Neurologic manifestations in emerging arboviral diseases in Rio de Janeiro City, Brazil, 2015-2016

Abstract INTRODUCTION Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders. METHODS Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results. RESULTS In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive. CONCLUSIONS Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.

Immunogenicity, reactogenicity and consistency of production of a Brazilian combined vaccine against diphtheria, tetanus, pertussis and Haemophilus influenzae type b

A randomized, double-blinded study evaluating the immunogenicity, safety and consistency of production of a combined diphtheria-tetanus-pertussis-Haemophilus influenzae type b vaccine entirely produced in Brazil by Bio-Manguinhos and Instituto Butantan (DTP/Hib-BM) was undertaken. The reference vaccine had the same DTP vaccine but the Hib component was produced using purified materials supplied by GlaxoSmithKline (DTP/Hib-GSK), which is registered and has supplied the Brazilian National Immunization Program for over more than five years. One thousand infants were recruited for the study and received vaccinations at two, four and six months of age. With respect to immunogenicity, the vaccination protocol was followed in 95.6 percent and 98.4 percent of infants in the DTP/Hib-BM and DTP/Hib-GSK groups, respectively. For the Hib component of the study, there was 100 percent seroprotection (>0.15 µg/mL) with all three lots of DTP/Hib-BM and DTP/Hib-GSK. The geometric mean titer (GMT) was 9.3 µg/mL, 10.3 µg/mL and 10.3 µg/mL for lots 1, 2 and 3 of DTP/Hib-BM, respectively, and the GMT was 11.3 g/mL for DTP/Hib-GSK. For diphtheria, tetanus and pertussis, seroprotection was 99.7 percent, 100 percent and 99.9 percent, respectively, for DTP/Hib-BM, three lots altogether and 99.2 percent, 100 percent and 100 percent for DTP/Hib-GSK. GMTs were similar across all lots and vaccines. Adverse events rates were comparable among the vaccine groups. The Brazilian DTP/Hib vaccine demonstrated an immunogenicity and reactogenicity profile similar to that of the reference vaccine.

Epidemiologia da doença meningocócica na cidade do Rio de Janeiro: modificaçöes após vacinaçäo contra os sorogrupos B e C / Epidemiology of meningococcal disease in the city of Rio de janeio: changes after vaccination against B and C serogroups

A doença meningocócica tem sido um sério problema de saúde pública no município do Rio de Janeiro nos últimos 10 anos, com altas taxas de incidência em crianças de baixa idade, elevada letalidade e predomínio do sorogrupo B. Em dezembro de 1994 foi realizada a segunda campanha de vacinaçäo anti-meningocócica contra os sorogrupos B e C, visando à imunizaçäo de crianças de 6 meses a 13 anos de idade. Foram vacinadas com duas doses cerca de 950 mil crianças. A vacina utilizada foi a produzida pelo Instituto Finlay de Cuba. Em 1995 foi observada uma modificaçäo no comportamento da doença, quando passou a predominar o sorogrupo C e aumentou a incidência global da doença, particularmente entre os menores de 1 ano, adolescentes e adultos jovens. Nos grupos etários vacinados, a incidência foi menor que no ano de 1994, em funçäo da diminuiçäo do sorogrupo B. Näo foram observadas modificaçöes importantes no comportamento da letalidade.