Mild and Asymptomatic Coronavirus Disease in Children, Adolescents, and Household Contacts and Prolonged Viral Excretion.

Method: This was a prospective, observational, and descriptive cohort study. Nasopharyngeal swabs and blood were collected six times at weekly intervals. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) tests and immunoglobulin (Ig) G and IgA assays were used to test for COVID-19. Results: Overall, 419 children and 253 adults were enrolled. There was a significant correlation between qRT-PCR confirmation and the 1 to <5 years age group (p=0.038). Serology changes or recent infections were detected significantly in children <6 months (IgG, p=0.006; IgA, p=0.001) and >5 years of age (IgA, p=0.040; IgG, p=0.031). The mean and median time-to-positivity (using qRT-PCR) was 17 days, with a minimum of 6 and a maximum of 34. Among adults, the mean and median time-to-positivity was 12.6 and 9 days, respectively, with a minimum of 6 and a maximum of 45. Conclusion: Oligosymptomatic conditions may delay diagnosis and facilitate viral transmission. Pediatric-focused research is required, and specific protective measures for children <6 months of age should be considered.

Neonatal consequences of maternal exposure to the chikungunya virus: Case reports.

RATIONALE: The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS: In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS: In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS: The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES: There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS: Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.

Evolução do saneamento básico e a sua relação com a saúde pública / Basic sanitation evolution and its relationship with public health

O objetivo deste trabalho é apresentar uma revisão bibliográfica da evolução do saneamento básico brasileiro em 50 anos, mostrando as técnicas atuais tratamento de água e esgoto, e relacionando estes dados com a incidência de Doenças Relacionadas ao Saneamento Ambiental Inadequado (DRSAI). Busca de livros, protocolos e artigos no Google Acadêmico com a pesquisa de palavras-chave correspondentes a (1) "Saneamento Básico and 1970 a 2020", (2) "Saneamento Básico and Realidade no Brasil", (3) "Técnicas de Saneamento", (4) "Saneamento and Urbanização", (5) "Saneamento inadequado and doenças", (6) "Doenças relacionadas ao saneamento ambiental inadequado" e (7) "Saneamento and arboviroses". O saneamento é um direito assegurado por Lei, e deve ser universalizado até 2030, de acordo com os objetivos para o desenvolvimento sustentável. O saneamento básico brasileiro evoluiu em 50 anos, porém ainda não é universal, como por exemplo, cerca de 10% região Norte tem acesso ao esgoto tratado. A ausência do saneamento, ou sua prestação de observadas em locais de acesso desigual ao saneamento básico e também em locais de urbanizados, como no Estado de São Paulo, um dos locais de maior acesso de água e esgoto tratados, apresenta alta incidência de arbovirose. Apesar do prazo para universalização do saneamento básico, o Brasil ainda se encontra distante desse cenário ideal. Além disso, a urbanização também torna o ambiente insalubre, propiciando a incidência de DRSAI. Sendo assim, para melhorias na saúde pública, é imprescindível a existência de um serviço adequado de tratamento e abastecimento de água e esgoto

This work aims to present a bibliographic review about the Brazilian basic sanitation evolution in 50 years, showing water and sewage treatment techniques and relating this data to Diseases Related to Inadequate Environmental Sanitation (DRIES) incidence. Search for books, protocols and articles on Google Scholar with the search for keywords corresponding to (1) "Basic Sanitation and 1970 to 2020", (2) "Basic Sanitation and Brazil's Reality", (3) "Sanitation Techniques", (4) "Sanitation and Urbanization", (5) "Inadequate Sanitation and Diseases", (6) "Diseases Related to Inadequate Environmental Sanitation" and (7) "Sanitation and arboviruses". Sanitation is a right guaranteed by law and clean water and treated sewage shall be universalized until 2030, according to goals for sustainable development. The basic sanitation evolved in 50 years but stills not universal (i.e. about 10% of the Northern region has access to treated sewage). Sanitation absence or its ineffective service bring harm to health with DRIES. DRIES are more observed in places of unequal access to basic sanitation and also in urbanized places, as in the State of São Paulo, one of the places of greater access of treated water and sewage and also with higher incidence of arboviruses. Despite basic sanitation universalization deadline, Brazil is still far from this ideal scenario. Moreover, urbanization makes the environmental unhealthy, providing DRIES incidence. Thus, to public health improvements, proper basic sanitation service is essential