Phylogenetic analysis reveals a new introduction of Yellow Fever virus in São Paulo State, Brazil, 2023.

Yellow Fever (YF) is a viral arbovirosis of Public Health importance. In Brazil, surveillance is focused mainly on detecting epizootic events of Platyrrhini. Herein, we compared the detection and phylogenetic analysis of YF virus in two neotropical primates (NTP), a Callithrix detected in the previous epidemic period (2016-2020), and a Callicebus nigrifons, showing a new introduction of YF in 2023. This paper illustrates the importance of joint actions of laboratory and field teams to ensure quick response to Public Health emergencies, such as the intensification of vaccination of susceptible human populations.

Naturally Acquired Rabies in White-Eared Opossum, Brazil.

Opossums are considered resistant to rabies. Nonhematophagous bats are reservoirs of rabies in urban areas of South America. We analyzed bats and opossums tested for rabies during 2021 in a highly urbanized city in Brazil to understand spillover in an urban setting. Wildlife surveillance is necessary to prevent rabies in humans and domestic animals.

Efficacies of insecticide dog collars against visceral leishmaniasis in low and high-income areas and the effects for non-collared neighbor dogs.

Previous studies demonstrated that insecticide collars are highly effective in reducing canine visceral leishmaniasis (CVL); however, it is unclear if the efficacy differs by socioeconomic conditions across diverse communities. This study aimed fourfold: (i) to evaluate the protection of 4% impregnated deltamethrin collared (DMC) dogs in different areas of an endemic city for visceral leishmaniasis (VL); (ii) to analyze socioeconomic variables with the seroconversion rates; (iii) to analyze the indirect effect of DMC on untreated dogs in areas of intervention; and, (iv) to evaluate the potential transmission to other dogs in the same household when one positive dog is present. The study employed the municipality of Bauru, São Paulo, Brazil, as the area of interest and used Geographic Information System tools to fit binary logistic regression models.  Dogs were divided into three cohort studies: intervention with DMC (I), indirect effect of DMC (IE), and control (C). Pre-intervention, lower mean income was associated with higher rates of CVL and a 142% increase in the odds of transmission (OR = 1.42, p-value = 0.001, CI 1.14,1.77). Post-intervention, lower-income areas depicted greater efficacy (76%) than higher-income areas (45%). The overall efficacy of DMC in preventing CVL was 63%; however, seroconversion rates were higher for IE (6.02%) than C (3.78%), revealing the failure of the indirect protection of DMC to manage the spread of the disease among the general non-wearing DMC canine population living in the same area. The protected dogs may repel the vectors, and non-protected dogs attract them, creating a higher transmission rate for non-protected dogs. Greater seroconversion was observed for living with an infected dog (10.20% in IE and 8.75% in C) than for the indirect effect of DMC, demonstrating the social burden of CVL. Overall, uncollared dogs have three times higher odds of being infected with CVL than DMC dogs (p < 0.005), and uncollared dogs living with (an) infected dog(s) in the same household can reach 3.5 times higher odds than those living with negative ones (p < 0.005). The results may assist in enhancing public policies and minimizing inequality in low and middle-income countries that suffer from neglected diseases such as VL.

Diagnosis and successful treatment of Brazillian porcupine poxvirus infection in a free-ranging hairy dwarf porcupine (Coendu spinosus).

Brazilian porcupine poxvirus (BPoPV) is a new poxvirus recently described in porcupines (Coendou prehensilis) from Brazil. Herein, we described a free-ranging adult male Coendou (Sphiggurus) spinosus rescued after being found lethargic on the ground in a rural area. The animal presented crusty, edematous, and suppurative skin lesions on the face, tail, and perineum, and yellowish ocular secretion. The diagnosis was performed by histopathology, transmission electron microscopy (TEM), PCR, and sequencing. Microscopically, proliferative and necrotizing dermatitis, subacute, multifocal with ballooning degeneration, and eosinophilic intracytoplasmic viral inclusion bodies were observed. TEM confirmed large brick-shaped virions inside the keratinocyte cytoplasm, measuring about 200-280 × 120-180 nm. Partial fragment of intracellular mature virion membrane protein gene and putative metalloproteinase gene was successfully amplified and sequenced, and the strain herein denoted IAL/21 V-102 was classified as BPoPV, showing 99.4% of nucleotide identity to the reference strain UFU/USP001. Enrofloxacin 10% (10 mg/kg) was administered every 24 h through intramuscular injection for 10 days, dipyrone/metamizole (25 mg/kg) every 24 h orally (PO) for 3 days, 0.5 ml (mL) of thymomodulin every 24 h PO for 30 days, and each 48 h for another 15 days. The lesions were cleaned and debrided every 15 days. Seventy-five days after the beginning of the treatment, the cutaneous lesions regressed, the animal gained weight, and was clinically stable. After treatment, the skin biopsy showed only mild epidermal acanthosis, intra-cellular edema, and mild lymphoplasmacytic perivascular dermatitis. No viral particles were observed by TEM and no poxviral DNA was amplified by PCR. This study documents the first case of confirmed and treated BPoPV infection in a hairy dwarf porcupine. The implemented therapeutic plan eliminated the infection and improved the general state of the animal.

Toxoplasmosis in a free-ranging hairy dwarf porcupine (Sphiggurus spinosus) with a potential novel genotype.

Toxoplasmosis is a zoonotic disease caused by the ubiquitous coccidia Toxoplasma gondii. Rodents play an important role in maintaining its life cycle, as they are one of the main diet sources for felids (wild and domestic), the unique definitive hosts. However, reports of toxoplasmosis in porcupines (Order Rodentia) are uncommon, with gaps concerning its pathophysiology. South America is the continent with the greatest genetic diversity of rodents and T. gondii. A free-ranging hairy dwarf porcupine was admitted to a wildlife rescue centre with a history of trauma. During rehabilitation, the animal presented neurological symptoms (sporadic episodes of hind limbs paresis) and died 5 months later. The main findings during necropsy were brain congestion and severe incisor overgrowth associated with maxillary perforation. The histopathological exam showed moderate encephalitis, with variable-sized round cysts, positive for PAS stain and immunohistochemistry for T. gondii. Additionally, two cysts were observed in the medulla of the adrenal gland. Molecular techniques were performed to characterize the parasite load by qPCR (Cq = 30) and the genotype by PCR-RFLP with 11 markers, which revealed a potential new genotype. This case adds to the body of knowledge in comparative pathology of Neotropical Rodentia and reports a new potential genotype circulating in South America.

The path of canine visceral leishmaniasis versus the path of Center for Zoonoses Control: contributions of spatial analysis to health.

Visceral leishmaniasis (VL) is a public health problem in Brazilian municipalities. As much as there is a planning of public policies regards VL in São Paulo State, new cases have been reported and spread. This paper aims to discuss how the Center for Zoonoses Control conducts its actions spatially in endemic city of Presidente Prudente, São Paulo State. Data are from the Municipal Health Department of Presidente Prudente, Adolfo Lutz Institute, and Brazilian Institute of Geography and Statistics. We spatially estimated the dog population per census tract and used geoprocessing tools to perform choropleth maps, spatial trends, and spatial autocorrelation. We found a spatial pattern of higher prevalence in the city's outskirt and a positive statistically significant spatial autocorrelation (I = 0.2, p-value < 0.000) with clusters of high-high relationships in the Northwest part of the city. Moreover, we identified a different direction in the path of the conducted serosurveys versus the canine VL trend, which stresses the fragility of the Center for Zoonoses Control actions to control the disease. The Center for Zoonoses Control always seems to chase the disease. The spatial analysis may be useful for rethinking how the service works and helps in public policies.

The path of canine visceral leishmaniasis versus the path of Center for Zoonoses Control: contributions of spatial analysis to health / O caminho da leishmaniose visceral canina versus o caminho do Centro de Controle de Zoonoses: contribuições da análise espacial para a saúde / La trayectoria de la leishmaniasis visceral canina versus la trayectoria del Centro para el Control de Zoonoses: contribuciones del análisis espacial a la salud

Visceral leishmaniasis (VL) is a public health problem in Brazilian municipalities. As much as there is a planning of public policies regards VL in São Paulo State, new cases have been reported and spread. This paper aims to discuss how the Center for Zoonoses Control conducts its actions spatially in endemic city of Presidente Prudente, São Paulo State. Data are from the Municipal Health Department of Presidente Prudente, Adolfo Lutz Institute, and Brazilian Institute of Geography and Statistics. We spatially estimated the dog population per census tract and used geoprocessing tools to perform choropleth maps, spatial trends, and spatial autocorrelation. We found a spatial pattern of higher prevalence in the city's outskirt and a positive statistically significant spatial autocorrelation (I = 0.2, p-value < 0.000) with clusters of high-high relationships in the Northwest part of the city. Moreover, we identified a different direction in the path of the conducted serosurveys versus the canine VL trend, which stresses the fragility of the Center for Zoonoses Control actions to control the disease. The Center for Zoonoses Control always seems to chase the disease. The spatial analysis may be useful for rethinking how the service works and helps in public policies.

A leishmaniose visceral (LV) é um problema de saúde pública nas cidades brasileiras. Por mais que haja um planejamento de políticas públicas para LV no Estado de São Paulo, Brasil, novos casos têm sido notificados e se disseminado. O artigo objetiva discutir como o Centro de Controle de Zoonoses realiza suas atividades espacialmente em uma cidade endêmica, Presidente Prudente, no Estado de São Paulo. Os dados são da Secretaria Municipal de Saúde de Presidente Prudente, Instituto Adolfo Lutz e Instituto Brasileiro de Geografia e Estatística. Estimamos espacialmente a população canina por setor censitário e utilizamos ferramentas de geoprocessamento para produzir mapas coropléticos, tendências espaciais e autocorrelação espacial. Encontramos um padrão espacial de maior prevalência na periferia da cidade e uma autocorrelação espacial positiva estatisticamente significativa (I = 0,2; p < 0,000) com clusters de relação alta-alta no noroeste da cidade. Além disso, identificamos uma direção diferente no caminho dos inquéritos sorológicos realizados versus a tendência na LV canina, o que enfatiza a fragilidade das medidas de controle do Centro de Controle de Zoonoses para controlar casos da doença. O Centro de Controle de Zoonoses parece estar sempre correndo atrás da doença. A análise espacial pode ser útil para repensar o funcionamento do serviço e auxiliar as políticas públicas.

La leishmaniasis visceral (LV) es un problema de salud pública en las ciudades brasileñas. Aunque hay políticas públicas de planificación relacionadas con la LV en el estado de São Paulo, Brasil, se han informado de nuevos casos, además de su propagación. El objetivo de este trabajo es discutir cómo el Centro de Control de Zoonosis dirige sus acciones espacialmente en una ciudad endémica del estado de São Paulo, Presidente Prudente. Los datos proceden de la Secretaría Municipal de Salud de Presidente Prudente, del Instituto Adolfo Lutz, y del Instituto Brasileño de Geografía y Estadística. Estimamos espacialmente la población de perros por sector censal y utilizamos herramientas de geoprocesamiento para elaborar mapas de coropletas, tendencias espaciales, y autocorrelación espacial. Encontramos un patrón espacial de más alta prevalencia en la periferia de la ciudad, además de una autocorrelación espacial positiva y estadísticamente significativa (I = 0,2; valor de p < 0,000) con clústeres de relaciones alto-alto en la parte noroccidental de la ciudad. Además, identificamos una dirección diferente en la trayectoria de las encuestas serológicas llevadas a cabo, frente a la tendencia de LV canina, que enfatiza la debilidad de acciones del Centro de Control de Zoonosis para controlar casos de la enfermedad. El Centro de Control de Zoonosis parece siempre estar tras la enfermedad. El análisis espacial podría ser útil para repensar cómo está funcionando el servicio, además de ayudar a políticas públicas.

Impact of the dog population and household environment for the maintenance of natural foci of Leishmania infantum transmission to human and animal hosts in endemic areas for visceral leishmaniasis in Sao Paulo state, Brazil.

When it comes to visceral leishmaniasis (VL) in Brazil, one of the main targets of public health policies of surveillance is the control of domestic canine reservoirs of Leishmania infantum. This paper aims to evaluate the effect of the dog population and household environment for the maintenance of natural foci in the transmission to human and animal hosts in an endemic city for VL, Bauru, in Brazil. We collected 6,578 blood samples of dogs living in 3,916 households from Nov.2019 to Mar.2020 and applied geospatial models to predict the disease risk based on the canine population. We used Kernel density estimation, cluster analysis, geostatistics, and Generalized Additive Models (GAM). To validate our models, we used cross-validation and created a receiver operating characteristic (ROC) curve. We found an overall canine VL (CVL) seroprevalence of 5.6% for the sampled dogs, while for the households, the positivity rate was 8.7%. Odds ratios (OR) for CVL increased progressively according to the number of canines for >2 dogs (OR 2.70); households that already had CVL in the past increased the chances for CVL currently (OR 2.73); and the cases of CVL increase the chances for human VL cases (OR 1.16). Our models were statistically significant and demonstrated a spatial association between canine and human disease cases, mainly in VL foci that remain endemic. Although the Kernel density ratio map had the best performance (AUC = 82), all the models showed high risk in the city's northwest area. Canine population dynamics must be considered in public policies, and geospatial methods may help target priority areas and planning VL surveillance in low and middle-income countries.

[The use of the geographic scale in health: the scales of visceral leishmaniasis]. / O uso da escala geográfica na saúde pública: as escalas da leishmaniose visceral.

The geographical scale has been broadly discussed in an attempt to formulate a concept that succeeds in explaining different space-related realities. In the various sectors of health planning, geographic categories and concepts have been adopted without understanding the problems inherent to the geographical scale, which directly affects public policies implemented and, consequently, people's lives. The scope of this paper was to discuss the concept of scale based on the different scale levels and the difficulty of their implementation by means of the activities of the organs that operate in public health surveillance that deal with visceral leishmaniasis. A systematic review of the literature was conducted to show how the debate about geographical scale and health is still incipient. Geographical concepts were used, integrating municipal, state and national policies from the perspective of the geographic scale. Thus, the contention is that cooperation between health agencies and society is possible by the transposition of scales, creating an environment of solidarity and a more effective health system. The discussion does not end here, but it will make it viable to reflect on the theoretical and methodological options in research and in public health.

A escala geográfica tem sido amplamente discutida na tentativa de formar um conceito que dê conta de explicar as diferentes realidades do espaço. Nos diversos seguimentos de planejamento em saúde, faz-se uma adoção das categorias e conceitos geográficos sem entender os problemas inerentes à escala geográfica, o que afeta diretamente nas políticas públicas implantadas e, consequentemente, na vida das pessoas. O objetivo deste artigo foi discutir o conceito de escala a partir dos seus diferentes níveis, e debater a dificuldade de articulá-los por meio da atuação dos órgãos de vigilância em saúde pública brasileira que lidam com a leishmaniose visceral. Realizamos uma revisão de literatura para demonstrar como o debate do conceito de escala geográfica com a saúde é ainda incipiente. Utilizamos conceitos geográficos, integrando as políticas municipais, estaduais e nacional sob a ótica da escala geográfica. Dessa forma, acreditamos que seja possível uma articulação dos órgãos dos sistemas de saúde com a sociedade na transposição de escalas, num acontecer solidário, produzindo um sistema de saúde mais eficaz. A discussão não será aqui esgotada, mas permitirá uma reflexão nas opções teórico-metodológicas em pesquisas e em saúde pública.

O uso da escala geográfica na saúde pública: as escalas da leishmaniose visceral / The use of the geographic scale in health: the scales of visceral leishmaniasis

Resumo A escala geográfica tem sido amplamente discutida na tentativa de formar um conceito que dê conta de explicar as diferentes realidades do espaço. Nos diversos seguimentos de planejamento em saúde, faz-se uma adoção das categorias e conceitos geográficos sem entender os problemas inerentes à escala geográfica, o que afeta diretamente nas políticas públicas implantadas e, consequentemente, na vida das pessoas. O objetivo deste artigo foi discutir o conceito de escala a partir dos seus diferentes níveis, e debater a dificuldade de articulá-los por meio da atuação dos órgãos de vigilância em saúde pública brasileira que lidam com a leishmaniose visceral. Realizamos uma revisão de literatura para demonstrar como o debate do conceito de escala geográfica com a saúde é ainda incipiente. Utilizamos conceitos geográficos, integrando as políticas municipais, estaduais e nacional sob a ótica da escala geográfica. Dessa forma, acreditamos que seja possível uma articulação dos órgãos dos sistemas de saúde com a sociedade na transposição de escalas, num acontecer solidário, produzindo um sistema de saúde mais eficaz. A discussão não será aqui esgotada, mas permitirá uma reflexão nas opções teórico-metodológicas em pesquisas e em saúde pública.

Abstract The geographical scale has been broadly discussed in an attempt to formulate a concept that succeeds in explaining different space-related realities. In the various sectors of health planning, geographic categories and concepts have been adopted without understanding the problems inherent to the geographical scale, which directly affects public policies implemented and, consequently, people's lives. The scope of this paper was to discuss the concept of scale based on the different scale levels and the difficulty of their implementation by means of the activities of the organs that operate in public health surveillance that deal with visceral leishmaniasis. A systematic review of the literature was conducted to show how the debate about geographical scale and health is still incipient. Geographical concepts were used, integrating municipal, state and national policies from the perspective of the geographic scale. Thus, the contention is that cooperation between health agencies and society is possible by the transposition of scales, creating an environment of solidarity and a more effective health system. The discussion does not end here, but it will make it viable to reflect on the theoretical and methodological options in research and in public health.

Avaliação da efetividade do uso de coleiras impregnadas com deltametrina no controle da leishmaniose visceral no município de Votuporanga, Estado de São Paulo, Brasil, 2014 ­ 2016 / Evaluation of the effectiveness of using deltamethrinimpregnated collars to control visceral leishmaniasis in the municipality of Votuporanga, State of São Paulo, Brazil, 2014 ­ 2016

O objetivo deste artigo é apresentar os principais resultados do Projeto de Inovação Tecnológica em Saúde realizado entre 2014 e 2015, destacando-se o uso de coleiras impregnadas com deltametrina a 4% em cães em uma região endêmica para leishmaniose visceral (LV), o município de Votuporanga, São Paulo, Brasil. Neste município, anterior à realização do projeto, eram registrados muitos casos caninos e humanos da doença, com elevada taxa de letalidade. Durante o projeto, foram monitorados cerca de 16,5 mil cães, examinadas 25.700 amostras de sangue, considerando-se as perdas e as entradas de novos animais durante os quatro inquéritos sorológicos. Após sua finalização, verificou-se uma diminuição da prevalência e incidência de LV canina, assim como do número de casos humanos. A diminuição dos casos caninos foi correlacionada positivamente aos casos humanos no período de 2011 a 2016 (Correlação de Pearson de 0.914, p-valor<0.05). Além disso, a análise espacial dos resultados corrobora a diminuição ou desaparecimento da concentração de casos caninos e, consequentemente, de fontes e de infecção nas áreas endêmicas à medida que avançaram no tempo e espaço as diferentes etapas de desenvolvimento do projeto. Apesar da drástica redução na incidência da LV canina, ainda permaneceram algumas áreas críticas. Os resultados delineados sugerem a revisão de protocolos e manuais demonstrando a efetividade do uso das coleiras como medida preventiva e potencial no controle da LV. (AU)

This paper aims to present the main results of the Health Technology Innovation Project carried out between 2014 and 2015, which evaluates the use of 4% deltamethrin-impregnated collars in dogs, in an endemic region for visceral leishmaniasis (VL), the municipality of Votuporanga, São Paulo, Brazil. Before this project, Votuporanga had notified canine and human cases of the disease, with a high case fatality rate. We monitored approximately 16.5 thousand dogs, 25,700 blood samples analyzed, considering losses and entrances of new animals during the four serological surveys. After the project, the prevalence and incidence of canine VL decreased as well as the number of human cases. We found a positive correlation between the decrease of infected dogs and human cases from 2011 to 2016 (Pearson correlation of 0.914, p-value <0.05). Furthermore, the spatial analysis of the results indicated areas with canine cases concentration that decreased its intensity or disappeared concomitantly to the project levels in the space-time. Despite the drastic reduction in the incidence of canine VL, some critical areas remain. The current results suggest the review of protocols and manuals demonstrating the effectiveness of the use of collars as a preventive measure and potential in the control of VL. (AU)

Avaliação da efetividade do uso de coleiras impregnadas com deltametrina no controle da leishmaniose visceral no município de Votuporanga, Estado de São Paulo, Brasil, 2014 – 2016 / Evaluation of the effectiveness of using deltamethrinimpregnated collars to control visceral leishmaniasis in the municipality of Votuporanga, State of São Paulo, Brazil, 2014 – 2016

O objetivo deste artigo é apresentar os principais resultados do Projeto de Inovação Tecnológica em Saúde realizado entre 2014 e 2015, destacando-se o uso de coleiras impregnadas com deltametrina a 4% em cães em uma região endêmica para leishmaniose visceral (LV), o município de Votuporanga, São Paulo, Brasil. Neste município, anterior à realização do projeto, eram registrados muitos casos caninos e humanos da doença, com elevada taxa de letalidade. Durante o projeto, foram monitorados cerca de 16,5 mil cães, examinadas 25.700 amostras de sangue, considerando-se as perdas e as entradas de novos animais durante os quatro inquéritos sorológicos. Após sua finalização, verificou-se uma diminuição da prevalência e incidência de LV canina, assim como do número de casos humanos. A diminuição dos casos caninos foi correlacionada positivamente aos casos humanos no período de 2011 a 2016 (Correlação de Pearson de 0.914, p-valor<0.05). Além disso, a análise espacial dos resultados corrobora a diminuição ou desaparecimento da concentração de casos caninos e, consequentemente, de fontes e de infecção nas áreas endêmicas à medida que avançaram no tempo e espaço as diferentes etapas de desenvolvimento do projeto. Apesar da drástica redução na incidência da LV canina, ainda permaneceram algumas áreas críticas. Os resultados delineados sugerem a revisão de protocolos e manuais demonstrando a efetividade do uso das coleiras como medida preventiva e potencial no controle da LV.

This paper aims to present the main results of the Health Technology Innovation Project carried out between 2014 and 2015, which evaluates the use of 4% deltamethrin-impregnated collars in dogs, in an endemic region for visceral leishmaniasis (VL), the municipality of Votuporanga, São Paulo, Brazil. Before this project, Votuporanga had notified canine and human cases of the disease, with a high case fatality rate. We monitored approximately 16.5 thousand dogs, 25,700 blood samples analyzed, considering losses and entrances of new animals during the four serological surveys. After the project, the prevalence and incidence of canine VL decreased as well as the number of human cases. We found a positive correlation between the decrease of infected dogs and human cases from 2011 to 2016 (Pearson correlation of 0.914, p-value <0.05). Furthermore, the spatial analysis of the results indicated areas with canine cases concentration that decreased its intensity or disappeared concomitantly to the project levels in the space-time. Despite the drastic reduction in the incidence of canine VL, some critical areas remain. The current results suggest the review of protocols and manuals demonstrating the effectiveness of the use of collars as a preventive measure and potential in the control of VL.