Phylogenetic Reconstructions Reveal the Circulation of a Novel Dengue Virus-1V Clade and the Persistence of a Dengue Virus-2 III Genotype in Northeast Brazil.

Dengue fever is among the most significant public health concerns in Brazil. To date, the highest number of Dengue notifications in the Americas has been reported in Brazil, with cases accounting for a total number of 3,418,796 reported cases as of mid-December 2022. Furthermore, the northeastern region of Brazil registered the second-highest incidence of Dengue fever in 2022. Due to the alarming epidemiological scenario, in this study, we used a combination of portable whole-genome sequencing, phylodynamic, and epidemiological analyses to reveal a novel DENV-1 genotype V clade and the persistence of DENV-2 genotype III in the region. We further report the presence of non-synonymous mutations associated with non-structural domains, especially the NS2A (non-structural protein 2A), as well as describe synonymous mutations in envelope and membrane proteins, distributed differently between clades. However, the absence of clinical data at the time of collection and notification, as well as the impossibility of monitoring patients in order to observe worsening or death, restricts our possibility of correlating mutational findings with possible clinical prognoses. Together, these results reinforce the crucial role of genomic surveillance to follow the evolution of circulating DENV strains and understand their spread across the region through inter-regional importation events, likely mediated by human mobility, and also the possible impacts on public health and outbreak management.

Anaphylactic reaction to praziquantel following schistosomiasis treatment.

Praziquantel (PZQ) is a medication used to treat several parasitic infections, including human schistosomiasis. Although this drug commonly causes transient adverse effects, severe hypersensitivity is rare, and only eight cases have been reported worldwide. Herein we report a case of a 13-year-old Brazilian female who developed anaphylaxis, a severe hypersensitive reaction, after taking praziquantel to treat Schistosoma mansoni infection. During a mass drug administration event in a socially vulnerable endemic area of Bahia (Brazil), after taking 60 mg/kg of praziquantel the patient developed rash and generalized edema an hour later, evolving to somnolence and hypotension. Following the anaphylactic episode, she received adequate treatment and recovered approximately 1 day later. Although praziquantel is considered safe, health professionals should be aware of potential life-threatening adverse events.