Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 824
Filtrar
1.
PLoS One ; 16(1): e0244937, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33406122

RESUMO

BACKGROUND: The impact of SARS-CoV-2 in regions endemic for both Dengue and Chikungunya is still not fully understood. Considering that symptoms/clinical features displayed during Dengue, Chikungunya and SARS-CoV-2 acute infections are similar, undiagnosed cases of SARS-CoV-2 in co-endemic areas may be more prevalent than expected. This study was conducted to assess the prevalence of covert cases of SARS-CoV-2 among samples from patients with clinical symptoms compatible with either Dengue or Chikungunya viral infection in the state of Espírito Santo, Brazil. METHODS: Presence of immunoglobulin G (IgG) antibody specific to SARS-CoV-2 nucleoprotein was detected using a chemiluminescent microparticle immunoassay in samples from 7,370 patients, without previous history of COVID-19 diagnosis, suspected of having either Dengue (n = 1,700) or Chikungunya (n = 7,349) from December 1st, 2019 to June 30th, 2020. FINDINGS: Covert cases of SARS-CoV-2 were detected in 210 (2.85%) out of the 7,370 serum samples tested. The earliest undiagnosed missed case of COVID-19 dated back to a sample collected on December 18, 2019, also positive for Dengue Virus. Cross-reactivity with either Dengue virus or other common coronaviruses were not observed. INTERPRETATION: Our findings demonstrate that concomitant Dengue or Chikungunya outbreaks may difficult the diagnosis of SARS-CoV-2 infections. To our knowledge, this is the first study to demonstrate, with a robust sample size (n = 7,370) and using highly specific and sensitive chemiluminescent microparticle immunoassay method, that covert SARS-CoV-2 infections are more frequent than previously expected in Dengue and Chikungunya hyperendemic regions. Moreover, our results suggest that SAR-CoV-2 cases were occurring prior to February, 2020, and that these undiagnosed missed cases may have contributed to the fast expansion of SARS-CoV-2 outbreak in Brazil. Data presented here demonstrate that in arboviral endemic regions, SARS-CoV-2 infection must be always considered, regardless of the existence of a previous positive diagnosis for Dengue or Chikungunya.


Assuntos
/epidemiologia , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Adulto , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Vírus Chikungunya/patogenicidade , Coinfecção/epidemiologia , Vírus da Dengue/patogenicidade , Erros de Diagnóstico/tendências , Surtos de Doenças , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , /patogenicidade
2.
PLoS One ; 15(12): e0243239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332373

RESUMO

In the last 40 years, Latin America countries, including Brazil, have suffered from the emergence and reemergence of arboviruses, first Dengue (DENV) and recently Zika (ZIKV) and Chikungunya (CHIKV). All three arboviruses are currently endemic in Brazil and have caused major outbreaks in recent years. Rio de Janeiro city, host of the last Summer Olympic Games and the Football World Cup, has been specially affected by them. A surveillance system based on symptomatic reports is in place in Rio, but the true number of affected individuals is unknown due to the great number of Zika, Dengue and Chikungunya asymptomatic cases. Seroprevalence studies are more suitable to evaluate the real number of cases in a given population. We performed a populational seroprevalence survey in Rio, with recruitment of a sample of volunteers of all ages and gender from July to October 2018, within randomly selected census tracts and household. A total of 2,120 volunteers were interviewed and tested with rapid immunochromatographic test for ZIKV, DENV and CHIKV. Individuals with positive results for IgG and/or IgM from only one virus were classified accordingly, while those with test results positive for both ZIKV and DENV were classified as flaviviruses. We corrected for sample design and non-response in data analysis, and calculated point estimate prevalence and 95% confidence intervals for each virus. Arbovirus prevalence in the Rio's population (n = 6,688,927) was estimated at 48.6% [95% CI 44.8-52.4] (n = 3,254,121) for flaviviruses and at 18.0% [95% CI 14.8-21.2] (n = 1,204,765) for CHIKV. Approximately 17.0% [95% CI 14.1-20.1] (n = 1,145,674) of Rio´s population had no contact with any of the three arboviruses. The reported cases of Zika, Dengue and Chikungunya by the current surveillance system in place is insufficient to estimate their real numbers, and our data indicate that Zika seroprevalence could be at least five times and Chikungunya 45 times bigger. The high number of individuals having never been infected by any of the three arboviruses, may indicate a proper scenario for future outbreaks.


Assuntos
Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Vírus Chikungunya/isolamento & purificação , Criança , Pré-Escolar , Estudos Transversais , Vírus da Dengue/isolamento & purificação , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Adulto Jovem , Zika virus/isolamento & purificação
3.
BMC Infect Dis ; 20(1): 881, 2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33234110

RESUMO

BACKGROUND: The State of Ceará, in Northeastern Brazil, suffers from a triple burden of arboviruses (dengue, Zika and chikungunya). We measured the seroprevalence of chikungunya, dengue and Zika and its associated factors in the population of Juazeiro do Norte, Southern Ceará State, Brazil. METHODS: A cross-sectional study of analytical and spatial analysis was performed to estimate the seroprevalence of dengue, Zika and chikungunya, in the year 2018. Participants were tested for IgM and IgG against these three viruses. Those with IgM and/or IgG positive tests results were considered positive. Poisson regression was used to analyze the factors associated with positive cases, in the same way that the spatial analysis of positive cases was performed to verify whether the cases were grouped. RESULTS: Of the 404 participants, 25.0% (103/404) were positive for CHIKV, 92.0% (373/404) for flavivirus (dengue or Zika) and of these, 37.9% (153/404) samples were classified as probable dengue infection. Of those who reported having had an arbovirus in the past, positive CHIKV cases had 58.7% arthralgia (PR = 4.31; 95% CI: 2.06-9.03; p = 0.000) mainly in the hands, ankles and feet. Age over 60 years had a positive association with cases of flavivirus (PR = 1.29; 95% CI: 1.09-1.54; p = 0.000). Fever, muscle pain, joint pain and skin rash were the most reported symptoms (46.1, 41.0, 38.3 and 28.41%, respectively). The positive cases of chikungunya and dengue or Zika were grouped in space and the city center was most affected area. CONCLUSIONS: Four years after the introduction of CHIKV, where DENV has been in circulation for over 30 years, 1/4 of the population has already been exposed, showing the extent of the epidemic. The measured prevalence was much higher than that reported by local epidemiological surveillance.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/imunologia , Vírus da Dengue/imunologia , Dengue/epidemiologia , Epidemias , Infecção por Zika virus/epidemiologia , Zika virus/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Febre de Chikungunya/virologia , Criança , Pré-Escolar , Estudos Transversais , Dengue/virologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem , Infecção por Zika virus/virologia
4.
Molecules ; 25(22)2020 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-33202656

RESUMO

The rapid spread of the new Coronavirus Disease 2019 (COVID-19) has actually become the newest challenge for the healthcare system since, to date, there is not an effective treatment. Among all drugs tested, Hydroxychloroquine (HCQ) has attracted significant attention. This systematic review aims to analyze preclinical and clinical studies on HCQ potential use in viral infection and chronic diseases. A systematic search of Scopus and PubMed databases was performed to identify clinical and preclinical studies on this argument; 2463 papers were identified and 133 studies were included. Regarding HCQ activity against COVID-19, it was noticed that despite the first data were promising, the latest outcomes highlighted the ineffectiveness of HCQ in the treatment of viral infection. Several trials have seen that HCQ administration did not improve severe illness and did not prevent the infection outbreak after virus exposure. By contrast, HCQ arises as a first-line treatment in managing autoimmune diseases such as rheumatoid arthritis, lupus erythematosus, and Sjögren syndrome. It also improves glucose and lipid homeostasis and reveals significant antibacterial activity.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Síndrome de Sjogren/tratamento farmacológico , Artrite Reumatoide/imunologia , Artrite Reumatoide/fisiopatologia , Betacoronavirus/patogenicidade , Febre de Chikungunya/tratamento farmacológico , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/fisiopatologia , Febre de Chikungunya/virologia , Vírus Chikungunya/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Esquema de Medicação , HIV/patogenicidade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/fisiopatologia , Infecções por HIV/virologia , Humanos , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Vírus da SARS/patogenicidade , Síndrome Respiratória Aguda Grave/tratamento farmacológico , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/fisiopatologia , Síndrome Respiratória Aguda Grave/virologia , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/fisiopatologia , Zika virus/patogenicidade , Infecção por Zika virus/tratamento farmacológico , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/fisiopatologia , Infecção por Zika virus/virologia
6.
PLoS Negl Trop Dis ; 14(10): e0008546, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017393

RESUMO

BACKGROUND: The 2005-06 chikungunya virus (CHIKV) outbreak in La Réunion suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period. OBJECTIVE & METHODS: The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA). RESULTS: No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores between children infected with CHIKV (n = 47) and children not infected with CHIKV (n = 592). Likewise, there were no differences between children infected with CHIKV post-partum (n = 19) versus children not infected with CHIKV (n = 592). CONCLUSION: Our findings suggest that children exposed and/or infected with CHIKV outside of the intrapartum period experience no significant neurodevelopmental delay at two years of age, as measured by the INTER-NDA, compared to their unexposed and/or uninfected peers. These results complement those of previous studies which showed a neurodevelopmental risk only for children infected during the intrapartum period, while the mother was highly viremic. These results might be reassuring for women of childbearing age and public health officials in CHIKV-endemic regions.


Assuntos
Febre de Chikungunya/epidemiologia , Desenvolvimento Infantil , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Febre de Chikungunya/transmissão , Vírus Chikungunya , Pré-Escolar , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/virologia , Feminino , Granada/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Masculino , Gravidez , Testes Sorológicos
7.
Am J Trop Med Hyg ; 103(6): 2429-2437, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33124532

RESUMO

Madariaga virus (MADV) has recently been associated with severe human disease in Panama, where the closely related Venezuelan equine encephalitis virus (VEEV) also circulates. In June 2017, a fatal MADV infection was confirmed in a community of Darien Province. We conducted a cross-sectional outbreak investigation with human and mosquito collections in July 2017, where sera were tested for alphavirus antibodies and viral RNA. In addition, by applying a catalytic, force-of-infection (FOI) statistical model to two serosurveys from Darien Province in 2012 and 2017, we investigated whether endemic or epidemic alphavirus transmission occurred historically. In 2017, MADV and VEEV IgM seroprevalences were 1.6% and 4.4%, respectively; IgG antibody prevalences were MADV: 13.2%, VEEV: 16.8%, Una virus (UNAV): 16.0%, and Mayaro virus: 1.1%. Active viral circulation was not detected. Evidence of MADV and UNAV infection was found near households, raising questions about its vectors and enzootic transmission cycles. Insomnia was associated with MADV and VEEV infections, depression symptoms were associated with MADV, and dizziness with VEEV and UNAV. Force-of-infection analyses suggest endemic alphavirus transmission historically, with recent increased human exposure to MADV and VEEV in Aruza and Mercadeo, respectively. The lack of additional neurological cases suggests that severe MADV and VEEV infections occur only rarely. Our results indicate that over the past five decades, alphavirus infections have occurred at low levels in eastern Panama, but that MADV and VEEV infections have recently increased-potentially during the past decade. Endemic infections and outbreaks of MADV and VEEV appear to differ spatially in some locations of eastern Panama.


Assuntos
Encefalomielite Equina do Leste/epidemiologia , Encefalomielite Equina Venezuelana/epidemiologia , Fazendeiros/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Alphavirus/imunologia , Infecções por Alphavirus/epidemiologia , Infecções por Alphavirus/imunologia , Infecções por Alphavirus/fisiopatologia , Animais , Anticorpos Antivirais/imunologia , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/imunologia , Febre de Chikungunya/fisiopatologia , Vírus Chikungunya/imunologia , Criança , Pré-Escolar , Estudos Transversais , Depressão/fisiopatologia , Tontura/fisiopatologia , Vírus da Encefalite Equina do Leste/imunologia , Vírus da Encefalite Equina Venezuelana/imunologia , Encefalomielite Equina do Leste/imunologia , Encefalomielite Equina do Leste/fisiopatologia , Encefalomielite Equina Venezuelana/imunologia , Encefalomielite Equina Venezuelana/fisiopatologia , Doenças Endêmicas , Epidemias , Fadiga/fisiopatologia , Feminino , Habitação/estatística & dados numéricos , Humanos , Imunoglobulina G , Imunoglobulina M , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/virologia , Panamá/epidemiologia , Vírus da Floresta de Semliki/imunologia , Estudos Soroepidemiológicos , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Adulto Jovem
9.
Lancet Neurol ; 19(10): 826-839, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32949543

RESUMO

BACKGROUND: Since 2015, the arthropod-borne viruses (arboviruses) Zika and chikungunya have spread across the Americas causing outbreaks, accompanied by increases in immune-mediated and infectious neurological disease. The spectrum of neurological manifestations linked to these viruses, and the importance of dual infection, are not known fully. We aimed to investigate whether neurological presentations differed according to the infecting arbovirus, and whether patients with dual infection had a different disease spectrum or severity. METHODS: We report a prospective observational study done during epidemics of Zika and chikungunya viruses in Recife, Pernambuco, a dengue-endemic area of Brazil. We recruited adults aged 18 years or older referred to Hospital da Restauração, a secondary-level and tertiary-level hospital, with suspected acute neurological disease and a history of suspected arboviral infection. We looked for evidence of Zika, chikungunya, or dengue infection by viral RNA or specific IgM antibodies in serum or CSF. We grouped patients according to their arbovirus laboratory diagnosis and then compared demographic and clinical characteristics. FINDINGS: Between Dec 4, 2014, and Dec 4, 2016, 1410 patients were admitted to the hospital neurology service; 201 (14%) had symptoms consistent with arbovirus infection and sufficient samples for diagnostic testing and were included in the study. The median age was 48 years (IQR 34-60), and 106 (53%) were women. 148 (74%) of 201 patients had laboratory evidence of arboviral infection. 98 (49%) of them had a single viral infection (41 [20%] had Zika, 55 [27%] had chikungunya, and two [1%] had dengue infection), whereas 50 (25%) had evidence of dual infection, mostly with Zika and chikungunya viruses (46 [23%] patients). Patients positive for arbovirus infection presented with a broad range of CNS and peripheral nervous system (PNS) disease. Chikungunya infection was more often associated with CNS disease (26 [47%] of 55 patients with chikungunya infection vs six [15%] of 41 with Zika infection; p=0·0008), especially myelitis (12 [22%] patients). Zika infection was more often associated with PNS disease (26 [63%] of 41 patients with Zika infection vs nine [16%] of 55 with chikungunya infection; p≤0·0001), particularly Guillain-Barré syndrome (25 [61%] patients). Patients with Guillain-Barré syndrome who had Zika and chikungunya dual infection had more aggressive disease, requiring intensive care support and longer hospital stays, than those with mono-infection (median 24 days [IQR 20-30] vs 17 days [10-20]; p=0·0028). Eight (17%) of 46 patients with Zika and chikungunya dual infection had a stroke or transient ischaemic attack, compared with five (6%) of 96 patients with Zika or chikungunya mono-infection (p=0·047). INTERPRETATION: There is a wide and overlapping spectrum of neurological manifestations caused by Zika or chikungunya mono-infection and by dual infections. The possible increased risk of acute cerebrovascular disease in patients with dual infection merits further investigation. FUNDING: Fundação do Amparo a Ciência e Tecnologia de Pernambuco (FACEPE), EU's Horizon 2020 research and innovation programme, National Institute for Health Research. TRANSLATIONS: For the Portuguese and Spanish translations of the abstract see Supplementary Materials section.


Assuntos
Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Febre de Chikungunya/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/sangue , Estudos Prospectivos , Infecção por Zika virus/sangue
11.
PLoS Negl Trop Dis ; 14(9): e0008549, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32881913

RESUMO

BACKGROUND: Chikungunya (CHIK) and yellow fever (YF) are becoming major public health threats in East African countries including Ethiopia. In Ethiopia, there is no reliable information about the epidemiology of CHIK. This study aimed to assess a community-based sero-prevalence of CHIK and YF in the South Omo Valley, an endemic area for YF. METHODS: Between February and June 2018, blood samples were collected from study participants and screened for IgG antibody against CHIK virus (CHIKV) and YF virus (YFV) infections using ELISA. Data were computerized using Epi Data Software v.3.1 and analyzed using SPSS. RESULTS: A total of 360 participants (51.7% males, age range from 6 to 80, mean age ± SD = 31.95 ± 14.05 years) participated in this study. The overall sero-prevalence of IgG antibody was 43.6% (157/360) against CHIKV, while it was 49.5% (155/313) against YFV. Out of 155 samples which were positive for IgG antibody to YFV, 93 (60.0%) were positive for IgG antibody to CHIKV. Out of 158 samples which were negative for IgG antibody to YFV, 64(40.5%) were positive for IgG antibody to CHIKV. There was a significant positive correlation between IgG antibodies to CHIKV and YFV (sr = 0.82; P<0.01). Residency in the Debub Ari district (AOR = 8.47; 95% CI: 1.50, 47.74) and travel history to sylvatic areas (AOR = 2.21; 95% CI: 1.02, 4.81) were significantly and positively associated with high sero-prevalence of IgG antibody to CHIKV and YFV, respectively. CONCLUSION: High sero-prevalence of IgG antibody to CHIKV shows the circulation of the virus in the present study area. A low sero-prevalence of IgG antibody to YFV in YF vaccine received individuals is highly concerning from a public health point of view as waning of immune response to YFV infection could result in a periodic outbreaks of YF in endemic areas.Nevertheless, the present study has not investigated for possible cross-reactivity of antibody to CHIKV with other alphaviruses like O'nyong-nyong virus and antibody to YFV with other flaviviruses like Dengue fever virus and this warrants further studies in the present study area.


Assuntos
Anticorpos Antivirais/sangue , Febre de Chikungunya/sangue , Febre Amarela/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/imunologia , Vírus Chikungunya/isolamento & purificação , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Estudos Soroepidemiológicos , Febre Amarela/epidemiologia , Febre Amarela/virologia , Vírus da Febre Amarela/imunologia , Vírus da Febre Amarela/isolamento & purificação , Adulto Jovem
12.
Braz J Infect Dis ; 24(5): 405-411, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941805

RESUMO

Several major epidemics of Zika fever, caused by the ZIKA virus (ZIKV), have emerged in Brazil since early 2015, eventually spreading to other countries on the South American continent. The present study describes the clinical manifestations and laboratory findings of patients with confirmed acute ZIKV infection during the first epidemic that occurred in Salvador, Brazil. All included patients were seen at the emergency room of a private tertiary hospital located in Salvador, Brazil from 2015 through 2017. Patients were considered eligible if signs of systemic viral febrile disease were present. All individuals were tested for ZIKV and Chikungunya infection using PCR, while rapid test was used to detect Dengue virus antibodies or, alternatively, the NS1 antigen. A diagnosis of acute ZIKV infection was confirmed in 78/434 (18%) individuals with systemic viral febrile illness. Positivity was mainly observed in blood, followed by saliva and urine. Coinfection with Chikungunya and/or Dengue virus was detected in 5% of the ZIKV-infected patients. The most frequent clinical findings were myalgia, arthralgia and low-grade fever. Laboratory analysis demonstrated normal levels of hematocrit, platelets and liver enzymes. In summary, in acute settings where molecular testing remains unavailable, clinicians face difficulties to confirm the diagnosis of ZIKV infection, as they rely only on clinical examinations and conventional laboratory tests.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Vírus da Dengue , Dengue , Epidemias , Infecção por Zika virus , Zika virus , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Humanos , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-32932665

RESUMO

The risk of increasing dengue (DEN) and chikungunya (CHIK) epidemics impacts 240 million people, health systems, and the economy in the Hindu Kush Himalayan (HKH) region. The aim of this systematic review is to monitor trends in the distribution and spread of DEN/CHIK over time and geographically for future reliable vector and disease control in the HKH region. We conducted a systematic review of the literature on the spatiotemporal distribution of DEN/CHIK in HKH published up to 23 January 2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. In total, we found 61 articles that focused on the spatial and temporal distribution of 72,715 DEN and 2334 CHIK cases in the HKH region from 1951 to 2020. DEN incidence occurs in seven HKH countries, i.e., India, Nepal, Bhutan, Pakistan, Bangladesh, Afghanistan, and Myanmar, and CHIK occurs in four HKH countries, i.e., India, Nepal, Bhutan, and Myanmar, out of eight HKH countries. DEN is highly seasonal and starts with the onset of the monsoon (July in India and June in Nepal) and with the onset of spring (May in Bhutan) and peaks in the postmonsoon season (September to November). This current trend of increasing numbers of both diseases in many countries of the HKH region requires coordination of response efforts to prevent and control the future expansion of those vector-borne diseases to nonendemic areas, across national borders.


Assuntos
Febre de Chikungunya , Dengue , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/transmissão , Vírus Chikungunya , Dengue/epidemiologia , Dengue/transmissão , Vírus da Dengue , Humanos , Saúde Pública , Análise Espaço-Temporal
14.
Rev. cuba. salud pública ; 46(3): e1903, jul.-set. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144551

RESUMO

Introducción: La infección aguda por chikungunya genera una alta carga de enfermedad y discapacidad dada principalmente por poliartralgias en fase aguda y artritis en fase crónica, sin embargo, presenta una sintomatología similar a otras arbovirosis, particularmente a las del dengue, lo que dificulta su diagnóstico. Objetivos: Caracterizar las manifestaciones clínicas de la infección aguda por chikungunya en los pacientes atendidos en el departamento de urgencias de la ciudad de Ibagué, Colombia, durante el brote epidémico transcurrido entre octubre de 2015 y octubre de 2016. Métodos: Estudio descriptivo, de corte transversal, en el cual se describieron las manifestaciones clínicas de la infección aguda por chikungunya, a través del instrumento desarrollado a partir de la revisión de la literartura que recogía las principales manifestaciones clínicas de la infección en fase aguda por chikungunya, como anexo a las fichas epidemiológicas de notificación obligatoria individual del Instituto Nacional de Salud que se reportan a la Secretaría Municipal de Ibagué-Tolima. Resultados: Se recolectaron 6752 fichas de pacientes atendidos en los servicios de urgencias, los que experimentaron fiebre de 38,5 ºC de 1-7 días (91,3 por ciento), mialgias (81,3 por ciento), eritema maculopapular (74,3 por ciento), artralgias severas (70,6 por ciento), poliartritis (41,1 por ciento) y adenomegalias retroauriculares (8 por ciento). Conclusiones: Los resultados obtenidos en el presente estudio aportan información importante para el diagnóstico clínico del chikungunya en sitios con características similares a las de ciudades hiperendemicas y facilita distinguir la enfermedad en fase aguda entre las diferentes arbovirosis circulantes con signos como las mialgias, adenoapatias retro-auriculares y artralgia severa(AU)


Introduction: The acute infection by Chikungunya generates a high burden of illness and disability mainly due to polyarthralgias in acute phase and artritis in chronic phase. However, it presents symptoms similar to other arboviruses, specially like dengue, which difficults its diagnosis. Objective: To characterize the clinical manifestations of the acute infection by Chikungunya in patients attended in the emergencies service of Ibagué city, Colombia, during the epidemic outbreak that occured from October, 2015 to October, 2016. Methods: Descriptive, cross-sectional study in which were described the clinical manifestations of the acute infection by chikungunya using an instrument developed from the review of the literature that comprises the main clinical manifestations of the infection by chikungunya in its acute phase, as an information attached to the epidemiologic records of individual obligatory notification of the National Institute of Health, which are reported to Ibagué-Tolima Municipal Secretary. Results: There were collected 6752 records of patients attended in emergency services, whom experienced fever of 38,5 ºC from 1 to 7 days (91,3 percent), myalgias (81,3 percent), maculopapular erythema (74,3 percent), severe arthralgias (70,6 percent), polyarthritis (41,1 percent) and retroarticular adenomegalies (8 percent). Conclusions: The results obtained in the present study provide important information for the clinical diagnosis of chikungunya in places with similar characteristics to the hyperepidemic cities and it facilitates to differentiate the disease in its acute phase among the different current arboviruses with signs of myalgia, retroarticular adenopathies and severe arthralgia(AU)


Assuntos
Febre de Chikungunya/epidemiologia , Infecções por Arbovirus/transmissão , Epidemiologia Descritiva , Estudos Transversais , Colômbia
15.
Am J Trop Med Hyg ; 103(4): 1660-1669, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32700661

RESUMO

Chikungunya fever is a viral mosquito-borne, acute febrile illness associated with rash, joint pain, and occasionally prolonged polyarthritis. Chikungunya outbreaks have been reported worldwide including many provinces of Thailand. Although chikungunya virus (CHIKV) occurs in Thailand, details on its epidemiology are lacking compared with dengue, a common mosquito-borne disease in the country. Therefore, study on CHIKV and its epidemiology in both humans and mosquitoes is required to better understand its importance clinically and dynamics in community settings. So a prospective examination of virus circulation in human and mosquito populations in northeastern Thailand using serological and molecular methods, including the genetic characterization of the virus, was undertaken. The study was conducted among febrile patients in eight district hospitals in northeastern Thailand from June 2016 to October 2017. Using real-time PCR on the conserved region of nonstructural protein 1 gene, CHIKV was detected in eight (4.9%) of 161 plasma samples. Only one strain yielded a sequence of sufficient size allowing for phylogenetic analysis. In addition, anti-CHIKV IgM and IgG were detected in six (3.7%) and 17 (10.6%) patient plasma samples. The single sequenced sample belonged to the East/Central/South Africa (ECSA) genotype and was phylogenetically similar to the Indian Ocean sub-lineage. Adult Aedes mosquitoes were collected indoors and within a 100-m radius from the index case house and four neighboring houses. CHIKV was detected in two of 70 (2.9%) female Aedes aegypti mosquito pools. This study clearly demonstrated the presence and local transmission of the ECSA genotype of CHIKV in the northeastern region of Thailand.


Assuntos
Aedes/virologia , Anticorpos Antivirais/sangue , Febre de Chikungunya/epidemiologia , Vírus Chikungunya/imunologia , Surtos de Doenças , Mosquitos Vetores/virologia , Adolescente , Adulto , Idoso , Animais , Febre de Chikungunya/transmissão , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Vírus Chikungunya/isolamento & purificação , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Filogenia , Estudos Prospectivos , Tailândia/epidemiologia , Adulto Jovem
16.
PLoS Negl Trop Dis ; 14(7): e0008061, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32687540

RESUMO

Tanzania has recently experienced outbreaks of dengue in two coastal regions of Dar es Salaam and Tanga. Chikungunya and Rift Valley Fever outbreaks have also been recorded in the past decade. Little is known on the burden of the arboviral disease causing viruses (Dengue, Rift Valley and Chikungunya) endemically in the inter-epidemic periods. We aimed at determining the prevalence of the dengue, rift valley and chikungunya among humans in two geo ecologically distinct sites. The community-based cross-sectional study was conducted in Magugu in Manyara region and Wami-Dakawa in Morogoro region in Tanzania. Venous blood was collected from participants of all age groups, serum prepared from samples and subjected to ELISA tests for RVFV IgG/IgM, DENV IgG/IgM, and CHIKV IgM/IgG. Samples that were positive for IgM ELISA tests were subjected to a quantitative RT PCR for each virus. A structured questionnaire was used to collect socio-demographic information. Data analysis was performed by using SPSSv22. A total of 191 individuals from both sites participated in the study. Only one individual was CHIKV seropositive in Magugu, but none was seropositive or positive for either RVFV or DENV. Of the 122 individuals from Wami-Dakawa site, 16.39% (n = 20) had recent exposure to RVFV while 9.83% (n = 12) were seropositive for CHIKV. All samples were negative by RVFV and CHIKV qPCR. Neither infection nor exposure to DENV was observed in participants from both sites. Being more than 5 in a household, having no formal education and having recently travelled to an urban area were risk factors associated with RVFV and CHIKV seropositivity. We report a considerable exposure to RVFV and CHIKV among Wami-Dakawa residents during the dry season and an absence of exposure of the viruses among humans in Magugu site. In both sites, neither DENV exposure nor infection was detected.


Assuntos
Anticorpos Antivirais/sangue , Febre de Chikungunya/sangue , Vírus Chikungunya/imunologia , Vírus da Dengue/imunologia , Dengue/sangue , Febre do Vale de Rift/sangue , Vírus da Febre do Vale do Rift/imunologia , Adulto , Animais , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/fisiologia , Estudos Transversais , Dengue/epidemiologia , Dengue/virologia , Vírus da Dengue/fisiologia , Feminino , Humanos , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Febre do Vale de Rift/epidemiologia , Febre do Vale de Rift/virologia , Vírus da Febre do Vale do Rift/fisiologia , Estudos Soroepidemiológicos , Tanzânia/epidemiologia , Adulto Jovem
17.
Am J Trop Med Hyg ; 103(3): 1228-1233, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32588813

RESUMO

Zoonotic pathogens such as arboviruses have comprised a significant proportion of emerging infectious diseases in humans. The role of wildlife species as reservoirs for arboviruses is poorly understood, especially in endemic areas such as Southeast Asia. This study aims to determine the exposure history of different macaque species from national parks in Thailand to mosquito-borne flaviviruses and alphavirus by testing the serum samples collected from 25 northern pigtailed macaques, 33 stump-tailed macaques, and 4 long-tailed macaques for the presence of antibodies against dengue, Zika, and chikungunya viruses by plaque reduction neutralization assay. Specific neutralizing antibodies against Dengue virus (DENV1-4) and Zika virus (ZIKV) were mainly found in stump-tailed macaques, whereas neutralizing antibody titers were not detected in long-tailed macaques and pigtailed macaques as determined by 90% plaque reduction neutralization assay (PRNT90). One long-tailed macaque captured from the south of Thailand exhibited antibody titers against chikungunya virus (CHIKV), suggesting enzootic of this virus to nonhuman primates (NHPs) in Thailand. Encroachment of human settlements into the forest has increased the interface that exposes humans to zoonotic pathogens such as arboviruses found in monkeys. Nonhuman primates living in different regions of Thailand showed different patterns of arboviral infections. The presence of neutralizing antibodies among wild monkeys in Thailand strongly suggests the existence of sylvatic cycles for DENV, ZIKV, and CHIKV in Thailand. The transmission of dengue, Zika, and chikungunya viruses among wild macaques may have important public health implications.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/imunologia , Culicidae/virologia , Vírus da Dengue/imunologia , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Zika virus/imunologia , Animais , Anticorpos Neutralizantes , Anticorpos Antivirais/sangue , Febre de Chikungunya/virologia , Dengue/virologia , Feminino , Geografia , Humanos , Macaca , Masculino , Mosquitos Vetores/virologia , Estudos Soroepidemiológicos , Tailândia/epidemiologia , Infecção por Zika virus/virologia
18.
Int J Infect Dis ; 97: 306-312, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32497797

RESUMO

BACKGROUND: Outbreak investigations typically focus their efforts on identifying cases that present at healthcare facilities. However, these cases rarely represent all cases in the wider community. In this context, community-based investigations may provide additional insight into key risk factors for infection, however, the benefits of these more laborious data collection strategies remains unclear. METHODS: We used different subsets of the data from a comprehensive outbreak investigation to compare the inferences we make in alternative investigation strategies. RESULTS: The outbreak investigation team interviewed 1,933 individuals from 460 homes. 364 (18%) of individuals had symptoms consistent with chikungunya. A theoretical clinic-based study would have identified 26% of the cases. Adding in community-based cases provided an overall estimate of the attack rate in the community. Comparison with controls from the same household revealed that those with at least secondary education had a reduced risk. Finally, enrolling residents from households across the community allowed us to characterize spatial heterogeneity of risk and identify the type of clothing usually worn and travel history as risk factors. This also revealed that household-level use of mosquito control was not associated with infection. CONCLUSIONS: These findings highlight that while clinic-based studies may be easier to conduct, they only provide limited insight into the burden and risk factors for disease. Enrolling people who escaped from infection, both in the household and in the community allows a step change in our understanding of the spread of a pathogen and maximizes opportunities for control.


Assuntos
Febre de Chikungunya/epidemiologia , Adolescente , Adulto , Idoso , Animais , Bangladesh/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças , Características da Família , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
19.
Rev Soc Bras Med Trop ; 53: e20190583, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578706

RESUMO

INTRODUCTION: We performed an epidemiological surveillance of the Chikungunya (CHIKV) lineages in Bahia after the 2014 East/Central/South African (ECSA) genotype outbreak. METHODS: Reverse-transcription polymerase chain reaction (RT-PCR), viral isolation, and phylogenetic analyses were conducted on serum samples from 605 patients with CHIKV-like symptoms during 2014-2018. RESULTS: Of the 605 samples, 167 were CHIKV-positive. Viral isolation was achieved for 20 samples; their phylogenetic analysis (E2 protein) revealed the presence of ECSA lineage and reinforced the phylogenetic relationship between ECSA and Indian Ocean lineages. CONCLUSIONS: The genomic surveillance of CHIKV showed that only ECSA lineage circulated in Bahia since the 2014 outbreak.


Assuntos
Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Genoma Viral/genética , Adulto , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Surtos de Doenças , Monitoramento Epidemiológico , Feminino , Genótipo , Humanos , Masculino , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
20.
Artigo em Inglês | MEDLINE | ID: mdl-32503246

RESUMO

The invasion of Aedes albopictus has played a major role in the resurgence of mosquito-borne diseases in Italy, generating the two largest chikungunya outbreaks in Europe (2007, 2017). Knowledge, attitude and practice (KAP) are important in order to prevent Aedes-borne disease transmission, yet so far they have not been assessed. To this scope we used multivariate logistic regression to investigate KAP of citizen-to-Aedes ecology and transmitted diseases. Data were collated by a structured questionnaire (18 questions) in 2016. Participants were selected in the Lazio region from members of native populations and two resident communities (RC) originating from the Indian subcontinent where Aedes-transmitted diseases are endemic. Results showed that compared to Italians, RC respondents had a higher knowledge and concern of Aedes-transmitted diseases (Odds Ratio = 2.61 (95%CI: 1.03-6.05); OR = 3.13 (2.15-4.65)) as well as their life cycles (OR = 2.49 (1.75-3.56); OR = 9.04 (6.22-13.66)). In contrast, they perceived a lower nuisance due to the presence of Ae. albopictus (OR = 0.2 (0.13-0.32); OR = 0.55 (0.38-0.78). These findings suggest that citizens in the Lazio region are not prepared to face a potential outbreak of arboviruses and further efforts should be made to increase knowledge, awareness and best practices.


Assuntos
Aedes , Febre de Chikungunya , Adulto , Animais , Febre de Chikungunya/epidemiologia , Surtos de Doenças , Feminino , Humanos , Itália/epidemiologia , Mosquitos Vetores , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA