ABSTRACT
Western equine encephalitis virus (WEEV) is a mosquitoborne virus that reemerged in December 2023 in Argentina and Uruguay, causing a major outbreak. We investigated the outbreak using epidemiologic, entomological, and genomic analyses, focusing on WEEV circulation near the ArgentinaâUruguay border in Rio Grande do Sul state, Brazil. During November 2023âApril 2024, the outbreak in Argentina and Uruguay resulted in 217 human cases, 12 of which were fatal, and 2,548 equine cases. We determined cases on the basis of laboratory and clinical epidemiologic criteria. We characterized 3 fatal equine cases caused by a novel WEEV lineage identified through a nearly complete coding sequence analysis, which we propose as lineage C. Our findings highlight the importance of continued surveillance and equine vaccination to control future WEEV outbreaks in South America.
Subject(s)
Disease Outbreaks , Encephalitis Virus, Western Equine , Molecular Epidemiology , Phylogeny , Animals , Encephalitis Virus, Western Equine/genetics , Humans , Horses , Uruguay/epidemiology , South America/epidemiology , Horse Diseases/epidemiology , Horse Diseases/virology , Male , Encephalomyelitis, Western Equine/epidemiology , Encephalomyelitis, Western Equine/virology , Female , Argentina/epidemiology , Encephalomyelitis, Equine/epidemiology , Encephalomyelitis, Equine/virology , Encephalomyelitis, Equine/veterinary , AdultABSTRACT
The spread of Chikungunya virus is a major public health concern in the Americas. There were >120,000 cases and 51 deaths in 2023, of which 46 occurred in Paraguay. Using a suite of genomic, phylodynamic, and epidemiologic techniques, we characterized the ongoing large chikungunya epidemic in Paraguay.
Subject(s)
Chikungunya Fever , Chikungunya virus , Epidemics , Humans , Chikungunya virus/genetics , Paraguay/epidemiology , South Africa , Chikungunya Fever/epidemiology , Phylogeny , GenotypeABSTRACT
Invasive meningococcal disease persists as a fulminant disorder worldwide. Although cases caused by Neisseria meningitidis serogroup X (MenX) occur infrequently, outbreaks have been reported in countries in Africa in recent decades. We report 2 cases of MenX invasive meningococcal disease in São Paulo, Brazil, in 2021 and 2022, during the COVID-19 pandemic.
Subject(s)
COVID-19 , Meningitis, Meningococcal , Meningococcal Infections , Meningococcal Vaccines , Neisseria meningitidis , Brazil/epidemiology , Humans , Meningitis, Meningococcal/epidemiology , Meningococcal Infections/epidemiology , PandemicsABSTRACT
We report a case of vertical transmission of Tonate virus in a pregnant woman from French Guiana. The fetus showed severe necrotic and hemorrhagic lesions of the brain and spinal cord. Clinicians should be made aware of possible adverse fetal outcomes in pregnant women infected with Tonate virus.
Subject(s)
Alphavirus , Brain , Female , French Guiana/epidemiology , Humans , Infectious Disease Transmission, Vertical , PregnancyABSTRACT
Among 713 equids sampled in northeastern Brazil during 2013-2018, West Nile virus seroprevalence was 4.5% (95% CI 3.1%-6.3%). Mathematical modeling substantiated higher seroprevalence adjacent to an avian migratory route and in areas characterized by forest loss, implying increased risk for zoonotic infections in disturbed areas.
Subject(s)
West Nile Fever , West Nile virus , Animals , Brazil/epidemiology , Ecology , Seroepidemiologic Studies , West Nile Fever/epidemiology , West Nile Fever/veterinaryABSTRACT
During the 2019 Eastern equine encephalitis virus (EEEV) outbreak in Michigan, two 2-month old Mexican wolf pups experienced neurologic signs, lymphohistiocytic neutrophilic meningoencephalitis with neuronal necrosis and neuronophagia, and acute death. We identified EEEV by reverse transcription real-time PCR and in situ hybridization. Vector mosquitoes were trapped at the zoo.
Subject(s)
Encephalitis Virus, Eastern Equine , Encephalomyelitis, Eastern Equine , Encephalomyelitis, Equine , Wolves , Animals , Horses , Michigan , Mosquito VectorsABSTRACT
Although essential for control strategies, knowledge about transmission cycles is limited for Venezuelan equine encephalitis complex alphaviruses (VEEVs). After testing 1,398 bats from French Guiana for alphaviruses, we identified and isolated a new strain of the encephalitogenic VEEV species Tonate virus (TONV). Bats may contribute to TONV spread in Latin America.
Subject(s)
Alphavirus , Chiroptera , Encephalitis Virus, Venezuelan Equine , Encephalomyelitis, Venezuelan Equine , Animals , French Guiana , HorsesABSTRACT
While studying aseptic meningitis in Salvador, Brazil, we diagnosed anicteric leptospirosis in 1.7% (5/295) of patients hospitalized for aseptic meningitis. Leptospirosis-associated meningitis patients had lower mean cerebrospinal fluid cell counts and protein than other-cause aseptic meningitis (p<0.05). Clinicians must consider leptospirosis-associated meningitis in appropriate clinical-epidemiologic contexts.
Subject(s)
Leptospirosis , Meningitis, Aseptic , Meningitis , Brazil , Humans , Leptospirosis/diagnosis , Leptospirosis/epidemiology , Meningitis/diagnosis , Meningitis/epidemiologyABSTRACT
The Biofire® Film Array Meningitis Encephalitis (FAME) panel can rapidly diagnose common aetiologies but its impact in Colombia is unknown. A retrospective study of adults with CNS infections in one tertiary hospital in Colombia. The cohort was divided into two time periods: before and after the implementation of the Biofire® FAME panel in May 2016. A total of 98 patients were enrolled, 52 and 46 were enrolled in the Standard of Care (SOC) group and in the FAME group, respectively. The most common comorbidity was human immunodeficiency virus infection (47.4%). The median time to a change in therapy was significantly shorter in the FAME group than in the SOC group (3 vs. 137.3 h, P < 0.001). This difference was driven by the timing to appropriate therapy (2.1 vs. 195 h, P < 0.001) by identifying viral aetiologies. Overall outcomes and length of stay were no different between both groups (P > 0.2). The FAME panel detected six aetiologies that had negative cultures but missed identifying one patient with Cryptococcus neoformans. The introduction of the Biofire FAME panel in Colombia has facilitated the identification of viral pathogens and has significantly reduced the time to the adjustment of empirical antimicrobial therapy.
Subject(s)
Encephalitis/diagnosis , Encephalitis/epidemiology , Meningitis/diagnosis , Meningitis/epidemiology , Multiplex Polymerase Chain Reaction/methods , Adult , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Encephalitis/drug therapy , Female , Humans , Male , Meningitis/drug therapy , Middle Aged , Retrospective StudiesABSTRACT
ABSTRACT The precise diagnosis of bacterial meningitis is essential. Cytological and biochemical examination of cerebrospinal fluid (CSF) are not specific. Conventional methods for bacterial meningitis lack sensitivity or take too long for a final result. Therefore, other methods for rapid and accurate diagnosis of central nervous system infections are required. FilmArray meningitis/encephalitis (ME) panel is a PCR multiplex for simultaneous and rapid identification of 14 pathogens, including 6 bacteria, 7 viruses, and Cryptococcus. We evaluated 436 CSF samples submitted to FilmArray ME Panel. Among them, 25 cases were positive for bacteria, being Streptococcus pneumonia the most frequent (48 %). Among positive cases for bacteria, 60 % were positive only with FilmArray. All the bacterial meningitis cases in which the only positive test was FilmArray had CSF findings suggestive of bacterial meningitis, including neutrophilic pleocytosis, increased CSF protein and lactate, and decreased CSF glucose. These findings suggest that FilmArray may increase the diagnostic sensitivity for bacterial meningitis.
Subject(s)
Humans , Cerebrospinal Fluid/microbiology , Cerebrospinal Fluid/virology , Meningitis, Bacterial/diagnosis , Multiplex Polymerase Chain Reaction/methods , Bacteria/isolation & purification , Viruses/isolation & purification , Microbial Sensitivity Tests/methods , Sensitivity and Specificity , Meningitis, Bacterial/cerebrospinal fluidABSTRACT
The precise diagnosis of bacterial meningitis is essential. Cytological and biochemical examination of cerebrospinal fluid (CSF) are not specific. Conventional methods for bacterial meningitis lack sensitivity or take too long for a final result. Therefore, other methods for rapid and accurate diagnosis of central nervous system infections are required. FilmArray meningitis/encephalitis (ME) panel is a PCR multiplex for simultaneous and rapid identification of 14 pathogens, including 6 bacteria, 7 viruses, and Cryptococcus. We evaluated 436 CSF samples submitted to FilmArray ME Panel. Among them, 25 cases were positive for bacteria, being Streptococcus pneumonia the most frequent (48 %). Among positive cases for bacteria, 60 % were positive only with FilmArray. All the bacterial meningitis cases in which the only positive test was FilmArray had CSF findings suggestive of bacterial meningitis, including neutrophilic pleocytosis, increased CSF protein and lactate, and decreased CSF glucose. These findings suggest that FilmArray may increase the diagnostic sensitivity for bacterial meningitis.
Subject(s)
Cerebrospinal Fluid/microbiology , Cerebrospinal Fluid/virology , Meningitis, Bacterial/diagnosis , Multiplex Polymerase Chain Reaction/methods , Bacteria/isolation & purification , Humans , Meningitis, Bacterial/cerebrospinal fluid , Microbial Sensitivity Tests/methods , Sensitivity and Specificity , Viruses/isolation & purificationABSTRACT
We report a 3-year-old child who was hospitalized because of severe manifestations of the central nervous system. The child died after 6 days of hospitalization. Analysis of postmortem cerebrospinal fluid showed the presence of yellow fever virus RNA. Nucleotide sequencing confirmed that the virus was wild-type yellow fever virus.
Subject(s)
RNA, Viral/genetics , Yellow Fever/cerebrospinal fluid , Yellow Fever/virology , Yellow fever virus/genetics , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Autopsy , Biomarkers , Brazil , Child, Preschool , Disease Progression , Fatal Outcome , Female , Humans , Phylogeny , Sequence Analysis, DNA , Symptom Assessment , Tomography, X-Ray Computed , Yellow Fever/diagnosis , Yellow Fever/drug therapy , Yellow fever virus/classification , Yellow fever virus/isolation & purificationABSTRACT
We describe a case of infection with Cronobacter sakazakii sequence type 494 causing bacteremia and meningitis in a hospitalized late premature infant in Brazil. We conducted microbiological analyses on samples of powdered infant formula from the same batch as formula ingested by the infant but could not identify the source of contamination.
Subject(s)
Cronobacter sakazakii/classification , Cronobacter sakazakii/genetics , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/microbiology , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/microbiology , Bacteremia , Brain/pathology , Brazil , Enterobacteriaceae Infections/transmission , Food Contamination , Food Microbiology , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Meningitis, Bacterial/transmission , Multilocus Sequence TypingABSTRACT
We report a case of eosinophilic meningitis complicated by transverse myelitis caused by Angiostrongylus cantonensis in a 10-year-old boy from Brazil who had traveled to Suriname. We confirmed diagnosis by serology and real-time PCR in the cerebrospinal fluid. The medical community should be aware of angiostrongyliasis in the Guiana Shield.
Subject(s)
Angiostrongylus cantonensis , Central Nervous System Protozoal Infections/diagnosis , Central Nervous System Protozoal Infections/parasitology , Strongylida Infections/diagnosis , Strongylida Infections/parasitology , Animals , Antiparasitic Agents/therapeutic use , Central Nervous System Protozoal Infections/drug therapy , Central Nervous System Protozoal Infections/epidemiology , Child , Guyana/epidemiology , Humans , Magnetic Resonance Imaging , Male , Meningitis/diagnosis , Meningitis/drug therapy , Meningitis/parasitology , Strongylida Infections/drug therapy , Strongylida Infections/epidemiology , Treatment OutcomeABSTRACT
An outbreak of meningococcal disease with a case-fatality rate of 30% and caused by predominantly serogroup W of Neisseria meningitidis began in Chile in 2012. This outbreak required a case-control study to assess determinants and risk factors for infection. We identified confirmed cases during January 2012-March 2013 and selected controls by random sampling of the population, matched for age and sex, resulting in 135 case-patients and 618 controls. Sociodemographic variables, habits, and previous illnesses were studied. Analyses yielded adjusted odds ratios as estimators of the probability of disease development. Results indicated that conditions of social vulnerability, such as low income and overcrowding, as well as familial history of this disease and clinical histories, especially chronic diseases and hospitalization for respiratory conditions, increased the probability of illness. Findings should contribute to direction of intersectoral public policies toward a highly vulnerable social group to enable them to improve their living conditions and health.
Subject(s)
Meningococcal Infections/epidemiology , Meningococcal Infections/microbiology , Neisseria meningitidis , Adolescent , Age Factors , Case-Control Studies , Child , Child, Preschool , Chile/epidemiology , Disease Outbreaks , Female , Humans , Infant , Infant, Newborn , Male , Meningococcal Infections/prevention & control , Neisseria meningitidis/classification , Odds Ratio , Risk Factors , Seasons , Serogroup , VaccinationABSTRACT
Introducción: las meningitis constituyen un importante problema de Salud Pública, que afectan de manera especial a los niños menores de 5 años. La etiología más frecuente es viral. Desde la introducción de la vacuna conjugada contra H. influenzae tipo b, S. pneumoniae y N. meningitidis los virus pasaron a ser los agentes más frecuentes. A nivel país, en 2014 y 2015, la etiología viral fue la más frecuente con valores de 69% y 77%, respectivamente, atribuyéndose a las bacterianas como segunda causa. Objetivos: describir las características epidemiológicas de las meningitis, en pacientes de todas las edades internados en el lapso de enero del 2014 a octubre del 2015 en el Hospital Nacional de Itauguá, Paraguay. Metodología: estudio epidemiológico, descriptivo, transversal. Se incluye a pacientes de todas las edades que ingresaron con sospecha de meningitis y/o encefalitis en el periodo de estudio. Resultados: en el periodo de estudio ingresaron 173 casos probables de 201 casos sospechosos de meningitis correspondiendo al 0,5% (173/35140) de todos los ingresos hospitalarios. El grupo etario más afectado fue el de menores de 5 años y entre los mayores de 5 años el de 5 a 14 años. En el 53% procedieron del Departamento Central. Los cuadros clínicos fueron: 98 casos (57%) encefalitis viral, meningitis bacteriana aguda 65 casos (37%), 7 casos (4%) meningitis micótica (Criptococcus). Fallecieron 3 casos de encefalitis y 9 casos de meningitis bacteriana aguda. De 25 casos en edad de vacunarse, 52 % se vacunaron para H. influenzae b y 16% contra P. pneumoniae. No se ha registrado vacunación para N. meningitis en ningún caso. Conclusiones: la incidencia total de meningitis en este periodo de estudio fue de 173 casos. Más de la mitad de los casos fueron de etiología viral. La bacteria más frecuentemente identificada fue S. pneumoniae. En general el grupo de edad más afectado fue el de menores de 5 años. La letalidad fue de 3% en los casos de encefalitis viral, 14% en meningitis bacteriana aguda y 43% en meningitis a Criptococcus. Se desconoce el estado de vacunación de casi la mitad de los casos sobre todo de la antineumocóccica.
Introduction: Meningitis is an important public health problem, which affects children under 5 years of age. The most frequent etiology is viral. Since the introduction of the conjugate vaccine against H. b, S. pneumoniae and N. meningitidis, they became the most frequent agents. In the hole country, in 2014 and 2015, the viral etiology was the most frequent with values ââof 69% and 77%, respectively, being attributed to the bacterial ones as the second cause. Objectives: To know the epidemiological characteristics of meningitis in all ages hospitalized patients from January 2014 to October 2015 at the National Hospital of Itaugua, Paraguay. Methodology: Epidemiological, descriptive, cross-sectional study. Patients of all ages admitted with suspected meningitis and / or encephalitis were included in the study. Results: During the study, 173 probable cases of 201 suspected cases of meningitis corresponding to 0.5% (173/35140) of all hospital admissions were registered. The more affected age group was the group of children under 5 and among patients with more than 5 years, were between 5 to 14 years; In 53%, they came from the central department.98 cases (57%) were viral encephalitis; Acute bacterial meningitis 65 cases (37%); 7 cases (4%) Fungal Meningitis (Cryptococcus). Of 41 confirmed viral cases (42%), 29 cases (71%) were by Enterovirus. 18 cases of MBA were confirmed; S.pneumoniae (8) or Spn, S were identified. Aureus (4), N.meningitidis (2) or NmStreptococcus group B (1), E. coli (1), S. Epidermidis MR (1) and S. agalactiae (1); From 5 Spn the sero types / serogroups were identified: 6C / 6D (1), serotype14 (1), serotype3 (1), NmW 135 (1), Nmsero group B (1) in a young adult case. There were 3 cases of encephalitis and 9 cases of MBA. Twenty-five cases were vaccinated for Hib and 16% were vaccinated against P.pneumoniae; No vaccination has been registered for Nm. Conclusions: The total incidence of meningitis in this period of study was 173 cases. More than half of the cases were of viral etiology; The most frequently identified bacterium was S. pneumoniae. In general, the most affected age group was children under 5 years of age. The majority coming from the Central department and Cordillera. The lethality was 3% in cases of viral encephalitis; 14% in MBA and 43% in Cryptococcus meningitis. It is unknown the vaccination status of almost half of the cases especially of the anti pneumococcal.