Individual, household and environmental factors associated with arboviruses in rural human populations, Brazil.

Landscape change is one of the foremost drivers of the emergence of infectious diseases. Exploring demographic, household and environmental conditions under which infectious diseases occur may inform strategies to prevent disease emergence in human populations. We collected blood samples from 523 humans and explore factors for arbovirus emergence in Bahia, Brazil. The overall arbovirus seroprevalence was 65.2%, with the genus Flavivirus most prevalent (64.4%). Based on monotypic reactions, the population had contact with five arbovirus: Dengue 3, Ilheus, Oropouche, Caraparu and Eastern equine encephalitis virus. To our knowledge, this is the first study reporting exposure to Oropouche, Caraparu and Eastern equine encephalitis virus in human populations in Bahia, Northeast of Brazil. The best model fit demonstrated that household and environmental variables were more predictive of the risk of arbovirus exposure than demographic variables. The presence of forest and free-living monkeys in the areas close to the communities had a protective effect for the human population (i.e. lower seroprevalence). The dilution effect is considered as one explanation for this finding. These results highlight the important ecological role of wildlife-friendly agriculture.

Diversity patterns of hematophagous insects in Atlantic forest fragments and human-modified areas of southern Bahia, Brazil.

There have been several important outbreaks of mosquito-borne diseases in the Neotropics in recent years, particularly in Brazil. Some taxa are also considered to be indicators of environmental health. Despite the importance of understanding insect abundance and distribution to the understanding of disease dynamics and design strategies to manage them, very little is known about their ecology in many tropical regions. We studied the abundance and diversity of mosquitoes and sand flies in the Bahia State of Brazil, a point of origin for arbovirus outbreaks, including Zika and Chikungunya fever. During 2009-2014, 51 mosquito taxa were identified, belonging to three dipteran families, Ceratopogonidae, Culicidae, and Psychodidae. The family Culicidae, including the Sabethini tribe, were the most abundant (81.5%) and most taxa-rich (n=45). While season (winter and summer) was a strong factor determinant of the occurrence of the most abundant taxa, the stratification level in the forest (ground or tree level) had a strong effect and the dominant taxa at ground level were completely different from the dominant species collected at tree level. We suggest that sites with a mix of forest and agroforestry systems support the highest biodiversity of hematophagous insects as compared to highly disturbed landscapes.

Molecular epidemiology of Laguna Negra virus, Mato Grosso State, Brazil.

We associated Laguna Negra virus with hantavirus pulmonary syndrome in Mato Grosso State, Brazil, and a previously unidentified potential host, the Calomys callidus rodent. Genetic testing revealed homologous sequencing in specimens from 20 humans and 8 mice. Further epidemiologic studies may lead to control of HPS in Mato Grosso State.

Pygmy rice rat as potential host of Castelo dos Sonhos Hantavirus.

To study the dynamics of wild rodent populations and identify potential hosts for hantavirus, we conducted an eco-epidemiologic study in Campo Novo do Parecis, Mato Grosso State, Brazil. We detected and genetically characterized Castelo dos Sonhos virus found in a species of pygmy rice rat (Oligoryzomys utiaritensis).

Hantaviruses and hantavirus pulmonary syndrome, Maranhao, Brazil.

To confirm circulation of Anajatuba virus in Maranhao, Brazil, we conducted a serologic survey (immunoglobulin G ELISA) and phylogenetic studies (nucleocapsid gene sequences) of hantaviruses from wild rodents and persons with hantavirus pulmonary syndrome. This virus is transmitted by Oligoryzomys fornesi rodents and is responsible for hantavirus pulmonary syndrome in this region.

Diagnosis of human rabies cases by polymerase chain reaction of neck-skin samples.

Rapid diagnosis of rabies in suspected human cases influences post-exposure prophylaxis for potential contacts of the patient and ensures appropriate patient management. Apart from the central nervous system (CNS), rabies virus (RABV) is usually present in small sensory nerves adjacent to hair follicles of infected humans. We used an RT-PCR, with primers targeted to the 3' terminal portion of the nucleoprotein gene (N), to test neck-skin samples of nine patients who had rabies in order to validate a diagnostic method that could serve as an additional tool for rabies diagnosis, particularly in antemortem samples. Six of eight postmortem samples were found to be positive for rabies by RT-PCR, and one of two samples collected antemortem was positive with this same technique. Results were confirmed by DNA sequencing; this validates RT-PCR and neck-skin as a suitable technique and type of sample, respectively, for use in the diagnosis of human rabies. RT-PCR applied to neck-skin biopsies could allow early diagnosis and lead to more effective rabies treatment.

Arboviruses Pathogenic for man in Brazil

Os mais importantes aspectos clinicicos e ecoepidemiologicos e aspectos preventivos acerca das arboviroses associadas com doenca humana no Brasil sao discutidos.Trinta e seis arbovirus dentre os tipos presentemente isolados no Pais tem sido incriminados como causadores de doenca humana. Destes, cinco sao importantes em termos de saude publica pois estao associados com epidemias , sao os virus Dengue (DEN), Mayaro(MAY), Oropouche (ORO), Rocio (ROC) e Febre amarela (FA). DEN e ORO estao associados com doenca humana epidemica em areas urbanas enquanto MAY, ROC e FA especialmente em areas rurais. Basicamente, o virus ORO determina um quadro febril algumas vezes acmpanhado por meningite asseptica. MAY e DEN sao responsaveis por quadros exantematicos, sendo que DEN, nos ultimos anos tem sido associado com quadros de febre hemorragica, o que sabidamente e o mecanismos pelo qual o virus FA determinaa sua apresentacao clinica classica e o ROC esta associado com graves quadros de encefalite. Trinta e um outros arbovirus tem sido associados com doenca febril benigna em poucos e esporadicos casos. Afora DEN e os Arenavirus Flexal e Sabia ( nao sao arbovirus), todos os arbovirus envolvidos com doenca humana na AmazoniaBrasileira, sao mantidos em natureza atraves de um ciclo silvestre desenvolvido na floresta, onde diversas especies de insetos hematofagos e vertebrados silvestres atuam como vetores e hospedeiros, respectivamente.O virus DEN tem um ciclo urbano em que o mosquito Aedes aegypti e o vetor e o homem atua como hospedeiro. Os arenavirus sao transmitidos diretamente ao homen atraves de excretas de roedores que sao seus principais hospedeiros.Excetuando os cinco virus associados com epidemias que causam um grande impacto socio-economico, inclusive levando a morte, casos verificados com FA, DEN e ROC, o verdadeiro papel dessesvirus como agentes sistematicos de doencas humanas e ainda puco conhecido. Novos estudos sao necessarios para esclarecer aspectos ainda obscuros acerca da epidemiologia da maioria desses arbovirus

The frist laboratory confirmed cases of dengue fever in Brazil: virus isolation and sorological results

Investigation of an extensive outbreak of febrile illness in the city of Boa Vista, Roraima State, Brazil, that began in late 1981 lasted until August 1982, established that dengue virus was incriminated in the etiology. Virological studies were madeon 31 selected patients, dengue virus (types 1 and 4) was isolated in 12 of them. The virus (both types) was also isolated from three of 51 pools (1,478 mosquitoes) of Aedes aegypti captured especially downtown. To isolate the virus, allthe material was inoculatedin Aedes albopictus cells (C6/36) and in suckling mice, and virus isolates were identified by the indirect immunofluorescence usingthe monoclonal antibodies. The results of hemagglutination inhibition and complement fixationtest with 27 paired acute convalescent phase sera and 359 single convalescent or contacts sera were highly suggestive of dengue etiology.The clinical features were those os classical dengue fever. Later, afterthe outbreak, serological survey involving899 sera was conducted in order to determine the extent of the epidemic. The results indicated that at 11,000 dengue cases ocurred. These are the first laboratory confirmed cases of dengue fever in Brazil

A recente outbreak of yellow fever in south of Maranhäo State, Brazil: epidemiological, clinical and entomological findings

An outbreak of Yellow fever virus (YF) ocorred in Maranhäo State in 1993 (Barra do Corda, Esperantinopolisand Mirador) and 1994 (Pastos Bons), where several cases were reported. In 1993 a total of 932 people was examined for YF distributedas follows: 32 from Barra do Corda, 26 from Esperantinópolis and 874 from Mirador. From these, 70 cases were YF confirmed serologically (IgM capture MAC ELISA), histopathologically and/or by virus isolation. Another 4 cases diagnosed clinically and epidemiologically, brougth the total to 74 (Barra do Corda:5; Esperantinópolis:7 and Mirador: 62). The age of patients ranged from 2 to 71 years old (mean: 24):32 (43.2 percent) were female and 42 (56.8 percent) male and total lethality-rate was 17.5 percent (13/74). In Mirador ( 17,565 inhabitants), where an intesive survey was carried out, the incidence was 3,5 per 1,000 people, but in the rural YF risk area (14,695 inhabitants) the incidence was 4.2, and the mortality 16.1 percent (10/62). A total of 45.2 percent (28/62) asymptomatic infections were registered. In 1994, a total of 49 serum samples was obtained, 2 by virus isolation, 2 by seroconversion and 12 by serology. On the other hand, no fatal cases were reported in Pastos Bons. In 1993 , 936 potential YF vectors were captured in Mirador and a single strain was isolated from a pool of Haemagogus janthinomys (infection rate (IR): 0.16 percent). In 1994, 16 strains were isolated from 1,318 Hg. janthinnomys (IR: 1.34 percent) and one Sabethes chloropterus (IR:1.67 percent). Our results suggest that this was the most extensive outbreak of YF in the last 20 years in Brazil