Epidemiological and viral features of a cohort of SARS-CoV-2 symptomatic and asymptomatic individuals in an area of the Colombian Caribbean.

BACKGROUND: Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is an emerging viral pandemic disease. In the last 6 months, SARS-CoV-2 has caused millions of reported cases and hundreds of thousands of deaths. As other world regions, South America has not contained the pandemic's advance since it lacks the hospital and economic capacities. Public health implications of transmission, while the asymptomatic/presymptomatic infection is a critical concern at the current pandemic. OBJECTIVE: Describe the socio-demographic, clinical, and viral features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. METHODS: Six hundred eighty-six clinical samples of suspected SARS-CoV-2 infection cases and contacts individuals from several hospital centers in the department of Córdoba, Colombia, were received at our laboratory between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by reverse transcription real-time polymerase chain reaction (RT-qPCR) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (Allplex™, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. RESULTS: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection; the average age was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had a cough, fever, and odynophagia; three of the patients reported having arthralgia. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest. Eighteen of 35 (51%) individuals were asymptomatic, and the average age was 30 (range, 6-61 years). Four asymptomatic individuals showed a higher copy than some symptomatic patients; nonetheless, the average of RNA copies 8.26 × 1010 was lower than the symptomatic. CONCLUSIONS: This study shows that asymptomatic patients may develop infections with a high number of RNA copies. Since a considerable percentage of infections may be asymptomatic/presymptomatic, enhanced testing approaches may be needed to detect these persons. Due the occurrence of a large proportion of infections being a result from transmission originated in asymptomatic/presymptomatic individuals, public health interventions in Colombia should be based on two steps: a massive molecular screening, and viral load quantification. Finally, a remarkable issue in our study is the average age of symptomatic and asymptomatic groups (43 and 30 respectively) which may be important because of the economic impact that has been caused by the coronavirus pandemic and may be probably the cause of the reduced lethality observed in the country and the department at the time of this study.

Hard ticks (Ixodida: Ixodidae) in the Colombian Caribbean harbor the Jingmen tick virus: an emerging arbovirus of public health concern.

BACKGROUND: Ticks are obligate hematophagous ectoparasites involved in transmitting viruses of public health importance. The objective of this work was to identify the Jingmen tick virus in hard ticks from the Colombian Caribbean, an arbovirus of importance for public health. METHODS: Ticks were collected in rural areas of Córdoba and Cesar, Colombia. Taxonomic identification of ticks was carried out, and pools of 13 individuals were formed. RNA extraction was performed. Library preparation was performed with the MGIEasy kit, and next-generation sequencing (NGS) with MGI equipment. Bioinformatic analyses and taxonomic assignments were performed using the Galaxy platform, and phylogenetic analyses were done using IQ-TREE2. RESULTS: A total of 766 ticks were collected, of which 87.33% (669/766) were Rhipicephalus microplus, 5.4% (42/766) Dermacentor nitens, 4.2% (32/766) Rhipicephalus linnaei, and 3.0% (23/766) Amblyomma dissimile. Complete and partial segments 1, 2, 3, and 4 of Jingmen tick virus (JMTV) were detected in the metatranscriptome of the species R. microplus, D. nitens, and A. dissimile. The JMTVs detected are phylogenetically related to JMTVs detected in Aedes albopictus in France, JMTVs detected in R. microplus in Trinidad and Tobago, JMTVs in R. microplus and A. variegatum in the French Antilles, and JMTVs detected in R. microplus in Colombia. Interestingly, our sequences clustered closely with JMTV detected in humans from Kosovo. CONCLUSIONS: JMTV was detected in R. microplus, D. nitens, and A. dissimile. JMTV could pose a risk to humans. Therefore, it is vital to establish epidemiological surveillance measures to better understand the possible role of JMTV in tropical diseases.

Clinical and Epidemiological Status of Leptospirosis in a Tropical Caribbean Area of Colombia.

OBJECTIVE: To describe and analyze the clinical and epidemiological status in 28 confirmed cases of human leptospirosis at the main public hospital of Cordoba. METHODS: Between 2012 and 2013, we conducted an active surveillance at the main hospital of Cordoba to establish the etiologic diagnosis of the undifferentiated tropical febrile illness (UTFI) cases. UTFI is defined as a fever without an infection focus in the initial physical examination or in basic laboratory tests. Patients in acute phase were accompanied by prodromal symptoms, including myalgia, arthralgia, headache, asthenia, chills, icterus, dyspnea, abdominal pain, rash, and nausea. Samples were collected on admission and at discharge. Clinical and epidemiological data were collected for each patient. Microscopic agglutination test (MAT) was performed. RESULTS: The 28 leptospirosis cases presented the following gender distribution: male (n=24) and female (n=4). The duration of hospitalization was 10.39 days. The main symptoms and clinical manifestations were fever, headache and nausea, vomiting, and abdominal pain, all of which occurred in up to 60% of patients. Of the 28 cases studied, 4 were fatal. The most frequent infecting serogroups were Ballum and Canicola. CONCLUSION: Leptospirosis is a common cause of undifferentiated tropical febrile illness in Colombia; it is important to establish ongoing and accurate surveillance for acute febrile illness to facilitate the detection of cases of leptospirosis.

Undifferentiated tropical febrile illness in Cordoba, Colombia: Not everything is dengue.

In Colombia, undifferentiated tropical febrile illness (UTFI) are frequent and of considerable concern. They also share many clinical features. Between 2012 and 2013 in an endemic tropical area of Cordoba, Colombia, we conducted a prospective study to establish an etiological diagnosis of UTFI. Using diagnostic tests for dengue, leptospirosis, hantavirus, malaria, rickettsia, brucellosis, hepatitis A and B on 100 patients recruited for the study. We identified 69 patients with presumed UTFI: leptospirosis (n=27), dengue (n=26), hantavirus infection (n=4), malaria (n=4), rickettsial infection (n=2), hepatitis A (n=1), and brucellosis (n=1); no hepatitis B cases were detected. Co-infections with malaria and leptospirosis (n=1), hepatitis A and dengue (n=1), hantavirus and dengue (n=1), hantavirus, dengue, and leptospirosis (n=1) were also identified. No etiologic agent was identified for 31 patients. We conclude that other etiologic agents besides dengue virus deserve greater attention by physicians and public health authorities in tropical area of Colombia.

[Acute meningitis in Córdoba, Colombia (2002-2004)]. / Meningitis agudas en Córdoba, Colombia 2002-2004.

OBJECTIVE: Establishing characteristic epidemiologic and microbiologic features of acute meningitis in the Córdoba department. METHODOLOGY: A descriptive epidemiological study was carried out between June 2002 and June 2004 at the Hospital San Jerónimo in Montería. All suspicious cases of meningitis were included; laboratory tests included cytological smear, biochemistry, latex, Gram stain and culture. RESULTS: 57 (11.3%) and 85 (16.8%) of the 503 samples of cerebrum spinal fluid (CSF) were confirmed by culture as being probable cases. There were 6 cases of polymicrobial infection, making a total of 63 isolates: 17 non-fermenting Gram-negative bacilli (26.9%), 16 Streptococcus pneumoniae (25.4%), 7 Enterobacteriaceae (11%), 5 Criptococcus neoformans (8%) 4 Neisseria meningitidis serotype B (6.3%), 3 S. viridans (4.8%), 2 Streptococcus group B (3.2%), 2 Haemophilus influenzae type B (3.2%), 2 Staphylococcus negative coagulase (3.2%), 2 S. aureus (3.2%), 2 Enterococcus (3.2%) and 1 Candida albicans (1.6%). The S. Pneumoniae serotypes found were: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=l1, 17F (n=l1, 1 (n=1). CONCLUSIONS: The study led to determining epidemiological and microbiological aspects of acute meningitis in the Códoba department which had been unknown up to now. Streptococcus pneumoniae (25.4% was the main aetiological agent of meningitis; the epidemiologic aspects so established confirmed the need for strengthening and implementing measures for controlling meningitis in C6ódoba and its surveillance there.

Epidemiological surveillance of herpes viral encephalitis in Cordoba, Colombia.

Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.

Seroprevalencia de Brucella sp. en équidos de Córdoba, Colombia / Brucella sp. seroprevalence in equids of Córdoba, Colombia

La brucelosis es considerada una de las zoonosis más importantes en el mundo por sus implicaciones en la salud pública y sus repercusiones en la producción pecuaria. En la especie equina, la presentación de esta enfermedad es importante, debido a que estos animales son huéspedes potenciales y contribuyen con la introducción de la enfermedad en zonas no afectadas, así como el mantenimiento en donde ocurre de forma endémica. En el departamento de Córdoba no se registran estudios recientes que establezcan la prevalencia y características epidemiológicas de la enfermedad en équidos. El objetivo del presente estudio fue estimar la prevalencia de Brucella sp. en équidos del departamento de Córdoba. Se realizó un estudio descriptivo de corte transversal que incluyó 506 équidos procedentes de 14 municipios del departamento. Fueron estudiados tres especies: equinos (n=257), asnales (n=130) y mulares (n=119), procedentes de 46 predios. Las técnicas empleadas para el diagnóstico serológico fueron aglutinación rápida en placa Rosa de Bengala (n=506) y la confirmatoria fue con el ELISA competitiva (n=23). Se realizó la PCR convencional amplificando la región IS711de Brucella sp. a partir de muestras de exudado (n=2) y sangre con EDTA (n=4). La seroprevalencia de brucelosis en équidos fue del 4,5 % (23/506) por Rosa de Bengala (RB), con una distribución por especies de: equinos 20, asnos 2 y mulas 1. Con el ELISA competitiva (ELISA-C) la seroprevalencia fue del 4,3% (1/23), mientras que por PCR no se detectó ADN bacteriano en las seis muestras analizadas. La positividad en predios fue del 28,2% (13/46). Las cifras de seroprevalencia obtenidas en el presente estudio, demuestran la importancia de la vigilancia en las diferentes especies susceptibles a la brucelosis.

Brucellosis is considered one of the most important zoonotic diseases in the world because of its implications for public health and its impact on livestock production. In the equine species, the presentation of this disease is important, because these animals are potential hosts and contribute to the introduction of the disease in unaffected areas, as well as to the maintenance of this disease in endemic zones. In the Department of Córdoba, Colombia, there have been no recent studies that establish the prevalence and epidemiological characteristics of the disease in equids. The purpose of the present study was to estimate the prevalence of Brucella sp. in equids of the department of Córdoba. A cross-sectional descriptive study was carried out involving 506 equids from 14 municipalities of the department. Three species from 46 farms were studied: horses (n=257), asses (n=130) and mules (n=119). The techniques used for the serological diagnosis were: rapid agglutination, which was performed in 506 equids, using the Bengal Rose (RB) method; and the confirmatory method was performed on 23 equids, using the competitive ELISA tecnique (C-ELISA). Conventional PCR was performed by amplifying the IS711 region of Brucella sp. from exudate samples (n=2) and EDTA blood (n=4). The results of the study showed that the seroprevalence of brucellosis in equids was 4.5% (23/506) using the RB methodology, with the following distribution by species: 20 horses, 2 asses and 1 mule. With the C-ELISA technique, the seroprevalence was 4.3% (1/23), whereas by PCR no bacterial DNA was detected in the six samples analyzed. The positivity in farms was 28.2% (13/46). In conclusion, the seroprevalence figures obtained in the present study demonstrate the importance of epidemiological surveillance in the different species susceptible to brucellosis.

Epidemiological surveillance of herpes viral encephalitis in Cordoba, Colombia / Vigilancia epidemiológica de encefalitis por herpes virus en Córdoba, Colombia

Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.(AU)

Objetivo Establecer una vigilancia epidemiológica de la encefalitis viral herpética en los principales hospitales de Montería, Córdoba. Materiales y Métodos Se realizó un estudio descriptivo de los casos de encefalitis viral entre septiembre de 2009 diciembre de 2011 en tres hospitales en la ciudad de Montería. Las muestras líquido cefalorraquídeo (LCR) de 118 pacientes fueron incluidos en el estudio. Los aspectos clínicos como el análisis citoquímico y microbiológico (tinción de Gram y cultivo) de LCR fueron utilizados para la selección de los pacientes. La detección de virus se realizó por PCR anidada multiplex para Herpes simplex virus 1 y 2, virus de Epstein Barr, virus zoster de la varicela y el citomegalovirus. Resultados Se detectó ADN viral del virus del herpes en 30 (25,4 %) muestras de LCR en los pacientes de la siguiente manera: 22 (18,6 %) Herpes simplex virus 1 y 2, 4 (3,3 %) Citomegalovirus y 1 (0,8 %) del virus de la varicela zóster. Se observaron Co-infecciones en 3 pacientes (2,5 %), 1 caso por el VHS-VZV y 2 casos por CMV / HSV. Las manifestaciones clínicas de los pacientes fueron: cefalea (18,6 %), fiebre (14,4 %), astenia (10,1 %), convulsiones (9,3 %), vómitos (8,4 %), y rigidez de nuca (5,9 %). El treinta por ciento de los pacientes también tenía VIH-SIDA. Se observó una tasa de letalidad del 20 % de los pacientes. Conclusiones Se demuestra que el herpesvirus es causa de infección del SNC en pacientes en Córdoba. Este estudio contribuye a la caracterización serológica viral epidemiológica de la encefalitis viral, así como en el manejo del paciente ya que se describen hallazgos clínicos importante en la población adulta estudiada.(AU)

Seroprevalencia de anemia infecciosa equina en los departamentos de Córdoba y Bolívar, Colombia / Seroprevalence of Equine Infectious Anemia in the Departaments of Córdoba and Bolivar, Colombia

La anemia infecciosa equina (AIE) es una enfermedad causada por un virus ARN de la familia Retroviridae, subfamilia Lentiviridae que afecta a todos los miembros de la familia de los équidos y posee distribución mundial. El objetivo del presente estudio fue estimar la seroprevalencia del virus de la anemia infecciosa equina (VAIE) en los departamentos de Córdoba y Bolívar, Colombia. Se realizó un estudio prospectivo que incluyó 380 équidos escogidos de forma aleatoria procedente de seis municipios de Córdoba (Montería, Puerto Escondido, Los Córdoba, Canalete, Sahagún y San Antero) y cinco municipios de Bolívar (El Carmen de Bolívar, Mompox, María la Baja, Magangue y Turbaco). Tres especies fueron incluidas: equinos (n=305), asnal (n=46) y mular (n=29), pertenecientes a 42 predios en los dos departamentos. El presente estudio permitió establecer una seroprevalencia al VAIE de 9,7% (37/380) en el total de équidos analizados, siendo para el departamento de Córdoba de 7,73% (15/194) en cuanto a los animales y de 53,8% (7/13) en predios y para el departamento Bolívar fue de 11,8% (22/186) en los animales y en predios de 34,48% (10/29). El presente estudio permitió conocer la seroprevalencia del VAIE en los departamentos de Córdoba y Bolívar y algunos datos demográficos relacionados con la enfermedad en estas regiones del país.

The Equine Infectious Anemia (EIA) is a disease caused by an RNA virus of the family Retroviridae, subfamily Lentiviridae, that affects all members of the Equidae family with a worldwide distribution. The main goal of this study was to estimate the seroprevalence of the Equine Infectious Anemia Virus (EIAV) in the Departments of Bolívar and Córdoba, Colombia. A prospective study was carried out and included 380 equidae from six municipalities of Córdoba (Montería, Puerto Escondido, Los Córdobas, Canalete, Sahagún, and San Antero) and five municipalities of Bolívar (El Carmen de Bolívar, Mompox, María La Baja, Magangue, and Turbaco). The animals were randomly selected and three species were included, namely donkeys (n=46), mules (n=29), and horses (n=305) from 42 farms in the two departments studied. The results enabled to establish a EIAV seroprevalence of 9.7% (37/380) in the total number of equidae analyzed in the Departments of Córdoba and Bolívar. The seroprevalence distribution was as follows: for the Department of Córdoba, 7.73 % (15/194) in terms of animals and 53.8 % (7/13) for the farms. For the Department of Bolívar, 11.8 % (22/186) in animals and 34.48 % (10/29) for the farms. These results also allowed to know some demographic data related to this disease in these regions.

Seroprevalencia de Leptospira sp., Rickettsia sp. Ehrlichia sp. en trabajadores rurales del departamento de Sucre, Colombia / Seroprevalence of Leptospira sp., Rickettsia sp. and Ehrlichia sp. in rural workers of Sucre, Colombia

Objective. Determinar la seroprevalencia de Leptospira sp., Rickettsia sp. y Ehrlichia sp. en trabajadores de áreas rurales del departamento de Sucre. Material y métodos. Se realizó un estudio escriptivo, prospectivo, de corte transversal, que pretendió determinar la seroprevalencia e Leptospira sp., Rickettsia sp. y Ehrlichia sp. en 90 trabajadores de áreas rurales del departamento de Sucre. Se estableció la presencia de anticuerpos séricos anti-IgM específicos anti-Leptospira por la técnica de ELISA indirecta. Para la determinación de Rickettsia sp. y Ehrlichia sp. se uso la técnica de inmunofluorescencia indirecta. Resultados. La población evaluada estaba compuesta por 27 (30%) ordeñadores, 21 (23%) jornaleros, 18 (20%) profesionales del campo y 24 (27%) que realizaban otras actividades. Ventidós (24%) muestras resultaron positivas en alguna de las pruebas. De éstas, 12 (13,3%) fueron positivas para Leptospira sp., 7 (7,8%) para Rickettsia sp. y 3 (3,3%) ara Ehrlichia sp. Conclusión. Este fue el primer estudio que se llevó a cabo en el departamento de Sucre y permitió demostrar que existe una prevalencia importante de Leptospira p.,Rickettsia sp. y Ehrlichia sp.. Los factores de riesgo ocupacional fueron factores determinantes en la seropositividad.

Objective. To determine the seroprevalence of Leptospira sp., Rickettsia sp. and Ehrlichia sp. in agricultural workers of Sucre. Methods. A descriptive prospective cross-sectional study was conducted in ninety rural workers of Sucre. Presence of serum antibodies anti-IgM specific anti-Leptospira by indirect ELISA was established. For the determination of Rickettsia and Ehrlichia indirect inmunoflorescence was used. Results.The population was composed by 27 (30%) milkers, 21 (23%) day workers, 18 farm professionals (20%) and 24 (26%) workers in others activities. A total of 22 (24%) samples were positive to some test. Twelve (13.3%) were positive to Leptospira sp., seven (7.8%) to Rickettsia sp. and three (3.3%) o Ehrlichia sp.. Conclusions. This is the first study carried out in Sucre; there is an important prevalence of Leptospira sp., Rickettsia sp. and Ehrlichia sp..The occupational risk factors were decisive in the seropositivity.

Meningitis Agudas en Córdoba, Colombia 2002 - 2004 / Acute meningitis in Córdoba, Colombia (2002-2004)

Objetivo: Establecer las características epidemiológicas y microbiológicas de las meningitis agudas del departamento de Córdoba. Métodos: Se realizó un estudio descriptivo de vigilancia epidemiológica en el Hospital San Jerónimo de Montería. Se tomaron todos los casos de meningitis, presentados (junio 2002 - junio 2004), las pruebas de laboratorio incluyeron: citoquímico, prueba de látex, tinción de Gram y cultivo. Resultados: Se analizaron 503 muestras de liquido cefalorraquídeo, confirmados por cultivo 57 (11,3 por ciento) casos y 85 (16,8 por ciento) casos probables. Se presentaron 63 aislamientos distribuidos así: 17 bacilos Gram negativos no fermentadores (26,9 por ciento), 16 Streptococcus pneumoniae (25,4 por ciento), 7 Enterobacterias (1 por ciento), 5 Criptococcus neoformans (8 por ciento), 4 Neisseria meningitidis serotipo B (6,3 por ciento), 3 S. viridans (4,8 por ciento), 2 Streptococcus grupo B (3,2 por ciento), 2 Haemophilus influenzae tipo B (3,2 por ciento), 2 S. aureus (3,2 por ciento), 2 Staphylococcus coagulasa negativos (3,2 por ciento), 2 Enterococcus (3,2 por ciento) y 1 Candida albicans (1,6 por ciento). Los serotipos de S. Pneumoniae fueron: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusión: El estudio permitió determinar los aspectos epidemiológicos y microbiológicos hasta ahora desconocidos de las meningitis agudas en el departamento de Córdoba. Streptococcus pneumoniae (25,4 por ciento) fue el principal agente causal de meningitis, los aspectos epidemiológicos establecidos confirman la necesidad de fortalecer e implantar medidas para el control y vigilancia de las meningitis en Córdoba.