RESUMO
BACKGROUND: Andes virus (ANDV) is a zoonotic Orthohantavirus leading to hantavirus cardiopulmonary syndrome. Although most transmissions occur through environmental exposure to rodent faeces and urine, rare person-to-person transmission has been documented, mainly for close contacts. This study investigates the presence and infectivity of ANDV in body fluids from confirmed cases and the duration of viraemia. METHODS: In this prospective study, 131 participants with confirmed ANDV infection were enrolled in Chile in a prospective study between 2008 and 2022. Clinical samples (buffy coat, plasma, gingival crevicular fluid [GCF], saliva, nasopharyngeal swabs [NPS], and urine) were collected weekly for 3 weeks together with clinical and epidemiological data. Samples were categorised as acute or convalescent (up to and after 16 days following onset of symptoms). Infectivity of positive fluids was assessed after the culture of samples on Vero E6 cells and use of flow cytometry assays to determine the production of ANDV nucleoprotein. FINDINGS: ANDV RNA was detected in 100% of buffy coats during acute phase, declining to 95% by day 17, and to 93% between days 23-29. ANDV RNA in GCF and saliva decreased from 30% and 12%, respectively, during the acute phase, to 12% and 11% during the convalescent phase. Successful infectivity assays of RT-qPCR-positive fluids, including GCF, saliva, NPS, and urine, were observed in 18 (42%) of 43 samples obtained during the acute phase of infection. After re-culture, the capacity to infect Vero E6 cells was maintained in 16 (89%) of 18 samples. Severity was associated with the presence of ANDV RNA in one or more fluids besides blood (odds ratio 2·58 [95% CI 1·42-5·18]). INTERPRETATION: ANDV infection is a systemic and viraemic infection, that affects various organs. The presence of infectious particles in body fluids contributes to our understanding of potential mechanisms for person-to-person transmission, supporting the development of preventive strategies. Detection of ANDV RNA in additional fluids at hospital admission is a predictor of disease severity. FUNDING: National Institutes of Health and Agencia de Investigación y Desarrollo. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.
Assuntos
Infecções por Hantavirus , Orthohantavírus , Viremia , Eliminação de Partículas Virais , Humanos , Estudos Prospectivos , Masculino , Adulto , Infecções por Hantavirus/transmissão , Infecções por Hantavirus/epidemiologia , Infecções por Hantavirus/virologia , Feminino , Orthohantavírus/isolamento & purificação , Chile/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , RNA Viral , Animais , Criança , Chlorocebus aethiops , Idoso , Células VeroRESUMO
Resumo Objetivo Compreender a percepção do acesso e da qualidade da alimentação para a população em situação de rua. Métodos Estudo descritivo qualitativo, realizado em um Centro de Referência da População de Rua na região centro-sul de Belo Horizonte (MG). Utilizou-se roteiro semiestruturado para a realização das entrevistas de 18 participantes. A coleta de dados ocorreu entre dezembro de 2020 e janeiro de 2021. A análise temática do material, proposta por Bardin, possibilitou a elaboração de três categorias empíricas. Resultados O público entrevistado era masculino, com idade média de 43 anos e tempo médio de situação de rua de 44,6 meses. O acesso à alimentação foi proveniente das doações de alimentos, refeições em instituições governamentais e aquisições ao dispor de renda. Foram relatadas dificuldades quanto à quantidade e qualidade dos alimentos, à aquisição das refeições nos fins de semana, aos sentimentos de medo e angústia perante a fome, à falta do alimento e pelo estigma social, agravados pela COVID-19. Conclusão Diante do cenário de iniquidades sociais, o direito ao acesso à alimentação não é garantido, sendo necessária a implementação de políticas públicas de proteção social que garantam os direitos básicos.
Resumen Objetivo Comprender la percepción del acceso y de la calidad de la alimentación según personas en situación de calle. Métodos Estudio descriptivo cualitativo, realizado en un Centro de Referencia de Personas de la Calle en la región centro-sur de Belo Horizonte (Minas Gerais). Se utilizó un guion semiestructurado para realizar entrevistas a 18 participantes. La recopilación de datos se realizó entre diciembre de 2020 y enero de 2021. El análisis temático del material, propuesto por Bardin, permitió la elaboración de tres categorías empíricas. Resultados El público entrevistado era masculino, de 43 años de edad promedio y tiempo promedio de situación de calle de 44,6 meses. El acceso a la alimentación fue proveniente de donaciones de alimentos, comidas en instituciones gubernamentales y adquisiciones al disponer de ingresos. Las personas relataron dificultades con relación a la cantidad y calidad de los alimentos, a la adquisición de comida los fines de semana, a los sentimientos de miedo y angustia ante el hambre, a la falta de alimentos y al estigma social, agravados por el COVID-19. Conclusión Ante el escenario de iniquidades sociales, el derecho al acceso a la alimentación no está garantizado, por lo cual es necesario implementar políticas públicas de protección social que garanticen los derechos básicos.
Abstract Objective To understand the perception of access to food and food quality for the street population. Methods This qualitative descriptive study was performed in a Reference Center for the Homeless Population in the south-central region of Belo Horizonte (MG). A semi-structured script was used to conduct interviews with 18 participants. Data collection occurred between December 2020 and January 2021. The thematic analysis of the material, as proposed by Bardin, made it possible to elaborate three empirical categories. Results The public interviewed was male, with a mean age of 43 years, and a mean time on the streets of 44.6 months. Access to food came from donations, meals at government institutions, and acquisition when income was available. Difficulties were reported regarding the quantity and quality of food, acquisition of meals on weekends, feelings of fear and anguish in the face of hunger, lack of food, and social stigma, which were aggravated by COVID-19. Conclusion As in this scenario of social inequalities the access to food is not guaranteed, implementing public policies of social protection is necessary to guarantee basic rights.
RESUMO
Echinococcosis is a neglected zoonosis that uses dogs and sheep as its main hosts in Chile. The Eg95 vaccine against sheep infection has been included in some control programs. Here, we assess the efficacy of the vaccination program in the hyperendemic Alto Biobío commune after 3 years of execution. Fisher's test and generalized linear models were used in the assessment. The program tried to offer a first dose at 2 months of age, a booster 1 month later, and yearly vaccination. Given logistic difficulties, important delays in vaccination occurred, and most animals did not receive the first booster. Dog deworming was not included in the program. Likely due to the aforementioned factors, the overall frequency of infection was not lower, but the proportion of large (>5 mm) cysts and fertile cysts was smaller after the program. The frequency of infection and/or the number of cysts were lower when the age at first dose was younger and the first booster was administered 1 month after the first dose. The results suggest that vaccination affects both cyst development after the larvae reach the target organs, as well as the development of the protoscolex once the cysts start developing.
RESUMO
BACKGROUND: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. AIM: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. METHOD: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. RESULTS: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. DISCUSSION: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.
Assuntos
Vacinas contra Influenza , Influenza Humana , Leucemia-Linfoma Linfoblástico de Células Precursoras , Anticorpos Antivirais , Criança , Humanos , Imunidade Humoral , Vírus da Influenza A Subtipo H1N1 , VacinaçãoRESUMO
Resumen Introducción: Los pacientes con leucemia linfoblástica aguda (LLA) tienen alto riesgo de influenza grave y la vacunación es altamente recomendada. La inmunogenicidad y efectividad de la vacuna es menor comparada a los sujetos sanos. Objetivo: Evaluar la respuesta inmune inducida por vacuna anti-influenza en niños con LLA y observar su efectividad. Métodos: Se reclutaron niños con LLA en terapia de mantención y niños sanos. Se tomaron muestras de sangre el día de la vacuna (D0) y al día 28 (D28), y se realizó test de inhibición de hemaglutinación (IHA) contra H1N1. Los pacientes fueron seguidos por un año, registrando datos clínicos y episodios de influenza. Resultados: Se incluyeron 34 niños con LLA y 9 niños sanos. Respecto al IHA en D28, 12/34 pacientes y 5/8 niños sanos presentaron títulos ≥ 1/40, resultando una tasa de seroprotección de 35 y 63%, respectivamente. Los niños seroprotegidos eran significativamente mayores. Durante el seguimiento, sólo tres pacientes, no seroprotegidos, presentaron infección por influenza, ninguno requirió oxigeno o cuidados intensivos. Discusión: Los niños con LLA alcanzaron una tasa seroprotección más baja que la observada en niños sanos. Sin embargo, ninguno de los niños seroprotegidos presentó infección por influenza, reforzando la recomendación de vacunación anual.
Abstract Background: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. Aim: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. Method: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. Results: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. Discussion: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.
Assuntos
Humanos , Criança , Vacinas contra Influenza , Influenza Humana , Leucemia-Linfoma Linfoblástico de Células Precursoras , Vacinação , Vírus da Influenza A Subtipo H1N1 , Imunidade Humoral , Anticorpos AntiviraisRESUMO
Abstract This research aimed to determine the presence of paramphistomids in cattle slaughtered in a slaughterhouse of the Ñuble Region of Chile, to identify flukes and to analyze the frequency of these parasites in the Maule, Ñuble, and Biobío administrative regions of Chile. Between October of 2016 and April of 2017, rumens of 494 cattle were examined for flukes in the forestomachs. Worms were identified morphologically and, in addition, molecular analysis of the internal transcriber spacer region 2 of the fluke's DNA was done and phylogenetic analyses were performed with Bayesian inference in 14 worms. The frequency was analyzed by locality (low- or highlands) and age. The overall frequency was 11.24%. The district with the highest frequency of presentation was Chillán Viejo (30.8%). Districts in the lowlands had similar frequencies to those in the mountain lands (p=0.1). The frequency of flukes was significantly higher in adult animals than in young ones (p<0.01). We obtained a 460 bp-length fragment of DNA that was identical to the sequences previously identified as Paramphistomum cervi and Calicophoron microbothrioides, and performed morphological analyses confirmed that our samples belonged to C. microbothrioides. This is the first published study of C. microbothrioides in Chile.
Resumo Este trabalho teve como objetivo determinar a presença de paramphistomídeos em bovinos abatidos em um matadouro da Região do Ñuble do Chile, para identificar parasitas e analisar a frequência desses parasitos nas regiões administrativas de Maule, Ñuble e Biobío, no Chile. Entre outubro de 2016 e abril de 2017, rúmens de 494 bovinos foram examinados à procura de vermes no pré-estômago. Os vermes foram identificados morfologicamente e, além disso, a análise molecular da região interna do espaçador do transcritor 2 do DNA e análises filogenéticas foram realizadas com inferência bayesiana em 14 vermes. A frequência foi analisada pela altitude da localidade (baixa ou alta) e idade. A frequência geral foi de 11,24%. O distrito com as maiores frequências de parasitismo foi Chillán Viejo (30,8%). Os distritos das terras baixas tinham frequências semelhantes às encontradas nas terras das montanhas (p=0,17). A frequência foi significativamente maior em animais adultos do que em jovens (p<0.01). Obtivemos um fragmento de DNA de 460 pb que era idêntico às sequências anteriores identificadas como Paramphistomum cervi e Calicophoron microbothrioides, e realizamos análises morfológicas que permitiram confirmar que nossas amostras pertenciam a C. microbothrioides. Este é o primeiro estudo publicado sobre C. microbothrioides no Chile.
Assuntos
Animais , Paramphistomatidae/genética , Bovinos/parasitologia , DNA de Helmintos/genética , Paramphistomatidae/anatomia & histologia , Paramphistomatidae/classificação , Filogenia , Chile , Matadouros , Análise de Sequência de DNARESUMO
This research aimed to determine the presence of paramphistomids in cattle slaughtered in a slaughterhouse of the Ñuble Region of Chile, to identify flukes and to analyze the frequency of these parasites in the Maule, Ñuble, and Biobío administrative regions of Chile. Between October of 2016 and April of 2017, rumens of 494 cattle were examined for flukes in the forestomachs. Worms were identified morphologically and, in addition, molecular analysis of the internal transcriber spacer region 2 of the fluke's DNA was done and phylogenetic analyses were performed with Bayesian inference in 14 worms. The frequency was analyzed by locality (low- or highlands) and age. The overall frequency was 11.24%. The district with the highest frequency of presentation was Chillán Viejo (30.8%). Districts in the lowlands had similar frequencies to those in the mountain lands (p=0.1). The frequency of flukes was significantly higher in adult animals than in young ones (p<0.01). We obtained a 460 bp-length fragment of DNA that was identical to the sequences previously identified as Paramphistomum cervi and Calicophoron microbothrioides, and performed morphological analyses confirmed that our samples belonged to C. microbothrioides. This is the first published study of C. microbothrioides in Chile.