RESUMO
BACKGROUND: The 2022-2023 period marked the largest global Mpox outbreak, with Latin America's situation notably underexplored. This study aims to estimate Mpox's instantaneous reproduction number (R(t)), analyze epidemiological trends, and map vaccination efforts in six Latin American countries. METHODS: Utilizing Pan American Health Organization Mpox surveillance data, we examined demographic characteristics, cumulative incidence rates, and epidemic curves, calculated R(t) with weekly sliding windows for each country, alongside a review of vaccination initiatives. RESULTS: From 2022 to 2023, 25,503 Mpox cases and 71 deaths were reported across Argentina, Brazil, Chile, Colombia, Mexico and Peru, with a significant majority (91.8%-98.5%) affecting men, with a mean age of 32-35 years. Maximum R(t) values varied across countries: Argentina (2.63; 0.85 to 5.39), Brazil (3.13; 2.61 to 3.69), Chile (2.91; 1.55 to 4.70), Colombia (3.15; 2.07 to 4.44), Mexico (2.28; 1.18 to 3.75), and Peru (2.84; 2.33 to 3.40). The epidemic's peak occurred between August and September 2022 with R(t) values subsequently dropping below 1. From November 2022, and as of February 2024, only Chile, Peru, and Brazil had initiated Mpox vaccination campaigns, with Colombia launching a Clinical Trial. CONCLUSION: The peak of the Mpox epidemic in the studied countries occurred before the commencement of vaccination programs. This trend may be then partly attributed to a combination of behavioral modifications in key affected communities and contact tracing local programs. Therefore, the proportion of the at-risk population that remains susceptible is still uncertain, highlighting the need for continued surveillance and evaluation of vaccination strategies.
Assuntos
Surtos de Doenças , Humanos , Surtos de Doenças/prevenção & controle , América Latina/epidemiologia , Masculino , Adulto , Feminino , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Incidência , Criança , Vacinas contra Influenza/administração & dosagem , Pré-Escolar , LactenteRESUMO
OBJECTIVES: To assess pediatricians' mumps knowledge and testing practices, to identify physician and practice characteristics associated with mumps testing practices, and to assess reporting and outbreak response knowledge and practices. STUDY DESIGN: Between January and April 2020, we surveyed a nationally representative network of pediatricians. Descriptive statistics were generated for all items. The χ2 test, t tests, and Poisson regression were used to compare physician and practice characteristics between respondents who would rarely or never versus sometimes or often/always test for mumps in a vaccinated 17-year-old with parotitis in a non-outbreak setting. RESULTS: The response rate was 67% (297 of 444). For knowledge, more than one-half of the pediatricians responded incorrectly or "don't know" for 6 of the 9 true/false statements about mumps epidemiology, diagnosis, and prevention, and more than one-half reported needing additional guidance on mumps buccal swab testing. For testing practices, 59% of respondents reported they would sometimes (35%) or often/always (24%) test for mumps in a vaccinated 17-year-old with parotitis in a non-outbreak setting; older physicians, rural physicians, and physicians from the Northeast or Midwest were more likely to test for mumps. Thirty-six percent of the pediatricians reported they would often/always report a patient with suspected mumps to public health authorities. CONCLUSIONS: Pediatricians report mumps knowledge gaps and practices that do not align with public health recommendations. These gaps may lead to underdiagnosis and underreporting of mumps cases, delaying public health response measures and contributing to ongoing disease transmission.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Caxumba/diagnóstico , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vacina contra Caxumba/administração & dosagem , Vacina contra Caxumba/imunologia , Pediatria/normas , Inquéritos e Questionários , Estados UnidosRESUMO
The recent reemergence of yellow fever virus (YFV) in Brazil has raised serious concerns due to the rapid dissemination of the virus in the southeastern region. To better understand YFV genetic diversity and dynamics during the recent outbreak in southeastern Brazil, we generated 18 complete and nearly complete genomes from the peak of the epidemic curve from nonhuman primates (NHPs) and human infected cases across the Espírito Santo and Rio de Janeiro states. Genomic sequencing of 18 YFV genomes revealed the estimated timing, source, and likely routes of yellow fever virus transmission and dispersion during one of the largest outbreaks ever registered in Brazil. We showed that during the recent epidemic, YFV was reintroduced from Minas Gerais to the Espírito Santo and Rio de Janeiro states multiple times between 2016 and 2019. The analysis of data from portable sequencing could identify the corridor of spread of YFV. These findings reinforce the idea that continued genomic surveillance strategies can provide information on virus genetic diversity and transmission dynamics that might assist in understanding arbovirus epidemics.IMPORTANCE Arbovirus infections in Brazil, including yellow fever, dengue, zika, and chikungunya, result in considerable morbidity and mortality and are pressing public health concerns. However, our understanding of these outbreaks is hampered by the limited availability of genomic data. In this study, we investigated the genetic diversity and spatial distribution of YFV during the current outbreak by analyzing genomic data from areas in southeastern Brazil not covered by other previous studies. To gain insights into the routes of YFV introduction and dispersion, we tracked the virus by sequencing YFV genomes sampled from nonhuman primates and infected patients from the southeastern region. Our study provides an understanding of how YFV initiates transmission in new Brazilian regions and illustrates that genomics in the field can augment traditional approaches to infectious disease surveillance and control.
Assuntos
Surtos de Doenças , Genoma Viral , Febre Amarela/epidemiologia , Febre Amarela/transmissão , Vírus da Febre Amarela/genética , Aedes/virologia , Alouatta/virologia , Animais , Brasil/epidemiologia , Callithrix/virologia , Cebus/virologia , Feminino , Variação Genética , Humanos , Incidência , Leontopithecus/virologia , Masculino , Mosquitos Vetores/virologia , Filogenia , Filogeografia , Sequenciamento Completo do Genoma , Febre Amarela/virologia , Vírus da Febre Amarela/classificação , Vírus da Febre Amarela/isolamento & purificação , Vírus da Febre Amarela/patogenicidadeRESUMO
Background: Foodborne disease outbreaks are one of the main health problems all over the world, which have an extensive impact on human health. Objetive: To analyze the foodborne disease outbreaks occurred in Chilean urban area from 2005 to 2010. Methods: We made a descriptive epidemiologic study. First, criteria were defined and classified according to previous epidemiologic investigations, clinical and environment samples, then. Variables of space, time, place and person were also analyzed. Results: Among 2,806 reported outbreaks, 2434 (86.7%) fulfilled the inclusion criteria. Incidence rate of the period (2005-2010) were 32 cases per 100 inhabitants. A total of 12,196 people were affected, with an average of 5 patients per outbreak. The households (36.2%), restaurants (16.3%), supermarkets (6.3%) free fair (4.4%) have been the most important outbreak areas. The foods involved were seafood (15.4%), fish (15.1%), and fast food (13.5%). The etiologic agents were Salmonella spp, Shigella spp, Vibrio parahaemolyticus. Conclusions: Outbreaks foodborne diseases are frequents in the Chilean urban area, which make vulnerable a lot of people. The largest numbers happened in the households and were due to bad handling and/or inappropriate storage of the foods.
Antecedentes: Las enfermedades transmitidas por alimentos (ETA) constituyen en el ámbito mundial, uno de los problemas sanitarios más comunes y de mayor impacto sobre la salud de las personas. Objetivo: Analizar los brotes de ETA notificados en la Región Metropolitana (RM) de Chile entre enero 2005 y junio 2010. Material y Métodos: Estudio epidemiológico descriptivo de base de datos de brotes de ETA que se clasificaron de acuerdo a encuesta epidemiológica y muestra clínica o ambiental. Se analizaron variables de espacio, tiempo, lugar y persona. Resultados: De los 2.806 brotes notificados, 2.434 (86,7%) cumplieron con los criterios de inclusión. Un total de 12.196 personas fueron afectadas, con un promedio de 5 enfermos por brote. La tasa de incidencia del período 2005-2010 fue 32 casos por 100 habitantes Los ámbitos de mayor brote fueron los hogares (36,2%), restaurantes (16,3%), supermercados (6,3%), ferias libres (4,4%). Los alimentos involucrados fueron mariscos (15,4%), pescados (15,1%), platos rápidos (13,5%). Los principales agentes etiológicos investigados fueron Salmonella spp, Shigella spp y Vibrio parahemolyticus. Conclusiones: Los brotes de ETA son muy frecuentes en la RM, comprometiendo un gran número de personas. La mayoría se produjeron en los hogares y fueron provocados por mala manipulación y/o conservación de los alimentos.