Patient-based dengue virus surveillance in Aedes aegypti from Recife, Brazil.

BACKGROUND & OBJECTIVES: Dengue is currently one of the most important arthropod-borne diseases and may be caused by four different dengue virus serotypes (DENV-1 to DENV-4), transmitted mainly by Aedes aegypti (Diptera: Culicidae) mosquitoes. With the lack of a dengue vaccine, vector control strategies constitute a crucial mode to prevent or reduce disease transmission. In this context, DENV detection in natural Ae. aegypti populations may serve as a potential additional tool for early prediction systems of dengue outbreaks, leading to an intensification of vector control measures, aimed at reducing disease transmission. In Brazil, this type of surveillance has been performed sporadically by a few groups and has not been incorporated as a routine activity in control programs. This study aimed at detecting DENV in natural Ae. aegypti from Recife, Pernambuco, to check the circulating serotypes and the occurrence of transovarial transmission in local mosquito populations. METHODS: From January 2005 to June 2006, mosquitoes (adults and eggs) were collected in houses where people with clinical suspicion of dengue infection lived at. RNA was extracted from pooled mosquitoes and RT-PCR was performed in these samples for detection of the four DENV serotypes. RESULTS & CONCLUSION: Out of 83 pools of adult mosquitoes collected in the field, nine were positive for DENV: five for DENV-1, two for DENV-2 and two for DENV-3. From 139 pools of adult mosquitoes reared from collected eggs, there were 17 positive pools: three for DENV-1, 10 for DENV-2, and four for DENV-3. These results are discussed in the paper in regard to the local dengue epidemiological data. The conclusions clearly point to the informative power and sensitivity of DENV entomological surveillance and to the importance of including mosquito immature forms in this strategy.

Phagocytosis of latex beads and bacteria by hemocytes of the triatomine bug Rhodnius prolixus (Hemiptera: Reduvidae).

Insect circulating hemocytes are primarily responsible for the immune defense against parasites and pathogens. Here, we have analyzed phagocytosis of both biotic (bacteria) and abiotic (latex) particles by circulating hemocytes of 5th-instar nymphs of the triatomine bug Rhodnius prolixus. The following hemocyte types were identified: prohemocytes, plasmatocytes, granulocytes, oenocytoids and adipohemocytes. There was a considerable change in the relative percentage of plasmatocytes and prohemocytes in the hemolymph after challenge with both latex beads and bacteria. Granulocytes and oenocytoids also change their relative percentage in response to latex bead and Staphylococcus aureus, respectively. No significant change was observed in adipohemocytes at any time or treatment. Our data demonstrated that plasmatocytes were the only cell type involved in phagocytosis of foreign particles. As in mammal cells, phagocytosis by both zipper and trigger mechanisms were observed for the uptake of latex beads and bacteria. Neither melanization nor micro-aggregation was observed towards latex particles or Escherichia coli. On the other hand, R. prolixus produced a strong melanization reaction against S. aureus, thus showing that differences exist in the responses to E. coli and to S. aureus. Ultrastructural changes observed in plasmatocytes, adipohemocytes and oenocytoids suggest that these hemocyte types are directly involved in the immune defense of R. prolixus against foreign particles.

Intra-abdominal sepsis: an immunocytochemical study of the small intestine mucosa.

AIM: To investigate immunocytochemical changes in intestinal tissues from patients with intra-abdominal sepsis, and to relate the changes to the possibility of enhanced bacterial adhesion and translocation. METHODS: Tissues from 17 patients suffering from intra-abdominal sepsis and from controls were sectioned and stained immunocytochemically for IgA, IgM, secretory component, J chain, and HLA-DR. Differences in the distribution and characteristics of positively staining cells between the patient groups were assessed. RESULTS: Patients with intra-abdominal sepsis had noticeable reductions in numbers of IgA and IgM plasma cells, reduced J chain staining, and had little immunoglobulin on the surfaces of enterocytes. In contrast, HLA-DR positive cells were increased in the sepsis compared with the control group. The plasma cells present showed cytological changes suggestive of apoptosis. CONCLUSIONS: Stress associated with sepsis and its immediate causes might result in increased plasma glucocorticoid levels that bring about apoptosis of mucosal plasma cells (or their precursors). The consequent reduction in expression of IgA and IgM may favour bacterial adhesion to the enterocytes and facilitate bacterial translocation into the tissues.

Absence of lysozyme (muramidase) in the intestinal Paneth cells of newborn infants with necrotising enterocolitis.

AIM: To determine immunocytochemically whether preterm and newborn infants with necrotising enterocolitis (NEC) show differences in numbers of lysozyme positive Paneth cells compared with normal controls, and to relate the findings to the possibility that lysozyme deficiency may facilitate the bacterial infections thought to be associated with this condition. METHODS: Tissues from 10 infants with NEC and from 11 matched controls were sectioned and stained immunocytochemically for lysozyme. Differences in the numbers of Paneth cells and degree of lysozyme positivity in the tissues were assessed. RESULTS: Tissues from NEC patients showed no, or very few, lysozyme positive Paneth cells, whereas controls showed strong positive staining. CONCLUSIONS: A deficiency or developmental defect in Paneth cells, resulting in an absence of lysozyme, may render the intestine more susceptible to bacterial infection, allowing organisms to adhere and translocate across the mucosa. Such enhancement of infection may contribute to the pathogenesis of NEC.

Lymphoscintigraphic assessment of the effect of diethylcarbamazine treatment on lymphatic damage in human bancroftian filariasis.

Despite many millions of doses administered over the past 40 years, basic and crucial issues regarding the use, mode of action, and effectiveness of diethylcarbamazine (DEC) in many clinical situations remain unresolved. To directly investigate whether the well-known microfilaricidal and macrofilaricidal actions of DEC actually result in subsequent improvement in existing damage to lymphatic vessels or lymph nodes, 29 study subjects in Recife, Brazil were stratified into three groups according to the severity of clinical manifestations of lymphatic insufficiency. After baseline radionuclide lymphoscintigraphy was performed, subjects were treated with two courses of DEC separated by at least a six-month interval and then rescanned one year after the baseline scan. A side-by-side comparison of images obtained at baseline with those obtained at follow-up in 13 asymptomatic microfilaremic individuals, six individuals with filarial fever, and in 10 individuals with chronic pathology demonstrated essentially unchanged lymphatic morphology in all but one individual whose disease actually progressed in the face of therapy. We conclude that two 12-day treatment courses of DEC did not have a demonstrable direct or indirect effect on existing structural damage to the lymphatic system even in those individuals with preclinical disease.

Diagnosis of Wuchereria bancrofti infection by the polymerase chain reaction using urine and day blood samples from amicrofilaraemic patients.

A sensitive and specific polymerase chain reaction (PCR) based on a highly repeated deoxyribonucleic acid (DNA) sequence (188 bp; SspI repeat) was tested for the detection of Wuchereria bancrofti DNA in blood and urine samples collected during the day from individuals in Coque, Recife, Brazil, an endemic area for W. bancrofti. All microfilaraemic individuals were also positive by PCR, irrespective of the samples used. The PCR system was capable of detecting W. bancrofti DNA in amicrofilaraemic individuals: c. 93% were positive by PCR when day blood samples were used and 59.7% when urine samples collected at 07:00 were used. Thus, nocturnally periodic W. bancrofti infection can be detected in blood samples collected during the day, which is convenient for large-scale screening. In addition, non-invasive urine collection provided suitable samples for PCR, which is clearly advantageous for preliminary mass diagnosis.

Efficacy of Bacillus sphaericus in control of the filariasis vector Culex quinquefasciatus in an urban area of Olinda, Brazil.

The efficacy of Bacillus sphaericus 2362 against Culex quinquefasciatus was tested in 1991-94 in a major Brazilian endemic zone for bancroftian filariasis. Continuous selection pressure against the mosquito population was sustained for 18 months through treatment of 2500 potential breeding sites occurring within a 5.7-km2 urban area in the Metropolitan Region of Recife. The impact of this control intervention was evaluated by comparing entomological indices with those from an untreated area. Application of the larvicide kept the Cx. quinquefasciatus population density significantly lower when compared to the untreated area, despite some operational difficulties. Adult densities remained lower for at least 5 months after spraying ceased. Pre-trial microfilaria rates from the untreated and operational area were 13.1% and 7.2%, respectively. A 60% reduction in human exposure to infective bites was recorded as a consequence of this vector population control.

Genetic differentiation of Aedes aegypti (Diptera: Culicidae), the major dengue vector in Brazil.

In 2000, Brazil reported 180,137 cases of dengue, approximately 80% of the total in the Americas. However, little is known about gene flow among the vector populations in Brazil. Random amplified polymorphic DNA (RAPD) was used to study the genetic structure of Aedes aegypti in 15 populations from five states, with a range extending 2,800 km. An analysis of 47 polymorphic RAPD loci estimated gene flow at the macro- (different states) and micro- (different cities) geographical levels. Genetic polymorphism was high (H(S) = 0.274), and high levels of genetic differentiation existed both between different states (G(ST) = 0.317) and between cities or neighborhoods in each state (G(ST) = 0.085-0.265). These values are higher than those described for any other populations of A. aegypti.

The LYMFASIM simulation program for modeling lymphatic filariasis and its control.

The LYMFASIM modeling framework for the transmission and control of the tropical parasitic disease lymphatic filariasis is described and its use in the context of an endemic community in north-eastern Brazil is illustrated. Lymphatic filariasis is a disease with a complex natural history with many unknowns. This complicates decision making with respect to control strategies. With LYMFASIM, a variety of hypotheses can be tested about the life history of the parasite Wuchereria bancrofti, its transmission from man to man through mosquitoes, the role of the immune system in regulating parasite numbers, the development of disease symptoms, and the effects of control measures (drug treatment or mosquito control). The implications of alternative assumptions and uncertainty about the quantification of parameters for the effectiveness of control strategies can be investigated. Thanks to the use of stochastic microsimulation, LYMFASIM is highly flexible and can be adapted and extended as new knowledge emerges.

Screening of exogenous enzymes for ruminant diets: relationship between biochemical characteristics and in vitro ruminal degradation.

With the objective of developing a rational approach for the selection of feed enzymes for ruminants, 22 commercial enzyme products were examined in terms of protein concentration, enzymic activities on model substrates, and hydrolytic capacity, the latter determined from the release of reducing sugars from alfalfa hay and corn silage. An in vitro ruminal degradation assessment was carried out using the same substrates, untreated or treated with the 22 enzyme products at 1.5 microL/g forage DM. Stepwise regressions were then performed to establish relationships between these factors. Protein concentration and enzymic activities explained at least 84% (P < 0.01) of the variation in the release of reducing sugars from alfalfa and corn silage. Alfalfa DM degradation after incubation with ruminal fluid for 18 h was positively related to xylanase activity (R2 = 0.29, P < 0.01), but the same activity was negatively related to DM degradation of corn silage (R2 = 0.19, P < 0.05). Protease activity explained a further 10% of the alfalfa DM degradation (P < 0.10). Following sequential steps involving the determination of rate and extent of DM and fiber degradation, the best candidates for alfalfa and corn silage were selected. Enzyme products effective with alfalfa hay seemed to exert part of their effect during the pretreatment period, whereas enzymes effective with corn silage worked exclusively after ruminal fluid was added. This finding suggests that different modes of action of exogenous enzymes are attacking different substrates and may partly explain enzyme-feed specificity. In alfalfa, it seems that effective enzymes work by removing structural barriers that retard the microbial colonization of digestible fractions, increasing the rate of degradation. In corn silage, effective enzymes seem to interact with ruminal enzymes to degrade the forage more rapidly, which is consistent with previous findings of synergism between exogenous and ruminal enzymes.

Partial purification and some properties of a hemolymph lectin from Panstrongylus megistus (Hemiptera, Reduviidae).

Hemagglutinating activity was studied in homogenates of three embryonic stages, and in the hemolymph of most instar larvae and in adult insects of Panstrongylus megistus, an important Chagas' disease vector in Brazil. A hemolymph lectin from the 5th instar larvae of P. megistus was purified through a biospecific adsorption by using formaldehyde-treated erythrocytes. The lectin fraction was desorbed with 0.2M D-galactose in 0.15M NaCl. The lectin fraction activity was inhibited by L-rhamnose, D-lactose, raffinose, D-galactose, and D-fucose. The electrophoretic pattern to native and acidic proteins resolved lectin fraction in two main bands with lectin activity. These bands were considered as multiple molecular forms or isoforms of P. megistus lectin. Under denaturating conditions, isoform 1 showed one band with apparent mol wt (MW) of 64 kDa while isoform 2 was resolved in two bands with MW of 64 and 33 kDa.

A simple method for detection of monoclonal isotypes.

A simple rapid method of enzyme labeled anti-isotype assay (ELIA) for detection of monoclonal isotype on hybridoma cells is proposed. This alternative method was first carried out on hybridoma cell lines 147C11 and 257C11 produced against Trypanosoma cruzi and male accessory secretion of Panstrongylus megistus, respectively. The monoclonal antibodies produced by these hybridoma were characterized by this method as IgM (147C11) and IgG1 (257C23) isotypes, allowing evaluation of isotype without having to wait until the concentration of antibody present in the supernatant itself rises. Results were confirmed by Ouchterlony immunodiffusion. The proposed method offers the advantages of a permanent rapid procedure for light microscopy.

A monoclonal antibody against blood forms of Trypanosoma cruzi lyses the parasite in vitro and inhibits host cell invasion.

Monoclonal antibodies (mAbs) of the IgM isotypes were produced from mice immunized with blood forms of Trypansoma cruzi Y strain. Characterization of the epitope recognized by one of the mAbs, 164C11, as well as the effects of this mAb on complement-mediated lysis and host cell invasion are reported. Immunocytochemical analysis showed that the mAb was reactive with various strains of T. cruzi (Y, WSL, and Colombiana) as well as other trypanosomatids. The mAb 164C11 demonstrated a high complement-mediated lytic activity against bloodstream trypomastigotes, being more effective than chronic mouse serum. A protein with an apparent molecular weight of 72 kDa was detected by this mAb on all developmental stages of T. cruzi. Studies using periodate and endoglycosidase treatments suggested that the epitope is not a carbohydrate and seems to be located on the parasite membrane. In addition, preliminary results are presented, suggesting that the 72-kDa protein is involved in adhesion/or internalization of bloodstream trypomastigotes.

Bancroftian filariasis in two urban areas of Recife, Brasil: the role of individual risk factors.

Bancroftian filariasis is spreading in towns of endemic areas in Recife, northeastern Brazil, where it is a major public health problem. This paper deals with the prevalence of microfilaraemia and filarial disease in two urban areas of Recife, studying their association with individual characteristics and variables related to the exposure to the vectors. The parasitologic survey was performed through a "door-to-door" census and microfilaraemia was examined by the thick-drop technique using 45 microliters of peripheral blood collected between 20:00 and 24:00 o'clock. 2,863 individuals aged between 5 and 65 years were interviewed and submitted to clinical examination. Males aged between 15 and 44 years old presented the greatest risk of being microfilaraemic. Microfilaraemia was also significantly associated with no use of bednet to sleep. The risk of being microfilaraemic was greater among those who had lived in the studied areas for more than 5 years. The overall disease prevalence was 6.3%. Males presented the greatest risk of developing acute disease. The risk of developing chronic manifestations was also greater among males and increased with age. We found no association between time of residence, bednet use, microfilaraemia and acute and chronic disease. We may conclude that in endemic areas there are subgroups of individuals who has a higher risk of being microfilariae carriers due to different behaviours in relation to vector contact.

[Views on the municipalization of lymphatic filariasis control in greater metropolitan Recife]. / Perspectivas da municipalização do controle da filariose linfática na região metropolitana do Recife.

Lymphatic filariasis is caused by the nematodes Brugia malayi, Brugia timori, and Wuchereria bancrofti. The disease occurs in developing countries and is more frequent in urban areas. An estimated 4 billion people live in at-risk areas. In Brazil the endemic is caused by W. bancrofti and was first documented in 1878. It was first detected in Recife in 1952. Currently, Recife and Belém are the only cities in Brazil where the endemic is considered a public health problem. The objectives of this study are to discuss the epidemiology and control of lymphatic filariasis and review its control since it was reported by Rachou in 1952. We analyze the "campanhista" or campaign-oriented model employed by the Sucam/FNS institutional program, as well as several proposed innovative methods. We present available strategies for control of filariasis through primary health care services, decentralization to the local level (or "municipalization"), and community-based health programs.

[Comparative studies on endemic areas of bancroftian filariasis in Greater Recife, Brazil]. / Estudo comparativo de áreas endêmicas de filariose bancroftiana na região metropolitana do Recife, Brasil.

Two districts in Recife (Santo Amaro and Campo Grande) and two districts in Olinda (Sapucaia and Salgadinho), were selected for a comparative study of bancroftian filariasis in Greater Recife. Selection parameters included similar socio-economic, demographic, and endemic levels of lymphatic filariasis. In the districts studied, streets were chosen randomly. These clusters consisted of 110 people each. A population sample was stratified by sex and age: 0-4, 5-9, 10-14, 15-19, 20-29, 30-39, 40-49, 50-59 and 60 years old and over. The parasitological data were obtained by measuring thick blood smears (60 micro l), collected from 8:00 to 12:00 PM and processed and stained with hematoxylin. The data were described in tables, and logarithimic expression graphics were used to analyze parasitic densities. In general, Recife showed a prevalence of 13.5%, and Olinda 12.3%. Mean parasitic densities were 41 and 70 microfilariae/60 micro l (mf/60 micro l), respectively. Higher microfilaremic rates were observed in Recife for the 20-29-year age bracket and in Olinda in the 30-39-year bracket. The authors concluded that the disease has returned to former endemic levels, and the data described call for a reevaluation of control campaigns carried out by the Brazilian National Health Foundation, since the endemic has already reached serious proportions.

Resistance to the organophosphate temephos: mechanisms, evolution and reversion in an Aedes aegypti laboratory strain from Brazil.

Insecticide resistance is one of the main problems in vector control programs. Because insects have developed resistance to all classes of available chemical insecticides, a proper surveillance and management of resistance in areas where these compounds are being utilized is crucial for the success of control programs. Since the mechanisms and molecular bases of resistance are various, they must be characterized to allow efficient monitoring strategies. Here we report the establishment of an Aedes aegypti strain resistant to temephos, named RecR, selected under laboratory conditions. The parental A. aegypti population was obtained from eggs collected in an area where temephos had been used for 8 years, and presented a baseline resistance ratio (RR) of 7. After 17 generations under selective pressure, the RR has increased to 180. Biochemical assays indicate that metabolic mechanisms are involved on temephos resistance in the selected strain. These experiments showed that, compared to the susceptible colony Rockefeller, RecR present higher activity of glutathione S-transferases (GSTs), alpha- and beta-esterases, and, to a lesser degree, mixed function oxidases (MFO). At the 14th or 17th generations, there was no cross resistance of these insects to deltamethrin, cypermethrin and malathion, while a low resistance level (RR=3) was observed for pyriproxyfen, a juvenile hormone analogue. Experiments on resistance reversal, performed through three different field simulated schemes using the resistant strain, showed that temephos susceptibility can be recovered. The establishment of an A. aegypti colony resistant to temephos is extremely valuable for a deeper understanding of resistance mechanisms and thus for further improvements in control strategies against this vector. With the urgent need on improving methodologies to monitor resistance, molecular studies such as microarrays, and resistant colonies such as RecR will certainly hasten such studies.

Effects of juvenile hormone analogue on ecdysis prevention induced by precocene in Rhodnius prolixus (Hemiptera:Reduviidae).

Precocene II, added to the meal of fourth-instar larvae of Rhodnius prolixus (25 micrograms/ml of blood), induced an increase in the duration of the molting cycle. This effect was related to the decrease of both the nuclear area of the prothoracic gland cells and the mitotic activity in epidermal cells. Juvenile hormone analogue applied topically (60 micrograms/insect) together with Precocene II treatment avoided atrophy of the prothoracic glands and induced a higher number of epidermal mitosis accelerating the time of subsequent ecdysis. A possible relationship between juvenile hormone and production of ecdysone is discussed.

Effects of gamma irradiation on the reproductive capacity and the longevity of Panstrongylus megistus (Hemiptera: Reduviidae).

The effects of radiation on the reproductive capacity and the longevity of Panstrongylus megistus were studied. An indirect correlation between longevity and radiation doses was observed. Males were more affected than females. Longevity of females submitted to 10 Gy was not different when compared to controls. Some of the irradiated males copulated and in these cases semen was transferred to females, but only few eggs were laid. Fertility was seriously affected in all irradiated groups, decreasing with increasing intensity of dose. The dose of 80 Gy induced sterility in males and females. Gelatinous spermatophores that were expelled by females irradiated with 20 and 40 Gy, may be a consequence of irradiation that induced modification in the bursa copulatrix pH.

Natural lectin activity in the haemolymph of Panstrongylus megistus (Heteroptera: Reduviidae).

The haemolymph of Panstrongylus megistus showed a natural lectin activity for a wide range of vertebrate erythrocytes. Agglutination was observed against all vertebrate erythrocytes tested (human ABO, duck, rabbit, mouse, sheep, chicken and cow). Cow erythrocytes showed the lowest titre. Concerning human erythrocytes, the lectin activity was similar in the types A+, B+ and AB+ while the highest activity was observed in the type O+. Determination of minimal inhibitory concentrations was carried out with human erythrocytes type O+. Agglutination was inhibited by several carbohydrates (rhamnose, D-galactose, raffinose, D-lactose and D-fucose). Rhamnose was reported as the strongest inhibitor (0.78 mM). The results suggest the presence of more than one lectin in the haemolymph of P. megistus.