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1.
Mem Inst Oswaldo Cruz ; 110(2): 230-4, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25946247

RESUMEN

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.


Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Modelos Estadísticos , Salud Pública/métodos , Vacunación/mortalidad , Vacuna contra la Fiebre Amarilla/efectos adversos , Fiebre Amarilla/prevención & control , Brasil/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Monitoreo Epidemiológico , Humanos , Medición de Riesgo/métodos , Fiebre Amarilla/epidemiología , Fiebre Amarilla/mortalidad
2.
Emerg Infect Dis ; 15(4): 663-7, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19331768

RESUMEN

To determine the presence of Kaposi sarcoma-associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural non-Amerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians.


Asunto(s)
Anticuerpos Antivirales/sangre , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Herpesviridae/epidemiología , Herpesvirus Humano 8/inmunología , Adolescente , Adulto , Donantes de Sangre , Brasil/epidemiología , Niño , Preescolar , Enfermedades Transmisibles Emergentes/inmunología , Enfermedades Transmisibles Emergentes/transmisión , Estudios Transversales , Femenino , Infecciones por Herpesviridae/inmunología , Infecciones por Herpesviridae/transmisión , Humanos , Indígenas Sudamericanos , Lactante , Recién Nacido , Trastornos Linfoproliferativos/epidemiología , Trastornos Linfoproliferativos/inmunología , Masculino , Población Rural , Sarcoma de Kaposi/epidemiología , Sarcoma de Kaposi/inmunología , Estudios Seroepidemiológicos , Población Urbana , Adulto Joven
3.
Clinics (Sao Paulo) ; 63(1): 21-6, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18305872

RESUMEN

INTRODUCTION: Since 1999, the Ministry of Health in Brazil has conducted campaigns of vaccination against influenza targeted towards the elderly, chronically-diseased people and health care workers. The vaccine against influenza is associated with adverse events of minor importance. OBJECTIVE: To investigate the early adverse events related to the vaccine against influenza. CASUISTICS AND METHODS: One hundred and ninety seven elderly individuals and health care workers vaccinated against influenza were included. An inquiry regarding adverse events related to the vaccine was applied seven days after the vaccination. RESULTS: Local adverse events were reported by 32.5% and systemic effects by 26.4% of the vaccinated subjects. Pain in the region of the injection, headache, myalgia, malaise, and coryza were more frequent in the workers than in the elderly (p<0.05). There was no statistically significant difference in the occurrence of fever. CONCLUSIONS: The belief of part of the population that credits frequent and uncomfortable adverse events to the vaccine was not confirmed. The subjective adverse events were more frequent in the health care workers, which can influence, in a negative way, the disclosure of the benefits of this vaccine due to their role as opinion makers.


Asunto(s)
Vacunas contra la Influenza/efectos adversos , Gripe Humana/prevención & control , Vacunación/efectos adversos , Adolescente , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos , Anciano , Brasil , Enfermedad Crónica , Femenino , Personal de Salud , Servicios de Salud para Ancianos , Humanos , Vacunas contra la Influenza/uso terapéutico , Masculino , Persona de Mediana Edad
5.
Toxicon ; 96: 68-73, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25549940

RESUMEN

Scorpionism is a public health problem in many tropical countries, especially in North Africa, South India, Latin America and the Middle East. In Brazil, patients with severe scorpion envenoming have mainly cardiovascular events, including acute heart failure, acute respiratory distress syndrome and shock, death is rare. We described 58 accidents presumably caused by Tityus obscurus in Brazilian Amazonia. Patients reported a sensation of "electric shocks" which could last hours. The vast majority of patients presented a clinical picture compatible with acute cerebellar dysfunction, beginning minutes and lasting up to 2 days after the accident. They presented cerebellar ataxia, dysdiadochokinesia, dysmetry, dysarthria, dyslalia, nausea and vomiting. Besides, some patients presented myoclonus and fasciculation which can also be attributed to cerebellar dysfunction or maybe the result of direct action on skeletal muscle. Two patients had evidence of intense rhabdomyolysis and acute kidney injury. The clinical picture in this scorpion envenoming is mainly characterized by an acute dysfunction of cerebellar activities and abnormal neuromuscular manifestations and in some cases muscle injury which are not described in any other region of the world. This work presents clinical, epidemiologic, laboratory and treatment aspects of this unmatched scorpion envenoming in the state of Pará, northern Brazil.


Asunto(s)
Enfermedades Cerebelosas/patología , Fasciculación/patología , Mioclonía/patología , Picaduras de Escorpión/complicaciones , Picaduras de Escorpión/epidemiología , Brasil/epidemiología , Enfermedades Cerebelosas/etiología , Niño , Preescolar , Fasciculación/etiología , Humanos , Masculino , Mioclonía/etiología
6.
PLoS Negl Trop Dis ; 8(3): e2740, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24625634

RESUMEN

Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.


Asunto(s)
Brotes de Enfermedades , Fiebre Amarilla/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Niño , Preescolar , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Vacunación/efectos adversos , Vacunación/estadística & datos numéricos , Vacuna contra la Fiebre Amarilla/administración & dosificación , Vacuna contra la Fiebre Amarilla/efectos adversos , Adulto Joven
8.
Rev Saude Publica ; 47(5): 881-9, 2013 Oct.
Artículo en Portugués | MEDLINE | ID: mdl-24626492

RESUMEN

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.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Culicidae/clasificación , Insectos Vectores/clasificación , Fiebre Amarilla/epidemiología , Adolescente , Adulto , Animales , Brasil/epidemiología , Niño , Preescolar , Enfermedades Transmisibles Emergentes/veterinaria , Brotes de Enfermedades , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Fiebre Amarilla/veterinaria , Adulto Joven
9.
Rev Soc Bras Med Trop ; 45(5): 639-42, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23152350

RESUMEN

INTRODUCTION: This study aimed to evaluate the response to hepatitis B (HB) revaccination of healthcare workers (HCW) who are negative for antibodies to HB surface antigen (anti-HBs) after a complete vaccination series. METHODS: HCW whose anti-HBs test was performed > 90 days after a HB vaccination course were given a 4th dose. A post-vaccination test was done within 30 to 90 days. RESULTS: One hundred and seventy HCW were enrolled: 126 (74.1%) were anti-HBs-positive after the 4th dose. CONCLUSIONS: Rechecking anti-HBs after the 4th HB vaccine dose is a practical approach in case of post-vaccination tests performed >90 days after the full vaccination course.


Asunto(s)
Personal de Salud/estadística & datos numéricos , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/inmunología , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B/prevención & control , Inmunización Secundaria , Adolescente , Adulto , Relación Dosis-Respuesta a Droga , Femenino , Hepatitis B/inmunología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/prevención & control , Estudios Prospectivos , Factores de Tiempo , Adulto Joven
10.
Mem. Inst. Oswaldo Cruz ; 110(2): 230-234, 04/2015. tab, graf
Artículo en Inglés | LILACS, SES-SP, SES SP - Instituto Adolfo Lutz, SES-SP, SESSP-IALACERVO | ID: lil-744473

RESUMEN

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.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , /terapia , /fisiopatología , Estilo de Vida
11.
Rev Soc Bras Med Trop ; 42(3): 342-4, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19684987

RESUMEN

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.


Asunto(s)
Antivenenos/uso terapéutico , Bothrops , Venenos de Crotálidos , Mordeduras de Serpientes/diagnóstico , Adulto , Animales , Bothrops/anatomía & histología , Brasil , Humanos , Masculino , Mordeduras de Serpientes/terapia
12.
Int J Dermatol ; 48(10): 1091-5, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19775402

RESUMEN

BACKGROUND: Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinical diagnosis, mainly in areas in which CL is not the first consideration of local physicians, has intensified efforts to describe diagnostic tests, which should be specific, sensitive, and practical. Amongst the new tests described are those including nucleic acid amplification (polymerase chain reaction, PCR) and immunohistochemistry (IHC). METHODS: In this study, we evaluated the sensitivity of a PCR based on small subunit (SSU) ribosomal DNA, in comparison with IHC using Leishmania spp. antibodies, in biopsies embedded in paraffin. RESULT: The results indicated a total sensitivity of 96% (90.9% with PCR and 68.8% with IHC), showing the possibility of using paraffin-embedded biopsies to diagnose CL. CONCLUSION: We propose the use of the two tests together as a routine protocol for diagnosis. This would require the provision of local medical services to perform molecular biology techniques and adequate Leishmania antibodies.


Asunto(s)
Leishmaniasis Cutánea/diagnóstico , Reacción en Cadena de la Polimerasa , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Adhesión en Parafina , Estudios Prospectivos , Sensibilidad y Especificidad , Adulto Joven
13.
Rev Soc Bras Med Trop ; 41(5): 474-8, 2008.
Artículo en Portugués | MEDLINE | ID: mdl-19009189

RESUMEN

The profile and vaccination status of travelers seeking pre-travel medical advice at the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine, and the vaccines recommended for them, were analyzed in the present study. Among the 445 travelers who were studied, 51% were women, the median age was 33.5 years, 51% were traveling on business and 39.5% were traveling for leisure purposes. The destinations most sought were Africa (47%), Asia (31.7%) and South America (21.4%). Vaccination before traveling was recommended for 385 (86.5%) of the travelers. The main vaccines recommended were against typhoid fever (55.7%), diphtheria-tetanus (54.1%), hepatitis A (46.1%), hepatitis B (44.2%) and yellow fever (24.7%). The pre-travel guidance was shown to be important not only for indicating the vaccines recommended for the trip, but also as an opportunity to update routine vaccinations.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Viaje/estadística & datos numéricos , Vacunación/normas , Adulto , Brasil , Control de Enfermedades Transmisibles/normas , Femenino , Humanos , Masculino , Estudios Retrospectivos
14.
Rev. saúde pública ; 47(5): 881-889, out. 2013. tab, graf
Artículo en Portugués | LILACS, SES-SP | ID: lil-700219

RESUMEN

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 ...


Asunto(s)
Adolescente , Adulto , Animales , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto Joven , Enfermedades Transmisibles Emergentes/epidemiología , Culicidae/clasificación , Insectos Vectores/clasificación , Fiebre Amarilla/epidemiología , Brasil/epidemiología , Enfermedades Transmisibles Emergentes/veterinaria , Brotes de Enfermedades , Fiebre Amarilla/veterinaria
16.
J Infect Dis ; 196(6): 844-52, 2007 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-17703414

RESUMEN

BACKGROUND: Human herpesvirus type 8 (HHV-8) is hyperendemic in Amerindian populations, but its modes of transmission are unknown. METHODS: Antibodies against either HHV-8 lytic antigen or HHV-8 latency-associated nuclear antigen (LANA) were detected, by immunofluorescence assays, in 339 Amerindians and 181 non-Amerindians from the Brazilian Amazon. Serological markers of oro-fecal (hepatitis A), parenteral (hepatitis B and C), and sexual (herpes simplex virus type 2 and syphilis) transmission were measured by specific ELISAs. Salivary HHV-8 DNA was detected by use of a nested polymerase chain reaction assay and was sequenced. RESULTS: Antibodies against either lytic antigen or LANA were detected in 79.1% of Amerindians and in 6.1% of non-Amerindians (adjusted seroprevalence ratio [SR], 12.63 [95% confidence interval {CI}, 7.1-22.4]; P<.0001). HHV-8 seroprevalence increased with age among Amerindians (P(Trend) < .001) and already had high prevalence in childhood but was not sex specific in either population. The 2 populations did not differ in seroprevalence of oro-fecal or parenteral markers, but seroprevalence of markers of sexual transmission was lower among Amerindians. HHV-8 DNA in saliva was detected in 47 (23.7%) of 198 HHV-8 seropositive Amerindians. Detection of HHV-8 DNA decreased with age (P(Trend) < .04) and was more common in men (SR, 2.14 [95% CI, 1.3-3.5]; P=.003). A total of 36 (76.6%) of the 47 saliva HHV-8 DNA samples were sequenced, and all clustered as subtype E. CONCLUSION: The data support the hypothesis of early acquisition and horizontal transmission, via saliva, of HHV-8 subtype E in Amerindian populations.


Asunto(s)
Infecciones por Herpesviridae/epidemiología , Infecciones por Herpesviridae/virología , Herpesvirus Humano 8/clasificación , Herpesvirus Humano 8/aislamiento & purificación , Esparcimiento de Virus , Adolescente , Adulto , Factores de Edad , Anticuerpos Antivirales/sangre , Brasil/epidemiología , Niño , Preescolar , Análisis por Conglomerados , ADN Viral/química , ADN Viral/genética , Femenino , Técnica del Anticuerpo Fluorescente , Infecciones por Herpesviridae/transmisión , Herpesvirus Humano 8/genética , Humanos , Indígenas Sudamericanos , Masculino , Filogenia , Reacción en Cadena de la Polimerasa , Población Rural , Saliva/virología , Análisis de Secuencia de ADN , Estudios Seroepidemiológicos , Factores Sexuales
17.
Rev. Soc. Bras. Med. Trop ; 42(3): 342-344, May-June 2009. ilus
Artículo en Inglés | LILACS | ID: lil-522268

RESUMEN

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.


Relatamos o primeiro caso de acidente por Bothriopsis taeniata no Brasil. A vítima, trabalhador rural com 43 anos de idade, foi picada pouco acima do calcanhar direito, apresentando quadro clínico compatível por envenenamento botrópico leve: discreto edema com hemorragia no local da picada e dor, embora com ausência de coagulopatia.


Asunto(s)
Adulto , Animales , Humanos , Masculino , Antivenenos/uso terapéutico , Bothrops , Venenos de Crotálidos , Mordeduras de Serpientes/diagnóstico , Brasil , Bothrops/anatomía & histología , Mordeduras de Serpientes/terapia
19.
Rev. Soc. Bras. Med. Trop ; 41(5): 474-478, set.-out. 2008. graf, tab
Artículo en Portugués | LILACS | ID: lil-496712

RESUMEN

O perfil dos indivíduos, a situação vacinal e as vacinas recomendadas aos viajantes que procuram o serviço médico de orientação pré-viagem do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram analisados no presente estudo. Dos 445 viajantes estudados, 51 por cento eram mulheres; a mediana de idade foi de 33,5 anos; 51 por cento viajavam a trabalho e 39,5 por cento por lazer. Destinos mais procurados: África (47 por cento); Ásia (31,7 por cento); América do Sul (21,4 por cento). Trezentos e oitenta e cinco (86,5 por cento) viajantes tiveram indicação de vacinação para viagem. Principais vacinas recomendadas: febre tifóide (55,7 por cento), difteria-tétano (54,1 por cento), hepatite A (46,1 por cento), hepatite B (44,2 por cento), febre amarela (24,7 por cento). A orientação pré-viagem mostrou-se importante não só para indicar as vacinas recomendadas para a viagem, mas também como oportunidade para atualização das vacinas de rotina.


TThe profile and vaccination status of travelers seeking pre-travel medical advice at the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine, and the vaccines recommended for them, were analyzed in the present study. Among the 445 travelers who were studied, 51 percent were women, the median age was 33.5 years, 51 percent were traveling on business and 39.5 percent were traveling for leisure purposes. The destinations most sought were Africa (47 percent), Asia (31.7 percent) and South America (21.4 percent). Vaccination before traveling was recommended for 385 (86.5 percent) of the travelers. The main vaccines recommended were against typhoid fever (55.7 percent), diphtheria-tetanus (54.1 percent), hepatitis A (46.1 percent), hepatitis B (44.2 percent) and yellow fever (24.7 percent). The pre-travel guidance was shown to be important not only for indicating the vaccines recommended for the trip, but also as an opportunity to update routine vaccinations.


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Control de Enfermedades Transmisibles/métodos , Viaje/estadística & datos numéricos , Vacunación/normas , Brasil , Control de Enfermedades Transmisibles/normas , Estudios Retrospectivos
20.
Clinics ; 63(1): 21-26, 2008. tab
Artículo en Inglés | LILACS | ID: lil-474923

RESUMEN

INTRODUCTION: Since 1999, the Ministry of Health in Brazil has conducted campaigns of vaccination against influenza targeted towards the elderly, chronically-diseased people and health care workers. The vaccine against influenza is associated with adverse events of minor importance. OBJECTIVE: To investigate the early adverse events related to the vaccine against influenza. CASUISTICS AND METHODS: One hundred and ninety seven elderly individuals and health care workers vaccinated against influenza were included. An inquiry regarding adverse events related to the vaccine was applied seven days after the vaccination. RESULTS: Local adverse events were reported by 32.5 percent and systemic effects by 26.4 percent of the vaccinated subjects. Pain in the region of the injection, headache, myalgia, malaise, and coryza were more frequent in the workers than in the elderly (p<0.05). There was no statistically significant difference in the occurrence of fever. CONCLUSIONS: The belief of part of the population that credits frequent and uncomfortable adverse events to the vaccine was not confirmed. The subjective adverse events were more frequent in the health care workers, which can influence, in a negative way, the disclosure of the benefits of this vaccine due to their role as opinion makers.


Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vacunas contra la Influenza/efectos adversos , Gripe Humana/prevención & control , Vacunación/efectos adversos , Sistemas de Registro de Reacción Adversa a Medicamentos , Brasil , Enfermedad Crónica , Personal de Salud , Servicios de Salud para Ancianos , Vacunas contra la Influenza/uso terapéutico
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