Antibody cross-reactivity and evidence of susceptibility to emerging Flaviviruses in the dengue-endemic Brazilian Amazon.

OBJECTIVES: Several Flaviviruses can co-circulate. Pre-existing immunity to one virus can modulate the response to a heterologous virus; however, the serological cross-reaction between these emerging viruses in dengue virus (DENV)-endemic regions are poorly understood. METHODS: A cross-sectional study was performed among the residents of Manaus city in the state of Amazonas, Brazil. The serological response was assessed by hemagglutination inhibition assay (HIA), enzyme-linked immunosorbent assay, and neutralization assay. RESULTS: A total of 74.52% of the participants were immunoglobulin G-positive (310/416), as estimated by lateral flow tests. Overall, 93.7% of the participants were seropositive (419/447) for at least one DENV serotype, and the DENV seropositivity ranged between 84.8% and 91.0%, as determined by HIA. About 93% had antiyellow fever virus 17D-reactive antibodies, whereas 80.5% reacted to wild-type yellow fever virus. Zika virus (ZIKV) had the lowest seropositivity percentage (52.6%) compared with other Flaviviruses. Individuals who were DENV-positive with high antibody titers by HIA or envelope protein domain III enzyme-linked immunosorbent assay reacted strongly with ZIKV, whereas individuals with low anti-DENV antibody titers reacted poorly toward ZIKV. Live virus neutralization assay with ZIKV confirmed that dengue serogroup and ZIKV-spondweni serogroup are far apart; hence, individuals who are DENV-positive do not cross-neutralize ZIKV efficiently. CONCLUSION: Taken together, we observed a high prevalence of DENV in the Manaus-Amazon region and a varying degree of cross-reactivity against emerging and endemic Flaviviruses. Epidemiological and exposure conditions in Manaus make its population susceptible to emerging and endemic arboviruses.

Is the brazilian diverse environment is a crib for the emergence and maintenance of exotic arboviruses?

We review the potential of Amazon forest as a source for circulation and maintenance of native arboviruses as well its capacity to host exotic arboviruses introduced in Brazil during their process of adapting to the Amazon environment. After a brief introduction about arboviruses isolated in Amazon region and description of the main arboviruses pathogenic to humans, we highlight the history of the last two exotic viruses introduced in Brazil - Chikungunya virus (CHIKV) and Zika virus (ZIKV) - and their consequences to the public health. Finally, we discuss and hypothesize what will happen with them after the outbreak. We look to the past to predict the future.

Characterization of recent and minimally passaged Brazilian dengue viruses inducing robust infection in rhesus macaques.

The macaque is widely accepted as a suitable model for preclinical characterization of dengue vaccine candidates. However, the only vaccine for which both preclinical and clinical efficacy results were reported so far showed efficacy levels that were substantially different between macaques and humans. We hypothesized that this model's predictive capacity may be improved using recent and minimally passaged dengue virus isolates, and by assessing vaccine efficacy by characterizing not only the post-dengue virus challenge viremia/RNAemia but also the associated-cytokine profile. Ten recent and minimally passaged Brazilian clinical isolates from the four dengue virus serotypes were tested for their infectivity in rhesus macaques. For the strains showing robust replication capacity, the associated-changes in soluble mediator levels, and the elicited dengue virus-neutralizing antibody responses, were also characterized. Three isolates from dengue virus serotypes 1, 2 and 4 induced viremia of high magnitude and longer duration relative to previously reported viremia kinetics in this model, and robust dengue virus-neutralizing antibody responses. Consistent with observations in humans, increased MCP-1, IFN-γ and VEGF-A levels, and transiently decreased IL-8 levels were detected after infection with the selected isolates. These results may contribute to establishing a dengue macaque model showing a higher predictability for vaccine efficacy in humans.

Seroprevalence of flaviviruses antibodies in water buffaloes (Bubalus bubalis) in Brazilian Amazon.

BACKGROUND: The state of Pará encompasses 26% of Brazilian Amazon where an enormous diversity of arboviruses has been found. This study aimed to assess the prevalence and distribution of hemagglutination-inhibition antibodies against antigens of six Flavivirus (yellow fever virus, Ilheus virus, Saint Louis encephalitis virus, Cacipacore virus, Bussuquara virus and Rocio virus) in water buffaloes in Pará state, Brazil. The prevalence of antibodies in these farm animals is important to determine the circulating arboviruses. FINDINGS: All investigated arboviruses were detected in the species studied and our results indicate that water buffaloes are susceptible to Flavivirus infection. Furthermore, there is solid evidence of active circulation of these viruses in the Brazilian Amazon. CONCLUSIONS: Water buffaloes showed higher prevalence of heterotypic antibody reactions and we hypothesized that they can serve as sentinels to detect the movement of such arboviruses in the Brazilian Amazon.

Seroprevalence of flaviviruses antibodies in water buffaloes (Bubalus bubalis) in Brazilian Amazon

The state of Pará encompasses 26% of Brazilian Amazon where an enormous diversity of arboviruses has been found. This study aimed to assess the prevalence and distribution of hemagglutination-inhibition antibodies against antigens of six Flavivirus (yellow fever virus, Ilheus virus, Saint Louis encephalitis virus, Cacipacore virus, Bussuquara virus and Rocio virus) in water buffaloes in Pará state, Brazil. The prevalence of antibodies in these farm animals is important to determine the circulating arboviruses.

Seroprevalence of flaviviruses antibodies in water buffaloes (Bubalus bubalis) in Brazilian Amazon

The state of Pará encompasses 26% of Brazilian Amazon where an enormous diversity of arboviruses has been found. This study aimed to assess the prevalence and distribution of hemagglutination-inhibition antibodies against antigens of six Flavivirus (yellow fever virus, Ilheus virus, Saint Louis encephalitis virus, Cacipacore virus, Bussuquara virus and Rocio virus) in water buffaloes in Pará state, Brazil. The prevalence of antibodies in these farm animals is important to determine the circulating arboviruses.

Immunopathogenesis of dengue hemorrhagic fever: contribution to the study of human liver lesions.

Dengue infection is an important tropical disease worldwide. The host immune response has been studied in order to better understand lesion mechanisms. It was performed an immunohistochemical study in 14 specimens of liver from patients with dengue hemorrhagic fever (DHF) to characterize cytokines and some factors present in liver lesions and their possible role in the pathogenesis of hepatic injury. Portal tract and hepatic acinus presented high expression of TLR2, TLR3, IL6, and granzyme B. Hepatic acinus also presented iNOS, IL18, and TGF-beta. Cells expressing IL12, IL13, JAk1, STAT1, and NF-κB were rarely visualized. Treg cells foxp3+ were absent. TLR2 and TLR3 seem to participate in cellular activation and cytokine production. Cytotoxic response seems to play a role. Although TGF-beta promotes the activation of Foxp3+ regulatory T cells, IL6 can significantly suppresses their generation. The expression of Treg cells is diminished probably as a result of the high frequency of these cytokines. Both cytokines play a role in the increased vascular permeability and edema observed in dengue liver specimens, with consequent plasma leakage and severity of the disease. It was observed a regular expression of IL-18 in hepatocytes and lymphocytes of the inflammatory infiltrate in portal tract, which reflects the acute inflammatory response that occurs in the liver and contributes to hepatic injury. At least in part, the increased number of cells expressing IL-18 could play a role of "up" regulation of FasL and correlate to the phenomenon of apoptosis, a mechanism of destruction of hepatocytes in DHF.

Epidemia de dengue em Fortaleza, Ceará: inquérito soro-epidemiológico aleatório / Dengue epidemic in a Northeastern Brazil: random epidemiological serum survey

Seguindo-se à epidemia de dengue (DEN), em 1994, em Fortaleza, Ceará, causada pelo sorotipo 2 (DEN-2), realizou-se inquérito soro-epidemiológico aleatório para avaliar e dimensionar o impacto da mesma e a prevalência do dengue por distrito sanitário. Foi aplicado questionário contendo informaçöes gerais, condiçöes socio-econômicas, informaçöes sobre o quadro clínico e tempo de doença. A amostra foi calculada para estimar uma prevalência de 20 por cento, com erro relativo de 10 por cento, e intervalo de confiança de 95 por cento (erro a de 5 por cento). O sorteio e as análises foram realizadas por meio de computador usando programas apropriados. Foram colhidas 1.341 amostras de soro de 9 distritos sanitários, testadas por inibiçäo da hemaglutinaçäo, sendo classificadas como negativas e positivas (respostas primária - RP e secundária - RS). Foram reativas 588 (44 por cento) amostras, sendo 93 (7 por cento) RP e 495 (37 por cento) RS. A prevalência global em Fortaleza variou de 21 por cento a 71 por cento. Houve 41 por cento (243/588) de infecçöes assintomáticas (IA) e 59 por cento (346/588) sintomáticas (IS). Näo houve diferença da prevalência quanto ao sexo, faixa etária e escolaridade, ao contrário da condiçäo socioeconômica que apresentou diferenças estatisticamente significantes (p<0,001). Ocorreram mais IA (p<0,001) e IS (p<0,0001) em casos de RS que RP, com significância estatística em ambos os sexos. Os sintomas mais prevalentes nos casos confirmados foram febre, cefaléia, mialgias, exantema, mal estar geral, tontura e artralgias, sendo que prirido, dor ocular, exantema e gengivorragia foram estatisticamente significantes (p<0,005). Tontura e artralgias foram mais associados com RS que com RP, havendo diferenças estatísticas (p<0,05)