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1.
Sci Transl Med ; 11(522)2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31826984

RESUMO

Flaviviruses such as dengue, yellow fever, Zika, West Nile, and Japanese encephalitis virus present substantial global health burdens. New vaccines are being sought to address safety and manufacturing issues associated with current live attenuated vaccines. Here, we describe a new insect-specific flavivirus, Binjari virus, which was found to be remarkably tolerant for exchange of its structural protein genes (prME) with those of the aforementioned pathogenic vertebrate-infecting flaviviruses (VIFs). Chimeric BinJ/VIF-prME viruses remained replication defective in vertebrate cells but replicated with high efficiency in mosquito cells. Cryo-electron microscopy and monoclonal antibody binding studies illustrated that the chimeric BinJ/VIF-prME virus particles were structurally and immunologically similar to their parental VIFs. Pilot manufacturing in C6/36 cells suggests that high yields can be reached up to 109.5 cell culture infectious dose/ml or ≈7 mg/liter. BinJ/VIF-prME viruses showed utility in diagnostic (microsphere immunoassays and ELISAs using panels of human and equine sera) and vaccine applications (illustrating protection against Zika virus challenge in murine IFNAR-/- mouse models). BinJ/VIF-prME viruses thus represent a versatile, noninfectious (for vertebrate cells), high-yield technology for generating chimeric flavivirus particles with low biocontainment requirements.

2.
J Biomol Struct Dyn ; : 1-12, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31779533

RESUMO

The Flavivirus genus comprise several important human pathogens, including dengue, West Nile, Yellow fever, Japanese encephalitis, Zika, and tick-borne encephalitis viruses. These enveloped viruses affect more than 2 billion people in the world, mainly in less developed countries. Although some vaccines exist for some flaviviruses, these vaccines are not universally available due to many factors and since their infections are a world-wide public health issue, the development of antiviral molecules is fundamental. Flavivirus membranes, through the help of the envelope E glycoprotein, fuse with endosomal compartments in a pH-dependent way to release their genome into the cytoplasm and require specific lipids, such as bis(monoacylglycero)phosphate (BMP), for efficient fusion. The fundamental role the envelope E protein has on viral entry and membrane fusion suggest that it is an essential antiviral target. In this work, we have used atomistic molecular dynamics simulations to study the binding of the head-group of BMP to the tip of the envelope E proteins of ZIKV, DENV, TBEV and JEV viruses whose three-dimensional structures are known. Our results indicate that, apart from the fusion loop, there are different amino acid residues in different regions of the envelope E proteins of flaviviruses capable of binding the head-group of BMP. These regions should work together to accomplish the binding and fusion of the envelope and endosomal membranes and represent a new target to develop and design potent and effective antiviral agents capable of blocking flavivirus-endosome membrane fusion. [Formula: see text].

3.
Rev Inst Med Trop Sao Paulo ; 61: e35, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340247

RESUMO

Yellow fever is one of the most important mosquito-borne diseases, which still affects a significant number of people every year, mainly in tropical countries. Mortality can be high, even with intensive treatment due to multiple organ failure, including acute kidney injury (AKI). This disease can also be a burden on the health care system in developing countries, without mentioning the number of lives that could be spared with an early diagnosis and adequate monitoring and treatment. The pathophysiology of yellow fever-induced acute kidney injury (AKI) is still to be completely understood, and the best clinical approach has not yet been determined. This manuscript presents the most recent scientific evidence of kidney involvement in yellow fever, since AKI plays an important role in the mortality rate. Recent outbreaks have occurred in Brazil and further studies are required to provide a better clinical control for patients with yellow fever.


Assuntos
Lesão Renal Aguda/virologia , Febre Amarela/complicações , Brasil , Humanos , Estações do Ano , Febre Amarela/diagnóstico , Febre Amarela/tratamento farmacológico , Febre Amarela/prevenção & controle
4.
PLoS Negl Trop Dis ; 13(7): e0007625, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31329590

RESUMO

BACKGROUND: New strategies for collecting post-mortem tissue are necessary, particularly in areas with emerging infections. Minimally invasive autopsy (MIA) has been proposed as an alternative to conventional autopsy (CA), with promising results. Previous studies using MIA addressed the cause of death in adults and children in developing countries. However, none of these studies was conducted in areas with an undergoing infectious disease epidemic. We have recently experienced an epidemic of yellow fever (YF) in Brazil. Aiming to provide new information on low-cost post-mortem techniques that could be applied in regions at risk for infectious outbreaks, we tested the efficacy of ultrasound-guided MIA (MIA-US) in the diagnosis of patients who died during the epidemic. METHODOLOGY/PRINCIPAL FINDINGS: In this observational study, we performed MIA-US in 20 patients with suspected or confirmed YF and compared the results with those obtained in subsequent CAs. Ultrasound-guided biopsies were used for tissue sampling of liver, kidneys, lungs, spleen, and heart. Liver samples from MIA-US and CA were submitted for RT-PCR and immunohistochemistry for detection of YF virus antigen. Of the 20 patients, 17 had YF diagnosis confirmed after autopsy by histopathological and molecular analysis. There was 100% agreement between MIA-US and CA in determining the cause of death (panlobular hepatitis with hepatic failure) and main disease (yellow fever). Further, MIA-US obtained samples with good quality for molecular studies and for the assessment of the systemic involvement of the disease. Main extrahepatic findings were pulmonary hemorrhage, pneumonia, acute tubular necrosis, and glomerulonephritis. One patient was a 24-year-old, 27-week pregnant woman; MIA-US assessed the placenta and provided adequate placental tissue for analysis. CONCLUSIONS: MIA-US is a reliable tool for rapid post-mortem diagnosis of yellow fever and can be used as an alternative to conventional autopsy in regions at risk for hemorrhagic fever outbreaks with limited resources to perform complete diagnostic autopsy.

5.
Korean J Parasitol ; 57(3): 283-290, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31284351

RESUMO

A rapid diagnostic test (RDT) kit was developed to detect non-structural protein 1 (NS1) of yellow fever virus (YFV) using monoclonal antibody. NS1 protein was purified from the cultured YFV and used to immunize mice. Monoclonal antibody to NS1 was selected and conjugated with colloidal gold to produce the YFV NS1 RDT kit. The YFV RDTs were evaluated for sensitivity and specificity using positive and negative samples of monkeys from Brazil and negative human blood samples from Korea. Among monoclonal antibodies, clones 3A11 and 3B7 proved most sensitive, and used for YFV RDT kit. Diagnostic accuracy of YFV RDT was fairly high; Sensitivity was 0.0% and specificity was 100% against Dengue viruses type 2 and 3, Zika, Chikungunya and Mayaro viruses. This YFV RDT kit could be employed as a test of choice for point-of-care diagnosis and large scale surveys of YFV infection under clinical or field conditions in endemic areas and on the globe.


Assuntos
Testes Diagnósticos de Rotina/métodos , Proteínas não Estruturais Virais/análise , Febre Amarela/diagnóstico , Vírus da Febre Amarela/isolamento & purificação , Animais , Anticorpos Antivirais/análise , Anticorpos Antivirais/imunologia , Feminino , Haplorrinos , Humanos , Imunização , Camundongos , Sensibilidade e Especificidade , Proteínas não Estruturais Virais/genética , Proteínas não Estruturais Virais/imunologia , Febre Amarela/sangue , Febre Amarela/imunologia , Febre Amarela/virologia , Vírus da Febre Amarela/genética , Vírus da Febre Amarela/imunologia , Vírus da Febre Amarela/fisiologia
6.
Nat Med ; 25(8): 1218-1224, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31308506

RESUMO

Flaviviral infections result in a wide spectrum of clinical outcomes, ranging from asymptomatic infection to severe disease. Although the correlates of severe disease have been explored1-4, the pathophysiology that differentiates symptomatic from asymptomatic infection remains undefined. To understand the molecular underpinnings of symptomatic infection, the blood transcriptomic and metabolomic profiles of individuals were examined before and after inoculation with the live yellow fever viral vaccine (YF17D). It was found that individuals with adaptive endoplasmic reticulum (ER) stress and reduced tricarboxylic acid cycle activity at baseline showed increased susceptibility to symptomatic outcome. YF17D infection in these individuals induced maladaptive ER stress, triggering downstream proinflammatory responses that correlated with symptomatic outcome. The findings of the present study thus suggest that the ER stress response and immunometabolism underpin symptomatic yellow fever and possibly even other flaviviral infections. Modulating either ER stress or metabolism could be exploited for prophylaxis against symptomatic flaviviral infection outcome.


Assuntos
Estresse do Retículo Endoplasmático , Vacina contra Febre Amarela/imunologia , Febre Amarela/metabolismo , Adulto , Ciclo do Ácido Cítrico , Suscetibilidade a Doenças , Humanos , Pessoa de Meia-Idade , Espécies Reativas de Oxigênio/metabolismo , Vacinas Atenuadas/imunologia , Febre Amarela/etiologia
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46581

RESUMO

A Febre do Mayaro é uma doença infecciosa febril aguda, cujo quadro clínico geralmente é de curso benigno, semelhante à Dengue e à Chikungunya. A Febre do Mayaro compõe a lista nacional de doenças de notificação compulsória imediata, conforme Portaria de Consolidação nº 4, de 28 de setembro de 2017.


Assuntos
Dengue , Febre de Chikungunya , Infecções por Arbovirus , Togaviridae , Infecções por Alphavirus , Febre Amarela
8.
Travel Med Infect Dis ; 30: 25-31, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31075425

RESUMO

BACKGROUND: We study the association between prior yellow fever immunization and clinical outcomes of dengue infections in individuals of varying sexes and ages. Serological interactions between dengue virus and other flaviviruses could drive antibody dependent enhancement, which is associated with disease severity in dengue infections. This effect may influence disease severity in individuals subsequently affected by related flaviviruses, such as dengue. We compare the severity of dengue episodes between patients vaccinated and non-vaccinated against yellow fever. METHODS: We evaluated the severity of 11,448 lab-confirmed dengue cases reported in São José do Rio Preto, Brazil, in 7370 YF vaccinated patients compared to 4043 unvaccinated patients. We regressed dengue severity against YF vaccine status and a number of demographic, clinical, and laboratory variables as controls. We also evaluated the association between YF vaccination status and the clinical and laboratory symptoms of dengue patients. RESULTS: We did not find any evidence of increased risk for severe dengue in patients vaccinated against YF (odds ratio = 1.00; 95% confidence interval = 0.87-1.14). Most of the variables analyzed did not have a statistically significant association with YF vaccination status. CONCLUSIONS: We found no evidence that YF vaccination in dengue-endemic areas increases the risk of severe dengue fever.


Assuntos
Dengue/patologia , Vacina contra Febre Amarela/imunologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Demografia , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/imunologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Vacina contra Febre Amarela/normas
9.
Insects ; 10(5)2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31083286

RESUMO

Brazil has experienced several arbovirus outbreaks in recent years, among which yellow fever stands out. The state of Minas Gerais faced outbreaks of sylvatic yellow fever in 2017 and 2018, with 1002 confirmed cases and 340 deaths. This work presents the results of survey efforts to detect the yellow fever virus in mosquitoes from two conservation areas in the metropolitan region of Belo Horizonte, Brazil. A total of 867 mosquitoes of 20 species were collected between September 2017 and May 2018, the most abundant being Psorophora (Janthinosoma) ferox (von Humboldt, 1819) (31.3%), Limatus durhamii Theobald, 1901 (19.1%) and Haemagogus (Haemagogus) janthinomys Dyar, 1921 (18.2%). Total RNA was extracted from the mosquitoes for real-time PCR analysis for yellow fever, chikungunya, mayaro, Zika and dengue viruses. The yellow fever infection rate was 8.2% for Hg. janthinomys (13 mosquitoes), which is the main vector of sylvatic yellow fever in Brazil. In addition to surveying the mosquito fauna of these conservation units, this work demonstrates the importance of monitoring the circulation of viruses near large urban centers.

10.
J Med Primatol ; 48(4): 211-217, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31032984

RESUMO

BACKGROUND: Free-ranging non-human primates (NHPs) can host a variety of pathogenic microorganisms, such as arboviruses, which include the yellow fever virus (YFV). This study aimed to detect the circulation of YF and other arboviruses in three wild Alouatta caraya populations in forests in southern Brazil. METHODS: We collected 40 blood and serum samples from 26 monkeys captured/recaptured up to four times from 2014 to 2016, searching for evidence of arboviruses by virus isolation, PCR, and neutralization tests. RESULTS: Viral isolation and genome detection were negative; however, we detected neutralizing antibodies against the Saint Louis, Ilhéus, and Icoaraci viruses in three NHPs. CONCLUSIONS: Saint Louis Encephalitis, Ilhéus, and Icoaraci viruses circulated recently in the region. Future studies should investigate the role of NHPs, other vertebrate hosts and wild vectors in the region's arbovirus circulation and the potential risks of the arboviruses to wildlife, domestic animals, and humans.

11.
J Med Entomol ; 56(4): 1154-1158, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-30927005

RESUMO

The Togolese Republic has a tropical and humid climate which constitutes an ideal environment for mosquitoes to breed and transmit diseases. The Aedes mosquito is known to transmit yellow fever (YF), dengue, chikungunya, and Zika viruses in West Africa. Togo has been suffering from YF virus transmission, despite vaccination efforts. Unfortunately, there is scarcity in the data that reflect mosquito spatial distribution in Togo, specifically possible YF vectors. In the current study, mosquito surveillance efforts targeted areas with confirmed YF cases between July and August 2012. Indoor mosquitoes were collected using knockdown insecticide spraying, whereas Biogents (BG) traps were used to collect outdoor mosquito adults. Mosquito larval surveillance was conducted as well. In total, 17 species were identified. This investigation revealed the presence of medically important vectors in Togo, especially the Aedes aegypti (Linnaeus) (Diptera: Culicidae) which was collected in the four regions. Screening of all pools of female Aedes mosquitoes for YF, by real-time PCR, showed negative results. This is the first record for Coquillettidia flavocincta (Edwards) (Diptera: Culicidae) species in West Africa. This preliminary work serves as a baseline for further mosquito distribution studies in Togo.

12.
FP Essent ; 476: 11-17, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30615405

RESUMO

Due to rapid globalization and ease of travel, mosquito-borne viral infections are now a concern for family physicians throughout the United States. Zika virus infection is one such concern. It is spread via mosquito bites or by sexual contact with an infected individual. Most patients are asymptomatic, and when symptoms occur, they are mild and nonspecific. The main concern is the potential of the infection to cause fetal anomalies. Dengue is another mosquito-borne viral infection. Symptoms of initial infection are mild, and may include arthralgias. Subsequent infection with a different serotype can cause life-threatening hemorrhagic fever or shock. Chikungunya virus infection is widespread in the Americas and symptoms are similar to those of dengue. However, it can cause a postviral chronic inflammatory rheumatism in up to half of patients. Yellow fever occurs mostly in sub-Saharan Africa and can cause hepatic failure. Encephalitis viruses, most commonly West Nile in the United States and others such as Japanese encephalitis virus, can cause neuroinvasive disease, most often in older adults. Vaccines are available for yellow fever and Japanese encephalitis viruses but the keys to prevention are insect avoidance, mosquito eradication, and use of mosquito repellants.


Assuntos
Culicidae , Dengue , Febre Amarela , Infecção por Zika virus , Animais , Dengue/diagnóstico , Dengue/terapia , Dengue/transmissão , Humanos , Estados Unidos , Febre Amarela/diagnóstico , Febre Amarela/terapia , Febre Amarela/transmissão , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/terapia , Infecção por Zika virus/transmissão
13.
JAMA Ophthalmol ; 137(3): 300-304, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30629101

RESUMO

Importance: Yellow fever virus (YFV) is a reemerging, potentially lethal arboviral disease that has been occurring recently in Africa and South America. Poor levels of immunization have facilitated the viral spread in southeastern Brazil, leading to an unprecedented outbreak that started in late 2016. Although human cases have been linked to sylvatic mosquitoes, the concern is that YFV may spread to urban centers infested with Aedes aegypti and Aedes albopictus mosquitoes and start a true urban cycle. Objective: To describe the ocular findings in patients with acute YFV infection. Design, Setting, Participants: Two adults with an acute YFV infection in southeastern Brazil underwent an ophthalmologic and ocular ultrasonographic examination in early 2018. Main Outcomes and Measures: Ocular findings in patients with acute YFV infection. Results: Both patients presented with increased choroidal thickness bilaterally seen on ocular ultrasonography. A man in his late 50s who had not been vaccinated previously also presented with bilateral, midperipheral, 360° choroidal detachment and yellowish subretinal lesions. After clinical deterioration and liver transplant, the man died. A woman in her early 30s who had been vaccinated previously for YFV presented with increased retinal venous congestion bilaterally. She was discharged with mild conjunctival chemosis and icterus. Conclusions and Relevance: These reports describe different patterns of ocular findings associated with YFV acute infection. However, the exact mechanism involved in the retinal and choroidal findings remains unclear.


Assuntos
Corioide/patologia , Retina/patologia , Febre Amarela/patologia , Adulto , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Vector Borne Zoonotic Dis ; 19(5): 365-369, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30431406

RESUMO

Tick-borne encephalitis virus (TBEV) can cause fever, headache, neurological disorders, and/or peripheral flaccid paralysis; therefore, it is a major threat to public health. A rapid, sensitive, and simple method for detecting anti-TBEV antibodies is needed urgently to determine infection and for vaccine evaluation. Here, a luciferase-based immunocomplex assay system (Luc-IC) was developed to detect TBEV antibodies. The system is based on a reporter Nano luciferase (NLuc) that is co-expressed as a fusion protein with viral envelope domain III (ED3) in COS7 cells. The cell supernatant was used directly to detect antigen without the need for a purification step. This simple procedure effectively improved the sensitivity of the assay. Sera from 50 patients with an acute tick-borne encephalitis infection were tested to determine the sensitivity of the NLuc-IC assay. Furthermore, 62 sera from individuals infected with Japanese encephalitis virus, West Nile virus, yellow fever virus, dengue virus, or Zika virus were also tested to determine specificity. The results demonstrated that the assay was 100% sensitive and 100% specific for TBEV antibodies. Thus, this very simple NLuc-IC assay is potentially useful for rapid and accurate diagnosis of TBEV infection in both humans and animals.


Assuntos
Anticorpos Antivirais/sangue , Complexo Antígeno-Anticorpo , Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Encefalite Transmitida por Carrapatos/diagnóstico , Encefalite Transmitida por Carrapatos/virologia , Animais , Humanos , Luciferases , Sensibilidade e Especificidade , Testes Sorológicos
15.
PLoS One ; 13(12): e0208907, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30566466

RESUMO

Dengue fever is known to be one of the most common arthropod-borne viral infectious diseases of public health importance. The disease is now endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, Southeast Asia and the Western Pacific with an estimated two fifths of the world's population being at risk. The notable endemic viral hemorrhagic fevers (VHFs) found in West Africa, including yellow fever, Lassa fever, Rift Valley fever, dengue fever and until recently Ebola have been responsible for most outbreaks with fatal consequences. These VHFs usually produce unclear acute febrile illness, especially in the acute phase of infection. In this study we detected the presence of 2 different serotypes (DENV-2 and DENV-3) of Dengue virus in 4 sera of 150 patients clinically suspected of Ebola virus disease during the Ebola Virus Disease (EVD) outbreak in West Africa with the use of serological and molecular test assays. Sequence data was successfully generated for DENV-3 and phylogenetic analysis of the envelope gene showed that the DENV-3 sequences had close homology with DENV-3 sequences from Senegal and India. This study documents molecular evidence of an indigenous Dengue fever viral infection in Ghana and therefore necessitates the need to have an efficient surveillance system to rapidly detect and control the dissemination of the different serotypes in the population which has the potential to cause outbreaks of dengue hemorrhagic fevers.


Assuntos
Vírus da Dengue/genética , Dengue , Ebolavirus/genética , Doença pelo Vírus Ebola , Dengue/epidemiologia , Dengue/genética , Dengue/virologia , Surtos de Doenças , Feminino , Gana/epidemiologia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/genética , Doença pelo Vírus Ebola/virologia , Humanos , Masculino
16.
Sheng Wu Gong Cheng Xue Bao ; 34(12): 2025-2034, 2018 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-30584713

RESUMO

Ebola virus (EBOV) is an extremely contagious pathogen first discovered in Africa associated with severe hemorrhagic disease in humans and nonhuman primates, which has resulted in at least 28 500 suspected cases and 11 300 confirmed deaths in 2014-2016 Ebola epidemic in West Africa. Rapid and sensitive detection of EBOV is the key to increasing the probability of survival and reducing infection rates in pandemic regions. Here, we report an ultrasensitive and instrument-free EBOV detection assay based on colloidal carbon immunochromatography. Carbon nanoparticle-labeled rabbit anti-EBOV-VP40 IgG were concentrated in the conjugate pad, monoclonal antibody (McAb, 4B7F9) against EBOV-VP40 and goat anti-rabbit IgG were immobilized on the nitrocellulose membrane with 2 µL/cm at a concentration of 1 mg/mL as test and control lines, respectively. Then the sample application pad, conjugate release pad, nitrocellulose membrane and absorbent pad were assembled into a lateral flow test strip. The test strip shows strong specificity against related viruses that share similar clinical symptoms and geographic range with EBOV, including marburg virus, influenza virus, yellow fever virus and dengue virus. In addition, 1 500 negative serums were tested with false-positive rate of 1.3‰ which significantly lower than that of ReEBOV™ colloidal gold test kit recommended by World Health Organization (WHO). The sensitivity of this strip was analyzed using inactivated EBOV with detection limit of 100 ng/mL (106 copies/mL) which clearly higher than that of ReEBOV™ dipstick (108 copies/mL). Furthermore, the strip showed excellent thermal stability characteristics in room temperature and could be as a point-of-care (POC), ultra-sensitive and specific promising candidate for EBOV serological screening in rural Africa or entry/exit ports.


Assuntos
Ebolavirus , Doença pelo Vírus Ebola , Nanopartículas , Animais , Carbono , Humanos , Coelhos
17.
PLoS Negl Trop Dis ; 12(12): e0007029, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30532188

RESUMO

BACKGROUND: Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of cases in future urban outbreaks. METHODOLOGY/PRINCIPAL FINDINGS: In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case investigation and hospital admission forms. Comparing clinical signs between confirmed and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31 years (IQR 25-37). 15 (19%) confirmed cases were infected locally in urban settings in DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6-9), to appearance of jaundice 8 days (IQR 7-11), to sample collection 9 days (IQR 7-14), and to hospitalization 17 days (IQR 11-26). A case definition including fever or jaundice, combined with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%). CONCLUSIONS/SIGNIFICANCE: As jaundice appeared late, the majority of cases were diagnosed too late for supportive care and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.


Assuntos
Febre Amarela/epidemiologia , Adulto , Angola , República Democrática do Congo/epidemiologia , Surtos de Doenças , Feminino , Humanos , Masculino , Viagem , População Urbana , Febre Amarela/diagnóstico , Febre Amarela/virologia , Vírus da Febre Amarela/genética , Vírus da Febre Amarela/isolamento & purificação , Vírus da Febre Amarela/fisiologia
18.
Ned Tijdschr Geneeskd ; 1622018 09 24.
Artigo em Holandês | MEDLINE | ID: mdl-30358370

RESUMO

BACKGROUND: Since 2016 outbreaks of yellow fever are reported in Brazil. This is a risk to unvaccinated travellers in that area. CASE DESCRIPTION: In early January, an unvaccinated traveller returning from São Paulo attended our outpatient clinic complaining of symptoms later diagnosed as yellow fever. The disease manifested itself as fever, lower back pain, nausea and highly elevated liver enzymes. A yellow fever infection has multiple stages. The first stage is acute infection which merges into the second stage which is when improvement occurs. Either improvement continues or transfers into a third stage which is characterized by multi-organ failure. In this particular patient, stage three did not occur. CONCLUSION: The goal of this case report is to show that vaccination against yellow fever is the most important preventive measure when travelling to an area where the yellow fever virus is in circulation. Yellow fever should not be forgotten in the differential diagnosis of a traveller with fever.


Assuntos
Viagem , Vacinação , Vacina contra Febre Amarela , Febre Amarela/prevenção & controle , Vírus da Febre Amarela , Brasil/epidemiologia , Surtos de Doenças , Febre , Humanos , Fígado/enzimologia , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/etiologia , Náusea/diagnóstico , Náusea/etiologia , Febre Amarela/complicações , Febre Amarela/diagnóstico , Febre Amarela/epidemiologia
19.
J. Bras. Patol. Med. Lab. (Online) ; 54(5): 296-305, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-975848

RESUMO

ABSTRACT Yellow fever is an infectious disease of acute evolution, initially non-contagious, transmitted by a ribonucleic acid (RNA) virus that belongs to the Flaviviridae family. In the period from December 2016 until March 17, 2017, 1, 561 suspected cases of wild yellow fever were reported to the Ministry of Health in Brazil. Among these cases, 850 (54.8%) remain under investigation, 448 (28.7%) were confirmed and 263 (16.9%) were discarded. Out of the total cases reported, 264 died, 144 (54.5%) were confirmed for the disease, 110 (41.7%) were investigated and 10 (3.8%) were discarded. The case fatality rate among confirmed cases was 32.2%. The specific diagnosis for determining the etiology of infection can be made by demonstrating the humoral response of the antibodies, virus isolation, or histopathological study of the liver. Only through early laboratory diagnosis and epidemiological data supply can government and cooperative organizations establish public policies to combat future disease epidemics, as well as social awareness campaigns.


RESUMO A febre amarela é uma doença infecciosa de evolução aguda, a princípio não contagiosa, transmitida por um vírus do ácido ribonucleico (RNA) que pertence à família Flaviviridae. No período de dezembro de 2016 a 17 de março de 2017, foram notificados ao Ministério da Saúde, 1.561 casos suspeitos de febre amarela silvestre no Brasil. Destes, 850 (54, 8%) permanecem em investigação; 448 (28, 7%) foram confirmados e 263 (16, 9%), descartados. Do total dos casos notificados, 264 evoluíram para óbito, sendo 144 (54, 5%) confirmados para a doença; 110 (41, 7%) em investigação e 10 (3, 8%), descartados. A taxa de letalidade entre os casos confirmados foi de 32, 2%. O diagnóstico específico para determinação da etiologia da infecção pode ser feito por meio da demonstração da resposta humoral dos anticorpos, do isolamento do vírus ou do estudo histopatológico do fígado. Apenas mediante o diagnóstico laboratorial precoce e o abastecimento de dados epidemiológicos é que governo e organizações cooperativas poderão estabelecer políticas públicas de combate a futuras epidemias da doença, bem como campanhas de conscientização social.

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