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In recent months, Paraguay has been grappled with a notable monkeypox outbreak, straining its healthcare infrastructure. The sudden spike in cases underlines the imperative need for a comprehensive understanding of the virus's dynamics, enabling the formulation of robust containment measures. To address this challenge, our team joined forces with the Central Public Health Laboratory of Asunción and the Pan-American Health Organization. Through this collaboration, we employed portable whole-genome sequencing combined with phylodynamic analysis to examine the MPXV strains circulating in Paraguay. Our genomic monitoring approach has produced the first 30 whole-genome sequences from Paraguay, all of which were identified under lineage IIb. Interestingly, our data suggest that the origin of the monkeypox virus in Paraguay at the beginning of 2022 can be traced back to Brazil. This introduction subsequently catalyzed further community spread that was further exacerbated by several independent introduction events as time progressed. These findings not only shed light on the transmission patterns of the virus but also highlight the pivotal role such insights play in sculpting effective response strategies and driving impactful public health measures. Furthermore, our findings strongly advocate intensified surveillance at international borders, ensuring swift detection and proactive countermeasures against potential outbreaks in the future.
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Epidemias , Mpox , Humanos , Mpox/epidemiologia , Paraguai/epidemiologia , Genômica , Surtos de DoençasRESUMO
The spread of Chikungunya virus is a major public health concern in the Americas. There were >120,000 cases and 51 deaths in 2023, of which 46 occurred in Paraguay. Using a suite of genomic, phylodynamic, and epidemiologic techniques, we characterized the ongoing large chikungunya epidemic in Paraguay.
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Febre de Chikungunya , Vírus Chikungunya , Epidemias , Humanos , Vírus Chikungunya/genética , Paraguai/epidemiologia , África do Sul , Febre de Chikungunya/epidemiologia , Filogenia , GenótipoRESUMO
Dengue virus (DENV) has been a major public health concern in Paraguay, with frequent outbreaks occurring since early 1988. Although control measures have been implemented, dengue remains a significant health threat in the country, and continued efforts are required for prevention and control. In response to that, in collaboration with the Central Public Health Laboratory in Asunción, we conducted a portable whole-genome sequencing and phylodynamic analysis to investigate DENV viral strains circulating in Paraguay over the past epidemics. Our genomic surveillance activities revealed the co-circulation of multiple DENV serotypes: DENV-1 genotype V, the emerging DENV-2 genotype III, BR4-L2 clade, and DENV-4 genotype II. Results additionally highlight the possible role of Brazil as a source for the international dispersion of different viral strains to other countries in the Americas emphasizing the need for increased surveillance across the borders, for the early detection and response to outbreaks. This, in turn, emphasizes the critical role of genomic surveillance in monitoring and understanding arbovirus transmission and persistence locally and over long distances.
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Vírus da Dengue , Dengue , Humanos , Vírus da Dengue/genética , Dengue/epidemiologia , Paraguai/epidemiologia , Estudos Retrospectivos , Filogenia , Sorogrupo , GenótipoRESUMO
The spread of vector-borne viruses, such as CHIKV, is a significant public health concern in the Americas, with over 120,000 cases and 51 deaths in 2023, of which 46 occurred in Paraguay. Using a suite of genomic, phylodynamic, and epidemiological techniques, we characterized the ongoing large CHIKV epidemic in Paraguay. Article Summary Line: Genomic and epidemiological characterization of the ongoing Chikungunya virus epidemic in Paraguay.
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La endoftalmitis infecciosa es una condición intraocular grave, aunque poco frecuente, que puede llevar a la pérdida de la visión. El diagnóstico etiológico precoz y el tratamiento adecuado llevan a una mejor evolución. Las técnicas microbiológicas convencionales tienen baja sensibilidad en el diagnóstico de la endoftalmitis infecciosa, en cambio la reacción en cadena de la polimerasa (PCR) es un método de mayor sensibilidad que está siendo utilizado ampliamente. El objetivo fue determinar por cultivo y PCR la etiología de la endoftalmitis infecciosa en pacientes que consultaron en centros oftalmológicos de Paraguay. Se estudiaron muestras de humor vítreo obtenidas por punción de 51 pacientes con endoftalmitis. La muestra se dividió en dos alícuotas; una para el estudio microbiológico convencional y la otra para la PCR anidada. Esta última utiliza un par de cebadores basado en secuencias conservadas del gen 16S ribosomal y cebadores específicos para bacterias gram positivas. Se estandarizó la PCR logrando una sensibilidad de detección de 3.10-5 ng/µl para S. aureus, 2,5.10-3 ng/µl para S. pneumoniae y 6.10-7 ng/µl para E. coli. De las 51 muestras, 12 (23,5%) fueron positivas por métodos microbiológicos convencionales y 26 (51,0%) por la PCR anidada. Por cultivo se identificaron predominantemente bacterias grampositivas 8/11 (73%) y un aislado de hongo filamentoso. La PCR anidada presentó muy buena sensibilidad y de gran utilidad en la identificación del origen bacteriano de la endoftalmitis, mejorando la sensibilidad del cultivo en 27,5%. La discriminación bacteriana en grampositivos y gramnegativos por la PCR se correlacionó con el cultivo en el 100% de los casos(AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Endoftalmite/microbiologia , Reação em Cadeia da Polimerase , Endoftalmite/diagnóstico , Estudos Transversais , Sensibilidade e Especificidade , Bactérias Gram-Positivas/genéticaRESUMO
A human adenovirus (HAdV) species D, was isolated from a hospitalised child with severe lower respiratory infection. It was initially detected in the nasopharyngeal aspirate of the child followed by conventional PCR amplification of the hexon, penton base, and fibre genes. Sanger DNA sequencing and phylogenetic analyses showed characteristics of a recombinant genome not described before. Next Generation Sequencing analysis was performed to reconstruct its complete DNA genome after viral isolation in adenocarcinoma human cell line (A549). A complete genomic sequence of 35.2 kb in length, with a G+C content of 57â% was obtained, related to HAdV-D29 (96â% identity). Imputed serology analysis demonstrated its novel type with a nucleotide sequence identity of 95.3â% (hexon loop 1) and 96â% (hexon loop 2) to HAdV-D9. The penton base gene showed a novel sequence, distantly related to HAdV-D44. The E3 and E4 regions evolved significantly from their ancestors. The fibre gene was almost identical to the knob region of HAdV-D15 but showed an unrelated shaft sequence. In conclusion the genomics of this novel HAdV, designated the HAdV-D83 [P83H9F15] prototype and bearing a new penton base gene, supports the importance of viral evolution to understand modified tissue tropism, enhanced transmission, or altered virulence.
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Adenovírus Humanos/classificação , Adenovírus Humanos/isolamento & purificação , Células A549 , Infecções por Adenoviridae/virologia , Adenovírus Humanos/genética , Composição de Bases , DNA Viral/química , DNA Viral/genética , Genoma Viral , Humanos , Lactente , Masculino , Nasofaringe/virologia , Filogenia , Reação em Cadeia da Polimerase , Infecções Respiratórias/virologia , Análise de Sequência de DNA , Homologia de Sequência , Infecções Tumorais por Vírus/virologia , Proteínas Estruturais Virais/genética , Cultura de VírusRESUMO
Introduction: Although the association of infection by toxoplasmosis with the development of nephrotic syndrome is uncommon, cases of this association have nevertheless been reported in the literature for more than two decades, not only for congenital toxoplasmosis, but also in acquired cases, and occasionally in immunocompetent patients. Development: A case is presented of an immunocompetent patient aged 15 with clinical and laboratory indications of nephrotic/nephritic syndrome, in whom serological tests showed toxoplasma infection. Conclusion: The presentation of nephrotic syndrome in ages where it is not commonly seen, leads to clinical suspicion of secondary causes. Active search for possible causes should include common tropical infections.
Introducción: Aunque no es frecuente la asociación de infección por toxoplasmosis y el desarrollo de síndrome nefrótico, desde hace más de dos décadas se han reportados casos de esta asociación en la literatura médica, no solo en casos de toxoplasmosis congénita, sino también adquirida, y esporádicamente en inmunocompetentes. Desarrollo: Se presenta un caso de un paciente de 15 años inmunocompetente con signos clínicos y paraclínicos de síndrome nefrótico/nefrítico, en quien se determinó por pruebas serológica infección aguda por Toxoplasmas. Conclusión: La presentación del Síndrome nefrótico en edades poco usuales, induce a la sospecha clínica de causas secundaria, la búsqueda activa de las posibles causas debe incluir infecciones parasitaria.
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Humanos , Proteinúria , Toxoplasma , Nefrose LipoideRESUMO
INTRODUCTION: Although the association of infection by toxoplasmosis with the development of nephrotic syndrome is uncommon, cases of this association have nevertheless been reported in the literature for more than two decades, not only for congenital toxoplasmosis, but also in acquired cases, and occasionally in immunocompetent patients. DEVELOPMENT: A case is presented of an immunocompetent patient aged 15 with clinical and laboratory indications of nephrotic/nephritic syndrome, in whom serological tests showed Toxoplasma infection. CONCLUSION: The presentation of nephrotic syndrome in ages where it is not commonly seen, leads to clinical suspicion of secondary causes. Active search for possible causes should include common tropical infections.
INTRODUCCIÓN: Aunque no es frecuente la asociación de infección por toxoplasmosis y el desarrollo de síndrome nefrótico, desde hace más de dos décadas se han reportados casos de esta asociación en la literatura médica, no solo en casos de toxoplasmosis congénita, sino también adquirida, y esporádicamente en inmunocompetentes. DESARROLLO: Se presenta un caso de un paciente de 15 años inmunocompetente con signos clínicos y paraclínicos de síndrome nefrótico/nefrítico, en quien se determinó por pruebas serológica infección aguda por Toxoplasma. CONCLUSIÓN: La presentación del Síndrome nefrótico en edades poco usuales, induce a la sospecha clínica de causas secundaria, la búsqueda activa de las posibles causas debe incluir infecciones parasitaria.
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Type 1 diabetes associated genes account for less than 50% of disease susceptibility. Human enteroviruses have been implicated as environmental factors that might trigger and/or accelerate this autoimmune disorder. We now report of a 12-year-old girl that developed pancreatic autoimmunity and type 1 diabetes after enteroviral infection. Diabetes-associated autoimmunity was evaluated by measurement of several islet cell related autoantibodies. Neutralizing antibodies to different enteroviruses were determined in the case and eight children suffering from aseptic meningitis during a large scale epidemic. Several types of diabetes-associated antibodies were detected post-infection in the adolescent with newly diagnosed type 1 diabetes, including islet cell antibodies (ICA) and tyrosine phosphatase antibodies (IA2A). ICA but not IA2A appeared in the non-diabetic enterovirus-infected subjects. Based on virological studies, type 1 diabetes pathogenesis process could have been triggered by echovirus 30 infections. This study provides the first evidence of an association between echovirus 30 infection with the presence of pancreatic autoimmunity and type 1 diabetes. Our data suggest that echovirus 30 Cuban strain could be considered a potentially diabetogenic enteroviral variant.
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Autoanticorpos/sangue , Diabetes Mellitus Tipo 1/etiologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Ilhotas Pancreáticas/imunologia , Adolescente , Artrite Infecciosa/sangue , Criança , Pré-Escolar , Cuba , Diabetes Mellitus Tipo 1/imunologia , Infecções por Enterovirus/imunologia , Feminino , Humanos , Lactente , Masculino , Testes de NeutralizaçãoRESUMO
Kaposi's sarcoma-associated herpesvirus (KSHV) is detected consistently in Kaposi's sarcoma (KS). Because of its dramatic sequence variation, the K1 gene has been used to classify KSHV. We found a diverse array of KSHV subtypes A1, A2, A3, A5, B1, B2, and C3 in 23 Cuban KS samples containing several novel sporadic insertions/deletions in subtypes A and C. The molecular epidemiology of the KSHV subtypes seems to reflect the unique mixed ethnic background of the Cuban population.
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Síndrome da Imunodeficiência Adquirida/complicações , Herpesvirus Humano 8/classificação , Sarcoma de Kaposi/virologia , Sequência de Aminoácidos , Cuba/epidemiologia , Feminino , Genes Virais , Herpesvirus Humano 8/genética , Humanos , Masculino , Dados de Sequência Molecular , Filogenia , Sarcoma de Kaposi/epidemiologiaRESUMO
La infección con el virus de la hepatitis B puede estar acompañada de desórdenes sistémicos autoinmunes o inespecíficos siendo su prevalencia desconocida. Se presenta un caso de hepatitis B aguda asociada a neuropatía
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Humanos , Masculino , Pessoa de Meia-Idade , Hepatite B/complicações , Doenças do Sistema Nervoso/complicaçõesRESUMO
La enfermedad acidopeptica es la resultante de la accion del complejo acido clorhidrico-pepsina sobre la mucosa gastrica. Entendiendolo asi, se puede presentar en cualquier localizacion orto topica o ectopica de la mucosa gastrica a nivel gastrointestinal (estomago, duodeno, esofago, diverticulo de Meckel), constituyendo cuadros clinicos definidos
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Humanos , Úlcera Péptica , Protocolos Clínicos , Úlcera Péptica/diagnóstico , Úlcera Péptica/fisiopatologia , Úlcera Péptica , Úlcera Péptica/cirurgiaRESUMO
El hemangioma hepático habitualmente es un hallazgo de autopsia o laparotomía. Ocurre en cualquier edad y por lo general mide menos de 4 cm. de diámetro mayor. En una revisión de 10,523 autopsias se encontraron 63 hemangiomas hepáticos. Ninguna muerte fue atribuible a esta tumoración. De 1975 a 1983 se sometieron a estudio histológico postquirúrgico 10 hemangiomas hepáticos. Cuatro estudios fueron hechos en pacientes intervenidos por la tumoración: a dos se les efectuó hepatectomía derecha, a otra ligadura de arterias hepáticas y a otro solo biopsia. En esta revisión no encontramos ningún paciente en quien la ruptura del tumor haya motivado una intervención de urgencia. Una paciente de 60 años tenía insuficiencia cardiaca y un gran hemangioma. La centelleografía, el ultrasonido, la tomografía axial computarizada y la arteriografía son los métodos que permiten establecer el diagnóstico. Si el paciente no es candidato a cirugía mayor o la lesión causa molestias mínimas, debe ser observado periódicamente con métodos no invasores. Si la lesión mide más de 4 cm. y está en un sitio accesible la resección es curativa