RESUMO
Infection by any of the four dengue virus (DENV) serotypes produces a wide spectrum of clinical illness in humans. Differences in clinical manifestation and severity have been associated with secondary heterologous infection, patient age, and virus serotype. In this context, this retrospective study sought to analyze the presentation of dengue in patients during the 2014 DENV-4 outbreak affecting the City of Orán, Salta Province, Argentina. Demographic data, clinical manifestations, and laboratory abnormalities of laboratory-confirmed dengue patients were compared between age groups and between patients with and without warning signs. Of 301 patients with laboratory-confirmed dengue, 37.9% presented dengue with warning signs. Although nearly half of all patients had secondary DENV infections, no severe dengue cases, or deaths were reported. Furthermore, no association was found between incidence of warning signs and pre-existing immunity to DENV. Pediatric patients were least likely to present warning signs and showed significantly decreased risk of fever, retro-orbital pain, arthalgia, diarrhea and thrombocytopenia, and higher risk of rash compared to older patients. Female patients of all ages were also at higher risk of developing several symptoms. The characterization of DENV-4 infection in humans, a DENV serotype recently reported in Argentina, revealed differences in clinical manifestations, laboratory parameters and the presence/absence of warning signs based on age group. Further investigation of these age-related differences should contribute to better assessment of dengue disease in at risk populations.
Assuntos
Dengue/epidemiologia , Dengue/patologia , Surtos de Doenças , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Adulto JovemRESUMO
We used blood samples of the Blue-footed Booby, considering sex (female and male) and age-class (adult and chick) of individuals at different breeding stages during two breeding seasons (2010-2011 and 2011-2012) in Isla El Rancho, Sinaloa, to determine lead, cadmium, and mercury concentrations. Lead and cadmium concentrations were below our detection limit (0.05 and 0.36ppm, respectively). A higher concentration of mercury was found in early stages of breeding, likely related to changes in mercury environmental availability. Mercury concentrations in adults did not relate with their breeding output. Males and adults had higher mercury concentration than females and chicks. We provide information of temporal, sex and age-related variations in the concentrations of mercury in blood of the Blue-footed Booby.