A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of São Paulo, Brazil.

We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.

Evaluation of Methods for Collecting Mosquitoes (Culicidae: Diptera) in Canopy and Ground Strata in the Brazilian Savanna.

The hand-net is the standard method for capturing mosquitoes with sylvatic diurnal activity in disease outbreaks in Brazil. However, occupational risks and biases related to the collectors' abilities and attractiveness are important limitations. In this study, we compared hand-nets with automatic traps (CDC) associated to CO2 and BG-Lure® in the Vassununga State Park, a Brazilian Savanna protection area. The collections carried out over 27 days on the ground and the forest canopy. A total of 1555 mosquitoes were obtained in 20 taxa. The diversity index ranged between 1.12 and 1.79 and the dominance index from 0.22 to 0.40. The dominant species on the ground was Aedes scapularis (46.0%), and in the canopy, Hg. janthinomys/capricornii (31.9%). Haemagogus leucocelaenus was rare (n = 2). The hand-net resulted in the greatest diversity and abundance of species in both strata, followed by the traps associated with CO2. A low degree of similarity was observed between the hand-net on the ground compared to the other capture methods. The use of BG-Lure® alone resulted in a low number of specimens. In conclusion, the hand-net is still the method of choice for collecting arbovirus vectors in the diurnal period, especially yellow fever vectors.

Evaluation of Methods to Collect Diurnal Culicidae (Diptera) at Canopy and Ground Strata, in the Atlantic Forest Biome.

Hand-held insect nets are the standard method for capturing vector mosquitoes of sylvatic arboviruses; however, occupational risks and biases due to individual skill and attractiveness are important limitations. The use of chemical attractants and automatic traps could be an alternative to resolve these limitations. This study compares the yields achieved using nets with those employing electrical traps with CO2 and BG-Lure®, near the ground and in the canopy strata (6.0 and 8.0 m high). The study was conducted at the Cantareira State Park, which is in the Brazilian Atlantic Forest biome. In the 18 collections performed, 3570 specimens of 52 taxa were obtained. The most frequent species captured near the ground were Wyeomyia confusa and Limatus durhamii, whereas Sabethes albiprivus, Sabethes purpureus, and Haemagogus leucocelaenus were the most frequent in the canopy. The nets resulted in greater species richness and abundance, followed by the trap employing CO2. The combination of CO2 traps with BG-Lure® did not improve performance. The use of BG-Lure® alone resulted in low abundance and a low number of species. Our results demonstrate that the use of traps with CO2 can be complementary to collections with nets; however, for species of epidemiological interest such as those of the genera Haemagogus and Sabethes, especially in the canopy, the net remains the method of choice.

Possible non-sylvatic transmission of yellow fever between non-human primates in São Paulo city, Brazil, 2017-2018.

Yellow Fever (YF) is a severe disease caused by Yellow Fever Virus (YFV), endemic in some parts of Africa and America. In Brazil, YFV is maintained by a sylvatic transmission cycle involving non-human primates (NHP) and forest canopy-dwelling mosquitoes, mainly Haemagogus-spp and Sabethes-spp. Beginning in 2016, Brazil faced one of the largest Yellow Fever (YF) outbreaks in recent decades, mainly in the southeastern region. In São Paulo city, YFV was detected in October 2017 in Aloutta monkeys in an Atlantic Forest area. From 542 NHP, a total of 162 NHP were YFV positive by RT-qPCR and/or immunohistochemistry, being 22 Callithrix-spp. most from urban areas. Entomological collections executed did not detect the presence of strictly sylvatic mosquitoes. Three mosquito pools were positive for YFV, 2 Haemagogus leucocelaenus, and 1 Aedes scapularis. In summary, YFV in the São Paulo urban area was detected mainly in resident marmosets, and synanthropic mosquitoes were likely involved in viral transmission.

Vectors of arboviruses in the state of São Paulo: 30 years of Aedes aegypti and Aedes albopictus.

OBJECTIVE: To describe the infestation of the municipalities of São Paulo by the vectors Aedes aegypti and Aedes albopictus, characterize seasonality and analyze average temperatures and larval densities. METHODS: We used maps with information on the infestation of municipalities between 1986 and 2015. The analysis of larval density of the species by the Wilcoxon test used the Breteau index values for Ae. aegypti and Ae. albopictus obtained from the Superintendency for Endemic Diseases Control database. In the seasonal description, arithmetic means of each vector were calculated by month and year. Mean temperature analyses were presented on maps with color gradients. RESULTS: The state of São Paulo is currently almost totally infested, with co-occurrence of species in 93.64% of the municipalities. The seasonality analysis showed the first quarter as the most favorable period for larval abundance. The increase of mean temperatures in geographical areas coincided with the temporal trajectory of Ae. aegypti territorial expansion. The mean larval density found was higher for Ae. aegypti than for Ae. albopictus (p = 0.00). CONCLUSIONS: Initially, these Culicidae occupied distinct and opposing areas. Over time, however, co-occurrence showed how great their capacity for adaptation is, even in the face of different social and urban conjunctures. The increase of the mean temperature contributed to Ae. Aegypti 's geographic expansion, as well as to the clearly seasonal profile of both species. In general, larval infestation by Ae. aegypti prevailed, which evidenced its competitive superiority. These data provide a better understanding of the dynamics of arboviral transmission in the state of São Paulo and can be used in vector surveillance and control.

Traços do ensino nightingaleano na formação da enfermeira cearense / Rasgos de enseñanza nightingaleana en la formación de enfermeras en ceará / Traits of nightingale teaching in the training of nurses from ceará

RESUMO Objetivo: descrever os traços do ensino Nightingaleano na formação da enfermeira cearense. Métodos: este estudo histórico é de natureza qualitativa. A história cultural foi o referencial teórico e metodológico do estudo. As fontes primárias foram constituídas de documentos escritos, arquivados no Núcleo de Documentação Informação História e Memória da Enfermagem no Ceará e a entrevista oral teve a participação de três professoras enfermeira/egressas da Escola de Enfermagem São Vicente de Paulo-Ceará. A análise dos documentos escritos foi guiada por Luchese. Já os documentos sonoros apoiaram-se em Albert. Resultados: a Escola de Enfermagem São Vicente de Paulo teve influência da Escola Anna Nery, configurando-se com a adoção do modelo anglo-americano, sendo um desdobramento Nightingaleano, distinguindo-se do modelo americano apenas neste quesito: escolas funcionando anexas a hospitais, demonstrando um ensino que privilegiava estágios hospitalares. Conclusão: o estudo em questão avança na origem do ensino cearense e acredita-se que reconhecer essa premissa contribuirá para ampliar o olhar da Enfermagem cearense, assim como refletir seu papel, sua imagem, sua identidade profissional perpassada ao longo da história da profissão.

RESUMEN Objetivo: describir los rasgos de la enseñanza Nightingaleana en la formación de enfermeras de Ceará. Métodos: Este estudio histórico es de naturaleza cualitativa. La historia cultural fue el marco teórico y metodológico del estudio. Las fuentes primarias consistieron en documentos escritos, archivados en el Centro de Documentación de Información, Historia y Memoria de la Enfermería de Ceará, y a la entrevista oral asistieron tres profesoras, enfermeras, egresadas de la Escuela de Enfermería São Vicente de Paulo, Ceará. El análisis de documentos escritos fue guiado por Luchese. Los documentos sonoros fueron apoyados por Albert. Resultados: la Escuela de Enfermería de São Vicente de Paulo fue influenciada por la Escuela Anna Nery, configurándose con la adopción del modelo angloamericano, siendo un despliegue Nightingaleano, distinguiéndose del modelo estadounidense solo en este aspecto: escuelas en funcionamiento adyacentes a hospitales, demostrando una enseñanza que favoreció las prácticas hospitalarias. Conclusión: el estudio en cuestión avanza en los orígenes de la docencia en Ceará y se cree que reconocer esta premisa ayudará a ampliar la perspectiva de la Enfermería en Ceará, así como a reflejar su rol, imagen, su identidad profesional permeada a lo largo de la historia de la profesión.

ABSTRACT Objective: to describe the features of Nightingale teaching in the training of nurses from Ceará. Methods: this historical study is qualitative in nature. Cultural history was the theoretical and methodological framework of the study. The primary sources consisted of written documents, filed at the Center for Documentation Information, History and Memory of Nursing in Ceará, and the oral interview was attended by three professors, nurses, graduates from the Escola de Enfermagem São Vicente de Paulo, Ceará. The analysis of written documents was guided by Luchese. The sound documents were supported by Albert. Results: the Escola de Enfermagem São Vicente de Paulo was influenced by the Escola Anna Nery, configuring itself with the adoption of the Anglo-American model, being a Nightingalean offshoot, distinguishing itself from the American model only in this aspect: schools functioning adjacent to hospitals, demonstrating a teaching that favored hospital internships. Conclusion: the study in question advances the origins of teaching in Ceará and it is believed that recognizing this premise will contribute to broadening the perspective of Nursing in Ceará, as well as reflecting its role, image, professional identity permeated throughout the history of the profession.

Assessment of the relationship between entomologic indicators of Aedes aegypti and the epidemic occurrence of dengue virus 3 in a susceptible population, São José do Rio Preto, São Paulo, Brazil.

The aims of this study were to describe the occurrence of dengue in space and time and to assess the relationships between dengue incidence and entomologic indicators. We selected the dengue autochthonous cases that occurred between September 2005 and August 2007 in São José do Rio Preto to calculate incidence rates by month, year and census tracts. The monthly incidence rates of the city were compared to the monthly Breteau indices (BI) of the São José do Rio Region. Between December 2006 and February 2007, an entomological survey was conducted to collect immature forms of Aedes aegypti in Jaguaré, a São José do Rio Preto neighborhood, and to obtain entomological indices. These indices were represented using statistical interpolation. To represent the occurrence of dengue in the Jaguaré neighborhood in 2006 and 2007, we used the Kernel ratio and to evaluate the relationship between dengue and the entomological indices, we used a generalized additive model in a spatial case-control design. Between September 2005 and August 2007, the occurrence of dengue in São José do Rio Preto was almost entirely caused by DENV3, and the monthly incidence rates presented high correlation coefficients with the monthly BI. In Jaguaré neighborhood, the entomological indices calculated by hectare were better predictors of the spatial distribution of dengue than the indices calculated by properties, but the pupae quantification did not show better prediction qualities than the indices based on the container positivity, in relation to the risk of dengue occurrence. The fact that the municipality's population had a high susceptibility to the serotype DENV3 before the development of this research, along with the almost total predominance of the occurrence of this serotype between 2005 and 2007, facilitated the analysis of the epidemiological situation of the disease and allowed us to connect it to the entomological indicators.

Vectors of arboviruses in the state of São Paulo: 30 years of Aedes aegypti and Aedes albopictus / Vetores de arboviroses no estado de São Paulo: 30 anos de Aedes aegypti e Aedes albopictus

ABSTRACT OBJECTIVE To describe the infestation of the municipalities of São Paulo by the vectors Aedes aegypti and Aedes albopictus, characterize seasonality and analyze average temperatures and larval densities. METHODS We used maps with information on the infestation of municipalities between 1986 and 2015. The analysis of larval density of the species by the Wilcoxon test used the Breteau index values for Ae. aegypti and Ae. albopictus obtained from the Superintendency for Endemic Diseases Control database. In the seasonal description, arithmetic means of each vector were calculated by month and year. Mean temperature analyses were presented on maps with color gradients. RESULTS The state of São Paulo is currently almost totally infested, with co-occurrence of species in 93.64% of the municipalities. The seasonality analysis showed the first quarter as the most favorable period for larval abundance. The increase of mean temperatures in geographical areas coincided with the temporal trajectory of Ae. aegypti territorial expansion. The mean larval density found was higher for Ae. aegypti than for Ae. albopictus (p = 0.00). CONCLUSIONS Initially, these Culicidae occupied distinct and opposing areas. Over time, however, co-occurrence showed how great their capacity for adaptation is, even in the face of different social and urban conjunctures. The increase of the mean temperature contributed to Ae. Aegypti 's geographic expansion, as well as to the clearly seasonal profile of both species. In general, larval infestation by Ae. aegypti prevailed, which evidenced its competitive superiority. These data provide a better understanding of the dynamics of arboviral transmission in the state of São Paulo and can be used in vector surveillance and control.

RESUMO OBJETIVO Descrever a infestação dos municípios paulistas pelos vetores Aedes aegypti e Aedes albopictus , caracterizar a sazonalidade e analisar as temperaturas médias e as densidades larvárias. MÉTODOS Foram empregados mapas com informações sobre a infestação dos municípios entre 1986 e 2015. A análise da densidade larvária das espécies pelo teste de Wilcoxon utilizou os valores do índice de Breteau para Ae. aegypti e Ae. albopictus obtidos no banco de dados da Superintendência de Controle de Endemias. Na descrição sazonal, foram calculadas as médias aritméticas de cada um por mês e ano. As análises de temperaturas médias foram apresentadas em mapas com gradientes de cores. RESULTADOS O estado de São Paulo apresenta-se na atualidade quase totalmente infestado, com coocorrência das espécies em 93,64% dos municípios. A análise da sazonalidade evidenciou o primeiro trimestre como o período mais favorável para a abundância larval. Observou-se elevação das temperaturas médias em áreas geográficas coincidentes com a trajetória temporal da expansão territorial de Ae. aegypti . O valor médio da densidade larvária de Ae. aegypti foi maior do que o verificado para Ae. albopictus (p = 0,00). CONCLUSÕES Esses culicídeos apresentaram, inicialmente, ocupação em áreas distintas e opostas. Entretanto, no decorrer do tempo, a coocorrência mostrou quão grande é a capacidade de adaptação, mesmo em face de conjunturas sociais e urbanas diferentes. A elevação da temperatura média contribuiu para a expansão geográfica de Ae. aegypti , assim como para o perfil nitidamente sazonal de ambas as espécies. No geral, a infestação larvária por Ae. aegypti foi predominante, o que evidenciou sua superioridade competitiva. Tais dados propiciam maior entendimento da dinâmica de transmissão de arboviroses no estado de São Paulo e são subsídios para a vigilância e o controle desses vetores.

Aedes aegypti entomological indices in an endemic area for dengue in Sao Paulo State, Brazil.

OBJECTIVE: To evaluate the most productive types of properties and containers for Aedes aegypti and the spatial distribution of entomological indices. METHODS: Between December 2006 and February 2007, the vector's immature forms were collected to obtain entomological indices in 9,875 properties in the Jaguare neighborhood of Sao Jose do Rio Preto, SP, Southeastern Brazil. In March and April 2007, a questionnaire about the conditions and characteristics of properties was administered. Logistic regression was used to identify variables associated with the presence of pupae at the properties. Indices calculated per block were combined with a geo-referenced map, and thematic maps of these indices were obtained using statistical interpolation. RESULTS: The properties inspected had the following Ae. aegypti indices: Breteau Index = 18.9, 3.7 larvae and 0.42 pupae per property, 5.2 containers harboring Ae. aegypti per hectare, 100.0 larvae and 11.6 pupae per hectare, and 1.3 larvae and 0.15 pupae per inhabitant. The presence of yards, gardens and animals was associated with the presence of pupae. CONCLUSIONS: Specific types of properties and containers that simultaneously had low frequencies among those positive for the vector and high participation in the productivity of larvae and pupae were not identified. The use of indices including larval and pupal counts does not provide further information beyond that obtained from the traditional Stegomyia indices in locations with characteristics similar to those of São José do Rio Preto. The indices calculated per area were found to be more accurate for the spatial assessment of infestation. The Ae. aegypti infestation levels exhibited extensive spatial variation, indicating that the assessment of infestation in micro areas is needed.

[Yellow fever: reemerging in the state of Sao Paulo, Brazil, 2009]. / Febre amarela silvestre: reemergência de transmissão no estado de São Paulo, Brasil, 2009.

OBJECTIVE: To describe the investigation of a sylvatic yellow fever outbreak in the state of Sao Paulo and the main control measures undertaken. METHODS: This is a descriptive study of a sylvatic yellow fever outbreak in the Southwestern region of the state from February to April 2009. Suspected and confirmed cases in humans and in non-human primates were evaluated. Entomological investigation in sylvatic environment involved capture at ground level and in the tree canopy to identify species and detect natural infections. Control measures were performed in urban areas to control Aedes aegypti . Vaccination was directed at residents living in areas with confirmed viral circulation and also at nearby cities according to national recommendation. RESULTS: Twenty-eight human cases were confirmed (39.3% case fatality rate) in rural areas of Sarutaiá, Piraju, Tejupá, Avaré and Buri. The deaths of 56 non-human primates were also reported, 91.4% were Allouatta sp. Epizootics was confirmed in two non-human primates in the cities of Itapetininga and Buri. A total of 1,782 mosquitoes were collected, including Haemagogus leucocelaenus , Hg. janthinomys/capricornii , and Sabethes chloropterus, Sa. purpureus and Sa. undosus . Yellow fever virus was isolated from a group of Hg. Leucocelaenus from Buri. Vaccination was carried out in 49 cities, with a total of 1,018,705 doses. Nine serious post-vaccination adverse events were reported. CONCLUSIONS: The cases occurred between February and April 2009 in areas with no recorded yellow fever virus circulation in over 60 years. The outbreak region occurred outside the original recommended vaccination area with a high percentage of susceptible population. The fast adoption of control measures interrupted the human transmission within a month and the confirmation of viral circulation in humans, monkeys and mosquitoes. The results allowed the identification of new areas of viral circulation but further studies are required to clarify the dynamics of the spread of this disease.

Isolation of yellow fever virus (YFV) from naturally infected Haemagogus (Conopostegus) leucocelaenus (diptera, cukicudae) in São Paulo State, Brazil, 2009.

After detecting the death of Howlers monkeys (genus Alouatta) and isolation of yellow fever virus (YFV) in Buri county, São Paulo, Brazil, an entomological research study in the field was started. A YFV strain was isolated from newborn Swiss mice and cultured cells of Aedes albopictus - C6/36, from a pool of six Haemagogus (Conopostegus) leucocelaenus (Hg. leucocelaenus) mosquitoes (Dyar & Shannon) collected at the study site. Virus RNA fragment was amplified by RT-PCR and sequenced. The MCC Tree generated showed that the isolated strain is related to the South American I genotype, in a monophyletic clade containing isolates from recent 2008-2010 epidemics and epizootics in Brazil. Statistical analysis commonly used were calculated to characterize the sample in relation to diversity and dominance and indicated a pattern of dominance of one or a few species. Hg. leucocelaenus was found infected in Rio Grande do Sul State as well. In São Paulo State, this is the first detection of YFV in Hg. leucocelaenus.

A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of São Paulo, Brazil

We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.

Aedes aegypti entomological indices in an endemic area for dengue in Sao Paulo State, Brazil / Indicadores entomológicos de Aedes aegypti em área endêmica de dengue, São Paulo, Brasil / Indicadores entomologicos de Aedes aegypti en area endemica de dengue, Sao Paulo, Brasil

OBJECTIVE: To evaluate the most productive types of properties and containers for Aedes aegypti and the spatial distribution of entomological indices. METHODS: Between December 2006 and February 2007, the vector's immature forms were collected to obtain entomological indices in 9,875 properties in the Jaguare neighborhood of Sao Jose do Rio Preto, SP, Southeastern Brazil. In March and April 2007, a questionnaire about the conditions and characteristics of properties was administered. Logistic regression was used to identify variables associated with the presence of pupae at the properties. Indices calculated per block were combined with a geo-referenced map, and thematic maps of these indices were obtained using statistical interpolation. RESULTS: The properties inspected had the following Ae. aegypti indices: Breteau Index = 18.9, 3.7 larvae and 0.42 pupae per property, 5.2 containers harboring Ae. aegypti per hectare, 100.0 larvae and 11.6 pupae per hectare, and 1.3 larvae and 0.15 pupae per inhabitant. The presence of yards, gardens and animals was associated with the presence of pupae. CONCLUSIONS: Specific types of properties and containers that simultaneously had low frequencies among those positive for the vector and high participation in the productivity of larvae and pupae were not identified. The use of indices including larval and pupal counts does not provide further information beyond that obtained from the traditional Stegomyia indices in locations with characteristics similar to those of São José do Rio Preto. The indices calculated per area were found to be more accurate for the spatial assessment of infestation. The Ae. aegypti infestation levels exhibited extensive spatial variation, indicating that the assessment of infestation in micro areas is needed. .

OBJETIVO: Avaliar os tipos de imóveis e de recipientes mais produtivos para o desenvolvimento de Aedes aegyptie a distribuição espacial de indicadores entomológicos. MÉTODOS: Foram realizadas coletas de formas imaturas de mosquitos para obtenção de indicadores entomológicos em 9.875 imóveis no bairro Jaguaré, no município de São José do Rio Preto, SP, entre dezembro de 2006 e fevereiro de 2007. Aplicou-se questionário sobre as condições e características de imóveis em março e abril de 2007. Utilizou-se regressão logística para identificar as variáveis associadas com a presença de pupas nos imóveis. Índices calculados por quadra foram combinados com mapas georreferenciados, possibilitando a produção de mapas temáticos por meio de interpolação estatística. RESULTADOS: Os imóveis inspecionados apresentaram os seguintes índices para Ae. aegytpi: Índice de Breteau de 18,9, 3,7 larvas e 0,42 pupas por imóvel, 5,2 recipientes com Ae. aegypti por hectare, 100,0 larvas e 11,6 pupas por hectare, e 1,3 larva e 0,15 pupa por habitante. Presença de quintal, jardim e animais associaram-se com a presença de pupas. CONCLUSÕES: Não foram identificados tipos específicos de imóveis e de recipientes que fossem pouco frequentes dentre aqueles com a presença do vetor e, ao mesmo tempo, que apresentassem elevada participação na produtividade de larvas e pupas. O uso de índices baseados na quantificação de larvas e pupas não traria informações além daquelas obtidas com os índices estegômicos tradicionais em localidades com características similares a São José do Rio Preto. Os índices calculados por área apresentaram maior acurácia para avaliar espacialmente ...

OBJETIVO: Evaluar los tipos de inmuebles y de recipientes más productivos para el desarrollo de Aedes aegypti y la distribución espacial de indicadores entomológicos MÉTODOS: Se realizaron colectas de formas inmaduras de mosquitos para obtención de indicadores entomológicos en 9.875 inmuebles en la urbanización Jaguaré, en el municipio de Sao José do Rio Preto, SP (Brasil), entre diciembre de 2006 y febrero de 2007. Se aplicó cuestionario sobre las condiciones y características de los inmuebles en marzo y abril de 2007. Se utilizó regresión logística para identificar las variables asociadas con la presencia de pupas en los inmuebles. Se combinaron los Índices calculados por cuadra con mapas georeferenciados, posibilitando la producción de mapas temáticos por medio de interpolación estadística. RESULTADOS: Los inmuebles inspeccionados presentaron los siguientes índices para Aedes aegypti: Índice de Breteau de 18,9, 3,7 larvas y 0,42 pupas por inmueble, 5,2 recipientes con Ae. Aegypti por hectárea, 100,0 larvas y 11,6 pupas por hectárea, y 1,3 larvas y 0,15 pupas por habitante. Presencia de patio, jardín y animales se asociaron con la presencia de pupas. CONCLUSIONES: No se identificaron tipos específicos de inmuebles y de recipientes que fueran poco frecuentes entre aquellos con la presencia del vector y, al mismo tiempo, que presentaran elevada participación en la productividad de larvas y pupas. El uso de índices basados en la cuantificación de larvas y pupas no traería informaciones aunadas a las obtenidas con los índices Stegómicos tradicionales en localidades con características similares a Sao José do Rio Preto. Los índices calculados por área presentaron mayor precisión para evaluar espacialmente la infestación y la infestación ...

Febre amarela silvestre: reemergencia de transmissao no estado de Sao Paulo, Brasil, 2009 / Fiebre amarilla silvestre: re emergencia de transmision en el estado de Sao Paulo, Brasil, 2009 / Yellow fever: reemerging in the state of Sao Paulo, Brazil, 2009

OBJETIVO Descrever a investigação do surto de febre amarela silvestre e as principais medidas de controle realizadas no estado de São Paulo. MÉTODOS Estudo descritivo do surto de febre amarela silvestre na região sudoeste do estado, entre fevereiro e abril de 2009. Foram avaliados casos suspeitos e confirmados em humanos e primatas não humanos. A investigação entomológica, em ambiente silvestre, envolveu captura em solo e copa de árvore para identificação das espécies e detecção de infecção natural. Foram realizadas ações de controle de Aedes aegypti em áreas urbanas. A vacinação foi direcionada para residentes dos municípios com confirmação de circulação viral e nos municípios contíguos, conforme recomendação nacional. RESULTADOS Foram confirmados 28 casos humanos (letalidade 39,3%) em áreas rurais de Sarutaiá, Piraju, Tejupá, Avaré e Buri. Foram notificadas 56 mortes de primatas não humanos, 91,4% do gênero Alouatta sp . A epizootia foi confirmada laboratorialmente em dois primatas não humanos, sendo um em Buri e outro em Itapetininga. Foram coletados 1.782 mosquitos, entre eles Haemagogus leucocelaenus , Hg. janthinomys/capricornii , Sabethes chloropterus , Sa. purpureus e Sa. undosus . O vírus da febre amarela foi isolado de um lote de Hg. leucocelaenus procedente de Buri. A vacinação foi realizada em 49 municípios, com 1.018.705 doses aplicadas e o registro de nove eventos adversos graves pós-vacinação. CONCLUSÕES Os casos humanos ocorreram entre fevereiro e abril de 2009 em áreas sem registro de circulação do vírus da febre amarela há mais de 60 anos. A região encontrava-se fora da área com recomendação de vacinação, com alto percentual da p...

OBJETIVO Describir la investigación de brote de fiebre amarilla silvestre y las principales medidas de control realizadas en el estado de Sao Paulo. MÉTODOS Estudio descriptivo del brote de fiebre amarilla silvestre en la región suroeste del Estado, entre febrero y abril de 2009. Se evaluaron casos sospechosos y confirmados en humanos y primates no humanos. La investigación entomológica, en ambiente silvestre, involucró capturo en suelo y copa de árboles para identificación de las especies y detección de infección natural. Se realizaron acciones de control de Aedes aegypti en áreas urbanas. La vacunación fue direccionada a residentes de los municipios con confirmación de circulación viral y en los municipios contiguos, siguiendo recomendación nacional. RESULTADOS Se confirmaron 28 casos en humanos (letalidad 39,3%) en áreas rurales de Sarutaiá, Pirajú, Tejupá, Avaré y Buri. Se notificaron 56 muertes de primates no humanos, 91,4% del género Allouatta sp. La epizootia fue confirmada laboratorialmente en dos primates no humanos siendo uno de Buri y el otro de Itapetininga. Se colectaron 1.782 mosquitos, entre ellos Haemagogus leucocelaenus, Hg. janthinomys/capricornii, y Sabethes chloropterus, Sa. purpureus y Sa. undosus. El virus de la fiebre amarilla fue aislado de un lote de Hg. leucocelaenus procedente de Buri. La vacunación fue realizada en 49 municipios, con 1.018.705 dosis aplicadas y el registro de nueve eventos adversos graves post-vacunación. CONCLUSIONES Los casos humanos ocurrieron entre febrero a abril de 2009 en áreas sin registro de circulación del virus de la fiebre amarilla por más de 60 años. La región se encontraba fuera del área de recomendación de vacunación, con alto porcentaje de población susceptible. La adopción oportuna de medidas de control permitió ...

OBJECTIVE To describe the investigation of a sylvatic yellow fever outbreak in the state of Sao Paulo and the main control measures undertaken. METHODS This is a descriptive study of a sylvatic yellow fever outbreak in the Southwestern region of the state from February to April 2009. Suspected and confirmed cases in humans and in non-human primates were evaluated. Entomological investigation in sylvatic environment involved capture at ground level and in the tree canopy to identify species and detect natural infections. Control measures were performed in urban areas to control Aedes aegypti . Vaccination was directed at residents living in areas with confirmed viral circulation and also at nearby cities according to national recommendation. RESULTS Twenty-eight human cases were confirmed (39.3% case fatality rate) in rural areas of Sarutaiá, Piraju, Tejupá, Avaré and Buri. The deaths of 56 non-human primates were also reported, 91.4% were Allouatta sp. Epizootics was confirmed in two non-human primates in the cities of Itapetininga and Buri. A total of 1,782 mosquitoes were collected, including Haemagogus leucocelaenus , Hg. janthinomys/capricornii , and Sabethes chloropterus, Sa. purpureus and Sa. undosus . Yellow fever virus was isolated from a group of Hg. Leucocelaenus from Buri. Vaccination was carried out in 49 cities, with a total of 1,018,705 doses. Nine serious post-vaccination adverse events were reported. CONCLUSIONS The cases occurred between February and April 2009 in areas with no recorded yellow fever virus circulation in over 60 years. The outbreak region occurred outside the original recommended vaccination area with a high percentage of susceptible population. The fast adoption of control measures interrupted the human transmission within a month and the confirmation of viral circulation in humans, monkeys and mosquitoes. The results allowed the identification of new areas of viral circulation but ...

Indicadores de infestação larvária e influência do porte populacional na transmissão de dengue no estado de São Paulo, Brasil: um estudo ecológico no período de 2007-2008 / Larval infestation indicators and influence of population size on dengue transmission in the State of São Paulo, Brazil: an ecological study in the periodo 2007-2008

Objetivo: descrever indicadores de infestação larvária e analisar a associação entre ocorrência de dengue, porte populacional e distância entre municípios no estado de São Paulo. Métodos: estudo ecológico utilizando indicadores larvários, segundo tipo de imóvel, e regressão logística. Foram utilizados dados dos sistemas da Superintendência de Controle de Endemias (Sucen) e do Centro de Vigilância Epidemiológica (CVE) dos anos 2007 e 2008. Resultados: o Índice de Infestação Predial e a positividadede Pontos Estratégicos e Imóveis Especiais apresentaram valores maiores em municípios com dengue. Nos municípios contidos num raio de 50km dos municípios-pólo, a chance de ocorrência de dengue foi o dobro dos municípios mais distantes. Naqueles com população maior que 50.000 habitantes, a chance de ocorrência de dengue foi cinco vezes aquela em municípios menores. Conclusão: é evidenciada a importância da adoção de estratégias de controle baseadas nos indicadores entomológicos, sobretudo nos municípios de grande porte.

Objective: to describe larval indicators and analyze the association of occurrence of dengue and population size and distance between municipalities in the State of São Paulo, Brazil. Methods: ecological study utilizing larval indicators according to property type and logistic regression. The data was obtained from the systems of Endemics Control Bureau and Center of Epidemiological Vigilance in 2007 and 2008. Results: household Index Infestation andpositivity of Strategic Points and Special Property were higher in municipalities with dengue. The chance of occurrence of dengue in municipalities less than 50km away from the major municipalities was twice as likely. The municipalities with populations greater than 50.000 inhabitants hadfive times more chance of dengue occurrence compared to the small municipalities. Conclusion: this study emphasizes the importance of adopting control strategies based on entomological indicators, especially in big municipalities.

Isolation of yellow fever virus (YFV) from naturally infectied Haemagogus (Conopostegus) leucocelaenus (diptera, cukicudae) in São Paulo State, Brazil, 2009 / Isolamento do vírus da Febre Amarela de mosquitos naturalmente infectados Haemagogus (Conopostegus) leucocelaenus (Diptera, Culicidae), São Paulo, Brasil, 2009

After detecting the death of Howlers monkeys (genus Alouatta) and isolation of yellow fever virus (YFV) in Buri county, São Paulo, Brazil, an entomological research study in the field was started. A YFV strain was isolated from newborn Swiss mice and cultured cells of Aedes albopictus - C6/36, from a pool of six Haemagogus (Conopostegus) leucocelaenus (Hg. leucocelaenus) mosquitoes (Dyar & Shannon) collected at the study site. Virus RNA fragment was amplified by RT-PCR and sequenced. The MCC Tree generated showed that the isolated strain is related to the South American I genotype, in a monophyletic clade containing isolates from recent 2008-2010 epidemics and epizootics in Brazil. Statistical analysis commonly used were calculated to characterize the sample in relation to diversity and dominance and indicated a pattern of dominance of one or a few species. Hg. leucocelaenus was found infected in Rio Grande do Sul State as well. In São Paulo State, this is the first detection of YFV in Hg. leucocelaenus.

Após a detecção de morte de macacos Bugios (gênero Alouatta) e isolamento do vírus da Febre Amarela (YFV) no município de Buri, Estado de São Paulo, Brasil, foi iniciada uma investigação entomológica em campo. Uma cepa de YFV foi isolada em camundongos recém-nascidos e cultura de células de Aedes albopictus - C6/36, a partir de um lote de seis mosquitos Haemagogus (Conopostegus) leucocelaenus (Hg leucocelaenus) Dyar & Shannon coletados no local de estudo. RNA do vírus foi amplificado por RT-PCR e seqüenciado. A topologia gerada indica que a cepa isolada está relacionada ao genótipo South American I, em clado monofilético englobando isolados recentes de epidemias e epizootias entre 2008 e 2009. Análises estatísticas geralmente usadas caracterizaram a amostra em relação à diversidade e dominância, indicando dominância relativa de uma ou poucas espécies. Hg. leucocelaenus foi detectado infectado também no Rio Grande do Sul. No Estado de São Paulo trata-se da primeira detecção do YFV em Hg leucocelaenus.

Malária adquirida durante atividade entomológica na Serra do Mar, regiäo Sudeste do Brasil / Malaria acquired during entomological research undertaken on the coastal range of southeastern Brazil

No início de 1993 foi detectado um foco de malária no Parque Estadual da Serra do Mar, área de Mata Atlântica no Estado de Säo Paulo (Brasil). Quando da realizaçäo da pesquisa entomológica ocorreu a infecçäo malárica por Plasmodium vivax em três capturadores da equipe de campo. A transmissäo ocorreu em área que vem apresentando baixos níveis de incidência de malária, e os capturadores tiveram um período de exposiçäo extremamente reduzido, sendo de apenas três horas em um dos casos

Recipientes artificiais utilizados como criadouros por Aedes aegypti na regiäo de Araçatuba, estado de Säo Paulo / The artificial recipients that serve as beeding sites for Aedes aegypti, in region of Araçatuba, Säo Paulo, Brazil

Pesquisa realizada na regiäo de Araçatuba, envolvendo 22 municípios. A área foi avaliada visando a conhecer a composiçäo e a disponibilidade, nos ambientes urbanos, de recipientes que apresentassem potencial para o desenvolvimento de formas imaturas de culicídeos. Com o objetivo de avaliar e comparar os diferentes tipos de recipientes, classificados em oito grupos, em relaçäo à ocupaçäo por Ae. aegypti, foi registrada a presença de formas larvais e de pupas da espécie, assim como a quantidade de exemplares referentes aos dois estágios evolutivos. Durante o período de novembro de 1993 a dezembro de 1994, foram visitados 31.870 imóveis, nos quais foram quantificados 197.529 recipientes com capacidade de armazenar água e servir como depósito de ovos e criadouros de Ae. aegypti. A pesquisa entomológica foi desenvolvida em 73.341 recipientes. Os recipientes utilizados como criadouros por Ae. aegypti estavam localizados predominantemente no peridomicílio, ambiente que, por questöes de manejo e disposiçäo inadequados, apresentou ampla disponibilidade de recipientes. A detecçäo de recipientes, em que formas imaturas de Ae. aegypti foram encontradas, mostrou-se mais abundante entre novembro e abril, período considerado mais favorável ao desenvolvimento do vetor, quando 90 por cento dos exemplares desta espécie foram coletados. Os grupos de recipientes que se destacaram como mais importantes, tanto em relaçäo aos encontros de recipientes contendo formas imaturas de Ae. aegypti como no que diz respeito ao número de exemplares coletados, foram: frascos e vasos, responsáveis, respectivamente, por 40,0 e 19 por cento das pupas coletadas, seguidos de peças e materiais com 11,4 por cento e pneus com 9,5 por cento destes exemplares

Produtividade e habitats larvários de Aedes aegypti em Santos, Estado de Säo Paulo / Productivity and larvae habitats of Aedes aegypti in Santos, Säo Paulo State

Objetivo. As populaçöes de Aedes aegypti apresentam elevada adaptabilidade ocupando, nos ambientes urbanos, variados tipos de habitats. Realizou-se o estudo com o objetivo de avaliar a produtividade desses criadouros. Método. A pesquisa foi realizada no município de Santos, entre novembro de 1999 e abril de 2000. Os imóveis foram avaliados quanto à presença de recipientes e ocupaçäo por Aedes aegypti, e caracterizados quanto ao tipo de material, localizaçäo, quantidade de água e sua reposiçäo. As larvas (3º e 4º estadios) e as pupas foram quantificadas e a biomassa das pupas foi medida. Foram estimados indicadores de infestaçäo e os grupos de recipientes considerados , foram avaliados mediante testes de comparaçöes múltiplas. Resultados. A disponibilidade foi elevada e os habitats estavam localizados predominantemente no peridomicílio, ambiente que concentrou 90,8 por cento dos recipientes positivos e 94 por cento dos exemplares coletados. Os grupos de recipientes ralo, frasco e vaso foram os habitats mais freqüentes. Indicadores baseados na quantidade de larvas e de pupas apresentaram correlaçäo com o índice de Breteau. O número médio de larvas diferenciou os grupos de recipientes pneu, tambor, caixa d'água e calha que apresentaram valores mais elevados. Em relaçäo à biomassa das pupas foram distinguidos, entre outros, os grupos caixa d'água, calha e ralo, cujos exemplares apresentaram maior peso. Apenas 8,7 por cento dos habitats foram responsáveis por 52 por cento das pupas coletadas. Conclusöes. A avaliaçäo dos habitats com base na presença da espécie pode levar à subestimaçäo ou superestimaçäo da importância de determinados tipos. A qualificaçäo e a biomassa de pupas indicam a contribuiçäo dos diferentes habitats para a populaçäo de mosquitos adultos. Apresentaram maior produtividade os habitats dos grupos caixa d'água, calha, ralo, pneu e tambor