All content matching "Brazil"

Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil

Summary Background By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

COVID-19, vaccine hesitancy and child vaccination: Challenges from Brazil

In the world, the governments' policy decisions in response to COVID-19 were very different. Many countries, including in the Americas, political polarisation in health policies has been used as a tool for ideological dispute, draining out the debate around the right to social protection and health. During 2021, these strategies were used in vaccination policies. The consequences of the dissemination of misinformation about COVID-19 vaccines overflows distrust and hesitation into an entire public health project.

Younger Brazilians hit by COVID-19 – What are the implications?

By the first week of June, Brazil had reached almost 17 million cases and a little more than 472,000 deaths. A notable demographic change has been observed within this period, in which young and middle-aged adults representing an increasing share of patients in wards and intensive care units (ICU).

Viral Genetic Evidence and Host Immune Response of a Small Cluster of Individuals with Two Episodes of SARS-CoV-2 Infection

The dynamics underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection remains poorly understood. We added to the registered case reports of reinfection in USA, Belgium/Netherlands, Ecuador and Hong Kong, a small cluster of individuals with two episodes of 2019 coronavirus disease (COVID-19). Virus genomic analysis and the host immune response were used to characterize this group.

Depression, Anxiety, and Lifestyle Among Essential Workers: A Web Survey From Brazil and Spain During the COVID-19 Pandemic

Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders.

Zika virus transmission by Brazilian Aedes aegypti and Aedes albopictus is virus dose and temperature-dependent

Results indicate that Brazilian populations of Ae. aegypti exhibit a much higher transmission potential for ZIKV than Ae. albopictus.

Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas

Since 2015 Brazil has experienced the social repercussions of the Zika virus epidemic, thus raising a debate about: difficulties of diagnosis; healthcare access for children with Zika Congenital Syndrome (ZCS); the search for benefits by affected families; social and gender inequalities; and a discussion on reproductive rights, among others. The objective of this article is to analyse access to specialized health services for the care of children born with ZCS in three North-eastern states of Brazil. 

Rapid decline of Zika virus NS1 antigen-specific antibody responses, northeastern Brazil

Researchers have found that ZIKV immunity might be shorter-lived than previously thought, which may contribute to local ZIKV resurgence once individual immune responses wane sufficiently to reduce community protective immunity in addition to birth and migration.

The global scientific research response to the public health emergency of Zika virus infection

Mapping the response to Zika, a public health emergency, demonstrated a clear pattern of the participation of countries in the scientific advances. The pattern of knowledge production found in this study represented varying country perspectives, research capacity and interests based first on their level of exposure to the epidemic and second on their financial positions regarding science.

Genomic and Epidemiological Surveillance of Zika Virus in the Amazon Region

This study reveals how the ZIKV epidemic was ignited and maintained within the largest urban metropolis in the Amazon. These results might contribute to improving the public health response to outbreaks in Brazil.

Robustness of Serologic Investigations for Chikungunya and Mayaro Viruses following Coemergence

In this study the authors' data provide a convenient and practicable solution to ensure robust differentiation of CHIKV- and MAYV-specific antibodies.

Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis

Uncertainty was a defining feature of the Brazilian Zika crisis of 2015–2016. This article identifies three forms of uncertainty: global health, public health and clinical uncertainty, and it suggests that “emergency research” was effective in tackling global health uncertainty.    

Spatiotemporal Analysis of the Population Risk of Congenital Microcephaly in Pernambuco State, Brazil

This study emphasizes the burden of microcephaly during the outbreak in Pernambuco, with estimates higher than in some previous studies, and with high risk in an inland region of the state for reasons which are yet to be clarified.

Viral emergence and immune interplay in flavivirus vaccines

Comment

Typical epidemiology of respiratory virus infections in a Brazilian slum

For this study researchers collected nasopharyngeal specimens from 282 children aged ≤5 years with acute respiratory tract infection (ARI) during 2005 to 2006 in one of the largest Brazilian slums.

Cross-Protection of Dengue Virus Infection against Congenital Zika Syndrome, Northeastern Brazil

The results reported in this study suggest that multitypic dengue virus infection may protect from, rather than enhance, development of congenital Zika syndrome.

Zika virus infection among symptomatic patients from two healthcare centers in Sao Paulo State, Brazil: prevalence, clinical characteristics, viral detection in body fluids and serodynamics

This study shows that urine ZIKV RT-PCR testing in the acute phase of infection can improve the sensitivity of diagnosis, while testing serum is probably less useful despite more sustained shedding in some cases. Higher sensitivity and specificity serological tests are needed for the diagnosis of patients who seek medical attention after the period of ZIKV detection by RT-PCR and for surveillance purposes in settings of high DENV background infection.

Genomic, epidemiological and digital surveillance of Chikungunya virus in the Brazilian Amazon

This study highlights the potential of combining traditional surveillance with portable genome sequencing technologies and digital epidemiology to inform public health surveillance in the Amazon region. Data reveal a large CHIKV-ECSA outbreak in Boa Vista, limited potential for future CHIKV outbreaks, and indicate a replacement of the Asian genotype by the ECSA genotype in the Amazon region.

The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births

This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. The finding of no alternative causes for geographic differences in microcephaly rate lead the authors to hypothesize that the Northeast region of Brazil was disproportionately affected by this Zika outbreak, with 94% of an estimated 8.5 million total cases occurring in this region, suggesting a need for seroprevalence surveys to determine the underlying reason.

Differential Shedding and Antibody Kinetics of Zika and Chikungunya Viruses, Brazil

Recurrent recent arbovirus infections suggested by serologic data and unspecific symptoms highlight the need for exhaustive virologic testing.

Potential of Aedes albopictus as a bridge vector for enzootic pathogens at the urban-forest interface in Brazil

Results from this study show that Ae. albopictus frequency declines as it penetrates into the forest and highlight its potential role as a bridge vector of zoonotic diseases at the edge of the Brazilian forests studied.

Potential effect of Zika virus infection on human male fertility?

The findings from this study suggest a possible long-term detrimental effect of ZIKV infection on human male fertility that has to be further explored in well-characterized samples from cohort studies conducted in ZIKV-endemic areas.

Genomic and epidemiological monitoring of yellow fever virus transmission potential

These results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.

Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

Data from this study support a link between maternal ZIKV infection and congenital malformations and suggest the occurrence of predominantly vector-borne ZIKV transmission in these cases. In addition, some highly prevalent TORCH pathogens may be misinterpreted as representative of ongoing ZIKV activity in the absence of exhaustive diagnostics in northeastern Brazil.

A Novel Marsupial Hepatitis A Virus Corroborates Complex Evolutionary Patterns Shaping the Genus Hepatovirus

The authors conducted field work in Brazil to sample marsupials, one of the most ancient mammalian lineages, and identified a new HAV, marsupial HAV (MHAV).

Evidence for multiple sylvatic transmission cycles during the 2016–2017 yellow fever virus outbreak, Brazil

Since December 2016, Brazil has experienced an unusually large outbreak of yellow fever (YF). Whether urb a n transmission may contribute to the extent of the outbreak is unclear. The objective of this study was to characterize YF virus (YFV) genomes and to identify spatial patterns to determine thedistribution and origin of YF cases in Minas Gerais, Espírito Santo and Rio de Janeiro, the most affected Brazilian states during the current YFV outbreak.

The Zika Virus Epidemic in Brazil: From Discovery to Future Implications

The authors of this study discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide.

Evidence for congenital Zika virus infection from neutralizing antibody titers in maternal sera, north-eastern Brazil

Results from this study suggest that despite the inter-individual variability in immune responses, the magnitude of the maternal ZIKV-specific neutralizing antibody response may prove useful to corroborate congenital ZIKV infection, contributing to reliable estimates of the manifestation index of ZIKV-associated congenital disease. Further studies will be needed to evaluate the time-course of maternal neutralizing antibody responses to identify whether a high maternal PRNT titer can be used as an early marker of congenital infection aiding potential antiviral intervention strategies.

InFocus interview with Vivian Avelino-Silva

Dr Fernando Bozza to give a talk about international collaboration during the Zika outbreak

Challenges of scientific collaboration during an outbreak: the recent experience with Zika in Brazil

Establishment and cryptic transmission of Zika virus in Brazil and the Americas

Results from this study further indicate that viruses from northeast Brazil were important for the continental spread of ZIKV. Within Brazil, the authors find instances of virus lineage movement from northeast to southeast Brazil; most of these events are dated to the second half of 2014 and led to onwards transmission in Rio de Janeiro and São Paulo states. The authors infer that ZIKV lineages disseminated from northeast Brazil to elsewhere in Central America, the Caribbean, and South America.

Culex quinquefasciatus from areas with the highest incidence of microcephaly associated with Zika virus infections in the Northeast Region of Brazil are refractory to the virus

The study shows that Culex quinquefasciatus should not be considered a potential vector of ZIKV in Brazil.

Risk of microcephaly after Zika virus infection in Brazil, 2015 to 2016

The key message from this study is that the large uncertainty around the risk estimate needs to be further investigated because of a) the possible existence of co-factors that are yet to be validated, b) the assumptions that the authors needed to make in the absence of good data for the proportion of women who were infected during pregnancy.

Risk of microcephaly after Zika virus infection in Brazil, 2015 to 2016

The key message from this study is that the large uncertainty around the risk estimate needs to be further investigated because of a) the possible existence of co-factors that are yet to be validated, b) the assumptions that the authors needed to make in the absence of good data for the proportion of women who were infected during pregnancy.

Funding available for the SPSAS in Arbovirology in Brazil

ZIKAlliance Kick-off Meeting in Brazil

Hosted by University Sao Paulo Medical School at the Centro de Convenções Rebouças ZIKAlliance, the multinational and multidisciplinary consortium coordinated by Inserm, the French National Institute of Health and Medical Research, and  created in response to a Horizon 2020 funding call by the European Commission’s Directorate-General Research and Innovation, has officially started its activities with the kick-off meeting held in Brazil over the 4^th and 5^th December 2016.

Zika Workshop Summary Now Available

GloPID-R members hosted the “GloPID-R Zika Virus Research Workshop” in Sao Paulo, Brazil on November 30 – December 2, 2016 to facilitate collaboration between members on Zika funded research projects. The workshop’s aim was to identify and establish collaboration and synergies between the research and capacity development projects in support of the Zika virus response in Latin America and the Caribbean funded by GloPID-R members worldwide.