G6P[8] Rotavirus a Possessing a Wa-like VP3 Gene from a Child with Acute Gastroenteritis Living in the Northwest Amazon Region.

The introduction of rotavirus A (RVA) vaccines has considerably reduced the RVA-associated mortality among children under 5 years of age worldwide. The ability of RVA to reassort gives rise to different combinations of surface proteins G (glycoprotein, VP7) and P (protease sensitive, VP4) RVA types infecting children. During the epidemiological surveillance of RVA in the Northwest Amazon region, an unusual rotavirus genotype G6P[8] was detected in feces of a 2-year-old child with acute gastroenteritis (AGE) that had been vaccinated with one dose of Rotarix® (RV1). The G6P[8] sample had a DS-1-like constellation with a Wa-like VP3 gene mono-reassortment similar to equine-like G3P[8] that has been frequently detected in Brazil previously. The results presented here reinforce the evolutionary dynamics of RVA and the importance of constant molecular surveillance.

Molecular Epidemiology of Sapovirus in Children Living in the Northwest Amazon Region.

Sapovirus is an important etiological agent of acute gastroenteritis (AGE), mainly in children under 5 years old living in lower-income communities. Eighteen identified sapovirus genotypes have been observed to infect humans. The aim of this study was to identify sapovirus genotypes circulating in the Amazon region. Twenty-eight samples were successfully genotyped using partial sequencing of the capsid gene. The genotypes identified were GI.1 (n = 3), GI.2 (n = 7), GII.1 (n = 1), GII.2 (n = 1), GII.3 (n = 5), GII.5 (n = 1), and GIV.1 (n = 10). The GIV genotype was the most detected genotype (35.7%, 10/28). The phylogenetic analysis identified sapovirus genotypes that had no similarity with other strains reported from Brazil, indicating that these genotypes may have entered the Amazon region via intense tourism in the Amazon rainforest. No association between histo-blood group antigen expression and sapovirus infection was observed.

Epidemiology of enteric virus infections in children living in the Amazon region.

OBJECTIVES: To verify the frequency of viruses causing acute gastroenteritis (AGE) in association with the histo-blood group antigen (HBGA) and Rotarix™ vaccination coverage in children from the Amazon region. DESIGN: Fecal and saliva samples were collected from children with AGE (n = 485) and acute respiratory infection (ARI) (n = 249) clinical symptoms. Rotavirus A (RVA), norovirus, human adenovirus (HAdV), and sapovirus (SaV) were verified in feces by molecular detection. Saliva samples were used for HBGA phenotyping/FUT3 genotyping. Blood group types, clinical aspects and Rotarix™ RVA vaccination data were recorded. RESULTS: Norovirus remained the most prevalently detected cause of AGE (38%, 184/485 and ARI 21.3%, 53/249). High HAdV frequencies were observed in AGE children (28.6%, 139/485) and ARI children (37.3%, 93/249). RVA was the third most prevalent virus causing AGE (22.7%, 110/485 and ARI 19.3%, 48/249) and a low RV1 coverage (61%, 448/734) was verified. The SaV frequencies were lower (7.2%, 35/485 for AGE and 6.8%, 17/249 for ARI). Secretor children were HBGA susceptible to HAdV infection (OR 1.5, 95% CI 1.0-2.3; P = 0.04) but not to RVA, norovirus or SaV infection. CONCLUSIONS: Norovirus could be considered the main etiological agent of AGE. No association was verified for HBGA susceptibility to RVA, norovirus and SaV. Secretor children showed a slight susceptibility to HAdV infection and the Le (a-b-) heterogeneous SNPs on the FUT3 gene.

First report of human astrovirus MLB2 in Brazil detected in feces of children with acute gastroenteritis living in the state of Roraima, Northern Brazil.

Human astrovirus (HAstV) 1-8 and highly divergent HAstVMLB1-3 genotypes have been detected in children both with and without acute gastroenteritis (AGE). One hundred and seventy fecal samples from children (≤5 years old) living in the Amazon region were evaluated for the presence of HAstV1-8, HAstV MLB1-3 and HAstVVA1-3, using an usual RT-PCR protocol and a new protocol with specific primers designed to detect HAstVMLB1-3. HAstVMLB1 and HAstV MLB2, as well as the HAstV3 and 5 genotypes were detected. HAstVMLB1-2 genotype was detected for the first time in Brazil at a frequency of 3.5% (6/170).

Human Bocavirus genotypes 1 and 2 detected in younger Amazonian children with acute gastroenteritis or respiratory infections, respectively.

OBJECTIVES: This study aimed to verify the frequency, genotypes, and etiological role of Human Bocavirus (HBoV) in younger Amazonian children with either acute gastroenteritis (AGE) or respiratory infections (ARI). The influence of Rotarix™ vaccination and co-infection status was also investigated. DESIGN: HBoV quantitative polymerase chain reaction (qPCR) testing was done on both fecal and saliva (1468 samples) from 734 children < 5 months old living in the Amazon (Brazil, Guyana, and Venezuela). High and median HBoV viral load samples were used for extraction, nested PCR amplification, and sequencing for genotyping. HBoV mRNA detection was done by reverse transcription following DNA amplification. RESULTS: The overall HBoV frequencies were 14.2% (69/485; AGE) and 14.1% (35/249; ARI) (p = 0.83). HBoV exclusively infected 4.5% (22/485; AGE) and 4% (10/249) of the Amazonian children (Odds ratios 1.13, 95% confidence interval= 2.42-0.52). HBoV 1 was mainly detected in feces and saliva from AGE children; and HBoV2, from ARI children. HBoV mRNA was detected only in feces. The Rotarix™ vaccination status did not affect the HBoV frequencies. CONCLUSIONS: We suggest that, after entry into the air/oral pathways, HBoV1 continues infecting toward the intestinal tract causing AGE. HBoV2 can be a causative agent of AGE and ARI in younger Amazonian children.

Estudo epidemiológico da diarreia aguda, correlação com etiologia viral e antígenos do grupo histo-sanguíneo em crianças ≤ 5 anos atendidas no Hospital da Criança de Santo Antônio em Boa Vista, Roraima, 2016-2017 / Epidemiological study of acute diarrhea, correlation with viral etiology and antigens of the histo-blood group in children ≤ 5 years old attended at the Hospital da Criança of Santo Antônio in Boa Vista, Roraima, 2016-2017

Neste estudo avaliamos o impacto das doenças diarreicas agudas (DDA) associadas aos rotavírus A (RVA), norovírus, adenovírus (HAdV), sapovírus (SaV), bocavírus (HBoV) e astrovírus (HAstV) em crianças ≤ 5 anos atendidas na emergência do Hospital da Criança de Santo Antônio (HCSA), Boa Vista, Roraima (RR), no período de outubro de 2016 a outubro de 2017. Foram coletadas, paralelamente, amostras de fezes e de saliva de 734 crianças sendo 485 com DDA e 249 com infecção respiratória aguda (IRA, grupo controle). O estudo teve a aprovação do CEP:1.333.480, 23/11/2015, UFRR. Os RVA, norovírus, HAdV, SaV e HBoV foram pesquisados nas 734 amostras de fezes e HAstV em 170 amostras de crianças com DDA. Adicionalmente, a presença dos HBoV foi também investigada em 38 amostras de saliva sendo 25 de crianças com DDA e 13 IRA. O perfil de susceptibilidade AB0, Lewis e secretor dos antígenos do grupo histosanguíneo (HBGA) foi determinado para todas as 734 crianças em salivas pela fenotipagem e em amostras de salivas pela genotipagem, sendo para o gene FUT2 em 166 amostras e para FUT3 em 42 amostras. Os aspectos clínicos, epidemiológicos e a cobertura da vacina Rotarix® (RV1) foram também avaliados. Os RVA, norovírus e SaV foram investigados pela metodologia de transcrição reversa seguida de amplificação genômica quantitativa (RT-qPCR); os HBoV e HAdV pela amplificação genômica quantitativa (qPCR) e os HAstV por amplificação genômica qualitativa (RT-PCR). A genotipagem dos HBoV e a detecção/genotipagem dos HAstV foi realizada pela PCR seguida de sequenciamento nucleotídico (método Sanger). O Ensaio imunoenzimático (EIA) e a amplificação genômica específica (PCR-touchdown), seguida de sequenciamento nucleotídico (Sanger) foram utilizadas respectivamente para a fenotipagem e genotipagem dos HBGA.

Nas crianças com DDA (n=485), observou-se as seguintes frequências virais: RVA (22,7%), norovírus (38%), HAdV (33,6%), SaV (7,3%) e HBoV (14,2%). Nas crianças com IRA (n=249), observou as seguintes frequências: RVA (19,3%), norovírus (21,3%), HAdV (39,5%), SaV (5,6%) e HBoV (14,1%). O perfil de detecção do HBoV nas 76 amostras de saliva e fezes pareadas foi diferente e correlacionado com os genótipos 1 a 3 detectados. Quanto aos HAstV, nas 170 amostras investigadas, observou-se as seguintes frequências e genótipos: HAstV clássicos: HAstV3 (0,60%) e HAsV5 (1,8%); HAstV não clássicos: HAstVMLB1-2 (3,5%), sendo esta a primeira descrição do HAstVMLB2 no Brasil. A cobertura vacinal para RV1 calculada foi de 61% e crianças vacinadas na faixa etária entre 6 e 24 meses apresentaram frequências mais elevadas de infecção pelo RVA. As 734 crianças apresentaram majoritariamente (54.5%) o perfil Lea+b+ (fraco secretor) e polimorfirmos de nucleotídico único (SNPs) foram detectados nos genes FUT2 e FUT3. Foi detectada susceptibilidade (HBGA) para a infecção pelos HAdV em crianças com IRA, perfil fraco secretor e grupo sanguíneo A ou O, de acordo com valores de Odds Ratio (OR) calculado. As frequência dos vírus detectados principalmente para os norovírus e HAdV em crianças com DDA, demostram a importância da etiologia viral nas DDA em crianças ≤ 5 anos de idade no período do estudo e podem estar relacionadas ao fator de susceptibilidade ao HBGA (incluindo heterogeneidade genética) e a baixa cobertura de RV1. (AU)

Phenotyping of Lewis and secretor HBGA from saliva and detection of new FUT2 gene SNPs from young children from the Amazon presenting acute gastroenteritis and respiratory infection.

The Histo-blood group antigens (HBGA) are host genetic factors associated with susceptibility to rotavirus (RV) and human norovirus (HuNoV), the major etiological agents of viral acute gastroenteritis (AGE) worldwide. The FUT2 gene expressing the alpha-1, 2-L- fucosyltransferase enzyme is important for gut HBGA expression, and also provides a composition of the phenotypic profile achieved through mutations occurring in populations with different evolutionary histories; as such, it can be considered a genetic population marker. In this study, Lewis and secretor HBGA phenotyping was performed using 352 saliva samples collected from children between three months and five years old born in the Amazon (Brazil, Venezuela and English Guyana) presenting AGE or acute respiratory infection (ARI), the latter considered as control samples. The total of children phenotyped as secretors was 323, corresponding to 91.80%. From these, 207 (58.80%) had a Le (a + b+) profile. The HBGA profiles were equally found in children with AGE as well as with ARI. The rs1047781 of the FUT2 gene was not detected in DNA from saliva cells with a Le (a+b+) profile. However, mutations not yet described in the FUT2 gene were observed: missense 325A>T, 501C>T, 585C>T, 855A>T and missense substitutions 327C>T [S (Ser) > C (Cys)], 446 T>C [L(Leu) > P(Pro)], 723C>A [N(Asn) > K(Lys)], 724A>T [I(Ile) > F(Phe)], 736C>A [H(His) > N(Asn)]. The SNP distribution in the FUT2 gene of the analyzed samples was very similar to that described in Asian populations, including indigenous tribes.

Feira de saúde do curso de medicina da UFRR: uma aproximação com a comunidade / Health fairs held by the UFRR school of medicine: an approach to the community

As Feiras de Saúde do curso de Medicina da Universidade Federal de Roraima (UFRR) buscam informar e sensibilizar a comunidade quanto à melhoria da qualidade de vida a partir da prevenção, orientando para a mudança de hábitos de vida e diagnosticando precocemente as doenças a fim de tratá-las e curá-las. Além disso, a UFRR busca se aproximar da população boa-vistense por meio desse trabalho de extensão universitária e da realização de um serviço de utilidade pública de grande relevância acadêmica e comunitária. A diversidade das lições aprendidas, registradas como relatos de experiências ou como estudos, pelo conjunto de profissionais, gestores, pesquisadores e acadêmicos constituiu um importante estímulo ao debate acerca dos limites e possibilidades do Programa Saúde da Família e da interação do acadêmico na comunidade.

Health fairs held by the School of Medicine at the Federal University in Roraima (UFRR) aim to raise community awareness concerning improved quality of life based on prevention, orienting people for lifestyle changes and early diagnosis of diseases. The university also promotes greater exchange with the population of Boa Vista through this extension work, a highly relevant public utility service for academia and the local community. The range of lessons learned, documented through reports of experiences and case studies by health professionals, administrators, researchers, and students, provided an important stimulus for the debate on the limits and possibilities of the Family Health Program and interaction between medical students and the community.