Oswaldo Cruz Foundation/FIOCRUZ to National Institute for Science and Technology on Innovation on Diseases of Neglected Populations (INCT/IDPN), Center for Technological Development in Health (CDTS), Fiocruz, Rio de Janeiro, RJ, Brazil. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Yellow Fever; Flavivirus; Antivirals; Sofosbuvir; Animal models.

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#Urban #yellowfever #outbreak—#DRC, 2016: Towards more rapid case detection (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Urban yellow fever outbreak—Democratic Republic of the Congo, 2016: Towards more rapid case detection

Brecht Ingelbeen , Nadine A. Weregemere, Harold Noel, Gaston P. Tshapenda, Mathias Mossoko, Justus Nsio, Axelle Ronsse, Steve Ahuka-Mundeke, Sandra Cohuet, Benoît I. Kebela

Published: December 7, 2018 / DOI: https://doi.org/10.1371/journal.pntd.0007029 / This is an uncorrected proof.

 

Abstract

Background

Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of cases in future urban outbreaks.

Methodology/Principal findings

In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case investigation and hospital admission forms. Comparing clinical signs between confirmed and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31 years (IQR 25–37). 15 (19%) confirmed cases were infected locally in urban settings in DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6–9), to appearance of jaundice 8 days (IQR 7–11), to sample collection 9 days (IQR 7–14), and to hospitalization 17 days (IQR 11–26). A case definition including fever or jaundice, combined with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%).

Conclusions/Significance

As jaundice appeared late, the majority of cases were diagnosed too late for supportive care and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.

 

Author summary

Yellow fever is a mosquito-borne viral infection characterized by fever, followed after several days by jaundice, liver or kidney failure, shock or bleeding in up to 25% of cases. Although the virus primarily circulates in forests among primates, it can also be transmitted from human to human by mosquitoes in urban areas. If infected patients are detected early, they could benefit from timely supportive treatment, and control measures such as mosquito bite prevention, mosquito control, and mass vaccination campaigns, could prevent further spread of the disease. During 2015–16 a yellow fever outbreak spread in urban areas of Angola and DRC. The present study showed that most yellow fever patients that were diagnosed in DRC had travelled from Angola where they have been infected, and that most were adult men. Nevertheless, several patients have been infected locally, in urban settings in three provinces of DRC. Patients were diagnosed only when jaundice appeared, more than a week after their illness started, too late to fully benefit from supportive treatment. During urban outbreaks, improving early access to healthcare and earlier detection of patients by recognizing acute fever when malaria infection is excluded, could improve yellow fever care and control.

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Citation: Ingelbeen B, Weregemere NA, Noel H, Tshapenda GP, Mossoko M, Nsio J, et al. (2018) Urban yellow fever outbreak—Democratic Republic of the Congo, 2016: Towards more rapid case detection. PLoS Negl Trop Dis 12(12): e0007029. https://doi.org/10.1371/journal.pntd.0007029

Editor: David W.C. Beasley, University of Texas Medical Branch, UNITED STATES

Received: September 27, 2018; Accepted: November 27, 2018; Published: December 7, 2018

Copyright: © 2018 Ingelbeen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Anonymized data of suspected and confirmed yellow fever cases reported during the outbreak and for which symptoms were recorded (as of 11/08/2016) is available from the Open Science Framework database (url: osf.io/xkafm). Diagnostic and outcome data may have been updated after 11/08/2016.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Yellow Fever; DRC.

—–

#Genomic and #epidemiological #monitoring of #yellowfever virus #transmission #potential (Science, abstract)

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

Genomic and epidemiological monitoring of yellow fever virus transmission potential

N. R. Faria1,*,†, M. U. G. Kraemer1,2,3,*, S. C. Hill1,*, J. Goes de Jesus4,*, R. S. Aguiar5,*, F. C. M. Iani6,7,*, J. Xavier4, J. Quick8, L. du Plessis1, S. Dellicour9, J. Thézé1, R. D. O. Carvalho7, G. Baele9, C.-H. Wu10, P. P. Silveira5, M. B. Arruda5, M. A. Pereira6, G. C. Pereira6, J. Lourenço1, U. Obolski1, L. Abade1,11, T. I. Vasylyeva1, M. Giovanetti4,7, D. Yi12, D. J. Weiss13, G. R. W. Wint1, F. M. Shearer13, S. Funk14, B. Nikolay15,16, V. Fonseca7,17, T. E. R. Adelino6, M. A. A. Oliveira6, M. V. F. Silva6, L. Sacchetto7, P. O. Figueiredo7, I. M. Rezende7, E. M. Mello7, R. F. C. Said18, D. A. Santos18, M. L. Ferraz18, M. G. Brito18, L. F. Santana18, M. T. Menezes5, R. M. Brindeiro5, A. Tanuri5, F. C. P. dos Santos19, M. S. Cunha19, J. S. Nogueira19, I. M. Rocco19, A. C. da Costa20, S. C. V. Komninakis21,22, V. Azevedo7, A. O. Chieppe23, E. S. M. Araujo4, M. C. L. Mendonça4, C. C. dos Santos4, C. D. dos Santos4, A. M. Mares-Guia4, R. M. R. Nogueira4, P. C. Sequeira4, R. G. Abreu24, M. H. O. Garcia24, A. L. Abreu25, O. Okumoto25, E. G. Kroon7, C. F. C. de Albuquerque26, K. Lewandowski27, S. T. Pullan27, M. Carroll28, T. de Oliveira4,17,29, E. C. Sabino20, R. P. Souza19, M. A. Suchard30,31, P. Lemey9, G. S. Trindade7, B. P. Drumond7, A. M. B. Filippis4, N. J. Loman8, S. Cauchemez15,16,*, L. C. J. Alcantara4,7,*,†, O. G. Pybus1,*,†

1 Department of Zoology, University of Oxford, Oxford, UK. 2 Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, USA. 3 Department of Pediatrics, Harvard Medical School, Boston, MA, USA. 4 Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil. 5 Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 6 Laboratório Central de Saúde Pública, Instituto Octávio Magalhães, FUNED, Belo Horizonte, Minas Gerais, Brazil. 7 Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 8 Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK. 9 Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium. 10 Department of Statistics, University of Oxford, Oxford, UK. 11 The Global Health Network, University of Oxford, Oxford, UK. 12 Department of Statistics, Harvard University, Cambridge, MA, USA. 13 Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK. 14 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 15 Mathematical Modelling of Infectious Diseases and Center of Bioinformatics, Institut Pasteur, Paris, France. 16 CNRS UMR2000: Génomique Évolutive, Modélisation et Santé, Institut Pasteur, Paris, France. 17 KwaZulu-Natal Research, Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa. 18 Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 19 Núcleo de Doenças de Transmissão Vetorial, Instituto Adolfo Lutz, São Paulo, Brazil. 20 Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 21 Retrovirology Laboratory, Federal University of São Paulo, São Paulo, Brazil. 22 School of Medicine of ABC (FMABC), Clinical Immunology Laboratory, Santo André, São Paulo, Brazil. 23 Coordenação de Vigilância Epidemiológica do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. 24 Departamento de Vigilância das Doenças Transmissíveis da Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília-DF, Brazil. 25 Secretaria de Vigilância em Saúde, Coordenação Geral de Laboratórios de Saúde Pública, Ministério da Saúde, Brasília-DF, Brazil. 26 Organização Pan – Americana da Saúde/Organização Mundial da Saúde – (OPAS/OMS), Brasília-DF, Brazil. 27 Public Health England, National Infections Service, Porton Down, Salisbury, UK. 28 NIHR HPRU in Emerging and Zoonotic Infections, Public Health England, London, UK. 29 Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa. 30 Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA. 31 Department of Biomathematics and Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA.

†Corresponding author. Email: nuno.faria@zoo.ox.ac.uk (N.R.F.); luiz.alcantara@ioc.fiocruz.br (L.C.J.A.); oliver.pybus@zoo.ox.ac.uk (O.G.P.)

* These authors contributed equally to this work.

Science  31 Aug 2018: Vol. 361, Issue 6405, pp. 894-899 / DOI: 10.1126/science.aat7115

 

Arbovirus risk in Brazil

Despite the existence of an effective vaccine for yellow fever, there are still almost 80,000 fatalities from this infection each year. Since 2016, there has been a resurgence of cases in Africa and South America—and this at a time when the vaccine is in short supply. The worry is that yellow fever will spread from the forests to the cities, because its vector, Aedes spp. mosquitoes, are globally ubiquitous. Faria et al. integrate genomic, epidemiological, and case distribution data from Brazil to estimate patterns of geographic spread, the risks of virus exposure, and the contributions of rural versus urban transmission (see the Perspective by Barrett). Currently, the yellow fever epidemic in Brazil seems to be driven by infections acquired while visiting forested areas and indicates spillover from susceptible wild primates.

Science, this issue p. 894; see also p. 847

 

Abstract

The yellow fever virus (YFV) epidemic in Brazil is the largest in decades. The recent discovery of YFV in Brazilian Aedes species mosquitos highlights a need to monitor the risk of reestablishment of urban YFV transmission in the Americas. We use a suite of epidemiological, spatial, and genomic approaches to characterize YFV transmission. We show that the age and sex distribution of human cases is characteristic of sylvatic transmission. Analysis of YFV cases combined with genomes generated locally reveals an early phase of sylvatic YFV transmission and spatial expansion toward previously YFV-free areas, followed by a rise in viral spillover to humans in late 2016. Our results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.

Keywords: Yellow Fever; Aedes spp.; Brazil; Flavivirus; Wildlife; Human.

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#Persistence of #Yellowfever virus outside the #Amazon Basin, causing #epidemics in Southeast #Brazil, from 2016 to 2018 (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018

Izabela Maurício de Rezende , Lívia Sacchetto , Érica Munhoz de Mello, Pedro Augusto Alves, Felipe Campos de Melo Iani, Talita Émile Ribeiro Adelino, Myrian Morato Duarte, Ana Luísa Furtado Cury, André Felipe Leal Bernardes, Tayrine Araujo Santos, Leonardo Soares Pereira, Maria Rita Teixeira Dutra, Dario Brock Ramalho,  [ … ], Betânia Paiva Drumond

Published: June 4, 2018 / DOI: https://doi.org/10.1371/journal.pntd.0006538 / This is an uncorrected proof.

 

Abstract

Background

Yellow fever (YF) is endemic in the Brazilian Amazon Basin, and sporadic outbreaks take place outside the endemic area in Brazil. Since 2016, YF epidemics have been occurring in Southeast Brazil, with more than 1,900 human cases and more than 1,600 epizooties of non-human primates (NHPs) reported until April 2018. Previous studies have demonstrated that Yellow fever virus (YFV) causing outbreaks in 2017 formed a monophyletic group.

Methodology/Principal findings

Aiming to decipher the origin of the YFV responsible for the recent epidemics, we obtained nucleotide sequences of YFV detected in humans (n = 6) and NHPs (n = 10) from Minas Gerais state during 2017–2018. Next, we performed evolutionary analyses and discussed the results in the light of epidemiological records (official numbers of YFV cases at each Brazilian Federative unit, reported by the Brazilian Ministry of Health). Nucleotide sequences of YFV from Southeast Brazil from 2016 to 2018 were highly conserved and formed a monophyletic lineage (BR-YFV_2016/18) within the genotype South America I. Different clusters were observed within lineage YFV-BR_2016/18, one containing the majority of isolates (from humans and NHPs), indicating the sylvatic transmission of YFV. We also detected a cluster characterized by two synapomorphies (amino acid substitutions) that contained YFV only associated with NHP what should be further investigated. The topology of lineage BR-YFV_2016/18 was congruent with epidemiological and temporal patterns of the ongoing epidemic. YFV isolates detected in 2016, in São Paulo state were located in the most basal position of the lineage, followed by the isolates from Minas Gerais and Espírito Santo obtained in 2017 and 2018. The most recent common ancestor of the lineage BR-YFV_2016/18 dated to 2015 (95% credible intervals = 2014–2016), in a period that was coincident with the reemergence of YFV in the Midwest region of Brazil.

Conclusions

The results demonstrated a single introduction of YFV in the Southeast region and the silent viral circulation before the onset of the outbreaks in 2016. Evolutionary analyses combined with epidemiological records supported the idea that BR-YFV_2016/18 was probably introduced from the Midwest into the Southeast region, possibly in São Paulo state. The persistence of YFV in the Southeast region, causing epidemics from 2016 to 2018, suggests that this region presents suitable ecological and climatic conditions for YFV maintenance during the epidemic and interepidemic seasons. This fact poses risks for the establishing of YF enzootic cycles and epidemics, outside the Amazon Basin in Brazil. YF surveillance and studies of viral dynamics deserve particular attention, especially in Midwest, Southeast and neighbor regions which are the main areas historically associated with YF outbreaks outside the Amazon Basin. YFV persistence in Southeast Brazil should be carefully considered in the context of public health, especially for public health decision-makers and researchers.

 

Author summary

Yellow fever (YF) is endemic in the Brazilian Amazon Basin, but sporadic outbreaks may take place outside this region. At the end of 2016, YF epidemics have been occurring in Southeast Brazil, with thousands of human cases (more than 1,900) and deaths of non-human primates (NHPs) reported so far. To better understand the origin and dynamics of YFV associated with these epidemics, we studied part of the viral genome obtained from humans and NHPs, in 2016 to 2018. All YFV grouped within a single group, indicating a single event of virus introduction in Southeast Brazil. Epidemiological data combined with our results suggested that the virus might have been introduced from the Midwest into the Southeast region, one year before the first outbreak was detected (2016). The persistence of YFV in the Southeast, causing epidemics from 2016 to 2018 indicates that this region presents suitable conditions for YFV maintenance, during the epidemic and non-epidemic periods. This fact may represent a risk for YFV establishment in Southeast Brazil. This information should be carefully considered by public health decision-makers and researchers in Brazil.

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Citation: Rezende IMd, Sacchetto L, Munhoz de Mello É, Alves PA, Iani FCdM, Adelino TÉR, et al. (2018) Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018. PLoS Negl Trop Dis 12(6): e0006538. https://doi.org/10.1371/journal.pntd.0006538

Editor: Benjamin Althouse, Institute for Disease Modeling, UNITED STATES

Received: March 6, 2018; Accepted: May 17, 2018; Published: June 4, 2018

Copyright: © 2018 Rezende et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: This work was supported by grant APQ01574-17, received by BPD from Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG; http://www.fapemig.br) and from Pró-Reitoria de Pesquisa da Universidade Federal de Minas Gerais (PRPq-UFMG; https://www.ufmg.br/prpq). Grants 440593/2016-6 and 440911/2016-8 were received by GdST and EGK, respectively, by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; http://www.cnpq.br). GdST and EGK are fellowships from CNPq. BdT received grant (Project RESERVOIRS) from ERDF from European Commission and Institut Pasteur de La Guyane. IMdR and LS received scholarships from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES; www.capes.gov.br). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Brazil; Yellow Fever; Wildlife; Human.

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#Yellowfever in two unvaccinated #French #tourists to #Brazil, January and March, 2018 (Euro Surveill., abstract)

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

Rapid communication / Open Access

Yellow fever in two unvaccinated French tourists to Brazil, January and March, 2018

Emma Oliosi1, Chantal Serero Corcos2, Paulo Feijo Barroso3, Alexandre Bleibtreu1, Gilda Grard4, Bispo Ana Maria De Filippis5, Eric Caumes1

Affiliations: 1 Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France; 2 Consulat général de France à Rio de Janeiro, Brazil; 3 Hospital Universitario Clementino Fraga Filho,Rio de Janeiro, Brazil; 4 Centre national de référence des arbovirus, HIA Laveran, Marseille, France; 5 Fundaçao Oswaldo Cruz, Rio de Janeiro, Brazil

Correspondence: Emma Oliosiemma.oliosigmail.com

Citation style for this article: Oliosi Emma, Serero Corcos Chantal , Barroso Paulo Feijo, Bleibtreu Alexandre, Grard Gilda, De Filippis Bispo Ana Maria, Caumes Eric. Yellow fever in two unvaccinated French tourists to Brazil, January and March, 2018. Euro Surveill. 2018;23(21):pii=1800240. https://doi.org/10.2807/1560-7917.ES.2018.23.21.1800240

Received: 06 May 2018;   Accepted: 24 May 2018

 

Abstract

We report two yellow fever cases in unvaccinated French travellers in Brazil in January and March 2018, respectively; one exposed during an excursion in Minas Gerais and the other in Ilha Grande. Both presented with fever, hepatitis, thrombocytopenia and leucopenia. Yellow fever diagnosis was based on RT-PCR and serological tests. Both patients recovered within a few days. The increasing occurrence of cases in unvaccinated travellers highlights the need to reinforce vaccination recommendation for travellers at-risk.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Brazil, vector-borne infections, viral infections, yellow fever, yellow fever virus, outbreaks, vaccines and immunisation

Keywords: Yellow Fever; France; Brazil.

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