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Objetivo: investigar os casos de febre maculosa, verificar os aspectos relacionados à assistência à saúde e caracterizar o perfil epidemiológico desses e do ambiente de infecção. Métodos: estudo descritivo dos casos confirmados de FM entre janeiro e novembro de 2017. Foi elaborado um formulário semiestruturado para coleta dos dados. Para as análises epidemiológicas, foram utilizados os programas EpiInfoTM 7 e Qgis® 2.18.1. Foram calculadas frequências, medidas de tendência central, dispersão e indicadores de oportunidade de assistência. Nos ambientes prováveis de infecção, foram realizadas coletas de carrapatos que foram identificados e submetidos à pesquisa de Rickettsia do grupo da FM. Resultados: foram confirmados 15 casos de FM; desses, a maioria foi do sexo masculino (93%) com média de 42 anos de idade; 10 evoluíram para óbito. Todos apresentaram febre, 13(87%) cefaleia e 12(80%) mialgia. Apresentaram mediana e média de evolução para óbito pela doença de 6 dias (1 a 9), oportunidades de hospitalização, tratamento, diagnóstico e notificação de 4,5(0 a 8); 7(0 a 26); 9(DP±6) e 33(DP±45) dias, respectivamente. Para assistência à saúde, 14(93%) casos procuraram atendimento mais de duas vezes, com tempo de internação de 4,5 dias (0 a 8 dias). O hospital foi o serviço procurado, exclusivamente, no quarto atendimento. Dengue e FM foram as hipóteses diagnósticas mais frequentes. Foram coletados 250 espécimes de carrapatos em quatro municípios, sendo em um município identificado Amblyomma sculptum naturalmente infectados. Conclusões: foram assinaladas condições assistenciais pouco sensíveis à ocorrência da FM, o que, provavelmente, colaborou para ocorrência de óbitos, além da necessidade de sensibilização de equipes de saúde e vigilância quanto à ocorrência da FM na região.

Objective: investigate the cases of spotted fever, verify aspects related to health care and characterize the epidemiological profile of these and of the environment of infection. Methods: A descriptive study of confirmed cases of SF between January and November 2017. A semi-structured form for data collection was developed. EpiInfoTM 7 and Qgis® 2.18.1. Frequencies, measures of central tendency, dispersion and indicators of opportunity of assistance were calculated. In the probable environments of infection ticks were collected, identified and submitted to Rickettsia research of the SF group. Results: Fifteen SF cases were confirmed; of these, the majority was male (93%) and averaged 42 years old; 10 evolved to death. All presented fever, 13 (87%) headache and 12 (80%) myalgia. They presented an average of evolution to death by SF of 6 days (1 to 9), opportunities for hospitalization, treatment, diagnosis and notification of 4.5(0 to 8); 7(0 to 26); 9(DP± 6) and 33(DP± 45) days respectively. For health care, 14(93%) cases sought care more than twice and were hospitalized for 4.5-days (0 to 8 days). The hospital was the only service exclusively sought in the fourth service. Dengue and SF were the most frequent diagnostic hypotheses. A total of 250 specimens of ticks were collected in four counties, and in one municipality Amblyomma sculptum was identified as naturally infected. Conclusions: It was pointed out that assistance conditions were not very sensitive to the occurrence of SF which probably contributed to the instance of deaths as well as the need for sensitization of health and surveillance teams regarding the appearance of SF in the region.

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Objetivo: investigar surto de toxoplasmose no município de Gouveia-MG, no período entre fevereiro e maio de 2015. Método: foram realizados estudos descritivo e caso-controle, com análise multivariada (regressão logística) e nível de significância de 5%. Definiu-se como caso o indivíduo com toxoplasmose aguda, confirmada laboratorialmente (IgM e/ou IgG reagentes e baixa avidez de IgG), e controle o indivíduo susceptível (IgM e IgG não reagentes). Resultado: o estudo contemplou 50 casos e 68 controles, sendo a maioria dos casos do sexo masculino (43 pacientes, 86%). Os casos tiveram 10 vezes mais chance de tomar água procedente do Manancial (IC95%: 2,8-37,4; p=0,01), 5,1 vezes mais chance de ingerir linguiça (IC95%: 1,2-20,4; p=0,02) e 4,5 vezes mais chance de ser do sexo masculino (IC95%: 1,2-16,7; p=0,02), quando comparados aos controles. Conclusão: foi confirmado um surto de toxoplasmose aguda, em Gouveia - MG, de transmissão hídrica e/ou alimentar. A maior ocorrência no sexo masculino pode estar relacionada a hábitos de risco, envolvidos na transmissão da doença. Foram propostas medidas que resultaram na diminuição e no controle dos casos da doença.

Objective: to investigate the outbreak of toxoplasmosis in the municipality of Gouveia-MG, between February and May 2015. Methods: Descriptive and case control study, with multivariate analysis (logistic regression) and level of significance of 5%. For the purpose of the study, a case was defined on an individual with laboratory which confirmed acute toxoplasmosis (IgM and/or IgG with low IgG avidity) and a control was a susceptible individual (nonreactive IgM and IgG). Results: The study comprised 50 cases and 68 controls, with most cases being male (43 patients, 86%). When compared to controls, cases had 10 times greater odds of having drunk water from Stream A (IC95%: 2,8-37,4; p=0,01), 5,1 times greater odds of having ingested sausage (IC95%: 1,2-20,4; p=0,02) and 4.5 times greater odds of being of male sex (IC95%: 1,2-16,7; p=0,02). Conclusion: A water/foodborne outbreak of acute toxoplasmosis was confirmed in Gouveia-MG, affecting predominantly men. This may be associated with habits regarding disease transmission. Measures that resulted in the reduction and control of cases of this disease have been proposed.

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OBJETIVO: to investigate the occurrence of GBS in the Metropolitan Region of Recife, PE, Brazil, 2015. METHODS: this was a descriptive study using data from the Hospital Information System, National Pharmaceutical Services Management System and interviews; GBS cases were classified according to Brighton criteria and prior infection according to laboratory and clinical criteria. RESULTS: in 2015, the number of GBS hospitalizations had a threefold increase in comparison to 2014. We investigated 44 confirmed or probable GBS cases, of which 18 had symptoms of Zika infection up to 35 days before the occurrence of GBS, mainly rash; one case was laboratory-confirmed for Zika virus infection and one death was registered. CONCLUSION: the findings reinforce a possible relationship between GBS and Zika infection, given the absence of increased GBS occurrence in previous dengue epidemic years, absence of chikungunya transmission records, presence of clinical manifestations compatible with infection and a laboratory confirmation.

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Objetivo: investigar a ocorrência da síndrome de Guillain-Barré (SGB) na Região Metropolitana do Recife, Brasil, 2015. Métodos: estudo descritivo com dados do Sistema de Informações Hospitalares, Sistema Nacional de Gestão da Assistência Farmacêutica e entrevistas; os casos de SGB foram classificados segundo os critérios de Brighton, e a infecção prévia, segundo critérios laboratoriais e clínicos. Resultados: em 2015, houve três vezes mais internações por SGB que em 2014; investigaram-se 44 casos confirmados ou prováveis de SGB, dos quais 18 apresentaram sintomas de infecção por Zika até 35 dias antes da ocorrência da SGB, principalmente exantema; houve um caso confirmado laboratorialmente para Zika e um óbito. Conclusão: os achados reforçam possível relação da SGB com infecção por Zika, por ausência de aumento da ocorrência da SGB em anos epidêmicos de dengue, ausência de registro de transmissão de chikungunya, presença de manifestações clínicas compatíveis com infecção por Zika e uma confirmação laboratorial.

Objetivo: investigar la ocurrencia de SGB en la Región Metropolitana de Recife, Brasil, 2015. Métodos: estudio descriptivo utilizando datos del Sistema de Información Hospitalaria, Sistema Nacional de Gestión de Atención Farmacéutica y entrevistas; los casos de SGB fueron clasificados de acuerdo con criterios de Brighton y la infección anterior segundo criterios laboratoriales y clínicos. Resultados: en 2015, hubo tres veces más internaciones por SGB que 2014; se investigaron 44 casos confirmados o probables de SGB, donde 18 tenían síntomas de infección por Zika hasta 35 días antes de la SGB, especialmente erupción; hubo una confirmación laboratorial de Zika y una muerte. Conclusión: los hallazgos refuerzan la posible relación de SGB con infección por Zika, frente la ausencia de aumento de la ocurrencia de SGB en años epidémicos de dengue, ausencia de registro de transmisión de chikungunya, presencia de manifestaciones clínicas compatibles con infección previa por Zika y una confirmación laboratorial.

Objetivo: to investigate the occurrence of GBS in the Metropolitan Region of Recife, PE, Brazil, 2015. Methods: this was a descriptive study using data from the Hospital Information System, National Pharmaceutical Services Management System and interviews; GBS cases were classified according to Brighton criteria and prior infection according to laboratory and clinical criteria. Results: in 2015, the number of GBS hospitalizations had a threefold increase in comparison to 2014. We investigated 44 confirmed or probable GBS cases, of which 18 had symptoms of Zika infection up to 35 days before the occurrence of GBS, mainly rash; one case was laboratory-confirmed for Zika virus infection and one death was registered. Conclusion: the findings reinforce a possible relationship between GBS and Zika infection, given the absence of increased GBS occurrence in previous dengue epidemic years, absence of chikungunya transmission records, presence of clinical manifestations compatible with infection and a laboratory confirmation.

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OBJETIVO: descrever as características clínicas e epidemiológicas dos casos de microcefalia em nascidos vivos no estado de Sergipe, Brasil, e calcular as prevalências em seus municípios. MÉTODOS: estudo descritivo sobre nascidos vivos no período de 1o/set a 30/nov de 2015, com dados de prontuários e entrevistas com as mães. RESULTADOS: confirmaram-se 83 casos de microcefalia, com três óbitos; a prevalência nos 26 municípios com casos confirmados variou de 18 a 185/10.000 nascidos vivos; a mediana do perímetro cefálico foi de 31cm (amplitude: 22,5 a 33,0cm); na ultrassonografia transfontanelar, observou-se agenesia de corpo caloso (26/43), lisencefalia (12/43), ausência de linha média (10/43) e ventriculomegalia (8/43); 40 mães referiram exantema na gestação, 23 no primeiro trimestre, com prurido, artralgia e cefaleia; sete foram positivas para infecções potencialmente causadoras de malformações. CONCLUSÃO: observou-se elevada ocorrência de casos de microcefalia, e relato de sinais e sintomas compatíveis com infecção por vírus Zika na gestação.

OBJETIVO: describir las características clínicas y epidemiológicas de los casos de microcefalia en nacidos vivos en Sergipe, Brasil, y calcular la prevalencia en los municipios. MÉTODOS: estudio descriptivo de nacidos vivos en el período de 1 de septiembre 30 de de noviembre de 2015. RESULTADOS: se confirmaron 83 casos de microcefalia, con tres muertes; la prevalencia en los 26 municipios osciló entre 18 y 185/10.000 nacidos vivos; la circunferencia de la cabeza media fue de 31cm (rango: 22,5;33,0); en la ecografía transfontanelar había agenesia del cuerpo calloso (26/43), lisencefalia (12/43), la ausencia de la línea media (10/43) y ventrículomegalia (8/43); 40 madres reportaron exantema en el embarazo, 23 en el primer trimestre, con prurito, artralgia y cefalea; siete fueron positivos para infecciones potencialmente causantes de malformaciones. CONCLUSIÓN: hubo una alta incidencia de casos de microcefalia, y la notificación de los signos y síntomas compatibles con infección por el virus Zika durante el embarazo.

OBJECTIVE: to describe the clinical and epidemiological characteristics of microcephaly cases in live births in Sergipe, Brazil, and to calculate the prevalence in its municipalities. METHODS: this is a descriptive study on live births from September 1st to November 30th, 2015, with data from medical records and interviews with mothers. RESULTS: 83 cases of microcephaly were confirmed, with three deaths; prevalence in the 26 municipalities with confirmed cases ranged from 18 to 185/10,000 live births; the median of head circumference was 31 cm (range: 22.5-33.0); agenesis of corpus callosum (26/43), lissencephaly (12/43), absence of midline (10/43) and ventriculomegaly (8/43) were observed in the transfontanellar ultrasound; 40 mothers reported rash in pregnancy, 23 in the first trimester, with pruritus, arthralgia and headache; seven were positive for infections potentially causing malformations. CONCLUSION: there was a high occurrence of cases of microcephaly, and reports of signs and symptoms compatible with Zika virus infection during pregnancy.

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OBJECTIVE: to describe the clinical and epidemiological characteristics of microcephaly cases in live births in Sergipe, Brazil, and to calculate the prevalence in its municipalities. METHODS: this is a descriptive study on live births from September 1st to November 30th, 2015, with data from medical records and interviews with mothers. RESULTS: 83 cases of microcephaly were confirmed, with three deaths; prevalence in the 26 municipalities with confirmed cases ranged from 18 to 185/10,000 live births; the median of head circumference was 31 cm (range: 22.5-33.0); agenesis of corpus callosum (26/43), lissencephaly (12/43), absence of midline (10/43) and ventriculomegaly (8/43) were observed in the transfontanellar ultrasound; 40 mothers reported rash in pregnancy, 23 in the first trimester, with pruritus, arthralgia and headache; seven were positive for infections potentially causing malformations. CONCLUSION: there was a high occurrence of cases of microcephaly, and reports of signs and symptoms compatible with Zika virus infection during pregnancy.

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Objetivo: descrever os casos notificados de síndrome de Guillain-Barré (SGB) e outras manifestações neurológicas com histórico de infecção por dengue, chikungunya ou Zika, na Região Metropolitana de Salvador e no município de Feira de Santana, Brasil. Métodos: estudo descritivo com dados de investigação conduzida pela vigilância epidemiológica, de março a agosto de 2015; para confirmar as manifestações neurológicas, considerou-se o registro de diagnóstico médico, e para infecção prévia, utilizaram-se critérios clínicos e laboratoriais. Resultados: dos 138 casos suspeitos investigados, 57 relataram quadro infeccioso até 31 dias antes dos sintomas neurológicos - 30 prováveis de infecção por Zika, 13 por dengue, 8 por chikungunya e 6 inconclusivos -; SGB foi a condição neurológica mais frequente (n=46); houve predomínio do sexo masculino (n=32), e a mediana de idade foi de 44 anos. Conclusão: a maioria dos casos relatou quadro clínico compatível com doença aguda pelo vírus Zika, que precedeu a ocorrência dos sintomas neurológicos.

Objetivo: investigar los casos notificados de síndrome de Guillain-Barré (SGB) y otras manifestaciones neurológicas con antecedentes de infección por dengue, chikungunya o Zika en la Región Metropolitana de Salvador y Feira de Santana, Brasil. Métodos: estudio descriptivo con datos de la investigación realizada por la vigilancia epidemiológica, de marzo a agosto de 2015. ; para confirmar una manifestación neurológica se consideró el registro de diagnóstico médico y para infección previa, criterios clínicos y de laboratorio. Resultados: de los 138 casos sospechosos investigados, 57 presentaron un cuadro infeccioso, hasta 31 días antes de presentar síntomas neurológicos. - 30 probablemente con infección por zika, 13 dengue, 8 chikungunya y 6 no concluyentes -; de éstos, SGB fue la condición neurológica más frecuente (n=46), hubo un predominio del sexo masculino (n=32) y la mediana de edad fue 44 (rango: 2-83) años. Conclusión: la mayoría de los casos relató un cuadro clínico compatible con enfermedad aguda por virus Zika, que precedió la aparición de síntomas neurológicos.

Objective: to describe the reported cases of Guillain-Barré Syndrome (GBS) and other neurological manifestations with a history of dengue, chikungunya or Zika virus infections, in the Metropolitan Region of Salvador and in the municipality of Feira de Santana, Brazil. Methods: this is a descriptive study with data of an investigation conducted by the epidemiological surveillance from March to August 2015; to confirm the neurological manifestations, medical diagnosis records were considered, and to prior infection, clinical and laboratory criteria were used. Results: 138 individuals were investigated, 57 reported infectious process up to 31 days before neurological symptoms - 30 possibly due to Zika, 13 to dengue, 8 to chikungunya and 6 were inconclusive -; GBS was the most frequent neurological condition (n=46), with predominance of male sex (n=32) and the median age was 44. Conclusion: most cases reported a clinical picture consistent with acute Zika virus disease, which preceded the occurrence of neurological symptoms.

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Objective: to describe the reported cases of Guillain-Barré Syndrome (GBS) and other neurological manifestations with a history of dengue, chikungunya or Zika virus infections, in the Metropolitan Region of Salvador and in the municipality of Feira de Santana, Brazil. Methods: this is a descriptive study with data of an investigation conducted by the epidemiological surveillance from March to August 2015; to confirm the neurological manifestations, medical diagnosis records were considered, and to prior infection, clinical and laboratory criteria were used. Results: 138 individuals were investigated, 57 reported infectious process up to 31 days before neurological symptoms - 30 possibly due to Zika, 13 to dengue, 8 to chikungunya and 6 were inconclusive -; GBS was the most frequent neurological condition (n=46), with predominance of male sex (n=32) and the median age was 44. Conclusion: most cases reported a clinical picture consistent with acute Zika virus disease, which preceded the occurrence of neurological symptoms.

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OBJETIVO: Confirmar a circulação do vírus Zika e descartar outros agentes etiológicos em surto ocorrido no Rio Grande do Norte (RN), Maranhão (MA) e Paraíba (PB), em maio/2015. MÉTODOS: estudo descritivo de série de casos com residentes em Natal-RN, Barra do Corda-MA, São Luís-MA e João Pessoa-PB, 20 em cada estado, com exantema e ausência de febre ou febre baixa e um dos seguintes sinais/sintomas, hiperemia conjuntival, artralgia ou edema de membros; realizou-se RT-PCR/isolamento para Zika, enterovírus e vírus respiratórios, e sorologias (dengue, rubéola e parvovírus B19). RESULTADOS: os principais sintomas foram exantema (n=60), prurido (n=54) e artralgia (n=47); 51 indivíduos não apresentaram febre; identificou-se vírus Zika em 18 casos (12 na PB, quatro no MA e dois no RN) e anticorpos para dengue em 14. CONCLUSÃO: os sintomas foram compatíveis com febre pelo vírus Zika; houve confirmação laboratorial de Zika e dengue.

OBJETIVOS: confirmar la circulación del virus Zika y descartar otros agentes etiológicos en el brote ocurrido en Rio Grande do Norte (RN), Maranhão (MA) y Paraíba (PB), en mayo/2015. MÉTODOS: estudio descriptivo de serie de casos con residentes de Natal-RN, Barra do Corda-MA, São Luís-MA y João Pessoa-PB, 20 en cada estado, con exantema y ausencia de fiebre o fiebre baja y uno de los siguientes signos/síntomas, hiperemia conjuntival, artralgia o edema de miembros; se realizaron RT-PCR/aislamiento para Zika, enterovirus y virus respiratorios y serologías (dengue, rubéola y parvovirus B19). RESULTADOS: los principales síntomas fueron exantema (n=60), prurito (n=54) y artralgia (n=47); 51 individuos no presentaron fiebre, se identificó virus Zika en 18 casos (12 en PB, cuatro en MA y dos en RN) y anticuerpos para dengue en 14. CONCLUSIÓN: Los síntomas fueron compatibles con fiebre por el virus Zika; hubo confirmación por laboratorio de Zika y dengue.

OBJECTIVE: to confirm Zika virus circulation and discard other etiological agents in an outbreak occurred in the states of Rio Grande do Norte, Maranhão and Paraíba, in May, 2015. METHODS: this is a case series descriptive study with residents in Natal-RN, Barra do Corda-MA, São Luis-MA and João Pessoa-PB, with 20 cases in each state, presenting rash, absent or mild fever and one of the following signs/symptoms: conjunctival hyperemia, arthralgia or limb edema; RT-PCR/isolation tests for Zika, enterovirus and respiratory viruses, and serology tests (dengue, rubella and parvovirus B19) were performed. RESULTS: the main symptoms were rash (n=60), pruritus (n=54), and arthralgia (n=47); 51 individuals did not present fever; Zika virus was identified in 18 cases (12 in Paraíba, four in Maranhão and two in Rio Grande do Norte), and antibodies to dengue, in 14 cases. CONCLUSION: the symptoms were consistent with Zika virus fever; there was laboratory confirmation for Zika and dengue.

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OBJECTIVE: to confirm Zika virus circulation and discard other etiological agents in an outbreak occurred in the states of Rio Grande do Norte, Maranhão and Paraíba, in May, 2015. METHODS: this is a case series descriptive study with residents in Natal-RN, Barra do Corda-MA, São Luis-MA and João Pessoa-PB, with 20 cases in each state, presenting rash, absent or mild fever and one of the following signs/symptoms: conjunctival hyperemia, arthralgia or limb edema; RT-PCR/isolation tests for Zika, enterovirus and respiratory viruses, and serology tests (dengue, rubella and parvovirus B19) were performed. RESULTS: the main symptoms were rash (n=60), pruritus (n=54), and arthralgia (n=47); 51 individuals did not present fever; Zika virus was identified in 18 cases (12 in Paraíba, four in Maranhão and two in Rio Grande do Norte), and antibodies to dengue, in 14 cases. CONCLUSION: the symptoms were consistent with Zika virus fever; there was laboratory confirmation for Zika and dengue.

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