Educação em saúde para prevenção da raiva humana / Health education for prevention of human rabies / Educación en salud para prevención de la rabia humana

A raiva é uma antropozoonose viral que se desenvolve de forma progressiva e aguda podendo apresentar até 100% de letalidade. O seu agente etiológico é o vírus rábico do gênero Lyssavirus pertencente à família Rhabdoviridae. O presente trabalho teve como objetivo divulgar informações acerca da ocorrência da raiva em humanos em virtude da sua expressiva importância para saúde pública e analisar a percepção da população sobre a raiva humana, de forma a obter dados relacionados a conhecimentos básicos sobre a doença. Para isso, foi criada uma página informativa denominada "@contraraiva_" na rede social Instagram para a realização de postagens interativas sobre o tema abordado, e uso de um questionário criado a partir da plataforma Google Forms em diferentes mídias sociais para a obtenção e coleta de dados. Foram obtidas 1.075 respostas, provenientes de diferentes localidades. O questionário alcançou todas as regiões brasileiras, todos 26 estados e o Distrito Federal. As informações publicadas pela página criada ajudaram a sanar dúvidas relacionadas aos principais aspectos da doença. Os dados obtidos a partir do questionário contribuem para o planejamento de ações voltadas para a educação em saúde de forma mais estratégica, visando contribuir para os pontos em que a população tem menos conhecimentos.(AU)

Rabies is a viral anthropozoonosis that is developed in a progressive and acute way and can present up to 100% lethality. Its etiologic agent is the rabies virus of the Lyssavirus gene belonging to the Rhabdoviridae family. This study aimed at disseminating information about the occurrence of rabies in humans due to its expressive importance for public health, and at analyzing the population perception on human rabies in order to obtain data related to basic knowledge about the disease. For that purpose, an information page called "@ contraraiva _" was created on the social network Instagram for providing interactive posts on the topic, and a questionnaire was created from the Google Forms platform on different social media to obtain and collect data. A total of 1,075 responses were obtained from different locations. The questionnaire included all Brazilian regions, all 26 states and the Federal District. The information published on the created page helped to clarify doubts related to the main aspects of the disease. The data obtained from the questionnaire contribute towards the planning of actions aimed at health education in a more strategic way, aiming at contributing to the points where the population is less knowledgeable.(AU)

La rabia es una antropozoonosis viral que se desarrolla de forma progresiva y aguda y puede presentar hasta un 100% de letalidad. Su agente etiológico es el virus de la rabia del género Lyssavirus perteneciente a la familia Rhabdoviridae. Este estudio tuvo como objetivo difundir informaciones sobre la ocurrencia de la rabia en humanos en virtud de su importancia expresiva para la salud pública, y analizar la percepción de la población sobre la rabia humana, con el fin de obtener datos relacionados a los conocimientos básicos sobre la enfermedad. Para ello, se creó una página de información denominada "@ contraraiva _" en la red social Instagram para realizar publicaciones interactivas sobre el tema abordado, y utilizar un cuestionario creado a partir de la plataforma Google Forms en diferentes redes sociales para la obtención y recolección de datos. Se obtuvieron 1.075 respuestas de diferentes lugares. El cuestionario llegó a todas las regiones brasileñas, a los 26 estados y al Distrito Federal. Las informaciones publicadas en el sitio web creado, ayudaron a sanar dudas relacionadas a los principales aspectos de la enfermedad. Los datos obtenidos del cuestionario contribuyen a la planificación de acciones orientadas a la educación para la salud de forma más estratégica, con el objetivo de contribuir a los puntos donde la población tiene menos conocimientos.(AU)

Rabies in Callithrix sp. in the urban area of Niterói, Rio de Janeiro, Brazil

Abstract In Brazil, rabies occurs mainly within an urban cycle, in which dogs and bats are reservoirs. This paper aims to report the occurrence of rabies in Callithrix sp. in Niterói, Rio de Janeiro, Brazil. In June 2019 a hybrid specimen was referred for diagnosis. The Direct Fluorescent Antibody, Mouse Inoculation, and Polymerase Chain Reaction tests were positive. A phylogenetic analysis was compatible with antigenic variant 3, characteristic of Desmodus rotundus. New studies should be undertaken to elucidate the real role of callitrichids in the urban rabies cycle.

Expert consensus on rabies exposure prophylaxis / 中华预防医学杂志

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post-exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization′s position paper on rabies vaccine in 2018 and related research progress in recent.

Epidemiologia descritiva da raiva dos herbívoros notificados no estado do Paraná entre 1977 e 2012 / Epidemiology of rabies in large animals of Parana, Brazil, from 1977 to 2012

Realizou-se estudo epidemiológico descritivo da raiva dos herbívoros no estado do Paraná entre os anos de 1977 e 2012. Os casos confirmados de raiva e o total de amostras de encéfalo encaminhadas para o diagnóstico foram distribuídos por espécie, por ano, por meses, por mesorregião geográfica e por municípios, aplicando-se o teste de Qui-quadrado para verificar se havia associação com esses fatores. Modelo probabilístico foi ajustado à série histórica para verificação de padrões cíclico ou sazonal. Comprovou-se que a raiva é uma doença endêmica no PR, com ocorrência variável entre os anos, sem padrão sazonal e com ciclicidade aparente a cada 18 anos, acometendo, sobretudo, bovinos (86,9%) e equídeos (11,3%). Verificou-se grande difusão no estado (47,6% dos municípios), e a maior expansão geográfica aconteceu na última década. As áreas de ocorrência maior foram as mesorregiões Centro Oriental e de Curitiba, seguidas por Norte Pioneiro e Oeste. O número de casos de raiva por município se correlacionou, ainda que fracamente, com o número de abrigos de Desmodus rotundus (r=0,469; p<0,0001). Sugere-se que a imunização anual de bovinos e equídeos passe a ser adotada nas áreas de maior ocorrência (mesorregiões Centro Oriental e de Curitiba) e encorajada nas de ocorrência intermediária (mesorregiões Norte Pioneiro e Oeste).(AU)

A descriptive epidemiological survey of rabies in herbivorous reared in the state of Parana, Brazil, was carried out from 1977 to 2012. The positive cases and the total number of brain samples processed for diagnostic purposes were distributed according to species, year, month, geographical region and municipality. Chi-square test was used to verify if rabies was associated to these factors. Probabilistic model was applied to historical series in order to verify cyclic and seasonal patterns. In Parana, rabies is an endemic disease with variable yearly occurrence, without seasonal pattern and with a possible cyclic pattern every 18 years. Cattle (86.9%) and equides (11.3%) were mainly affected. Rabies was registered in 47.6% of all municipalities, indicating a great spread of this disease in Parana, mainly during the last decade. Middlewest and Curitiba regions, followed by Pioneer North and West regions, were the areas of most occurrence. The number of cases per municipality was weakly correlated with the number of shelters for Desmodus rotundus (r=0.469; p<0.0001). Therefore, we suggest that annual immunization of cattle and equides should be applied in the high occurrence areas (Middlewest and Curitiba regions) and encouraged in intermediate occurrence areas (Pioneer North and West regions).(AU)

Presencia de virus rábico en murciélagos hematófagos encolombia (ciénaga de oro y sahagún, córdoba) / Presence of rabies virus in bloodsucking bats in colombia (ciénaga de oro and sahagún, córdoba)

El objetivo de este estudio fue determinar la presencia de virus rábico en poblaciones de D. rotundus mediante la técnica de la inmunofluorescencia directa. Por medio de un estudio epidemiológico descriptivo de corte transversal y de un muestreo por conveniencia, se seleccionaron fincas en Ciénaga de Oro y hagún (Córdoba), donde se observó la presencia de murciélagos hematófagos por la visualización de mordeduras en bovinos y equinos, y se implementó la captura de D. rotundus mediante el atrapamiento con redes de niebla. En las 33 salidas, se capturaron 250 D. rotundus. Se tomaron 100 especímenes a los cuales se les practicó la eutanasia con el fin de detectar el virus de la rabia; los demás especímenes fueron tratados con un anticoagulante tópico y liberados con el fin de controlar la población de D. rotundus. Las capturas de los murciélagos hematófagos y las técnicas de diagnóstico se implementaron con el acompañamiento de funcionarios de la Oficina de Epidemiología del ICA (Córdoba), dentro del programa de control de la rabia bovina. Sólo el 13% de D. rotundus procedentes de diferentes zonas rurales de Sahagún fueron positivos por la inmunofluorescencia directa y ninguna muestra fue positiva por la prueba biológica. Se debe continuar realizando vigilancia epidemiológica y control poblaciones de D. rotundus e implementar programas de vacunación masiva en animales de compañía y de interés zootécnico; así como también de educación a la población para la concientización de riesgos y de los beneficios ecológicos de la fauna silvestre; siendo estas las mejores herramientas para prevenir la transmisión.

The objective of this study was to determine the presence of Rabies virus in D. rotundus populations through the direct immunofluorescence technique. Using a descriptive cross-sectional epidemiological study and of a convenience sampling. Farms in Ciénaga de Oro and Sahagún (Córdoba) were selected where the presence of bloodsucker bats was detected because of bites in cattle and horses, and the capture of D. rotundus was implemented using trapping with mist nets. A total of 250 D. rotundus were caught in the 33 journeys, and 100 specimens were taken which underwent euthanasia to detect the rabies virus. The rest of the samples were treated with a topic anticoagulant and set free to control D. rotundus population. The capture of bloodsucking bats and the diagnosis techniques were carried out with the support of public servants from the epidemiology office of ICA (Colombian acronym for Colombian Institute of Agriculture) - Cordoba as part of the bovine rabies control program. Only 13% of the D. rotundus coming from different rural areas of Sahagún were positive for direct immunofluorescence, and no sample was positive for the biological test. Epidemiological watch and D. rotundus populations control must continue as well as the implementation of massive vaccination programs for escort animals and those of zootechnical concern and of educational programs to the community to raise awareness of risks and the ecological benefits of wildlife as the best tools to prevent transmission.

Enfermedad neurllógica bovina con diagnóstico n conclusivo en la región norte de Colombia. analisis histológico e inmunohistoquímico / Neurologiol diseeases in cttle with non-conclusive diagnostic in the Coloombia northern region. histological and inmunohistochemical analyses

La enfermedad neurológica bovina genera altas pérdidas económicas en las ganaderías y algunos de sus agentes etiológicos son zoonóticos, hechos que hacen prioritario su estudio. El objetivo del trabajo fue identificar antígenos del virus de la rabia y del herpes virus bovino-5 (BoHV-5) en muestras de encéfalos de bovinos archivados como casos de enfermedad neurológica con diagnóstico no conclusivo. Se seleccionaron 10 muestras del laboratorio del Instituto Colombiano Agropecuario -ICA- de Montería. Los tejidos fueron analizados mediante histopatología e inmunohistoquímica; para esta última técnica fueron utilizados tres anticuerpos: dos contra antígenos del virus de la rabia a una dilución de 1:200 y uno contra BoHV-5 a una dilución de 1:100. Histológicamente en nueve casos se observaron lesiones que variaron de tipo y severidad; la identificación de antígenos del virus de la rabia se demostró en 20% (2/10) de los casos y en ningún caso se demostró la presencia BoHV-5. Se discute sobre los resultados histopatológicos e inmunohistoquímicos y se concluye la importancia de asociar los hallazgos de las dos técnicas para establecer la etiología de la enfermedad neurológica, especialmente en casos con diagnóstico inconcluso.

Bovine neurological disease generates high economic losses in herds and some of its etiological agents are zoonotic, situations that make priority their study. The aim of this study was to identify antigens rabies virus and bovine herpesvirus-5 (BoHV-5) in cattle brain samples archived as cases of neurological disease with no conclusive diagnosis. 10 samples were selected from laboratory of the Colombian Agricultural Institute -ICA- at Monteria. Tissues were analyzed by histopathology and immunohistochemistry techniques. For immunohistochemical analysis, three antibodies were used: two against antigens of rabies virus at a dilution of 1:200, and one against antigens of BoHV-5 at a dilution of 1:100. Histologically lesions i nine cases lesions that varied in type and severity were observed; antigens detection of rabies virus could be demonstrated by immunohistochemistry in 20% (2/10) of cases and could not be demonstrated in any case the presence BoHV-5. We discuss on the histopathological and immunohistochemical finding, it is concluded on the importance of perform association of the two techniques to assist the establishing of the neurological disease etiology, especially in case without diagnostic.

Encefalitis rábica humana secundaria a mordedura por gato infectado por un virus rábico de origen silvestre / Encephalitis Due to Rabies Secondary to the Bite of a Cat Infected With a Rabies Virus of Silvester Origen

La rabia es una enfermedad viral zoonótica, producida por un virus del genero Lyssavirus de la Familia Rhabdoviridae, cuya principal fuente de transmisión es la mordedura de animales a humanos. Es una enfermedad fatal y se han descrito casos por ciclos urbanos y rurales. El caso que reportamos es el de una joven de 22 años, quien ingresa por un cuadro de dolor de características neuropáticas en el miembro superior derecho, con antecedente de mordedura por un gato de varios meses atrás, hospitalizada por el servicio de Neurología por sospecha de lesión de plejo braquial, con resonancia de columna cervical y líquido cefalorraquídeo (LCR) normales, quien posteriormente presenta deterioro clínico tórpido a un proceso encefalopático que en pocos días la llevó a la muerte. Se confirmó que la paciente presentó una encefalitis por un virus de rabia. Expondremos cómo fue el manejo de la paciente y todos los nexos epidemiológicos.

Rabies is a zoonotic viral disease, caused by a virus of the genus Lyssavirus of the Rhabdoviridae family. Its main source is transmission from animals to humans bite. The disease is fatal and has been reported to occur in rural and urban cycles. This reported case is a 22-year old, who was admitted with symptoms of neuropathic pain in the right arm, with a history of being bitten by a cat a few months earlier. The patient was hospitalized in the Neurology Department for suspected brachial plexopathy, and normal spinal MRI and cerebrospinal fluid (CSF) were found. The patient subsequently presented encephalopathic decline that resulted in death within a few days. It was confirmed that the patient had encephalitis due to the rabies virus. We present the management of the patient and all epidemiological links.

Rabies in humans and non-human in the state of Pará, Brazilian Amazon

We evaluate the relationship of positive cases of rabies with the continuing expansion of livestock production, and analyse the trends of this zoonosis in human population in the state of Pará, Brazilian Amazon. The distribution of rabies cases was recorded between 1999 and 2004. Of 148 cases of rabies, 21% were in humans and 79% in non-human mammals. The rapid growth in livestock numbers seems to be associated with the increase of positive cases in bovine livestock transmitted by vampire bats. This idea is supported by positive and significant relationship of both events in time (p < 0.01), but failed when spatial distribution among regions of the state was considered. However, rabies cases tend to occur toward the northeastern of the state of Pará, where rabies cases are proportionally five times greater than other mesoregions, suggesting that increased livestock production may influence the increase of this zoonosis.

Transmisión del virus de la rabia entre murciélagos urbanos del departamento del Valle del Cauca, Colombia, 1999-2008 / Rabies virus transmission among urban bats in the department of Valle del Cauca, Colombia, 1999-2008

Introducción. La intromisión humana en ecosistemas silvestres ha provocado cambios de comportamiento en los murciélagos, con la consecuente invasión a viviendas, convirtiéndolos en un factor de riesgo para la transmisión de la rabia a humanos y mascotas. Objetivos. Determinar en el departamento del Valle del Cauca, las asociaciones entre hábitos de comportamiento y transmisión de rabia entre murciélagos y su significado epidemiológico con énfasis en riesgo para la población humana. Materiales y métodos. Durante el periodo de diciembre 1999 a junio 2008, fueron capturados 1.321 murciélagos por el programa de vigilancia de rabia en el departamento del Valle del Cauca. El diagnóstico de rabia se hizo por inmunofluorescencia directa e inoculación en ratones, utilizando tejido encefálico de los murciélagos capturados. La tipificación viral se hizo por inmunofluorescencia indirecta usando anticuerpos monoclonales. Resultados. Se detectaron dos ejemplares de Eptesicus brasiliensis positivos para rabia en los años 2000 y 2002, y dos casos más en especímenes de E. brasiliensis y Molossus molossus, en el 2008. No se detectó el virus de la rabia en E. brasiliensis ni en M. molossus, ni en ninguna otra especie durante los años 1999, 2001, 2003, 2004, 2006 y 2007. Se encontraron distintas especies de murciélagos, como E. brasiliensis, M. molossus, Myotis nigricans, Glossophaga soricina, Noctiliio albiventris y Carollia perspicillata, compartiendo refugios en casas. Se detectaron virus rábicos de las variantes antigénicas 3 y 4, en murciélagos M. molossus y E. brasiliensis. Conclusiones. La presencia en el Departamento del Valle del Cauca de las variantes antigénicas 3 y 4 del virus rábico en murciélagos no hematófagos de hábitos caseros, probablemente, ha sido facilitada por la deforestación de los hábitats naturales de estas especies; además, el estilo de arquitectura urbana provee un hábitat artificial que posibilita el contacto físico entre las especies y la transmisión de rabia entre ellas. Ante las dificultades para controlar la rabia en murciélagos y la falta de herramientas adecuadas, la vigilancia continua de la enfermedad en los murciélagos, basada en el diagnóstico y la tipificación de los virus rábicos por laboratorio, en de los asentamientos humanos y alrededor de ellos, la vacunación preventiva en animales domésticos y de producción, así como la educación de la comunidad (para la concientización del riesgo y la recolección pasiva de muestras para su análisis), se convierten en las mejores herramientas para prevenir la transmisión a humanos.

Introduction: Human activities in the wild have recently increased the changes in bat behavior and invasion of houses, turning these animals into a health threat for humans and pets. Objectives: To determine the associations between behavioral habits and rabies transmission among bats in the department of Valle del Cauca and to assess the risk the existence of rabies in house dwelling bats presents for human health. Material and methods: In the period from December 1999 to June 2008, 1,321 hematophagous and non-hematophagous bats were captured for rabies epidemiological surveillance in the department of Valle del Cauca, Colombia. Rabies was diagnosed by direct immunofluorescence test on the brain tissue of collected animals. Viral typification was achieved by indirect immunofluorecense using rabies specific monoclonal antibodies. Results: Four bats were positive for rabies: two Eptesicus brasiliensis in 2000 and 2002, and an Eptesicus brasiliensis and a Molossus molossus in 2008. During the years 1999, 2001, 2003, 2004, 2006 and 2007 no rabies virus was found in E. brasiliensis and M. molossus or in any other bat species. Various species including E. brasiliensis, M. molossus, Myotis nigricans, Glossophaga soricina, Noctiliio albiventris and Carollia perspicillata were found sharing shelters in houses. Rabies virus antigenic variants 3 and 4 were found in M. molossus and E. brasiliensis bats only. Conclusions: The presence and potential spread of rabies antigenic variants 3 and 4 to cities have very likely been facilitated by the perturbation of the natural habitats of non-hematophagous bats in the department of Valle del Cauca; the urban architecture style also provides an artificial habitat which allows for physical contact and rabies transmission among the species. Seeing the difficulty for controlling rabies in bats and the lack of adequate tools, intensive laboratory based rabies surveillance in and around human settlements, preventive vaccination for house and production animals, and education for the community (in relation to increasing the awareness concerning the risk, and passive recollection of samples for analysis) represent major preventive strategies against bat rabies transmission to humans and pets.

Evaluación de la seroconversión como respuesta a la vacunación antirrábica en perros en el departamento del Valle del Cauca, Colombia, 2009 / Evaluation of the seroconversion as a response to rabies vaccination in dogs, Valle del Cauca, Colombia, 2009

Introducción. El departamento del Valle del Cauca ha estado libre de rabia canina por más de 20 años, aunque persisten focos de rabia silvestre que amenazan a humanos y sus mascotas; por ello, como medida preventiva. se realizan anualmente campañas de vacunación antirrábica canina. Objetivos. Medir el impacto de la vacunación en términos de seroconversión de anticuerpos neutralizadores y de porcentaje de perros con respuesta inmunitaria humoral adecuada, relacionando variables propias de estos animales y de las condiciones de vacunación. Discutir el significado epidemiológico de los resultados y sus implicaciones en salud pública. Materiales y métodos. Se obtuvo suero e información de 569 perros vacunados en los 42 municipios de Valle del Cauca. La inmunidad humoral se investigó por ELISA cuantitativa. La información se analizó con el programa Epi-Info 6.0. Resultados. El 9,1 % de los perros de la muestra fueron seronegativos y el 25,1 % no evidenciaron respuesta inmunitaria humoral adecuada a la vacunación. La concentración de anticuerpos disminuyó gradualmente desde la aplicación de la vacuna, y estuvo asociada a edad y calidad de las vacunas, aunque no estuvo asociada a sexo ni a raza. Conclusiones. Con el fin de aumentar los porcentajes de perros seropositivos y con respuesta inmunitaria humoral adecuada, se hacen las siguientes recomendaciones: 1) utilizar vacunas antirrábicas viables;2) aplicar dos dosis de vacuna durante los primeros seis meses de vida de los cachorros; 3) aplicar refuerzos de vacuna, por lo menos, una vez al año; 4) que las autoridades vigilen las actividades y los procesos programáticos relacionados con la vacunación antirrábica por particulares.

Introduction. The province of Valle del Cauca has been free of dog rabies for more than 20 years. However, sylvatic rabies foci remain which are threats to the health of the populace and its pets. Rabies vaccination campaigns are carried out annually in all 42 counties of the province. Objectives. The impact of dog vaccination was evaluated on the basis of humoral immunoresponse, population parameters and correlation with variables inherent to the vaccination process and logistics. Materials and methods. Sera and associated data were obtained from each of the 42 counties for a total sample of 569 rabies-vaccinated dogs. Rabies neutralizing antibodies were measured by quantitative ELISA. The data were analyzed with the statistical programs in Epi-Info 6.0. Results. Nearly 10% of dogs were seronegative (9.1%) and an additional 25.1% did not elicit an adequate humoral immune response to vaccination. Concentration of rabies neutralizing antibodies diminished gradually with the time after vaccination and was correlated with dog age and vaccine quality. No associations were noted between dog gender or breed. Conclusions. These data permit the following recommendations: (1) only viable, non expired rabies vaccines must be used to immunize animals, (2) two doses of rabies vaccine must be applied during the first six months of dog life, (3) booster immunizations must be administered every year, (4) practices and processes related to rabies vaccination in private institutions must inspected regularly by health authorities.

Detecção de núcleoproteína-RNA do vírus rábico em diversos órgãos fora do sistema nervoso central de morcegos hematófagos infectados naturalmente / Detection of rabies virus nucleoprotein-RNA in several organs outside the Central Nervous System in naturally-infected vampire bats

Rabies is a neurological disease, but the rabies virus spread to several organs outside the central nervous system (CNS). The rabies virus antigen or RNA has been identified from the salivary glands, the lungs, the kidneys, the heart and the liver. This work aimed to identify the presence of the rabies virus in non-neuronal organs from naturally-infected vampire bats and to study the rabies virus in the salivary glands of healthy vampire bats. Out of the five bats that were positive for rabies in the CNS, by fluorescent antibody test (FAT), viral isolation in N2A cells and reverse transcription - polymerase chain reaction (RT-PCR), 100 percent (5/5) were positive for rabies in samples of the tongue and the heart, 80 percent (4/5) in the kidneys, 40 percent (2/5) in samples of the salivary glands and the lungs, and 20 percent (1/5) in the liver by RT-PCR test. All the nine bats that were negative for rabies in the CNS, by FAT, viral isolation and RT-PCR were negative for rabies in the salivary glands by RT-PCR test. Possible consequences for rabies epidemiology and pathogenesis are discussed in this work.

A raiva é uma doença neurológica, mas o vírus da raiva se dispersa para diversos órgãos fora do sistema nervoso central (SNC). Antígeno ou RNA do vírus da raiva já foram detectados em vários órgãos, tais como glândula salivar, pulmão, rim, coração e fígado. O presente trabalho teve como objetivo identificar a presença do vírus da raiva em órgãos não neuronais de morcegos hematófagos infectados naturalmente, e pesquisar a presença do vírus na glândula salivar de morcegos hematófagos sadios. Dos cinco morcegos positivos para a raiva no SNC pelas técnicas de imunofluorescência direta e isolamento viral em células N2A, 100 por cento (5/5) foram positivos para a raiva nas amostras de língua e coração, 80 por cento (4/5) no rim, 40 por cento (2/5) nas amostras de glândula salivar e pulmão, e 20 por cento (4/5) no fígado pe la técnica de RT-PCR. Todos os nove morcegos negativos no SNC, pela imunofluorescência e isolamento viral, foram negativos na glândula salivar pela RT-PCR. Possíveis consequências para a epidemiologia e patogênese da raiva são discutidas.

Aspectos clínico-patológicos e imuno-histoquímicos de equídeos infectados pelo vírus da raiva / Clinic-pathological and immunohistochemical aspects of equids infected with rabies virus

Foram analisados 14 equídeos (13 equinos e 1 muar) com diagnóstico clínico e histológico de raiva provenientes de quatro regiões do Brasil. O curso clínico médio foi de quatro dias de evolução, incluindo incoordenação motora, paralisia dos membros pélvicos, paresia dos membros torácicos e decúbito. Os achados histopatológicos caracterizaram-se por meningoencefalite e meningomielite não supurativa com infiltrado perivascular linfoplasmocitário. Corpúsculos de Negri foram observados em 64,28 por cento (9/14) dos casos, principalmente na medula espinhal cervical e nos neurônios de Purkinje do cerebelo. Em 55,55 por cento (5/9) dos equídeos analisados tiveram resultado positivo pela técnica de imunofluorescência direta para raiva. Todos os casos foram positivos na imuno-histoquímica para raiva, cujas reações foram mais evidentes no córtex temporal, córtex occipital e medula espinhal cervical. A técnica de imuno-histoquímica foi essencial para confirmar todos os casos de raiva nos equídeos.

Thirteen horses and one mule from four regions of Brazil with clinical and histological diagnosis of rabies were analyzed. The clinical course lasted four days, with motor incoordination, paresis and paralysis of the legs, and decubitus. The main histopathological findings were lymphoplasmacytic meningoencephalitis and non-suppurative meningomyelitis associated with characteristic Negri bodies in 64.28 percent (9/14) cases, mainly in the cervical spinal cord and in Purkinje neurons of the cerebellum. In 55.55 percent (5/9), the animals examined were positive by for the fluorescent antibody test for rabies. All animals were positive in immunohistochemistry for rabies, whose immunolabeling were more evident in the temporal cortex, occipital cortex and cervical spinal cord. Immunohistochemistry procedure was essential to confirm all cases of rabies in the equids.

Brote de rabia humana transmitida por gato en el municipio de Santander de Quilichao, Colombia, 2008 / An outbreak of human rabies transmitted by a cat in the town of Santander de Quilichao, Colombia, 2008

Objetivos En marzo de 2008 ocurrió en el municipio de Santander de Quilichao- Cauca, Colombia, un brote de rabia de origen silvestre con 2 víctimas humanas. El presente artículo apunta a describir las técnicas diagnósticas de laboratorio, las acciones de investigación de campo y control de foco empleadas, y su significado epidemiológico e implicaciones en salud pública. Métodos La rabia se diagnosticó por inmunofluorescencia directa, prueba biológica en ratón, histopatología e inmunohistoquímica, y se tipificó utilizando anticuerpos monoclonales. La investigación de campo se enfocó en la búsqueda de contactos humanos y animales, identificación de casos sospechosos y búsqueda institucional de accidentes rábicos. El control de foco consistió en aplicación de tratamiento post exposición a la población expuesta, vacunación canina y felina, recolección y eliminación de animales callejeros y educación a la comunidad. Resultados Dos casos de rabia en humanos fueron diagnosticados y uno en gato por nexo epidemiológico. La variante antigénica 3 fue aislada de los casos humanos. Se vacunaron en total 11 369 caninos, 3 325 felinos y 217 humanos. Conclusiones Se confirma la amenaza para los humanos que representa la rabia en el ecosistema silvestre. El brote tuvo origen en vampiro y el transmisor a los humanos fue un gato confirmando a esta especie doméstica como vínculo entre la rabia de origen silvestre y el ecosistema urbano, por ende su importancia en el enfoque de las acciones de prevención y control de la rabia. Se resalta la necesidad de implementar y mantener acciones para el control de la rabia silvestre que permitan minimizar su impacto en humanos.

Objectives A sylvatic rabies outbreak during March 2008 caused two human deaths in the town of Santander de Quilichao in Cauca, Colombia. This article describes the diagnostic laboratory techniques used, the field investigation and focus control used, as well as this outbreak's epidemiological significance and implications for public health. Methods Rabies was diagnosed by direct immunofluorescence, biological tests involving inoculating mice, histopathology and immunohistochemistry and then typed by using monoclonal antibodies. Field investigation focused on searching for human and animal contacts, identifying suspicious cases and conducting an institutional search for rabid accidents. Focus control consisted of post-exposure treatment of the exposed population, vaccinating dogs and cats, collecting and eliminating stray animals and educating the community. Results Two human rabies cases were confirmed in the laboratory and another was inferred in a cat by epidemiological nexus. Antigenic variant 3 was isolated from the human cases. 11,369 dogs, 3,325 cats and 217 humans were vaccinated. Conclusions This study confirmed that rabies in the wild represents a threat for humans. The outbreak described here originated in vampire bats and was transmitted to humans by a cat, pointing out the nexus between wild rabies and the urban ecosystem which cats represent, thereby becoming a target for rabies' control and prevention activities. This study underlines the urgency of implementing and maintaining rabies control and prevention activities in the wild to minimise its impact on humans.

Aspectos clínicos e patológicos em bovinos afetados por raiva com especial referência ao mapeamento do antígeno rábico por imuno-histoquímica / Clinical and pathological aspects in cattle affected by rabies with special reference to the rabies antigen mapping by immunohistochemistry

Este estudo retrospectivo incluiu achados clínicos e patológicos de 15 bovinos afetados por raiva. Em treze dos quinze casos, raiva foi confirmada por imunofluorescência direta. Bovinos entre 4 meses e 8 anos foram afetados. O curso clínico variou de três a sete dias. A forma paralítica foi a mais frequente e incluiu incoordenação, paresia e paralisia dos membros pélvicos, decúbito, movimentos de pedalagem e morte. Os principais achados histopatológicos foram meningoencefalite linfoplasmocitária associada com corpúsculos de Negri em 86,6 por cento dos casos. Todos os casos foram positivos na imuno-histoquímica para raiva, cujas reações foram mais evidentes no tronco encefálico, incluindo bulbo, ponte e mesencéfalo, além de gânglio trigêmeo. A imuno-histoquímica demonstrou o vírus da raiva em axônios, dendritos e pericário de neurônios, como agregados de grânulos ou em formações arredondadas associadas com números variáveis de corpúsculos de inclusão virais nos neurônios. Houve também marcação nos neurônios de Purkinje e de seus processos na camada molecular, nos núcleos do tronco encefálico e camada profunda do córtex telencefálico. A imuno-histoquímica pode ser importante ferramenta diagnóstica no diagnóstico da raiva, especialmente em situações nas quais não é possível manter refrigeração adequada das amostras e em casos com meningoencefalite não-supurativa e ausência de corpúsculos de inclusão.

This retrospective study included clinical and pathological findings from 15 cattle affected by rabies. Thirteen of the 15 cases were confirmed by direct immunofluorescence. Cattle between 4 months and 8 years of age were affected. Clinical course ranged from 3 to 7 days. Paralytical form was the most common clinical picture and included incoordination, paresis, and paralysis of the pelvic members, besides recumbence, paddling, and death. The main histopathological findings were lymphoplasmacytic meningoencephalitis associated with characteristic Negri bodies in 86.6 percent of the cases. All cases showed anti-rabies immunostaining, which were most prominent in the brainstem including medulla oblongata, pons, and midbrain, besides trigeminal ganglion. Positive labeling was present within axons, dendrites, and perikarya of neurons as aggregates of granules or round formations associated with varying numbers of inclusion bodies. Immunostaining was also observed in the Purkinje neurons and their processes in the molecular layer, in the neurons of of the brainstem, and deep layer of the telencephalic cortex. Immunohistochemistry may be an important auxiliary tool for the diagnosis of rabies, especially in circumstances in which refrigeration cannot be adequately maintained, and in cases characterized by nonsuppurative meningoencephalitis with absence of inclusion bodies.

Ocorrência de raiva em ovinos no Rio Grande do Sul / Occurrence of rabies in sheep in Rio Grande do Sul, Brazil

Descreve-se a ocorrência de raiva em ovinos na região Central do Rio Grande do Sul em novembro de 2003. Foram afetados dois ovinos de raça mista, um macho de três meses e uma fêmea de 2,5 anos de idade que apresentaram sinais clínicos com evolução de cinco dias e caracterizados por dificuldade de locomoção, tremores musculares, decúbito lateral, convulsões, opistótono e febre. Histologicamente havia mielomeningoencefalite não-supurativa, associada a inclusões eosinofílicas intracitoplasmáticas (corpúsculos de Negri) em neurônios nos dois ovinos afetados. Em um ovino em que o gânglio de Gasser foi examinado, havia ganglionite não-supurativa. As lesões concentravam-se predominantemente na substância cinzenta da medula espinhal, no tronco encefálico e no cerebelo. Antígeno viral foi detectado em seções selecionadas de ponte e bulbo submetidas ao teste de imuno-histoquímica utilizando anticorpo policlonal anti-ribonucleoproteína do vírus da raiva. Os casos ocorreram em meio a um surto de raiva bovina transmitida por morcegos e foram considerados, com bases epidemiológicas, como transmitidos da mesma forma, como ocorre na raiva endêmica de bovinos no Rio Grande do Sul.(AU)

Cases of rabies in sheep occurring in November 2003, in central Rio Grande do Sul state, Brazil, are described. A 3-month-old male, and a 2.5-month-old female sheep were affected. Clinical signs were characterized by abnormal gait, trembling, lateral recumbency, convulsion, opisthotonus, and fever. Histological findings included a non-suppurative myelomeningoencephalitis associated with intracytoplasmic eosinophilic inclusion (Negri) bodies in neurons. Lesions were predominantly observed in gray matter of the spinal cord, brainstem and cerebellum. There was non-suppurative Gasserian ganglionitis in one sheep in which this structure was examined. Immunohistochemistry using rabies virus ribonucleoprotein polyclonal antibody yelded positive result in brain tissue from both sheep. The cases herein reported occurred concomitantly to an outbreak of bat transmitted rabies in cattle in the same region and were considered, on epidemiological basis, to be transmitted by bats, as occurs in endemic bovine rabies in Rio Grande do Sul.(AU)