RESUMEN
Zika virus is an arthropod-borne virus that is a member of the family Flaviviridae transmitted mainly by mosquitoes of the genus Aedes. Although usually asymptomatic, infection can result in a mild and self-limiting illness characterised by fever, rash, arthralgia, and conjunctivitis. An increase in the number of children born with microcephaly was noted in 2015 in regions of Brazil with high transmission of Zika virus. More recently, evidence has been accumulating supporting a link between Zika virus and microcephaly. Here, we describe findings from three fatal cases and two spontaneous abortions associated with Zika virus infection.
Asunto(s)
Niño , Virus Zika , MicrocefaliaRESUMEN
During 1985-1995, illnesses clinically and epidemiologically compatible with Brazilian spotted fever were identified in 17 patients in the county of Pedreira, in the state of São Paulo, Brazil. Spotted-fever group rickettsial infection was confirmed by serology and/or immunostaining of tissues in 10 of these patients. Immunostaining confirmed infection in a 37-year-old pregnant patient, although rickettsial antigens were not demonstrable in the tissues of the fetus. A serosurvey was conducted in four localities in the county to determine the prevalence of subclinical or asymptomatic infections with spotted fever group rickettsiae. Five hundred and twenty-five blood samples were tested by an indirect immunofluorescence assay for antibodies reactive with Rickettsia rickettsii. Twenty-two (4.2%) of these samples demonstrated titers > or = 1:64. The results indicate that Brazilian spotted fever is endemic within this region of Brazil.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Enfermedades Endémicas/estadística & datos numéricos , Rickettsia rickettsii/aislamiento & purificación , Fiebre Maculosa de las Montañas Rocosas/epidemiología , Adulto , Animales , Brasil/epidemiología , Niño , Preescolar , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Rickettsia rickettsii/inmunología , Fiebre Maculosa de las Montañas Rocosas/inmunología , Fiebre Maculosa de las Montañas Rocosas/microbiología , Estudios Seroepidemiológicos , Pruebas Serológicas , Piel/patologíaRESUMEN
Between 1993 and 1998, 10 cases of clinical hantavirus infection were diagnosed in Brazil. Hantavirus-specific IgM, or positive immunohistochemical analysis for hantavirus antigen, or positive reverse transcription-polymerase chain reaction results for hantavirus RNA were used to confirm nine of these cases; eight were hantavirus pulmonary syndrome (HPS), and one was mild hantavirus disease. The remaining clinical case of hantavirus infection was fatal, and no tissue was available to confirm the diagnosis. During the first 7 months of 1998, five fatal HPS cases caused by a Sin Nombre-like virus were reported from three different regions in the State of São Paulo, Brazil: two in March (Presidente Prudente Region), two in May (Ribeirão Preto Region), and one in July (Itapecerica da Serra Region). Epidemiologic, ecologic, and serologic surveys were conducted among case contacts, area residents, and captured rodents in five locations within the State of São Paulo in June of 1998. Six (4.8%) of 125 case contacts and six (5.2%) of 116 area residents had IgG antibody to Sin Nombre virus (SNV) antigen. No case contacts had a history of HPS-compatible illness, and only one area resident reported a previous acute respiratory illness. A total of 403 rodents were captured during 9 nights of trapping (1969 trap nights). All 27 rodents that were found to be positive for IgG antibody to SNV antigen were captured in crop border and extensively deforested agricultural areas where four of the 1998 HPS case-patients had recently worked. The IgG antibody prevalence data for rodents suggest that Bolomys lasiurus and perhaps Akodon sp. are potential hantavirus reservoirs in this state of Brazil.
Asunto(s)
Anticuerpos Antivirales/sangre , Reservorios de Enfermedades , Síndrome Pulmonar por Hantavirus/epidemiología , Orthohantavirus/inmunología , Enfermedades de los Roedores/virología , Zoonosis , Adolescente , Adulto , Animales , Antígenos Virales/inmunología , Brasil/epidemiología , Reservorios de Enfermedades/veterinaria , Resultado Fatal , Femenino , Orthohantavirus/aislamiento & purificación , Infecciones por Hantavirus/epidemiología , Infecciones por Hantavirus/virología , Síndrome Pulmonar por Hantavirus/virología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Enfermedades de los Roedores/inmunología , Roedores , Estudios SeroepidemiológicosRESUMEN
Between November 1993 and March 1994, a cluster 6 pediatric patients with acute febrile illnesses associated with rashes was identified in Jujuy Province, Argentina. Immunohistochemical staining of tissues confirmed spotted fever group rickettsial infection in a patient with fatal disease, and testing of serum of a patient convalescing from the illness by using an indirect immunofluorescence assay (IFA) demonstrated antibodies reactive with spotted fever group rickettsiae. A serosurvey was conducted among 16 households in proximity to the index case. Of 105 healthy subjects evaluated by IFA, 19 (18%) demonstrated antibodies reactive with rickettsiae or ehrlichiae: 4 had antibodies reactive with Rickettsia rickettsii, 15 with Ehrlichia chaffeensis, and 1 with R. typhi. Amblyomma cajennense, a known vector of R. rickettsii in South America, was collected from pets and horses in the area. These results are the first to document rickettsial spotted fever and ehrlichial infections in Argentina.
Asunto(s)
Ehrlichia chaffeensis/aislamiento & purificación , Ehrlichiosis/epidemiología , Rickettsia rickettsii/aislamiento & purificación , Fiebre Maculosa de las Montañas Rocosas/epidemiología , Adolescente , Adulto , Anticuerpos Antibacterianos/sangre , Argentina/epidemiología , Niño , Preescolar , Ehrlichia chaffeensis/inmunología , Resultado Fatal , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Técnicas para Inmunoenzimas , Masculino , Rickettsia rickettsii/inmunología , Fiebre Maculosa de las Montañas Rocosas/fisiopatología , Estudios SeroepidemiológicosRESUMEN
In the spring of 1996, multiple cases of an acute febrile illness resulting in several deaths in remote locations in Peru were reported to the Centers for Disease Control and Prevention (CDC). The clinical syndromes for these cases included dysphagia and encephalitis. Because bat bites were a common occurrence in the affected areas, the initial clinical diagnosis was rabies. However, rabies was discounted primarily because of reported patient recovery. Samples of brain tissue from two of the fatal cases were received at CDC for laboratory confirmation of the rabies diagnosis. An extensive array of tests on the formalin-fixed tissues confirmed the presence of both rabies viral antigen and nucleic acid. The virus was shown to be most closely related to a vampire bat rabies isolate. These results indicate the importance of maintaining rabies in the differential diagnosis of acute febrile encephalitis, particularly in areas where exposure to vampire bats may occur.
Asunto(s)
Encefalopatías/diagnóstico , Encéfalo/virología , Quirópteros/virología , Virus de la Rabia/aislamiento & purificación , Rabia/diagnóstico , Animales , Anticuerpos Monoclonales , Anticuerpos Antivirales/sangre , Antígenos Virales/análisis , Secuencia de Bases , Encéfalo/ultraestructura , Encefalopatías/virología , Cartilla de ADN/química , Brotes de Enfermedades , Vectores de Enfermedades , Femenino , Técnica del Anticuerpo Fluorescente Directa , Histocitoquímica , Humanos , Hibridación in Situ , Ratones , Ratones Endogámicos ICR , Datos de Secuencia Molecular , Hibridación de Ácido Nucleico , Perú , Reacción en Cadena de la Polimerasa , Rabia/mortalidad , Rabia/virología , Virus de la Rabia/genética , Virus de la Rabia/inmunología , Alineación de Secuencia , Homología de Secuencia de Ácido NucleicoRESUMEN
In October 1995, epidemic "hemorrhagic fever," without jaundice or renal manifestations, was reported in rural Nicaragua following heavy flooding; 2259 residents were evaluated for nonmalarial febrile illnesses (cumulative incidence, 6.1%) and 15 (0.7%) died with pulmonary hemorrhage. A case-control study found that case-patients were more likely than controls to have ever walked in creeks (matched odds ratio [MOR], 15.0; 95% confidence interval [CI], 1.7-132.3), have household rodents (MOR, 10.4; 95% CI, 1.1-97.1), or own dogs with titers >/=400 to Leptospira species (MOR, 23.4; 95% CI, 3.6-infinity). Twenty-six of 51 case-patients had serologic or postmortem evidence of acute leptospirosis. Leptospira species were isolated from case-patients and potential animal reservoirs. This leptospirosis epidemic likely resulted from exposure to flood waters contaminated by urine from infected animals, particularly dogs. Leptospirosis should be included in the differential diagnosis for nonmalarial febrile illness, particularly during periods of flooding or when pulmonary hemorrhage occurs.
Asunto(s)
Hemorragia/complicaciones , Leptospirosis/epidemiología , Enfermedades Pulmonares/complicaciones , Adolescente , Adulto , Animales , Estudios de Casos y Controles , Bovinos , Niño , Preescolar , Desastres , Brotes de Enfermedades , Vectores de Enfermedades , Perros , Hemorragia/microbiología , Caballos , Humanos , Incidencia , Lactante , Leptospira/clasificación , Leptospira/aislamiento & purificación , Leptospirosis/complicaciones , Leptospirosis/microbiología , Enfermedades Pulmonares/microbiología , Nicaragua/epidemiología , Roedores , Porcinos , Microbiología del AguaRESUMEN
During an investigation of hantavirus pulmonary syndrome (HPS) in Paraguay in 1995, sera from persons with HPS-like illness, houshold contacts of confirmed HPS case-patients, and a sample of the area residents were analyzed by ELISA for antibodies to Sin Nombre virus (SNV). Rodent serosurveys and analysis of precipitation records were also conducted. Twenty-three of 24 available probable cases were SNV antibody-positive, 17 of whom were ill between July 1995 and January 1996. Four (14.8%) of 27 case-contacts and 44 (12.8%) of 345 community residents were also seropositive. Calomys laucha (vesper mouse) was the most common rodent species captured and the most frequently SNV-seropositive. Rainfall in May 1995 was 10-fold greater than that seen in May over the preceding 11 years. This 17 case-cluster represents the largest documented outbreak since HPS was first recognized in 1993. Calomys laucha is the likely primary rodent reservoir for a SNV-like hantavirus in western Paraguay. Fluctuations in monthly precipitation rates may have contributed to increased risk for HPS in this region.
Asunto(s)
Anticuerpos Antivirales/sangre , Brotes de Enfermedades , Síndrome Pulmonar por Hantavirus/epidemiología , Orthohantavirus/inmunología , Roedores/virología , Adulto , Animales , Análisis por Conglomerados , Reservorios de Enfermedades/veterinaria , Femenino , Orthohantavirus/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Paraguay/epidemiología , Lluvia , Roedores/inmunologíaAsunto(s)
Brotes de Enfermedades , Fiebre/epidemiología , Hemorragia/epidemiología , Leptospirosis/epidemiología , Enfermedades Pulmonares/epidemiología , Diagnóstico Diferencial , Fiebre/etiología , Hemorragia/etiología , Humanos , Leptospira/aislamiento & purificación , Leptospirosis/complicaciones , Leptospirosis/diagnóstico , Enfermedades Pulmonares/etiología , Nicaragua/epidemiologíaRESUMEN
An infant boy with a congenital immunodeficiency had fatal disseminated measles after administration of a live attenuated measles vaccine. This rare complication was confirmed with molecular virologic techniques. Although efforts to expand availability of vaccinations are critically important, caution is warranted in children with potentially severe immunologic dysfunction.