Co-infection of Peruvian horse sickness virus and West Nile virus associated with neurological diseases in horses from Brazil.

In 2018, during the surveillance for West Nile virus (WNV) in horses with neurological clinical signs in the state of Espírito Santo (Brazil), 19 animals were investigated, and 52 biological samples were collected for WNV diagnostic. One brain sample was positive for WNV by RT-qPCR and the virus was isolated in C6/36 cell culture and sequenced. We obtained a nearly complete genome of WNV co-infected with Peruvian horse sickness virus (PHSV) in the cell culture. After confirmation of PHSV by next-generation sequencing, a new PHSV RT-qPCR protocol was developed, which was used to detect another horse positive only for PHSV. This assay provides a simple and direct method for easy identification of PHSV from biological samples from horses and may become a useful tool in the epidemiological surveillance of this virus. It is the first case of PHSV in Brazil, and only the third country overall to report, 23 years after the first confirmed notification in Peru. Moreover, it is the first reported co-infection of PHSV and WNV in a horse with neurological signs, confirmed by RT-qPCR.

Epidemiologic profile and histopathological findings in Neotropical Primates during and after the yellow fever outbreak in Espírito Santo, Brazil.

Yellow fever (YF) is a viral disease whose transmission involves non-human primates (NHP), mosquitoes, and humans. Between 2016 and 2018 occurred the largest YF outbreak in the last 100 years in Brazil. We analyzed epidemiologic profile and geographic distribution of epizootics and described most frequent histopathological findings in NHP that died during YF outbreak in the state of Espírito Santo. We consider 487 epizootics notifications registered at the State Health Department from January 2017 to July 2020. Throughout the state, 51 (65.4%) municipalities reported epizootics, with more cases in central and metropolitan areas. Reverse transcription polymerase chain reaction and immunohistochemistry were laboratory tests performed for diagnosis of yellow fever, with 160 (32.9%) positive results, 314 (64.5%) negative and 13 (2.7%) inconclusive. Histopathological findings were compared statistically between positive and negative animals for YF. The liver was the most affected organ. Hemorrhage, hepatocyte necrosis, steatosis, cholestasis and eosinophilic degeneration were statistically more frequent in positive animals. Tubular necrosis, nephritis, congestion and lymphoid hypoplasia on spleen were statistically correlated to positive animals. Knowledge of pathogenic aspect of YF is necessary to guarantee that samples from Neotropical primates are properly used for YF surveillance purposes, to ensure appropriate diagnoses and subsequent public health responses.

SARS-CoV-2 infection prevalence and associated factors: a serial population-based study in Espírito Santo, Brazil, May to June 2020. / Prevalência e fatores associados à infecção por SARS-CoV-2: estudo de base populacional seriado, no Espírito Santo, de maio a junho/2020.

OBJECTIVE: To analyze SARS-CoV-2 seroprevalence and association of sociodemographic and clinical aspects in the state of Espírito Santo, Brazil. METHODS: This was a serial cross-sectional study carried out in four phases, using households as the unit of analysis, from May to June 2020. Eleven municipalities were surveyed, with a sample of 4,500 households in each phase. RESULTS: Prevalence ranged from 2.1% (95%CI 1.7;2.5) on May 10 (first phase) to 9.6% (95%CI 8.8;10.4) on June 21 (fourth phase). In the Greater Vitória Metropolitan Region, the prevalence were 2.7% (95%CI 2.2;3.3) in the first phase, and 11.5% (95%CI 10.5;12.6) in the fourth phase; in the interior region of the state, prevalence ranged from 0.4% (95%CI 0.1;0.9) to 4.4% (95%CI 3.2;5.5) between the two phases. CONCLUSION: The increase in SARS-CoV-2 seroprevalence found in the fourth phase highlighted the high transmission of the virus, information that can support management of the pandemic.

Prevalence and factors associated with SARS-CoV-2 infection: a serial population-based study in Espírito Santo, Brazil, May to June 2020 / Prevalencia y factores asociados a la infección por SARS-CoV-2: un estudio poblacional seriado en Espírito Santo, Brasil, de mayo a junio de 2020 / Prevalência e fatores associados à infecção por SARS-CoV-2: estudo de base populacional seriado, no Espírito Santo, em maio-junho/2020.

Objective: To analyze the seroprevalence of SARS-CoV-2 and the association of sociodemographic and clinical aspects in the state of Espírito Santo, Brazil. Methods: Serial cross-sectional study carried out in four phases, using households as the unit of analysis, from May to June 2020. 11 municipalities were surveyed, with a sample of 4,500 households in each phase. Results: the prevalence ranged from 2.1% (95%CI: 1.7;2.5) on May 10 (first stage) to 9.6% (95%CI: 8.8;10.4), on June 21 (fourth stage). In the metropolitan region of Greater Vitória, the prevalences were 2.7% (95%CI: 2.2;3.3), in the first, and 11.5% (95%CI: 10.5;12.6) in the fourth stage; within the state it ranged from 0.4% (95%CI: 0.1;0.9) to 4.4% (95%CI: 3.2;5.5) between the two stages. Conclusion: The increase in SARS-CoV-2 seroprevalence observed in the fourth phase highlighted the high transmission of the virus, supporting the management of the pandemic.

Objetivo: Analizar la seroprevalencia del SARS-CoV-2 y la asociación de aspectos sociodemográficos y clínicos en el estado de Espírito Santo, Brasil. Métodos: Estudio transversal seriado realizado en cuatro fases, utilizando los hogares como unidad de análisis, de mayo a junio de 2020. Se encuestaron 11 municipios, con una muestra de 4.500 hogares en cada fase. Resultados: la prevalencia varió de 2,1% (IC95%: 1,7;2,5) el 10 de mayo (primera etapa) a 9,6% (IC95%: 8,8;10,4), el 21 de junio (cuarta etapa). En la región metropolitana de la Gran Vitória, las prevalencias fueron de 2,7% (IC95%: 2,2;3,3), en la primera, y de 11,5% (IC95%: 10,5;12,6) en la cuarta etapa; dentro del estado osciló entre 0,4% (IC95%: 0,1;0,9) y 4,4% (IC95%: 3,2;5,5). Conclusión: El aumento de la seroprevalencia del SARS-CoV-2 observado en la cuarta fase destacó la alta transmisión del virus, apoyando el manejo de la pandemia.

Objetivo: Analisar a soroprevalência de SARS-CoV-2 e sua associação com aspectos sociodemográficos e clínicos, no estado do Espírito Santo, Brasil. Métodos: Estudo transversal seriado, realizado em quatro fases, no período de maio a junho de 2020, utilizando os domicílios como unidade de análise. Foram pesquisados 11 municípios, com amostra de 4.500 domicílios em cada fase. Resultados: a soroprevalência de SARS-CoV2 variou de 2,1% (IC95%: 1,7;2,5) em 10 de maio (primeira etapa) a 9,6% (IC95%: 8,8;10,4) em 21 de junho (quarta etapa). Na região metropolitana da Grande Vitória, as prevalências foram de 2,7% (IC95%: 2,2;3,3), na primeira, e de 11,5% (IC95%: 10,5;12,6) na quarta etapa; no interior do estado, a prevalência variou de 0,4% (IC95%: 0,1;0,9) a 4,4% (IC95%: 3,2;5,5) entre a primeira e a quarta etapas. Conclusão: O aumento da soroprevalência de SARS-CoV-2 observado na quarta fase destacou a elevada transmissão do vírus, subsidiando a gestão da pandemia.

[Yellow fever prevention and control: assessment of surveillance activities in a previously unaffected area in Brazil]. / Prevenção e controle da febre amarela: avaliação de ações de vigilância em área indene no Brasil.

Following the reemergence of yellow fever in 2014/2015, Brazil recorded its largest yellow fever epidemic in recent decades, mainly affecting the country's Southeast region. Yellow fever is a hemorrhagic viral disease caused by a flavivirus transmitted by sylvatic mosquitos (Haemagogus; Sabethes). In the urban cycle, eradicated in Brazil since 1942, the virus is transmitted by Aedes aegypti. Nonhuman primates are the principal hosts of the virus and constitute "sentinels" in yellow fever surveillance. This article describes the control and prevention activities launched during the yellow fever epidemic in the State of Espírito Santo, Brazil, and the implementation of vaccination, through an ecological study with a spatial approach. The study revealed the lack of detection of epizootics in nonhuman primates by surveillance services in Espírito Santo, with simultaneous detection in humans. The study presented the evolution of vaccination activities, reaching 85% overall coverage for the state in six months, varying widely, from 59% to 122%, between municipalities (counties). Importantly, 55% of the municipalities with timely immunization, considering the interval adopted for this study, did not present human cases. The intensification of surveillance activities, communication between areas, and multidisciplinary teams in managing the epidemic optimized the detection and diagnosis of human cases and allowed control of the epidemic. The study identifies progress and points to some late measures and gaps in surveillance that require improvements.

A partir da reemergência da febre amarela em 2014/2015, o Brasil registrou nos anos sequentes sua maior epidemia de febre amarela das últimas décadas, atingindo principalmente a região sudeste. A febre amarela, doença viral hemorrágica, é causada por um flavivírus, transmitido por mosquitos silvestres (Haemagogus; Sabethes). Na ocorrência do ciclo urbano, erradicado no Brasil desde 1942, a transmissão se dá pelo Aedes aegypti. Primatas não humanos são os principais hospedeiros do vírus e constituem "sentinelas" na vigilância da febre amarela. Este artigo descreve as ações de controle e prevenção desencadeadas durante a epidemia de febre amarela no Estado do Espírito Santo, Brasil, e a implementação da vacinação por meio de um estudo ecológico com abordagem espacial. O estudo evidenciou a falha na detecção de epizootias em primatas não humanos pelos serviços de vigilância do Espírito Santo, sendo simultânea à detecção em humanos. Apresentou a evolução das ações de vacinação, com alcance de 85% de cobertura vacinal geral para o estado em seis meses, sendo heterogênea entre os municípios (de 59% a 122%). Destaca-se que 55% dos municípios com ações de imunização em tempo oportuno, considerando o intervalo adotado para este estudo, não apresentaram casos em humanos. A intensificação das ações de vigilância, interlocução entre as áreas e equipes multidisciplinares na condução da epidemia otimizou a detecção e o diagnóstico dos casos em humanos e viabilizou o controle da epidemia. Foi possível reconhecer avanços, apontar algumas medidas tardias e lacunas na vigilância que necessitam melhorias.

A partir del resurgimiento de la fiebre amarilla en 2014/2015, Brasil registró los años siguientes su mayor epidemia de fiebre amarilla de las últimas décadas, alcanzando principalmente la región sudeste. La fiebre amarilla, enfermedad viral hemorrágica, es causada por un flavivirus, transmitido por mosquitos silvestres (Haemagogus; Sabethes). Respecto a la ocurrencia del ciclo urbano, erradicado en Brasil desde 1942, la transmisión se produce por el Aedes aegypti. Primates no humanos son los principales huéspedes del virus, y constituyen "centinelas" en la vigilancia de la fiebre amarilla. Este artículo describe las acciones de control y prevención desencadenadas durante la epidemia de fiebre amarilla en el Estado de Espírito Santo, Brasil, y la implementación de la vacunación mediante un estudio ecológico con abordaje espacial. El estudio evidenció el fallo en la detección de epizootias en primates no humanos por los servicios de vigilancia de Espírito Santo, siendo simultánea a la detección en humanos. Presentó la evolución de las acciones de vacunación, con alcance de un 85% de cobertura en la vacunación general para el estado en seis meses, siendo heterogénea entre los municipios (de 59% a 122%). Se destaca que un 55% de los municipios con acciones de inmunización en tiempo oportuno, considerando el intervalo adoptado para este estudio, no presentaron casos humanos. La intensificación de las acciones de vigilancia, interlocución entre las áreas y equipos multidisciplinarios en la gestión de la epidemia optimizó la detección y diagnóstico de los casos humanos y viabilizó el control de la epidemia. Fue posible reconocer avances, apuntar algunas medidas tardías y lagunas en la vigilancia que necesitan mejorías.

Prevalência e fatores associados à infecção por SARS-CoV-2: estudo de base populacional seriado, no Espírito Santo, de maio a junho/2020 / Prevalencia y factores asociados a la infección por SARS-CoV-2: un estudio poblacional seriado en Espírito Santo, Brasil, de mayo a junio de 2020 / SARS-CoV-2 infection prevalence and associated factors: a serial population-based study in Espírito Santo, Brazil, May to June 2020

Objetivo: Analisar a soroprevalência de SARS-CoV-2 e sua associação com aspectos sociodemográficos e clínicos, no estado do Espírito Santo, Brasil. Métodos: Estudo transversal seriado, realizado em quatro fases, no período de maio a junho de 2020, utilizando os domicílios como unidade de análise. Foram pesquisados 11 municípios, com amostra de 4.500 domicílios em cada fase. Resultados: A soroprevalência de SARS-CoV-2 variou de 2,1% (IC95% 1,7;2,5), em 10 de maio (primeira etapa), a 9,6% (IC95% 8,8;10,4) em 21 de junho (quarta etapa). Na Região Metropolitana da Grande Vitória, as prevalências foram de 2,7% (IC95% 2,2;3,3), na primeira, e de 11,5% (IC95% 10,5;12,6) na quarta etapa; no interior do estado, a prevalência variou de 0,4% (IC95% 0,1;0,9) a 4,4% (IC95% 3,2;5,5) entre a primeira e a quarta etapas. Conclusão: O aumento da soroprevalência de SARS-CoV-2 observado na quarta fase destacou a elevada transmissão do vírus, informação que pode subsidiar a gestão da pandemia.

Objetivo: Analizar la seroprevalencia del SARS-CoV-2 y la asociación de aspectos sociodemográficos y clínicos en el estado de Espírito Santo, Brasil. Métodos: Estudio transversal seriado realizado en cuatro fases, utilizando los hogares como unidad de análisis, de mayo a junio de 2020. Se encuestaron 11 municipios, con una muestra de 4.500 hogares en cada fase. Resultados: La prevalencia varió de 2,1% (IC95% 1,7;2,5) el 10 de mayo (primera etapa) a 9,6% (IC95% 8,8;10,4), el 21 de junio (cuarta etapa). En la Región Metropolitana de la Gran Vitória, las prevalencias fueron de 2,7% (IC95% 2,2;3,3), en la primera, y de 11,5% (IC95% 10,5;12,6) en la cuarta etapa; en el estado osciló entre 0,4% (IC95% 0,1;0,9) y 4,4% (IC95% 3,2;5,5). Conclusión: El aumento de la seroprevalencia del SARS-CoV-2 observado en la cuarta fase destacó la alta transmisión del virus, información que puede subsidiar el manejo de la pandemia.

Objective: To analyze SARS-CoV-2 seroprevalence and association of sociodemographic and clinical aspects in the state of Espírito Santo, Brazil. Methods: This was a serial cross-sectional study carried out in four phases, using households as the unit of analysis, from May to June 2020. Eleven municipalities were surveyed, with a sample of 4,500 households in each phase. Results: Prevalence ranged from 2.1% (95%CI 1.7;2.5) on May 10 (first phase) to 9.6% (95%CI 8.8;10.4) on June 21 (fourth phase). In the Greater Vitória Metropolitan Region, the prevalence were 2.7% (95%CI 2.2;3.3) in the first phase, and 11.5% (95%CI 10.5;12.6) in the fourth phase; in the interior region of the state, prevalence ranged from 0.4% (95%CI 0.1;0.9) to 4.4% (95%CI 3.2;5.5) between the two phases. Conclusion: The increase in SARS-CoV-2 seroprevalence found in the fourth phase highlighted the high transmission of the virus, information that can support management of the pandemic.

Prevenção e controle da febre amarela: avaliação de ações de vigilância em área indene no Brasil / Yellow fever prevention and control: assessment of surveillance activities in a previously unaffected area in Brazil / Prevención y control de la fiebre amarilla: evaluación de acciones de vigilancia en un área indemne de Brasil

A partir da reemergência da febre amarela em 2014/2015, o Brasil registrou nos anos sequentes sua maior epidemia de febre amarela das últimas décadas, atingindo principalmente a região sudeste. A febre amarela, doença viral hemorrágica, é causada por um flavivírus, transmitido por mosquitos silvestres (Haemagogus; Sabethes). Na ocorrência do ciclo urbano, erradicado no Brasil desde 1942, a transmissão se dá pelo Aedes aegypti. Primatas não humanos são os principais hospedeiros do vírus e constituem "sentinelas" na vigilância da febre amarela. Este artigo descreve as ações de controle e prevenção desencadeadas durante a epidemia de febre amarela no Estado do Espírito Santo, Brasil, e a implementação da vacinação por meio de um estudo ecológico com abordagem espacial. O estudo evidenciou a falha na detecção de epizootias em primatas não humanos pelos serviços de vigilância do Espírito Santo, sendo simultânea à detecção em humanos. Apresentou a evolução das ações de vacinação, com alcance de 85% de cobertura vacinal geral para o estado em seis meses, sendo heterogênea entre os municípios (de 59% a 122%). Destaca-se que 55% dos municípios com ações de imunização em tempo oportuno, considerando o intervalo adotado para este estudo, não apresentaram casos em humanos. A intensificação das ações de vigilância, interlocução entre as áreas e equipes multidisciplinares na condução da epidemia otimizou a detecção e o diagnóstico dos casos em humanos e viabilizou o controle da epidemia. Foi possível reconhecer avanços, apontar algumas medidas tardias e lacunas na vigilância que necessitam melhorias.

Following the reemergence of yellow fever in 2014/2015, Brazil recorded its largest yellow fever epidemic in recent decades, mainly affecting the country's Southeast region. Yellow fever is a hemorrhagic viral disease caused by a flavivirus transmitted by sylvatic mosquitos (Haemagogus; Sabethes). In the urban cycle, eradicated in Brazil since 1942, the virus is transmitted by Aedes aegypti. Nonhuman primates are the principal hosts of the virus and constitute "sentinels" in yellow fever surveillance. This article describes the control and prevention activities launched during the yellow fever epidemic in the State of Espírito Santo, Brazil, and the implementation of vaccination, through an ecological study with a spatial approach. The study revealed the lack of detection of epizootics in nonhuman primates by surveillance services in Espírito Santo, with simultaneous detection in humans. The study presented the evolution of vaccination activities, reaching 85% overall coverage for the state in six months, varying widely, from 59% to 122%, between municipalities (counties). Importantly, 55% of the municipalities with timely immunization, considering the interval adopted for this study, did not present human cases. The intensification of surveillance activities, communication between areas, and multidisciplinary teams in managing the epidemic optimized the detection and diagnosis of human cases and allowed control of the epidemic. The study identifies progress and points to some late measures and gaps in surveillance that require improvements.

A partir del resurgimiento de la fiebre amarilla en 2014/2015, Brasil registró los años siguientes su mayor epidemia de fiebre amarilla de las últimas décadas, alcanzando principalmente la región sudeste. La fiebre amarilla, enfermedad viral hemorrágica, es causada por un flavivirus, transmitido por mosquitos silvestres (Haemagogus; Sabethes). Respecto a la ocurrencia del ciclo urbano, erradicado en Brasil desde 1942, la transmisión se produce por el Aedes aegypti. Primates no humanos son los principales huéspedes del virus, y constituyen "centinelas" en la vigilancia de la fiebre amarilla. Este artículo describe las acciones de control y prevención desencadenadas durante la epidemia de fiebre amarilla en el Estado de Espírito Santo, Brasil, y la implementación de la vacunación mediante un estudio ecológico con abordaje espacial. El estudio evidenció el fallo en la detección de epizootias en primates no humanos por los servicios de vigilancia de Espírito Santo, siendo simultánea a la detección en humanos. Presentó la evolución de las acciones de vacunación, con alcance de un 85% de cobertura en la vacunación general para el estado en seis meses, siendo heterogénea entre los municipios (de 59% a 122%). Se destaca que un 55% de los municipios con acciones de inmunización en tiempo oportuno, considerando el intervalo adoptado para este estudio, no presentaron casos humanos. La intensificación de las acciones de vigilancia, interlocución entre las áreas y equipos multidisciplinarios en la gestión de la epidemia optimizó la detección y diagnóstico de los casos humanos y viabilizó el control de la epidemia. Fue posible reconocer avances, apuntar algunas medidas tardías y lagunas en la vigilancia que necesitan mejorías.

Living conditions, seroprevalence and symptoms of COVID-19 in slums in the Metropolitan Region of Vitória (Espírito Santo).

OBJECTIVES: to estimate the prevalence of SARS-CoV-2 infection in residents of the Greater Vitória region living in subnormal and non-subnormal agglomerates, and to compare sociodemographic and clinical characteristics of total residents (infected and not infected with SARS-CoV-2) between them. METHODS: Population-based prevalence study conducted by serological testing in 2020, with a study unit in households in Greater Vitória, grouped into census tracts classified as sub-normal agglomerates and non-sub-normal agglomerates. The two groups were compared in terms of prevalence and associated factors. The significance level adopted was 5%. RESULTS: The prevalence found in the sub-normal clusters was 12.05% (95%CI 9.59-14.50), and in the non-sub-normal clusters 10.23% (95%CI 7.97-12.50) this difference was not statistically significant (p = 0.273). Comparing the sociodemographic characteristics, more people who declare themselves to be of mixed race were found in the sub-normal clusters, a higher percentage of illiterates and people with only elementary education, greater number of residents per household, longer stay in public transportation, sharing a bathroom with another household, fewer bedrooms per residence and higher frequency of irregular water supply when compared to non-sub-normal clusters (p < 0.05). CONCLUSIONS: The epidemiological characteristics of sub-normal clusters' residents show the social inequalities that can hinder control measures in a pandemic situation.

COVID-19 in children, adolescents and young adults: a cross-sectional study in Espírito Santo, Brazil, 2020. / COVID-19 em crianças, adolescentes e jovens: estudo transversal no Espírito Santo, 2020.

OBJECTIVE: To analyze self-reported sociodemographic and clinical characteristics among individuals aged 2 to 22 years and possible associations with SARS-CoV-2 infection in Espírito Santo, Brazil. METHODS: This was a serial cross-sectional population-based study carried out from May to June 2020. The COVID-19 positivity rate was assessed by serological testing, and associated factors were assessed using Pearson's chi-square test (5% significance level). RESULTS: Among 1,693 individuals aged 2 to 22 years, 6.1% tested positive for COVID-19 and, among these, 35.5% did not present any symptoms. Differences were identified between positive and negative cases regarding the number of symptoms (p-value=0.001).Coughing was reported by 40.4% of positive individuals. Only 14.3% sought health care, namely 29.8% among those who tested positive and 13.3% among those who tested negative (p-value=0.001). CONCLUSION: The percentage of asymptomatic patients can impact the COVID-19 transmission chain in schools and fuel outbreaks of the disease in schools.

Covid-19 in subnormal and non-subnormal cluster areas in Espírito Santo, Brazil / Covid-19 em áreas de aglomerados subnormais e não subnormais no Espírito Santo, Brasil

Objectives: to estimate the prevalence of SARS-CoV-2 infection in residents of the Greater Vitória region living in subnormal and non-subnormal agglomerations; and, compare sociodemographic and clinical characteristics of total residents (infected and not infected with SARS-CoV-2), among these clusters. Method: Population-based prevalence study, through serological testing carried out in 2020, with a study unit in households in Greater Vitória, grouped into census tracts classified as sub-normal clusters (AGSN) and non-sub-normal clusters (AGNSN ). The two groups were compared in terms of prevalence and associated factors. The significance level adopted was 5%. Results: The prevalence found in the AGSN was 12.05% (95% CI from 9.59 to 14.50%), and in the AGNSN group it was 10.23% (95% CI from 7.97% to 12.50% ) this difference was not statistically significant (p = 0.273). Comparing the sociodemographic characteristics, more people who declare themselves to be of mixed race were found in the SGNA, a higher percentage of illiterates and people with only elementary education, greater number of residents per household, longer stay in public transport, sharing a bathroom with another household , fewer bedrooms per residence and higher frequency of irregular water supply when compared to AGNSN(P<0.05). Conclusions: The epidemiological characteristics of the SNGA residents show the social inequalities that can hinder control measures in a pandemic situation.

Objetivos: estimar prevalência de infecção pelo SARS-CoV-2 em residentes na região da Grande Vitória moradores de aglomerados subnormais e não subnormais; e, comparar características sociodemográficas e clínicas dos residentes totais (infectados e não infectados com o SARS-CoV-2), entre esses aglomerados.  Método: Estudo de prevalência de base populacional, por meio de teste sorológico realizado em 2020, com unidade de estudo em domicílios da Grande Vitória, agrupados em setores censitários classificados como Aglomerados sub-normais (AGSN) e os Aglomerados não sub-normais (AGNSN). Os dois grupos foram comparados quanto a prevalência e fatores associados. O nível de significância adotado foi de 5%. Resultados: A prevalência encontrada no AGSN foi 12,05% (IC 95% de 9,59 a 14,50%), e no grupo AGNSN foi 10,23% (IC 95% de 7,97% a 12,50%) esta diferença não foi estatisticamente significante (p = 0,273). Comparando-se as características sociodemográficas foram encontradas nos AGSN mais pessoas que se autodeclaram da raça cor parda, percentual maior de analfabetos e pessoas apenas com ensino fundamental, maior número de moradores por domicílio, maior permanência em transporte coletivo, compartilhamento de banheiro com outro domicílio, menos dormitórios por residência e maior frequência de abastecimento irregular de água quando comparadas aos AGNSN(P<0,05). Conclusões: As características epidemiológicas dos moradores de AGSN evidenciam as desigualdades sociais que podem dificultar as medidas de controle em uma situação de pandemia.

COVID-19 in children, adolescents and young people: Survey in Espírito Santo, Brazil, 2020 / COVID-19 em crianças, adolescentes e jovens: estudo transversal no Espírito Santo, 2020

Objective: To Analyze self-reported sociodemographic and clinical aspects among individuals aged 2 to 22 years and possible associations with SARS-CoV-2 infection in Espírito Santo. Methods: Serial cross-sectional population-based study carried out from May to June 2020. The percentage of positivity for COVID-19 was evaluated by serological test, and the associated factors by Pearson's chi-square test (significance level of 5%). Results: Among 1,693 individuals aged 2 to 22 years, 6,1% tested positive for COVID-19 and, among these, 35.5% did not present any symptoms. Differences were identified between positive and negative regarding the number of symptoms (p-value=0.001). Cough was reported by 40.4% of positive individuals. Only 14.3% sought health care, with 29.8% among the positive and 13.3% among the negative (p-value=0.001). Conclusion: The percentage of asymptomatic patients can impact the transmission chain of COVID-19 in schools and boost outbreaks of the disease in schools.

Objetivo: Analisar aspectos sociodemográficos e clínicos autorreferidos entre indivíduos de 2 a 22 anos de idade e possíveis associações com infecção por SARS-CoV-2 no Espírito Santo, Brasil. Métodos: Estudo transversal seriado de base populacional, realizado de maio a junho de 2020. Avaliou-se o percentual de positividade para COVID-19, por teste sorológico, e os fatores associados pelo teste qui-quadrado de Pearson (nível de significância de 5%). Resultados: Entre 1.693 indivíduos de 2 a 22 anos, 6,1% apresentaram teste positivo para COVID-19; destes, 35,5% não apresentaram nenhum sintoma. Identificou-se diferenças entre os soropositivos e soronegativos quanto ao número de sintomas (p-valor=0,001). A tosse foi relatada por 40,4% dos indivíduos soropositivos. Apenas 14,3% procuraram unidades de saúde, sendo 29,8% entre os soropositivos e 13,3% entre os soronegativos (p-valor=0,001). Conclusão: O percentual de indivíduos assintomáticos pode impactar a cadeia de transmissão da COVID-19 nas escolas, e impulsionar surtos da doença no mesmo ambiente escolar.

COVID-19 em crianças, adolescentes e jovens: estudo transversal no Espírito Santo, 2020 / COVID-19 en niños, adolescentes y jóvenes: estudio transversal en Espírito Santo, Brasil, 2020 / COVID-19 in children, adolescents and young adults: a cross-sectional study in Espírito Santo, Brazil, 2020

Objetivo: Analisar aspectos sociodemográficos e clínicos autorreferidos entre indivíduos de 2 a 22 anos de idade e possíveis associações com infecção por SARS-CoV-2 no Espírito Santo, Brasil. Métodos: Estudo transversal seriado de base populacional, realizado de maio a junho de 2020. Avaliou-se o percentual de positividade para COVID-19, por teste sorológico, e os fatores associados pelo teste qui-quadrado de Pearson (nível de significância de 5%). Resultados: Entre 1.693 indivíduos de 2 a 22 anos, 6,1% apresentaram teste positivo para COVID-19; destes, 35,5% não apresentaram nenhum sintoma. Foram identificadas diferenças entre os soropositivos e soronegativos quanto ao número de sintomas (p-valor=0,001). A tosse foi relatada por 40,4% dos indivíduos soropositivos. Apenas 14,3% procuraram unidades de saúde, sendo 29,8% entre os soropositivos e 13,3% entre os soronegativos (p-valor=0,001). Conclusão: O percentual de indivíduos assintomáticos pode impactar a cadeia de transmissão da COVID-19 nas escolas, e impulsionar surtos da doença no mesmo ambiente escolar.

Objetivo: Analizar aspectos sociodemográficos y clínicos autoinformados en individuos de 2 a 22 años y posibles asociaciones con la infección por SARS-CoV-2 en Espírito Santo. Métodos: Estudio transversal seriado realizado de mayo a junio de 2020. El porcentaje de positividad para COVID-19 se evaluó mediante prueba serológica y los factores asociados mediante la prueba de chi-cuadrado de Pearson (significación del 5%). Resultados: Entre 1.693 individuos de 2 a 22 añoo, el 6,1% dio positivo para COVID-19 y, entre estos, el 35,5% no presentó ningún síntoma. Se identificaron diferencias entre seropositivo y seronegativo en cuanto al número de síntomas (p=0,001). El 40,4% de los seropositivos informaron tos. El 14,3% buscó asistencia sanitaria, el 29,8% entre los seropositivos y el 13,3% entre los seronegativos (p=0,001). Conclusión: El porcentaje de pacientes asintomáticos puede impactar la transmisión de COVID-19 en las escuelas y potenciar brotes de la enfermedad en el mismo ambiente.

Objective: To analyze self-reported sociodemographic and clinical characteristics among individuals aged 2 to 22 years and possible associations with SARS-CoV-2 infection in Espírito Santo, Brazil. Methods: This was a serial cross-sectional population-based study carried out from May to June 2020. The COVID-19 positivity rate was assessed by serological testing, and associated factors were assessed using Pearson's chi-square test (5% significance level). Results: Among 1,693 individuals aged 2 to 22 years, 6.1% tested positive for COVID-19 and, among these, 35.5% did not present any symptoms. Differences were identified between positive and negative cases regarding the number of symptoms (p-value=0.001). Coughing was reported by 40.4% of positive individuals. Only 14.3% sought health care, namely 29.8% among those who tested positive and 13.3% among those who tested negative (p-value=0.001). Conclusion: The percentage of asymptomatic patients can impact the COVID-19 transmission chain in schools and fuel outbreaks of the disease in schools.

Living conditions, seroprevalence and symptoms of COVID-19 in slums in the Metropolitan Region of Vitória (Espírito Santo) / Condições de vida, soro prevalência e sintomas de COVID-19 em favelas na Região Metropolitana de Vitória (Espírito Santo)

ABSTRACT: Objectives: to estimate the prevalence of SARS-CoV-2 infection in residents of the Greater Vitória region living in subnormal and non-subnormal agglomerates, and to compare sociodemographic and clinical characteristics of total residents (infected and not infected with SARS-CoV-2) between them. Methods: Population-based prevalence study conducted by serological testing in 2020, with a study unit in households in Greater Vitória, grouped into census tracts classified as sub-normal agglomerates and non-sub-normal agglomerates. The two groups were compared in terms of prevalence and associated factors. The significance level adopted was 5%. Results: The prevalence found in the sub-normal clusters was 12.05% (95%CI 9.59-14.50), and in the non-sub-normal clusters 10.23% (95%CI 7.97-12.50) this difference was not statistically significant (p = 0.273). Comparing the sociodemographic characteristics, more people who declare themselves to be of mixed race were found in the sub-normal clusters, a higher percentage of illiterates and people with only elementary education, greater number of residents per household, longer stay in public transportation, sharing a bathroom with another household, fewer bedrooms per residence and higher frequency of irregular water supply when compared to non-sub-normal clusters (p < 0.05). Conclusions: The epidemiological characteristics of sub-normal clusters' residents show the social inequalities that can hinder control measures in a pandemic situation.

RESUMO: Objetivo: Estimar prevalência de infecção pelo SARS-CoV-2 em residentes na região da Grande Vitória, moradores de aglomerados subnormais e não subnormais, e comparar características sociodemográficas e clínicas dos residentes totais (infectados e não infectados com o SARS-CoV-2), entre esses aglomerados. Métodos: Estudo de prevalência de base populacional, por meio de teste sorológico realizado em 2020, com unidade de estudo em domicílios da Grande Vitória, agrupados em setores censitários classificados como aglomerados subnormais e aglomerados não subnormais. Os dois grupos foram comparados quanto à prevalência e aos fatores associados. O nível de significância adotado foi de 5%. Resultados: A prevalência encontrada em não aglomerados subnormais foi 12,05% (IC95% 9,59-14,50) e no grupo aglomerados não subnormais foi 10,23% (IC95% 7,97-12,50), e essa diferença não foi estatisticamente significante (p = 0,273). Comparando-se as características sociodemográficas, encontraram-se nos aglomerados subnormais mais pessoas que se autodeclaram da raça/cor parda, percentual maior de analfabetos e de pessoas apenas com ensino fundamental, maior número de moradores por domicílio, maior permanência em transporte coletivo, compartilhamento de banheiro com outro domicílio, menos dormitórios por residência e maior frequência de abastecimento irregular de água quando comparado aos aglomerados não subnormais (p<0,05). Conclusões: As características epidemiológicas dos moradores de aglomerados subnormais evidenciam as desigualdades sociais que podem dificultar as medidas de controle em uma situação de pandemia.

Yellow fever outbreak in a rural-urban mixed community of Espírito Santo, Brazil: epidemiological aspects.

OBJECTIVE: To describe the epidemiological aspects of an outbreak of yellow fever (YF) that occurred in the state of Espírito Santo, Brazil, from 1 January 2017 - 31 July 2017. METHODS: A descriptive, quantitative, retrospective approach analyzed secondary data obtained from the national notification systems, Information System of Diseases Notifications (SINAN), Laboratory Environment Manager (GAL), and the Espírito Santo Health Secretariat (SESA). RESULTS: From 1 January 2017 - 8 July 2017, a total of 824 cases were reported in Espírito Santo, 307 (37%) of which were confirmed as YF. Of these, 95 (30.9%) died from the disease. Men were those most affected, corresponding to 244 (79.5%) cases, and women to 63 (20.5%) cases. The greatest incidence rate registered was in the city of Santa Leopoldina (380.2 cases/100 000 inhabitants). The outbreak evolved rapidly and a response was possible due to a multidisciplinary group created specifically to tackle the YF outbreak. CONCLUSIONS: The data were received and analyzed quickly and the response, consisting of immediate treatment of the cases and a blocking vaccination strategy, was developed to halt the progression of this fatal disease. In spite of these efforts, the case fatality rate of yellow fever remained high.

Yellow fever outbreak in a rural-urban mixed community of Espírito Santo, Brazil: epidemiological aspects

[ABSTRACT]. Objective. To describe the epidemiological aspects of an outbreak of yellow fever (YF) that occurred in the state of Espírito Santo, Brazil, from 1 January 2017 – 31 July 2017. Methods. A descriptive, quantitative, retrospective approach analyzed secondary data obtained from the national notification systems, Information System of Diseases Notifications (SINAN), Laboratory Environment Manager (GAL), and the Espírito Santo Health Secretariat (SESA). Results. From 1 January 2017 – 8 July 2017, a total of 824 cases were reported in Espírito Santo, 307 (37%) of which were confirmed as YF. Of these, 95 (30.9%) died from the disease. Men were those most affected, corresponding to 244 (79.5%) cases, and women to 63 (20.5%) cases. The greatest incidence rate registered was in the city of Santa Leopoldina (380.2 cases/100 000 inhabitants). The outbreak evolved rapidly and a response was possible due to a multidisciplinary group created specifically to tackle the YF outbreak. Conclusions. The data were received and analyzed quickly and the response, consisting of immediate treatment of the cases and a blocking vaccination strategy, was developed to halt the progression of this fatal disease. In spite of these efforts, the case fatality rate of yellow fever remained high.

[RESUMEN]. Objetivo. Describir los aspectos epidemiológicos de un brote de fiebre amarilla ocurrido en el estado de Espírito Santo (Brasil), del 1 de enero al 31 de julio del 2017. Métodos. Por medio de un enfoque descriptivo, cuantitativo y retrospectivo se analizaron los datos secundarios obtenidos a partir de los sistemas de notificación nacionales, el sistema informático de notificación de enfermedades (SINAN), el sistema de gestión del entorno de laboratorio (GAL) y la Secretaría de Salud de Espírito Santo (SESA). Resultados. Del 1 de enero al 8 de julio de 2017 se notificó un total de 824 casos de fiebre amarilla en Espírito Santo, de los cuales 307 (37%) fueron confirmados. De estos, 95 (30,9%) murieron por causa de la enfermedad. El mayor número de afectados correspondió a la población masculina, con 244 casos (79,5%), mientras que 63 casos (20,5%) fueron mujeres. La tasa de incidencia más alta registrada se observó en la ciudad de Santa Leopoldina (380,2 casos/100 000 habitantes). El brote evolucionó rápidamente y se logró darle respuesta gracias a un grupo multidisciplinario formado específicamente para contrarrestar este brote de fiebre amarilla. Conclusiones. Los datos se recibieron y analizaron rápidamente. La respuesta para detener la progresión de esta enfermedad mortal consistió en un tratamiento inmediato de los casos y una estrategia de vacunación de bloqueo. A pesar de estos esfuerzos, la tasa de letalidad de la fiebre amarilla continuó siendo alta.

[RESUMO]. Objetivo. Descrever os aspectos epidemiológicos de um surto de febre amarela ocorrido no Estado de Espírito Santo, Brasil, no período de 1o de janeiro de 2017 a 31 de julho de 2017. Métodos. O estudo se baseou em um enfoque descritivo, quantitativo e retrospectivo para analisar dados secundários obtidos dos sistemas nacionais de notificação: Sistema de Informação de Agravos de Notificação (SINAN), sistema Gerenciador de Ambiente Laboratorial (GAL) e Secretaria de Estado da Saúde de Espírito Santo (SESA). Resultados. No período de 1o de janeiro de 2017 a 8 de julho de 2017, 824 casos foram notificados no Espírito Santo, sendo 307 (37%) confirmados como febre amarela. Ocorreram 95 casos de morte pela doença (30,9%). O sexo masculino foi o mais afetado, sendo registrados 244 casos (79,5%) no sexo masculino e 63 casos (20,5%) no sexo feminino. A taxa de incidência mais alta foi verificada na cidade de Santa Leopoldina, com 380,2 casos por 100 mil habitantes. O surto progrediu rapidamente e a resposta foi possível com a ação de um grupo multidisciplinar formado para combater o surto de febre amarela. Conclusões. Os dados foram obtidos e analisados com rapidez e a resposta, consistindo de tratamento imediato dos casos e uma estratégia de vacinação de bloqueio, visou deter a progressão desta doença fatal. Apesar dos esforços, a taxa de letalidade da febre amarela continuou alta.

First isolation of West Nile virus in Brazil.

BACKGROUND: Serological evidence of West Nile virus (WNV) infection has been reported in different regions of Brazil from equine and human hosts but the virus had never been isolated in the country. OBJECTIVES: We sought to identify the viral etiology of equine encephalitis in Espírito Santo state. METHODS: We performed viral culture in C6/36 cells, molecular detection of WNV genome, histopathology and immunohistochemistry from horse cerebral tissue. We also carried out sequencing, phylogenetic analysis and molecular clock. FINDINGS: Histopathologic analysis from horse cerebral tissue showed injury related to encephalitis and WNV infection was confirmed by immunohistochemistry. The virus was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) from brain tissue and subsequently isolated in C6/36 cells. WNV full-length genome was sequenced showing the isolated strain belongs to lineage 1a. The molecular clock indicated that Brazilian WNV strain share the same common ancestor that were circulating in US during 2002-2005. MAIN CONCLUSIONS: Here we report the first isolation of WNV in Brazil from a horse with neurologic disease, which was clustered into lineage 1a with others US WNV strains isolated in beginning of 2000's decade.

First isolation of West Nile virus in Brazil

BACKGROUND Serological evidence of West Nile virus (WNV) infection has been reported in different regions of Brazil from equine and human hosts but the virus had never been isolated in the country. OBJECTIVES We sought to identify the viral etiology of equine encephalitis in Espírito Santo state. METHODS We performed viral culture in C6/36 cells, molecular detection of WNV genome, histopathology and immunohistochemistry from horse cerebral tissue. We also carried out sequencing, phylogenetic analysis and molecular clock. FINDINGS Histopathologic analysis from horse cerebral tissue showed injury related to encephalitis and WNV infection was confirmed by immunohistochemistry. The virus was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) from brain tissue and subsequently isolated in C6/36 cells. WNV full-length genome was sequenced showing the isolated strain belongs to lineage 1a. The molecular clock indicated that Brazilian WNV strain share the same common ancestor that were circulating in US during 2002-2005. MAIN CONCLUSIONS Here we report the first isolation of WNV in Brazil from a horse with neurologic disease, which was clustered into lineage 1a with others US WNV strains isolated in beginning of 2000's decade.

Phylogenetic analysis of the S segment from Juquitiba hantavirus: identification of two distinct lineages in Oligoryzomys nigripes.

The purpose of this study was to investigate the phylogenetic relationship of the Juquitiba virus (JUQV) carried by Oligoryzomys nigripes in endemic and non-endemic areas of Brazil. Wild rodents infected with the Juquitiba virus (JUQV) were sampled from a non-Hantavirus Cardiopulmonary Syndrome endemic area in Brazil. Three strains from O. nigripes were identified by the sequencing of the complete S segment and compared to previous studies of JUQV available in GenBank. The phylogenetic analysis of the complete S segment revealed two distinct clades; the first clade was composed of the JUQV from two non-endemic areas in Brazil and the second clade contained JUQV strains from Argentina, Paraguay and other Brazilian endemic areas.