Phylogenetic relationship between rabies virus (Lyssavirus rabies) variants from two different species / Relações filogenéticas do vírus da raiva (Lyssavirus rabies) em duas diferentes espécies / Relaciones filogenéticas del virus de la rabia (Lyssavirus rabies) en dos especies diferentes

Rabies is a fatal zoonotic disease that affects several mammals. Hematophagous bats are recognized hosts of the rabies virus, and their main food source is the blood of other mammals, particularly cattle. During feeding, bats transmit the virus to cattle, which are victims of the disease, contributing to economic losses and increasing the risk of infection for humans. Based on this affinity in the rabies cycle between bats and cattle, the objective of this study was to analyze the phylogenetic relationships of rabies virus samples in cattle and bats. The G gene of the rabies virus was chosen for this study because it is directly related to the infection process. Nucleotide sequences of the viral G gene were selected from GenBank for samples obtained from infected cattle and bats. Maximum parsimony analyses were conducted using the Molecular Evolutionary Genetics Analysis software. The Maxima Parsimony tree indicated a phylogenetic relationship between the G genes of both hosts, indicating that the virus evolved from bats to cattle. Analysis of parsimoniously informative sites revealed that the viral G gene carried specific mutations in each host. Knowledge of the evolutionary relationships between the rabies virus and its hosts is critical for identifying potential new hosts and the possible routes of infection for humans.

A Raiva é uma zoonose fatal que infecta várias espécies de mamíferos. Os morcegos hematófagos são reconhecidos como hospedeiros do vírus da Raiva e sua principal fonte de alimento é o sangue de outros mamíferos, especialmente os bovinos. Quando se alimentam, os morcegos transmitem o vírus para o bovino os quais são vítimas da doença, contribuindo para perdas econômicas e riscos de infecção para humanos. Baseado nesta afinidade do ciclo da Raiva entre morcegos e bovinos, o objetivo deste estudo foi analisar as relações filogenéticas de amostras do vírus da Raiva em ambos os hospedeiros, bovinos e morcegos. O gene G do vírus da Raiva foi escolhido para esta pesquisa porque ele está diretamente relacionado ao processo de infecção. Sequências de nucleotídeos do gene G viral foram selecionadas no GenBank a partir de amostras obtidas de bovinos e morcegos infectados. Análises de Máxima Parcimônia foram conduzidas utilizando o software Molecular Evolutionary Genetics Analysis. A árvore de Máxima Parcimônia indicou uma relação filogenética entre o gene G de ambos os hospedeiros, indicando que o vírus evoluiu dos morcegos para os bovinos. A análise dos sítios parcimoniosamente informativos revelou que o gene G viral apresentou mutações específicas em cada hospedeiro. O conhecimento sobre as relações evolutivas do vírus da Raiva e seus hospedeiros é crucial para identificar nos hospedeiros potenciais e novas rotas possíveis de infecção para humanos.

La rabia es una zoonosis fatal que infecta a varias especies de mamíferos. Los murciélagos hematófagos son reconocidos como huéspedes del virus de la rabia y su principal fuente de alimentación es la sangre de otros mamíferos, especialmente del ganado. Al alimentarse, los murciélagos transmiten el virus al ganado que es víctima de la enfermedad, contribuyendo a pérdidas económicas y riesgos de infección para los humanos. Basado en esta afinidad del ciclo de la rabia entre murciélagos y ganado, el objetivo de este estudio fue analizar las relaciones filogenéticas de las muestras de virus de la rabia tanto en huéspedes, ganado y murciélagos. El gen G del virus de la rabia fue elegido para esta investigación porque está directamente relacionado con el proceso de infección. Las secuencias de nucleótidos del gen G viral se seleccionaron en GenBank a partir de muestras obtenidas de bovinos y murciélagos infectados. Los análisis de parsimonia máxima se realizaron utilizando el software Molecular Evolutionary Genetics Analysis. El árbol de Máxima Parsimônia indicó una relación filogenética entre el gen G de ambos huéspedes, indicando que el virus evolucionó de murciélagos a bovinos. El análisis de los sitios parsimoniosamente informativos reveló que el gen G viral presentaba mutaciones específicas en cada huésped. El conocimiento sobre las relaciones evolutivas del virus de la rabia y sus huéspedes es crucial para identificar huéspedes potenciales y nuevas posibles rutas de infección para humanos.

Proctitis y úlcera ano-rectal como presentación inicial en pacientes con Viruela símica

Objetivo: Describir hallazgos clínicos, quirúrgicos e imagenológicos de la patología anorrectal en pacientes con Viruela Símica. Materiales y Métodos: Reporte de serie de casos clínicos, observacional, en pacientes con Viruela Símica tratados en un centro de salud privado desde agosto 2022 a diciembre 2022. Resultados: El 100% de los casos pertenecía al sexo masculino, la edad promedio fue de 32 años, todos los pacientes mantuvieron relaciones sexuales con otros hombres, la mayoría debuto con síntomas rectales, incluyendo proctalgia, prurito anal y heces diarreicas con mucosidad. El diagnóstico se confirmó mediante PCR (reacción de polimerasa en cadena) y el tratamiento fue sintomático, con mejoría en todos los pacientes en un seguimiento de 10 días. Discusión: La Viruela Símica es una enfermedad viral que se encuentra, principalmente, en regiones remotas de África Central, con brotes esporádicos en países africanos. Está relacionada con el virus de la viruela y se transmite, principalmente, del contacto con animales infectados o fluidos corporales. La enfermedad presenta síntomas similares a la gripe, seguidos del desarrollo de una erupción cutánea que progresa a pústulas y costras. No hay tratamiento específico para la viruela símica, el manejo medico alivia los síntomas. El brote de viruela símica en 2022 presentó características novedosas y atípicas en su forma de presentación. Conclusión: Los síntomas rectales asociados a una historia clínica compatible con viruela símica se deben considerar como diagnóstico diferencial a la proctitis por esta etiología específica y emergente.

Objective: To describe clinical, surgical and imaging findings of anorectal pathology in patients with monkeypox. Materials and Methods: Observational clinical case series report in patients with monkeypox treated in a private health center from August 2022 to December 2022. Results: 100% of the cases were male, the average age was 32 years old, all patients had sexual intercourse with other men, most debuted with rectal symptoms, including proctalgia, anal itching, and diarrheal stools with mucus. Diagnosis was confirmed by PCR (polymerase chain reaction) and treatment was symptomatic, with improvement in all patients at a 10-day follow-up. Discussion: Monkeypox is a viral disease found mainly in remote regions of Central Africa, with sporadic outbreaks in African countries. It is related to the smallpox virus and is transmitted primarily from contact with infected animals or bodily fluids. The disease presents with flu-like symptoms, followed by the development of a skin rash that progresses to pustules and scabs. There is no specific treatment for monkeypox; medical management alleviates the symptoms. The monkeypox outbreak in 2022 presented novel and atypical characteristics in its presentation. Conclusion: Rectal symptoms associated with a clinical history compatible with monkeypox should be considered as a differential diagnosis of proctitis due to this specific and emerging etiology.

Ebola virus disease: a zoonotic disease with an extremely high fatality rate / 中国热带医学

@# Ebola virus disease (EVD) is a severe infectious disease caused by Ebola virus in humans and primates. The main clinical features are fever and bleeding. The disease was first identified in Zaire and Sudan in Africa in 1976. Since then, it has caused many large-scale epidemics in Africa. One of the largest and most complex Ebola outbreaks in history was the 2014-2016 outbreak in West Africa, which caused more cases and deaths than all previous outbreaks combined. As of 2022, about 35 000 EVD cases and 15 000 deaths have been reported. During the African pandemic, EVD also spread to other regions outside the African continent, such as the Americas and Europe, and became a public health issue of worldwide concern. In Africa, the re-emergence of the disease in Uganda and the Republic of Congo in 2022 has attracted much attention from the world. This article systematically summarizes the history, epidemiological distribution, route of infection, clinical symptoms, diagnosis, treatment, prevention and control of Ebola virus disease, so as to provide reference for relevant workers in China.

Knowledge, attitude and practices regarding dengue and its vector among medical practitioners in Malakand region, Pakistan

Abstract Dengue fever (DF) is increasingly recognized as one of the worlds major mosquito borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Dengue fever is endemic in most part of Pakistan and continues to be a public health concern. Knowledge, attitude and practices can play an important role in management of the disease. Current study was aimed to determine the level of knowledge, attitude and practices regarding dengue fever among health practitioners, to study the level of knowledge and attitude with preventive practices for dengue fever. A cross sectional study was carried out in medical practitioners of the four districts of Malakand region during October to November 2019. A pre-structured questionnaire was used to collect data from medical practitioners. Data was analyzed using Graph Pad version 5. Significant value was considered when less than 0.05 (at 95% confidence of interval). The results revealed that most of participants have seen dengue vector (62%), the media being the most quoted source of information. Nearly 81.2% participants were aware from transmission of dengue fever is by mosquito bite. Practices based upon preventive measures were found to be predominantly focused towards prevention of mosquito bites rather than elimination of breeding places. Although the knowledge regarding DF and mosquito control measure was quite high among the medical practitioners but this knowledge was not put into practice. Further studies are required to aware the people about dengue and its vector in order to get prevention and control.

Resumo A dengue (DF) é cada vez mais reconhecida como uma das principais doenças transmitidas por mosquitos do mundo e causa significativa morbidade e mortalidade em países tropicais e subtropicais. A dengue é endêmica na maior parte do Paquistão e continua a ser um problema de saúde pública. Conhecimento, atitude e práticas podem desempenhar papel importante no manejo da doença. O presente estudo teve como objetivo determinar o nível de conhecimento, atitude e práticas em relação à dengue entre os profissionais de saúde, para estudar o nível de conhecimento e atitude com as práticas preventivas da dengue. Um estudo transversal foi realizado com médicos dos quatro distritos da região de Malakand de outubro a novembro de 2019. Um questionário pré-estruturado foi usado para coletar dados de médicos. Os dados foram analisados no Graph Pad versão 5. Valor significativo foi considerado quando menor que 0,05 (com intervalo de confiança de 95%). Os resultados revelaram que a maioria dos participantes já viu o vetor da dengue (62%), sendo a mídia a fonte de informação mais citada. Quase 81,2% dos participantes sabiam que a transmissão da dengue é por picada de mosquito. Constatou-se que as práticas baseadas em medidas preventivas se concentravam predominantemente na prevenção de picadas de mosquitos, e não na eliminação de criadouros. Embora o conhecimento sobre DF e medidas de controle de mosquitos fosse bastante elevado entre os médicos, esse conhecimento não foi colocado em prática. Mais estudos são necessários para conscientizar a população sobre a dengue e seu vetor, a fim de se obter prevenção e controle.

AN EXTENSIVE STUDY ON MONKEYPOX: AN EMERGING GLOBAL CRISIS

Introduction: Several viral diseases with epidemic potential are currently threatening global health security. One of them is Monkeypox. It is an emerging zoonotic infection which is caused by the monkeypox virus. In the past, this disease used to be primarily detected in West and Central Africa. However, the current upsurge of cases outside the African region has led the world to explore the causes that have led to the current situation. Aim and objectives of this study was to explore the reasons for the current upsurge and describe the epidemiology of the disease. The keywords below were used to search from public da Material and Methods: tabases and review the relevant publications on Monkeypox disease and its epidemiology. This search was further used to analyse and summarise the findings into tables and other graphical representation of the data. Monkeypox cases are currently being reported Result and Conclusion: from non-endemic countries e.g. USA, UK, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Canary Islands, Israel and Switzerland. There are no reported cases of monkeypox virus in India till date as on 6th June 2022. Cases have mainly but not exclusively been identified amongst men who have sex with men (MSM) seeking care in primary care and sexual health clinics in the range of 22 to 63 years of age. Follow public health measures to prevent another pandemic in the recent future.

Máscara N95 e o dilema da trajetória balística das partículas respiratórias na COVID-19 / N95 mask and the dilemma of the ballistic trajectory of respiratory particles in COVID-19 / Respiradores N95 y el dilema de la trayectoria balística de partículas respiratorias en COVID-19

Objetivo: Apresentar elementos teóricos acerca da transmissão do SARS-CoV-2 por meio das partículas respiratórias, para além do seu diâmetro aerodinâmico e trajetória balística, a subsidiar reflexões sobre a adequação do uso de máscaras pelos profissionais de saúde. Método: Ensaio acadêmico com o uso de dados de revisão narrativa da literatura. Resultados: Clarifica a confusão acerca dos termos gotículas, núcleos de gotículas, aerossóis e par-tículas, divergências que contribuem para entendimentos diferenciados sobre os mecanismos de transmissão desse agente etiológico, levando à adoção de distintas medidas de intervenção para o controle do vírus. Apresenta dados da transmissibilidade do SARS-CoV-2 pelo ar, a despeito das dificuldades técnica e metodológica para a detecção desse agente em tal meio, situação que dificulta conclusões contundentes acerca da transmissão aérea do pató-geno.Conclusão: Acredita-se ser um erro usar a falta de conclusões sobre a identificação do SARS-CoV-2 em amostras de ar para questionar a transmis-são aérea e, igualmente, para recomendar medidas de prevenção segundo o tamanho aerodinâmico dos vírus. Assim, o uso da máscara N95 por profis-sionais de saúde durante pandemia deve ser medida basilar e inequívoca para a proteção e a segurança dessa população.

Objective: To present theoretical elements about the transmission of SARS CoV-2 through respiratory particles, in addition to its aerodynamic dia-meter and ballistic trajectory, to support reflections on the adequacy of the use of masks by health professionals. Method: Academic essay using narrative review data from the literature. Results: Clarifies the confusion about the terms droplets, droplet nuclei, aerosols and particles, divergences that contribute to diffe-rentiated understandings about transmission mechanisms of this etiological agent, with the adoption of different intervention measures to control this virus. It shows data on the transmissibility of SARS-CoV-2 by air, despite the technical and methodological difficulties for detecting this agent in the air, a situation that hinders hard conclusions about the aerial transmission of this pathogen. Conclusions: It is believed to be an error to use the lack of sars-cov-2 identification conclusions in air samples, to question airborne transmission, also to recommend prevention measures depending on the aerodynamic size of viruses. Thus, the use of the N95 mask by health professionals during the pandemic should be a basic and unequivocal measure for the protection and safety of this population.

Objetivo: Presentar elementos teóricos sobre la transmisión del SARS CoV-2 a través de partículas respiratorias, además de su diámetro aerodi-námico y trayectoria balística, para apoyar reflexiones sobre la adecuación del uso de mascarillas por parte de los profesionales sanitarios. Método: Ensayo académico utilizando datos de revisión narrativa de la literatura. Resultados: Aclara la confusión sobre los términos gotitas, núcleos de gotitas, aerosoles y partículas, divergencias que contribuyen a entendimientos diferenciados sobre los mecanismos de transmisión de ese agente etiológico, con la adop-ción de diferentes medidas de intervención para controlar ese virus. Presenta datos sobre la transmisibilidad del SARS-CoV-2 por vía aérea, a pesar de las dificultades técnicas y metodológicas para detectar ese agente en el aire, situación que dificulta duras conclusiones sobre la transmisión aérea del pató-geno. Conclusión: Se cree que es un error utilizar la falta de conclusiones sobre la identificación del SARS-CoV-2 en muestras de aire para cuestionar la transmisión aérea e, igualmente, recomendar medidas de prevención según el tamaño aerodinámico de los virus. Así, el uso de los respiradores N95 por parte de los profesionales sanitarios durante la pandemia debe ser una medida básica e inequívoca para la protección y seguridad de esta población.

Caracterización clínico-epidemiológica de pacientes con VIH/sida en el municipio Manuel Tames, Guantánamo

RESUMEN Introducción: En el municipio Manuel Tames, de la provincia de Guantánamo, no se han realizado estudios que caractericen los pacientes con infección por VIH/sida. Objetivo: Caracterizar clínico-epidemiológicamente a los pacientes con VIH/sida, pertenecientes al municipio Manuel Tames, Guantánamo. Método: Se realizó un estudio descriptivo, transversal, retrospectivo que abarca el periodo comprendido entre 1988-2020. La población estudiada fue de 46 pacientes con el diagnóstico de VIH/sida. Se estudiaron las siguientes variables: edad, sexo, estado civil, año de diagnóstico, clasificación clínica, fuente de pesquisa, esquema de tratamiento, enfermedades concomitantes. Resultados: Los pacientes más afectados se encontraron entre las edades de 25 a 34 años (n=18; 31,9 %), en el sexo masculino (n=28; 60,9 %). El mayor número de los pacientes se encontró soltero (n=37; 80,4 %). La fuente de pesquisa más usual fue la categoría de captado (n=11; 23,9 %). El mayor número de pacientes se halló en la categoría A (n=33; 71,7 %), lo que respalda la cifra de que 32 pacientes (69,6 %) no tuvieran ninguna enfermedad asociada a la infección por el virus. El mayor porcentaje de los pacientes utilizó el esquema terapéutico de Dulutegravir + Trubada (n=26; 56,5 %). Conclusiones: Se puede concluir que la infección por VIH/sida es una enfermedad que se observa en las edades medias de la vida, con un aumento del número de infecciones en tanto pasan los años. Cuando los pacientes mantienen un esquema de tratamiento se observan menos enfermedades concomitantes y se mantienen en las categorías clínicas que menos complicaciones presentan.

ABSTRACT Introduction: No studies have been conducted to characterize patients with HIV/AIDS infection in Manuel Tames municipality, Guantánamo. Objective: To characterize clinically and epidemiologically the HIV/AIDS infected patients in Manuel Tames municipality, Guantanamo. Method: A descriptive, cross-sectional, retrospective study was carried out, covering the period 1988-2020. The studied population consisted of 46 patients with a diagnosis of HIV/AIDS. Variables studied were as follow: age, sex, marital status, year of the diagnosis report, clinical classification, source of information, scheme of treatment, concomitant diseases. Results: Patients 25 to 35 years old were found as the most affected (n=18; 31.9%), with a predominance of males (n=28; 60.9%). Most of patients were found single (n=37; 80.4%). The most common source of information was the capitated category (n=11; 23.9%). Most patients were found in category A (n=33; 71.7%), which supports the figure that 32 patients (69.6%) had no disease associated with virus infection. The highest percentage of patients used the Dulutegravir plus Trubada treatment scheme (n=26; 56.5%). Conclusions: As an end point of the outcome it can be said that HIV/AIDS infection is a disease seen in the middle ages of life, with an increasing number of infections as the years go by. When patients maintain a correct treatment schedule, fewer concomitant diseases are observed and they remain in the clinical categories with the fewest complications.

RESUMO Introdução: No município de Manuel Tames, província de Guantánamo, não foram realizados estudos que caracterizassem pacientes com infecção por HIV/AIDS. Objetivo: Caracterizar clínico-epidemiologicamente os pacientes com HIV/AIDS, pertencentes ao município de Manuel Tames, Guantánamo. Método: Foi realizado um estudo descritivo, transversal e retrospectivo abrangendo o período de 1988-2020. A população estudada foi de 46 pacientes com diagnóstico de HIV/AIDS. Foram estudadas as seguintes variáveis: idade, sexo, estado civil, ano do diagnóstico, classificação clínica, fonte de investigação, esquema de tratamento, doenças concomitantes. Resultados: Os pacientes mais acometidos estavam na faixa etária de 25 a 34 anos (n=18; 31,9%), no sexo masculino (n=28; 60,9%). O maior número de pacientes era solteiro (n=37; 80,4%). A fonte de pesquisa mais comum foi a categoria recrutada (n=11; 23,9%). O maior número de pacientes foi encontrado na categoria A (n=33, 71,7%), corroborando a cifra de que 32 pacientes (69,6%) não apresentavam nenhuma doença associada à infecção viral. O maior percentual de pacientes usava o esquema Dulutegravir + Trubada (n=26; 56,5%). Conclusões: Pode-se concluir que a infecção pelo HIV/AIDS é uma doença que se observa na idade média da vida, com aumento do número de infecções com o passar dos anos. Quando os pacientes mantêm um esquema de tratamento, menos doenças concomitantes são observadas e eles permanecem nas categorias clínicas que apresentam menos complicações.

Intervenciones físicas para interrumpir o reducir la propagación de virus respiratorios / Physical interventions to interrupt or reduce the spread of respiratory viruses

Resumen Las epidemias virales o pandemias de infecciones respiratorias agudas, como la gripe o el síndrome respiratorio agudo grave, representan una amenaza mundial. Los medicamentos antivirales y las vacunas pueden ser insuficientes para prevenir su propagación. Por lo anterior, una revisión sistemática Cochrane evaluó la eficacia de las intervenciones físicas para interrumpir o reducir la propagación de virus respiratorios.

Abstract Viral epidemics or pandemics of acute respiratory infections, like influenza or severe acute respiratory syndrome pose a global threat. Antiviral drugs and vaccination may be insufficient to prevent their spread. Therefore, a Cochrane systematic review evaluated effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses.

Frequency and trend of dengue fever in a tertiary care hospital in Kancheepuram, Tamilnadu: three-year retrospective study

Background: Dengue is a mosquito borne viral disease which is endemic in the tropical and subtropical regions. In the recent years it has become a significant public health problem and its incidence is increasing in India. In 2016 1.1 lakh new dengue cases were reported in India. The objectives of the study was to describe the frequency and distribution of dengue infection and to determine the association between dengue infection and selected variables.Methods: The study is a hospital based retrospective study conducted in a tertiary care hospital in a rural area of Kancheepuram district. Three-year data (January 2015 to December 2017) was collected from the medical records department of the hospital. Dengue cases were diagnosed by ELISA test.Results: Among 340 dengue patients admitted in the hospital 240 (74.5%) were male and 100 (25.5%) were female. In this study, 306 (90%) patients were of the classical dengue type and 34 (10%) patients belong to dengue haemorrhagic fever type. There is a spike in the case load after the monsoons. There was a positive statistical significant association (p<0.0001) between dengue infection and male sex, low socioeconomic status and platelet count at the time of admission.Conclusions: Results of the study indicate that there should be proper education of the public through various available Medias and awareness campaigns. All dengue patients must be appropriately treated in order to prevent complications. The national vector borne disease control program must extend its coverage to combat dengue infection.

Research progress of ginseng prescription, ginseng and ginsenoside in prevention and treatment of viral diseases / 中草药

Clinical practice since the outbreak of the novel coronavirus disease (COVID-19) has proven that the prevention and control measures of traditional Chinese medicine and the integrated treatment of traditional Chinese and Western medicine in China have effectively controlled the epidemic situation. Up to March 6 in 2020, Chinese medicine participated in the treatment of nearly 60 000 confirmed cases, and more than 20 000 were cured and discharged. In the critical period, the frequency of use of ginseng in the distribution of prescriptions, Chinese patent medicines and drug compatibility accounted for 56.41% of the drug distribution. According to the classification of ginseng compound, ginseng compound or ginseng single herb integrated with other antiviral drugs, ginseng extract, and ginsenosides, this article reviews the literature reports on ginseng prescriptions, ginseng and its saponins in the prevention and treatment of viral diseases, and related antiviral mechanisms, etc, with view to providing scientific basis for the use of ginseng and its saponins to prevent and treat viral diseases such as novel coronavirus pneumonia.

Infecciones respiratorias virales en pacientes hospitalizados en una unidad de cuidados intensivos neonatales / Viral respiratory infections in hospitalized patients in a neonatal intensive care unit

Introducción: Las infecciones respiratorias virales constituyen una problemática nacional y las unidades de cuidados intensivos neonatales, no están exentas de estas. Objetivo: Describir la frecuencia y características clínicas de las infecciones respiratorias virales en neonatos internados en un servicio de Neonatología durante el periodo de enero 2017 a octubre 2018. Materiales y Métodos: Estudio observacional, descriptivo, retrospectivo. Fueron analizadas historias clínicas de pacientes hospitalizados en la unidad de cuidados intensivos neonatales, que tuvieron diagnóstico de infecciones respiratorias de origen viral, el método de diagnóstico fue inmunofluorescencia directa, inmunocromatografía y PCR en tiempo real. Se excluyeron pacientes que procedan de otro servicio y hayan iniciado los síntomas antes del ingreso a nuestro centro. Variables: edad gestacional, edad posnatal, peso de nacimiento, síntomas, tipo de virus, prescripción de antibióticos. Los datos fueron analizados con Excel, utilizando estadísticas descriptivas. Resultados: De los 761 pacientes, 65 pacientes presentaron diagnóstico de infección respiratoria viral: frecuencia del 8,5%. EL promedio de edad fue de 17±10 días El método de diagnóstico más frecuente fue inmunofluorescencia 92%, Los síntomas más comunes fueron las secreciones respiratorias (74%) y desaturaciones (64%); Los virus más frecuentes fueron: Sincitial Respiratorio 26%, Influenza B 25%, Influenza A en un 18%. El 66% requirió tratamiento de soporte respiratorio. Un paciente falleció por causas no relacionadas a la infección respiratoria viral. Conclusiones: La frecuencia de infecciones virales fue del 8,5%. Los virus más frecuentes fueron VSR e influenza B. Más de la mitad necesitaron soporte respiratorio. Ningún paciente falleció.

Introduction: Viral respiratory infections are a national problem and neonatal intensive care units are not exempt from these infections. Objective: To describe the frequency and clinical characteristics of viral respiratory infections in newborns admitted to a Neonatology unit during january 2017 to october 2018 timeframe. Materials and Methods: This was an observational, descriptive and retrospective study. We reviewed the clinical records of patients admitted to the neonatal intensive care unit who were also diagnosed with a viral respiratory infection. To determine the etiology, we used direct immunofluorescence, immunochromatography and real-time PCR. Patients who were transferred from another service and whose symptoms began prior to transfer to our unit were excluded. Variables: gestational age, postnatal age, birth weight, symptoms, type of virus, antibiotic prescription. Data were analyzed with Excel, using descriptive statistics. Results: Of the 761 patients, 65 patients were diagnosed with a viral respiratory infection, a frequency of 8.5%. The average age was 17 ± 10 days. The most frequent diagnostic method was immunofluorescence (92%). The most common symptoms were respiratory secretions (74%) and desaturations (64%); The most frequent viruses were: Respiratory Syncytial (26%), Influenza B (25%) and Influenza A (18%). 66% required respiratory support treatment. One patient died from causes unrelated to the viral respiratory infection. Conclusions: The frequency of viral infections was 8.5%. The most frequent viruses were RSV and influenza B. More than half needed respiratory support. No patient died.

A fluorescent bead-based multiplex PCR assay for the simultaneous detection of seven viral diseases endemic in Africa / 中华实验和临床病毒学杂志

Objective@#To establish a fluorescent bead-based multiplex assay for the simultaneous detection of seven viral diseases endemic in Africa.@*Methods@#The genomic sequences of the viral pathogens causing Rift valley fever, Yellow fever, Marburg virus disease, Ebola virus disease, Lassa fever, Crimean-Congo hemorrhagic fever and Chikungunya fever were compared, PCR detection target fragments were selected, and amplification primers and hybrid probes were designed. The reference samples of related pathogens were prepared by chemical synthesis of DNA and in vitro transcription RNA. The sensitivity and stability of the detection method were evaluated. The specificity was evaluated by testing 30 samples of suspected dengue fever, and hantavirus diseases, and 32 healthy human blood samples.@*Results@#The fluorescent bead-based multiplex assay could specifically detect the corresponding pathogen, the detection limit was at a range of 102-105 copies/ μl, the specificity was 100%, and the intra-assay coefficient of variation was below 12%, and the inter-assay coefficient of variation was below 15%.@*Conclusions@#A fluorescent bead-based multiplex PCR assay for the simultaneous detection of seven viral diseases endemic in Africa was established, which may provide a new choice for the screening of suspected infectious diseases.

Keeping track of hidden dangers - The short history of the Sabiá virus

Abstract Emerging infectious diseases are a global threat. In countries like Brazil, where biodiversity is high and public health conditions in terms of infrastructure and medical care are often precarious, emerging diseases are particularly worrisome. The lack of monitoring strategies to identify pathogens with the potential to cause outbreaks or epidemics is another problem in Brazil and other developing countries. In this article, we present the history of the Sabiá virus (SABV), a pathogen that was described in the 1990s in Brazil. Several aspects of the biology and ecology of the SABV remain unknown. The SABV has the potential to cause hemorrhagic fever in humans. To date, four cases of human infections have been reported worldwide; two were naturally acquired (both in Brazil), whereas the other two were linked to occupational exposure in the laboratory environment (one in Brazil and one in the USA). In this review, we summarize the basic biological and ecological characteristics of the SABV. This is the first work to gather all available data on the historical aspects involving the cases of SABV infection along with an update on its characteristic features.

Swinepox dermatitis in backyard pigs in Northeastern Brazil / Varíola em suínos no Nordeste do Brasil

This article describes five outbreaks of swinepox in backyard pigs in Northeastern Brazil. It affected backyard pigs from herds of poor hygienic-sanitary conditions with severe fly and lice infestations. The morbidity ranged from 33.3 to 100% among affected herds, with mortality reaching up to 60%. The affected pigs developed multifocal to coalescent gray to white papules and blisters in the skin, with eventual eruptions, evolving to erosions and crusts. In addition to skin lesions, affected piglets presented apathy, anorexia and fever. The disease was auto-limiting, resolving within 15 to 25 days. Histological examination revealed proliferative and ulcerative vesiculopustular dermatitis with ballooning degeneration of epithelial cells, perivascular inflammatory infiltrates of lymphocytes, plasma cells, neutrophils, eosinophils and some macrophages in the dermis. Intracytoplasmic eosinophilic inclusions were consistently observed in keratinocytes. Total DNA extracted from fresh tissue fragments obtained from one outbreak and formalin-fixed, paraffin-embedded (FFPE) tissue from the other four outbreaks was submitted to polymerase chain reaction (PCR) for Swinepox virus (SWPV) and Vaccinia virus (VACV). Genetic SWPV material was identified by PCR in fresh material from one outbreak. Nucleotide sequencing and phylogenetic analysis of the PCR amplicons (viral polymerase gene) demonstrated 100% homology with sequences from SWPV. All tissues were PCR negative for VACV. Swine poxvirus is present in backyard pigs in Northeastern Brazil, indicating the need of including SWPV in the differential diagnosis of dermatitis in pigs.(AU)

Em cinco surtos de varíola em suínos no Nordeste do Brasil foram acometidos leitões e suínos adultos, de rebanhos domésticos criados em condições higiênico-sanitárias precárias, que apresentavam graves infestações por moscas e piolhos. A morbidade variou de 33,3-100% entre os rebanhos afetados e a mortalidade atingindo 60%. Os animais afetados desenvolveram pápulas cinzentas ou esbranquiçadas coalescentes e vesículas, que evoluíram para erosões e crostras. Além das lesões de pele, os leitões afetados apresentavam apatia, anorexia e febre. A doença foi autolimitante, com resolução em 15 a 25 dias. Histologicamente, observou-se dermatite proliferativa e ulcerativa com degeneração balonosa das células do epitélio, infiltrado inflamatório perivascular de linfócitos, plasmócitos, neutrófilos, eosinófilos e escassos macrófagos na derme. Inclusões eosinofílicas intracitoplasmáticas foram consistentemente observadas em queratinócitos. DNA total extraído a partir de fragmentos de tecido frescos obtidos a partir de um surto, e de tecido fixado em formol e embebido em parafina dos outros quatro surtos, foram submetidos à reação em cadeia da polimerase (PCR) para o vírus da varíola suína (SWPV) e o vírus vaccínia (VACV). Material genético do SWPV foi identificado por PCR em material fresco de um surto. O sequenciamento e análise filogenética dos produtos de amplificação da PCR (gene da polimerase viral) demonstraram 100% de homologia com sequências do SWPV. Todos os fragmentos de tecidos foram negativos para VACV na PCR. Este artigo relata a circulação de poxvírus suíno no Nordeste do Brasil, indicando a necessidade de incluir SWPV no diagnóstico diferencial de dermatite em suínos.(AU)

A Case of Concurrent Acute Viral Myocarditis and Intussusceptions in a 3-Year-Old Child / 대한법의학회지

Chickenpox is an acute disease caused by the varicella-zoster virus (VZV), a herpesvirus that causes human infection worldwide. Primary VZV infection routinely occurs during childhood and is usually a self-limiting illness in immunocompetent children. However, chickenpox can be a severe disease in adolescents, adults, and immunosuppressed or immunocompromised patients. Although vaccination substantially attenuates disease manifestations, significant complications such as secondary soft tissue infection, encephalitis, and pneumonia can occur. We present a rare autopsy case of concurrent acute myocarditis and intussusceptions in a 3-year-old female child who presented with chickenpox followed by abdominal pain and sudden death. The present case emphasizes the potential for fatal complications of viral infections, which should be considered in cases of sudden unexpected infectious death in children.

Estudio Comparativo entre Terapia con Melissa officinalis vs. Tratamiento Convencional con Aciclovir Tópico al 5% para Lesiones Herpéticas Tipo 1 / Comparative Study of Therapy with Melissa Officinalis vs. Conventional Topical Treatment with 5% Acyclovir in Type 1 Herpes Lesions

El herpes simple tipo I es una patología infecciosa e inflamatoria de tipo vírico que se caracteriza por la aparición de lesiones ulcerativas extra orales, de duración aproximada de 14 días y que provocan gran picazón e incomodidad a las personas que lo padecen. El objetivo de este trabajo fue evaluar el uso la Melissa officinalis (toronjil) como terapia alternativa sobre el tiempo de remisión y el número de las lesiones extraorales en pacientes con herpes simple del comparado con el Aciclovir tópico al 5% como terapia convencional. Se realizó un ensayo clínico, aleatorizado y enmascarado simple, controlado. Se evaluó a 34 pacientes con lesiones herpéticas extra orales activas en la etapa primaria vesiculosa, sin patologías asociadas a alteraciones del sistema inmunológico como diabetes mellitus, alergias e hipertensión arterial. Se les administró el tratamiento tópico y se les evalúo diariamente las lesiones herpéticas. La Melissa officinalis posee un efecto antiviral sobre lesiones herpéticas tipo 1 al igual que el Aciclovir tópico al 5%, pero la Melissa officinalis es más efectivo en la disminución de días con lesiones herpéticas (valor p=0,05). La Melissa officinalis tiene un efecto antiviral positivo sobre lesiones herpéticas tipo 1, disminuyendo el número total de días con las lesiones herpéticas en comparación con el Aciclovir tópico al 5%.

Herpes simplex type I is an infectious viral and inflammatory disease type which is characterized by the appearance of extra- oral ulcerative lesions of approximately 14 days that cause severe itching and discomfort for those who have the lesions. The objective of this study was to evaluate the use of Melissa officinalis (lemon balm) as an alternative therapy on remission time and the number of extra oral lesions in patients with herpes simplex compared with topical 5% acyclovir and conventional therapy. A clinical, randomized and single-blind, controlled trial study was carried out. Thirty-four patients were evaluated with active extra- oral herpetic vesicular lesions in primary stage, without pathologies associated with immune system disorders such as diabetes mellitus, allergies and hypertension. They were given topical treatment and herpetic lesions were evaluated daily. Melissa officinalis has an antiviral effect on type 1 herpes lesions as 5% topical acyclovir, Melissa officinalis but is more effective in the reduction of days with herpetic lesions (p value <0.05). In conclusion, Melissa officinalis has a positive antiviral effect on type 1 herpes lesions, reducing the total number of days with herpetic lesions compared with topical 5% acyclovir.

Concordancia del hisopado nasal con el hisopado nasofaríngeo en la detección de virus respiratorios por inmunofluorescencia directa / Concordance of nasal swabs and nasopharyngeal swabs in the detection of respiratory viruses by direct immunofluorescence

Background: The most used test for the diagnosis of viral respiratory infection is the detection of viral antigens by direct immunofluorescence (DFA), in samples taken by nasopharyngeal swab (NPS) or aspirate (NPA). It would be desirable to have a less uncomfortable technique to obtain a sample from the patient, but of equal performance. Aim: To evaluate the diagnostic agreement between nasal swab (NS) and nasopharyngeal swab (NPS) in the detection of respiratory viruses by DFA and compare the degree of discomfort of both techniques in pediatric patients. Methodology: Cross-sectional study in children who consulted to a pediatric emergency service with respiratory symptoms. Two samples (NPS and NS) per child were collected. The concordance between the two was determined by Kappa (K) coefficient and the degree of discomfort by a visual pain scale. Results: We obtained 112 samples from 56 children, one by each technique. 82.1% were concordant, K = 0.61 (CI95%, 0.39-0.83) for the detection of any virus, and K = 0.69 (CI 95%, 0.46- 0.92) and K = 0.76 (CI 95%, 0.51-1) for syncytial respiratory virus and influenza A detection, respectively. The degree of discomfort was significantly lower for the NS. Conclusion: There is considerable agreement in the detection of respiratory viruses by DFA between samples obtained by NS and NPS, but not enough to recommend a change in the sampling method in this population.

Introducción: El examen más utilizado para el diagnóstico de infecciones respiratorias virales es la detección de antígenos virales por inmunofluorescencia directa (IFD) en muestras tomadas por hisopado nasofaríngeo (HNF) o aspirado (ANF). Sería deseable contar con una técnica de toma de muestra menos molesta para el paciente pero de igual rendimiento que las mencionadas. Objetivo: Evaluar la concordancia diagnóstica entre hisopado nasal (HN) e HNF en la detección de virus respiratorios por IFD y comparar el grado de molestia de ambas técnicas en pacientes pediátricos. Métodos: Estudio transversal en niños que consultaron en una urgencia pediátrica por síntomas respiratorios agudos. Se recolectaron dos muestras (por HNF y HN) por cada niño para detección viral mediante IFD. Se determinó la concordancia entre ambas mediante coeficiente Kappa (K) y se analizó el grado de molestia que causa la toma de muestra con escala visual. Resultados: Se obtuvo 112 muestras en 56 niños, una por cada técnica. La concordancia entre ellas fue de 82,1%, con un K = 0,61 (IC95% 0,39-0,83) para la detección de cualquier virus, K = 0,69 (IC 95% 0,46- 0,92) para virus respiratorio sincicial y K = 0,76 (IC 95% 0,51-1) para influenza A. El grado de molestia fue significativamente menor para el HN. Conclusiones: Existe una concordancia considerable en la detección de virus respiratorios mediante IFD en muestras tomadas por HNF como HN, pero insuficiente como para recomendar un cambio de metodología de la toma de muestra en esta población.

The Development of Anti-inflammatory Drugs for Viral Diseases

Viral disease is traditionally thought to result from an insufficient response of the host to infection, leading to increased replication of viruses and consequently disease. However, the disease is not the simple result of uncontrolled replication of virus. Indeed, the inflammatory response triggered by certain infection is frequently the cause of tissue damage and death. This inflammatory situation can be called as immunopathologic phenomena. By understanding the mechanisms which drive disease, novel therapies may be devised for treatment of patients. I will describe the situations of some viral diseases in which unwanted (excessive, misplaced or altered) inflammation causes immunopathologic phenomena and is responsible for disease induction. In these situations, I will also describe some candidates of antiviral drug which inhibit or modulate the inflammatory response to viral infection.

La influenza A (H1N1): estado actual del conocimiento / Influenza A (H1N1) virus: current information

Se revisó la bibliografía actualizada sobre el tema a partir de los principales buscadores, y reuniones internacionales realizadas sobre la pandemia de la influenza A (H1N1). Se tratan los aspectos relacionados con la historia, la aparición de la pandemia, la biología de la enfermedad, la epidemiología, el cuadro clínico, el tratamiento y el pronóstico y la prevención. La gripe A (H1N1) es una pandemia causada por una variante nueva del virus de la Influenza A que ha sufrido cambios antigénicos en la hemaglutinina y la neuraminidasa. Esto hace que la población sea altamente vulnerable a la infección y produce una sobrecarga temporal enorme a los servicios de salud. El virus se trasmite como otros virus Influenza. Su letalidad es similar a la de la influenza estacional, pero puede incrementarse en personas con factores de riesgo y en adultos jóvenes sanos. El asma y el embarazo parecen ser condiciones de base importantes para incrementar la severidad de la infección. Puede existir cierta protección por inmunidad cruzada con cepas que circularon en el pasado. El espectro clínico va desde personas asintomáticas hasta las formas graves que requieren internación en cuidados intensivos, con rápido deterioro hasta llegar a la insuficiencia respiratoria en un plazo de 24 horas. La vacunación durante la pandemia no parece ser suficientemente efectiva. Son necesarios antivirales (oseltamivir y zanamivir), y las medidas preventivas higiénico-sanitarias son muy eficaces.

An updated review using the main search motors and international meetings already celebrated related to Influenza A H1N1 pandemics. Items related to the history, the appearance of the pandemics, the biology of the disease, its epidemiology, clinics, treatment, prognosis and prevention. Grippe A H1N1 is a pandemic caused by a new variant of the Influenza A virus that has suffered antigenic changes in haemaglutinin and neuraminidase. This turns populations more susceptible to this infection and produces a temporary burden on the health services. This virus is transmitted like other influenza viruses. Its lethality is similar to that observed for the seasonal influenza, but may be enhanced in people having risk factors and in healthy young adults. Asthma and pregnancy seem to be basic conditions to increase the severity of the infection. Certain degree of protection may exist, due to cross immunity with ancient strains that circulated in the past times. The clinical spectrum goes from asymptomatic people to the most severe forms requiring intensive care, when a rapid deterioration of the health up to reach a respiratory failure in 24 hours. Vaccination during the epidemics seems to be non effective. Antiviral agents (oseltamivir and zanamivir) are necessary, and the preventive hygiene-sanitary measures are highly effective.

Exantemas virales / Viral exanthems

Una gran variedad de agentes microbiológicos se han asociado con manifestaciones cutáneas, entre ellas virus, bacterias, parásitos y hongos. Muchas de las enfermedades virales se manifiestan con exantemas. Estas erupciones constituidas por las lesiones más variadas (máculas, pápulas, vesículas, pústulas, petequias), son frecuente motivo de consulta en la edad pediátrica. Numerosos factores dentro de la historia clínica pueden ser de gran ayuda. La mayoría de estos exantemas es autolimitada y queda catalogada como 'virales' sin haberse alcanzado un diagnóstico etiológico. Otros exantemas son más característicos de un cuadro clínico y la semiología basta para hacer un diagnóstico certero.

A great variety of microbiological agents have been associated with skin manifestations, among virus, bacterias, parasites, fungi. Many of viral diseases are manifested by exanthema. These eruptions are constituted by very different lesions (macula, papule, vesicle, pustule, petechiae) are the reason of the consultation in the childhood frequently. Many factors of the clinical history may help us. Mostly of these exanthemas are autolimited and stay catalogued as 'viral manifestations' without they have reached an etiologic diagnosis yet. Another exanthemas are typical from a clinic entity and the semiology is enough to do an exactly diagnosis.