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Simultaneous circulation of all four dengue serotypes in Manaus, State of Amazonas, Brazil in 2011
Bastos, Michele de Souza;Figueiredo, Regina Maria Pinto de;Ramasawmy, Rajendranath;Itapirema, Evaulino;Gimaque, Jo?o Bosco Lima;Santos, Lucilaide Oliveira;Figueiredo, Luiz Tadeu Moraes;Mour?o, Maria Paula Gomes;
Revista da Sociedade Brasileira de Medicina Tropical , 2012, DOI: 10.1590/S0037-86822012000300022
Abstract: introduction: manaus, the capital city of the state of amazon with nearly 2 million inhabitants, is located in the middle of the amazon rain forest and has suffered dengue outbreaks since 1998. methods: in this study, blood samples were investigated using reverse transcriptase-polymerase chain reaction (rt-pcr), aimed at identifying dengue virus serotypes. results: acute phase sera from 432 patients were tested for the presence of dengue virus. out of the 432 patients, 137 (31.3%) were found to be positive. all the four dengue virus serotypes were observed. conclusions: the simultaneous circulation of the four dengue serotypes is described for the first time in manaus and in brazil.
P. vivax Malaria and Dengue Fever Co-infection: A Cross-Sectional Study in the Brazilian Amazon
Belisa M. L. Magalh?es,André M. Siqueira,Márcia A. A. Alexandre,Marcela S. Souza,Jo?o B. Gimaque,Michele S. Bastos,Regina M. P. Figueiredo,Gisely C. Melo,Marcus V. G. Lacerda ,Maria P. G. Mour?o
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0003239
Abstract: Background Malaria and dengue are the most prevalent vector-borne diseases worldwide and represent major public health problems. Both are endemic in tropical regions, propitiating co-infection. Only few co-infection cases have been reported around the world, with insufficient data so far to enhance the understanding of the effects of co-infection in the clinical presentation and severity. Methodology/Principal Findings A cross-sectional study was conducted (2009 to 2011) in hospitalized patients with acute febrile syndrome in the Brazilian Amazon. All patients were submitted to thick blood smear and PCR for Plasmodium sp. detection, ELISA, PCR and NS1 tests for dengue, viral hepatitis, HIV and leptospirosis. In total, 1,578 patients were recruited. Among them, 176 (11.1%) presented P. vivax malaria mono-infection, 584 (37%) dengue fever mono-infection, and 44 (2.8%) were co-infected. Co-infected patients had a higher chance of presenting severe disease (vs. dengue mono-infected), deep bleeding (vs. P. vivax mono-infected), hepatomegaly, and jaundice (vs. dengue mono-infected). Conclusions/Significance In endemic areas for dengue and malaria, jaundice (in dengue patients) and spontaneous bleeding (in malaria patients) should raise the suspicion of co-infection. Besides, whenever co-infection is confirmed, we recommend careful monitoring for bleeding and hepatic complications, which may result in a higher chance of severity, despite of the fact that no increased fatality rate was seen in this group.
Serological evidence of hantavirus infection in rural and urban regions in the state of Amazonas, Brazil
Gimaque, Jo?o Bosco Lima;Bastos, Michele de Souza;Braga, Wornei Silva Miranda;Oliveira, Cintia Mara Costa de;Castilho, Márcia da Costa;Figueiredo, Regina Maria Pinto de;Galusso, Elizabeth dos Santos;Itapirema, Evaulino Ferreira;Figueiredo, Luiz Tadeu Moraes de;Mour?o, Maria Paula Gomes;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000100019
Abstract: hantavirus disease is caused by the hantavirus, which is an rna virus belonging to the family bunyaviridae. hantavirus disease is an anthropozoonotic infection transmitted through the inhalation of aerosols from the excreta of hantavirus-infected rodents. in the county of itacoatiara in the state of amazonas (am), brazil, the first human cases of hantavirus pulmonary and cardiovascular syndrome were described in july 2004. these first cases were followed by two fatal cases, one in the municipality of maués in 2005 and another in itacoatiara in 2007. in this study, we investigated the antibody levels to hantavirus in a population of 1,731 individuals from four different counties of am. sera were tested by igg/igm- enzyme-linked immune-sorbent assay using a recombinant nucleocapsid protein of the araraquara hantavirus as an antigen. ten sera were igg positive to hantavirus (0.6%). among the positive sera, 0.8% (1/122), 0.4% (1/256), 0.2% (1/556) and 0.9% (7/797) were from atalaia do norte, careiro castanho, itacoatiara and lábrea, respectively. none of the sera in this survey were igm-positive. because these counties are distributed in different areas of am, we can assume that infected individuals are found throughout the entire state, which suggests that hantavirus disease could be a local emerging health problem.
Clinical and Virological Descriptive Study in the 2011 Outbreak of Dengue in the Amazonas, Brazil
Valquiria do Carmo Alves Martins, Michele de Souza Bastos, Rajendranath Ramasawmy, Regina Pinto de Figueiredo, Jo?o Bosco Lima Gimaque, Wornei Silva Miranda Braga, Mauricio Lacerda Nogueira, Sergio Nozawa, Felipe Gomes Naveca, Luiz Tadeu Moraes Figueiredo, Maria Paula Gomes Mour?o
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0100535
Abstract: Background Dengue is a vector-borne disease in the tropical and subtropical region of the world and is transmitted by the mosquito Aedes aegypti. In the state of Amazonas, Brazil during the 2011 outbreak of dengue all the four Dengue virus (DENV) serotypes circulating simultaneously were observed. The aim of the study was to describe the clinical epidemiology of dengue in Manaus, the capital city of the state of the Amazonas, where all the four DENV serotypes were co-circulating simultaneously. Methodology Patients with acute febrile illness during the 2011 outbreak of dengue, enrolled at the Funda??o de Medicina Tropical Dr. Heitor Viera Dourado (FMT-HVD), a referral centre for tropical and infectious diseases in Manaus, were invited to participate in a clinical and virological descriptive study. Sera from 677 patients were analyzed by RT-nested-PCRs for flaviviruses (DENV 1–4, Saint Louis encephalitis virus-SLEV, Bussuquara virus-BSQV and Ilheus virus-ILHV), alphavirus (Mayaro virus-MAYV) and orthobunyavirus (Oropouche virus-OROV). Principal Findings Only dengue viruses were detected in 260 patients (38.4%). Thirteen patients were co-infected with more than one DENV serotype and six (46.1%) of them had a more severe clinical presentation of the disease. Nucleotide sequencing showed that DENV-1 belonged to genotype V, DENV-2 to the Asian/American genotype, DENV-3 to genotype III and DENV-4 to genotype II. Conclusions Co-infection with more than one DENV serotype was observed. This finding should be warning signs to health authorities in situations of the large dispersal of serotypes that are occurring in the world.
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