Larval trematodes hosted by Biomphalaria straminea in the Brazilian semiarid region: implications for schistosomiasis control.

The present study aimed to identify larval trematodes shed by snails found in water bodies used by urban communities in a former schistosomiasis endemic area in the state of Piauí, in the Brazilian semiarid region. A malacological survey was performed followed by analysis of the cercariae shed by the snails after light exposure. Biomphalaria straminea specimens (n=1,224) were obtained from all seven collection sites. Cercariae shed by snails were i) single tailed, in which one type of cercariae was identified ( Echinostoma cercariae), and ii) with bifurcated tail (brevifurcate apharyngeate distome, brevifurcate pharyngeate distome, and longifurcate pharyngeate distome [strigeocercaria]). Brevifurcate apharyngeate distome were further examined and the presence of spikes in swimming membranes enabled the identification of Spirorchiidae cercariae in all individuals, demonstrating the absence of cercariae compatible with Schistosoma mansoni . Nevertheless, the accurate diagnosis of S. mansoni circulation in former endemic areas is still necessary.

Novel MLST sequence types of pathogenic Leptospira spp.: Opening the black box of animal leptospirosis in Brazil.

In the current context of the emergence of certain infectious diseases and discussion of the One Health concept for many of these, the study of leptospirosis - both in domestic and wild hosts - cannot be neglected. The study of animal leptospirosis has evolved in recent years. It has been demonstrated that the human-animal-environment interface is more important than previously thought. In the present study, 35 strains of five pathogenic Leptospira species were isolated from different animal species in Brazil and characterized by rrs, secY, and Multilocus Sequence Typing (MLST) sequencing. Phylogenetic inferences were performed and the molecular diversity of the populations (intra- and inter-population levels) was evaluated. Among the five studied species, 18 different sequence types (STs) were found (22 new alleles and 11 new STs). eBURST analysis revealed two clonal complexes (CCs) and seven singletons. A high genetic diversity was demonstrated (H = 0.954 ± 0.017), mainly for the L. santarosai population (H = 0.942 ± 0.034, n = 20). The same strain was identified in different host species, as well as strains with zoonotic potential circulating in the country. Although the difficulty of culturing Leptospira strains is well known, the high variability of the strains found in Brazil highlights the importance of animals in maintaining the biological cycle of the bacterium in nature. Moreover, the selection of autochthonous strains for the development of vaccines becomes a challenge.

Kato-Katz thick smears as a DNA source of soil-transmitted helminths.

Despite the reduction in the prevalence of soil-transmitted helminthiases in many regions of the world, morbidity rates remain high in some rural regions. The Kato-Katz technique is a simple, inexpensive and field-applicable tool commonly used for the diagnosis and worm-burden characterization of these infections. Molecular studies have revolutionized our understanding of the epidemiology and evolutionary genetics of parasites. In this study we recovered helminthic DNA from Kato-Katz slides (n = 93) prepared in 2011 in the Brazilian Amazon. We achieved DNA recovery by polymerase chain reaction (PCR) in 84% of cases for Ascaris sp. and 75% of cases for hookworms. The sequencing confirmed the specific species of the amplicons. The slides stored for a few years could be analysed using this methodology, allowing access to DNA from a large collection of samples. We must consider the Kato-Katz thick smears as a source of helminth DNA. This can significantly reduce logistical difficulties in the field in terms of obtaining, preserving, transporting and initial processing of samples.

Occurrence of human sapoviruses in wastewater and stool samples in Rio De Janeiro, Brazil.

AIM: To determine the prevalence and molecular epidemiology of human sapovirus (SaV) in both wastewater and stool samples in a 3-year (2012-2014) surveillance study performed in Rio de Janeiro State, Brazil. METHODS AND RESULTS: A total of 156 wastewater and 341 stool samples were analysed using quantitative real-time PCR. SaV was detected in 3·5% (12/341) in stool samples with virus load concentrations ranging from 10(4) to 10(9) genome copies per gram (gc g(-1) ), and in 33·0% (51/156) wastewater samples, with range concentration varying from 10(4) to 10(6)  gc l(-1) . Partial genome sequencing of wastewater and stool samples revealed the circulation of genotypes GI.1, GI.2, GI.6, GII.1 and GV.1. CONCLUSION: This study demonstrated the prevalence of human SaV in acute gastroenteritis (AGE) cases and revealed, for the first time, the environmental dissemination of those viruses in Brazil. SIGNIFICANCE AND IMPACT OF THE STUDY: SaV diagnosis should be considered in hospitalized children with AGE and the higher positive rate detection in environmental samples suggests that SaV infection could be underestimated or associated with asymptomatic cases.

Evaluation of the swab sampling method to recover viruses from fomites.

The monitoring of virus contamination on fomites, especially at hospitals has been used for a more effective evaluation of the microbiological quality of surfaces. Swab sampling is the method used currently, although the use of an internal control process (ICP) has not yet been assessed. The aim of this study is to determine the recovery rate of murine norovirus 1 (MNV-1) and bacteriophage PP7 on different surfaces in order to assess their potential use as an ICP. For this purpose both viruses were spiked experimentally both on porous and non-porous formic as well as on rubberized surfaces. Quantitative PCR (qPCR) showed a variable efficiency with a percentage recovery ranging from 0.6 to 77% according to viruses and surfaces. A global analysis suggested that MNV-1 could be used as a potential ICP for the swab sampling method.

Outbreaks of attacks by hematophagous bats in isolated riverine communities in the Brazilian Amazon: a challenge to rabies control.

Human rabies has re-emerged in Latin America due to bat associated transmission. We present data related to attacks by hematophagous bats in three riverine communities in the Rio Negro basin, Brazilian Amazon. A cross-sectional survey was carried out to obtain demographic and epidemiological data through interviews with 201 inhabitants. A total of 721 bat attacks with bites took place from 2004 to 2006, 238 (33%) reported by residents in Campinas do Rio Preto, 329 (46%) in Águas Vivas and 154 (21%) in the community of Malalahá. Incidence density among surveyed inhabitants was 84 attacks/100 persons-years in Campinas do Rio Preto, 249 attacks/100 persons-years in Águas Vivas and 81 attacks/100 persons-years in Malalahá. The proportion of surveyed inhabitants bled by bats at least once was 67% (63/94) in Campinas do Rio Preto, 96% (42/44) in Águas Vivas and 62% (39/63) in Malalahá. Among subjects bled by bats, the average number of bites was 4.6 ± 4.2 standard deviations (SD) in Campinas do Rio Preto, 8 ± 6 SD in Águas Vivas and 4.1 ± 3.9 SD in Malalahá. Regarding houses, 67% (26/39) had animals in the peridomestic environment (chickens and/or dogs) and all were vulnerable to bats due to gaps in the walls and/or in the windows and doors. In 13 dwellings, rudimentary protection against bats through the fixation of fishing nets and/or straw nets to the windows and other openings was observed. Among dwellers reporting attacks, 48% (68/144) received the full post-exposure anti-rabies vaccination protocol with five doses of diploid human cell vaccine, 28% (39/144) received an incomplete schedule (1-4 doses), and 26% (37/144) did not receive any dose. No cases of rabies were reported during the study; however, regular pre-exposure vaccination in the studied populations must be considered.

Prevalence and epidemiology of intestinal parasitism, as revealed by three distinct techniques in an endemic area in the Brazilian Amazon.

This survey aims to estimate the prevalence of intestinal parasitic infections in Santa Isabel do Rio Negro, Amazonian Brazil, through three distinct techniques, correlating the prevalence rates with family income and age groups as well as assessing the household clustering of infections. Prevalence rates were assessed through Graham (n=113), Baermann-Moraes (n=232) and Ritchie (n=463) methods. The Graham method was adopted only for children under 5 years old, 15% of whom were positive for Enterobius vermicularis. By the Baermann-Moraes technique, 5·6% of the samples were positive for Strongyloides stercoralis larvae. The Ritchie technique disclosed the following results: Ascaris lumbricoides (26%), Trichuris trichiura (22·5%), hookworms (9·5%), Entamoeba histolytica/Entamoeba dispar (25·3%), Giardia lamblia (12·5%) and E. vermicularis (0·6%). Children aged 5-14 years presented the highest prevalence for pathogenic parasites. Giardiasis and hookworm infection rates were inversely related to family income. The presence of positive contacts in the same household substantially increased the risk of infection by enteric parasites: odds ratio (OR)=2·70, 95% confidence interval (CI)=1·69-4·29 for ascariasis; OR=2·17, 95% CI=1·34-3·51 for trichuriasis; OR=2·13, 95% CI=1·08-4·17 for hookworm disease; OR=3·42, 95% CI=1·86-6·30 for giardiasis; and OR=2·16, 95% CI=1·35-3·47 for amoebiasis, supporting infection clustering in the home. Intestinal parasitoses are extremely frequent in the studied area, and routine methods for diagnosis may underestimate the prevalence of enterobiasis and strongyloidiasis.

Surveillance of norovirus infections in the state of Rio De Janeiro, Brazil 2005-2008.

A 4-year (2005-2008) norovirus (NoV) surveillance study was conducted in the state of Rio Janeiro, Brazil, to demonstrate the role of these viruses in outbreaks and sporadic cases of acute gastroenteritis. A cohort of 1,687 fecal samples was obtained from patients with gastroenteritis; 324 were rotavirus-positive. Of the remainder 1,363 rotavirus-negative samples, 1,087 samples were tested for NoV RNA in this study. The study enrolled 267 outpatients from Municipal Public Health Centers and 820 inpatients, whose samples were obtained by active surveillance in Public Hospitals. Fecal samples were tested by reverse transcription (RT) followed by polymerase chain reaction (PCR) using the MON 431-434 set of degenerate primers for NoV GI and GII detection, and there were 35.1% (381/1,087) positive samples for NoV, consisting of 30.2% (248/820) and 49.8% (133/267) from inpatient and outpatient, respectively. Children infected by NoV had significantly more frequent mucus in feces, vomiting and fever. No seasonal pattern in NoV infections was observed in patients admitted to hospital; however, two peaks of NoV infections were observed from ambulatory cases, suggesting that there was an occurrence of outbreaks in those time periods. Molecular characterization revealed GII to be the most prevalent genogroup, totaling 96.3% (104/108) of all sequences analyzed, and GII.4 was the genotype detected most frequently (80.7%), followed by GII.6, 3, 14, 7, and 8. Two GI strains, GI.2 and GI.3, were also observed. The number of outbreaks and sporadic cases described in this study highlights the need to implement diagnosis of NoV in surveillance laboratories.

Increasing incidence of malaria in the Negro River basin, Brazilian Amazon.

Malaria in Brazil is virtually restricted to the Amazon Region, where it has a heterogeneous geographic distribution. We reviewed secondary data in order to describe the regional and temporal distribution of 8018 malaria cases seen between 2003 and 2007 in Santa Isabel do Rio Negro, a municipality in the northwest Brazilian Amazon. A significant rise in malaria incidence, mainly in the Yanomami Indian reservation, was observed during this time. Anopheline breeding sites were also mapped and entomological data were obtained through the capture of larval and adult mosquitoes. Thirty-three potential breeding sites were identified in the urban and periurban areas, 28 of which were positive for anopheline larvae. Anopheles darlingi specimens were captured in both intra- and peridomicile locations in the urban areas. Demographic data were also assessed via a sectional survey, revealing that the majority of dwellings were vulnerable to mosquitoes. This study suggests that urban and periurban areas of this municipality are highly susceptible to epidemic malaria, which is endemic in the Yanomami Indian reservation near the city. In addition, transmission can be perpetuated autochthonously in the urban area, drawing attention to the continuous need for preventative measures such as controlling adult and aquatic stages of mosquitoes and improving housing.