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2.
Goiânia; SES-GO; 30 mar. 2020. 1-3 p.
Non-conventional in Portuguese | SES-GO, ColecionaSUS, CONASS, LILACS | ID: biblio-1141386

ABSTRACT

O projeto QUANTIZIKA HUMANO, desenvolvido por docentes de várias unidades acadêmicas da Universidade Federal de Goiás (UFG), teve início em 2016, quando um grupo de pesquisadores composto por professores das áreas de biologia molecular e genética, epidemiologista e médico sanitarista, selecionaram pacientes que apresentavam sintomas semelhantes a dengue, inicialmente com a finalidade de rastrear aqueles que pudessem apresentar infecção pelo vírus da Zika. Durante o rastreamento molecular, e por meio de técnica própria desenvolvida na pesquisa, foram identificados também casos de infecção pelo vírus Mayaro (FERNANDES, M. 2019).


The QUANTIZIKA HUMANO project, developed by professors from several academic units of the Federal University of Goiás (UFG), began in 2016, when a group of researchers composed of professors from the fields of molecular biology and genetics, epidemiologist and sanitary doctor, selected patients with symptoms similar to dengue, initially with the purpose of tracking those who could present zika virus infection. During molecular screening, and through its own technique developed in the research, cases of Mayaro virus infection were also identified (FERNANDES, M. 2019).


Subject(s)
Humans , Alphavirus Infections/diagnosis , Alphavirus Infections/virology
3.
Rev. panam. salud pública ; 44: e14, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101772

ABSTRACT

ABSTRACT Objectives. To assess the distribution of Mayaro virus (MAYV) in Latin America and the Caribbean and evaluate existing country-level MAYV surveillance mechanisms. Methods. Research was conducted from May 2018 through May 2019 to collect data from academic literature on Mayaro fever in Latin America and the Caribbean. PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS, and Google Scholar were searched for peer-reviewed journal articles, and data from health authorities, including the Pan American Health Organization (PAHO) and ministries of health, was also sought. MAYV-related publications published from 1954 through 2019 were screened. Publications that added to the overall understanding of MAYV, including its geographical and epidemiological distribution, were included in this report. Results. A total of 901 MAYV cases have been reported in humans in countries in Latin America and the Caribbean. Since its discovery in 1954 in Trinidad and Tobago, MAYV has been isolated from individuals living in Argentina, Bolivia, Brazil, Ecuador, French Guiana, Haiti, Mexico, Panama, Peru, and Venezuela. Of those 901 cases, 42 of them were reported exclusively by health authorities. In contrast, 843 confirmed and presumptive autochthonous cases and an additional 16 imported cases were identified in academic literature. No country-level surveillance mechanisms for MAYV were recorded in academic literature or by health authorities. Conclusions. This report demonstrates that MAYV surveillance efforts are limited in comparison to the virus's presence in Latin America and the Caribbean, highlighting the importance of enhancing arboviral surveillance systems in the affected countries.(AU)


RESUMEN Objetivos. Evaluar la distribución del virus Mayaro (MAYV) en América Latina y el Caribe y los mecanismos de vigilancia de nivel nacional. Métodos. Entre mayo de 2018 y mayo de 2019 se llevó a cabo una revisión bibliográfica sobre la fiebre de Mayaro en América Latina y el Caribe en las bases de datos PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS y Google Académico para identificar artículos en revistas arbitradas; también se revisó información suministrada por las autoridades sanitarias, entre ellas la Organización Panamericana de la Salud y los ministerios de salud. Se revisaron artículos relacionados con MAYV publicados entre 1954 y 2019. En este informe se incluyeron artículos que contribuyeran a la comprensión general sobre el MAYV, incluida su distribución geográfica y su epidemiología. Resultados. Se han reportado 901 casos de MAYV en seres humanos en 11 países de América Latina y el Caribe. Desde su descubrimiento en 1954 en Trinidad y Tobago, MAYV ha sido aislado de personas en Argentina, Bolivia, Brasil, Ecuador, Guayana Francesa, Haití, México, Panamá, Perú y Venezuela. De estos 901 casos, 42 fueron reportados exclusivamente por las autoridades sanitarias. A la vez, en la bibliografía se identificaron 844 casos autóctonos confirmados o presuntivos y 15 casos importados. A través de la bibliografía o las autoridades sanitarias no se identificaron mecanismos de vigilancia de nivel nacional para el MAYV. Conclusiones. En América Latina y el Caribe la vigilancia del MAYV es limitada en comparación con la presencia del virus en la región; es necesario mejorar los sistemas de vigilancia de arbovirus en los países afectados.(AU)


RESUMO Objetivo. Analisar a distribuição do vírus Mayaro (MAYV) na América Latina e Caribe e avaliar os mecanismos nacionais de vigilância. Métodos. Dados da literatura acadêmica sobre a febre Mayaro na América Latina e Caribe foram coletados de maio de 2018 a maio de 2019. Foram pesquisadas as bases de dados PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS e Google Acadêmico para identificar artigos em revistas revisadas por pares; também foram examinados dados de autoridades sanitárias, incluindo a Organização Pan-Americana da Saúde (OPAS), e dos ministérios de saúde. Artigos relacionados com MAYV publicados de 1954 a 2019 foram revisados. Este relatório incluiu artigos que contribuíssem para o entendimento geral do MAYV, com informações sobre distribuição geográfica e epidemiologia. Resultados. Foram registrados 901 casos de MAYV em humanos em 11 países da América Latina e do Caribe. Desde a sua descoberta em 1954 em Trinidad e Tobago, o MAYV foi isolado em indivíduos na Argentina, Bolívia, Brasil, Equador, Guiana Francesa, Haiti, México, Panamá, Peru e Venezuela. Desses 901 casos, 42 foram comunicados exclusivamente pelas autoridades sanitárias. Por sua vez, 844 casos autóctones confirmados ou suspeitos e 15 casos importados foram descritos na literatura. Nenhum mecanismo nacional de vigilância do MAYV foi identificado na literatura ou pelas autoridades sanitárias. Conclusões. Na América Latina e Caribe, a vigilância do MAYV é limitada em contraste com a presença do vírus na região; é importante melhorar os sistemas de vigilância desse arbovírus nos países afetados.(AU)


Subject(s)
Humans , Disease Outbreaks/prevention & control , Alphavirus Infections/epidemiology , Public Health Surveillance/methods , West Indies/epidemiology , Latin America/epidemiology
4.
Rev. cuba. med. gen. integr ; 35(2): e831, abr.-jun. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093498

ABSTRACT

Introducción: En los últimos años, debido a los movimientos migratorios, se ha desarrollado una expansión de nuevas enfermedades, como chikungunya, zika, oropuche y mayaro. Caso clínico: Paciente que manifestaba síntomas de fiebre, cefalea y artralgias persistente. Después de un arduo estudio y eliminación de otras patologías se llega al diagnóstico de virus mayaro. El paciente residía en una zona nororiental del Perú. Se brindó tratamiento de soporte junto con hidratación, paracetamol 500 mg cada 8 horas y se indicó cita diaria para evaluación. El paciente evolucionó favorablemente a los pocos días. Conclusiones: La vigilancia, las pruebas y el control vectorial siguen siendo claves para prevenir la propagación de este tipo de virus. La posibilidad de que el virus mayaro se urbanice aún más. Se debe tener siempre en cuenta el diagnóstico diferencial de virus mayaro(AU)


Introduction: In recent years, due to migratory movements, an expansion of new diseases has developed, such as chikungunya, zika, oropuche and mayaro. Clinical case: Patient with the following symptoms: fever, headache and persistent arthralgia. After an arduous study and ruling out other possible diseases, we diagnose mayaro virus. The patient resided in a northeastern part of Peru. Supportive treatment was provided along with hydration; paracetamol 500 mg every 8 hours and daily appointment for evaluation was indicated. The patient evolved favorably within a few days. Conclusions: Surveillance, testing and vector control are still key to monitoring and preventing the spread of this type of virus. The possibility of mayaro virus becoming more urbanized is worthy of attention. The differential diagnosis of mayaro virus should always be considered(AU)


Subject(s)
Humans , Male , Female , Alphavirus Infections/diagnosis , Alphavirus Infections/prevention & control , Alphavirus Infections/epidemiology , Vector Control of Diseases , Peru
6.
Braz. j. infect. dis ; 21(5): 540-544, Sept.-Oct. 2017. graf
Article in English | LILACS | ID: biblio-888906

ABSTRACT

Abstract Mayaro virus is an alphavirus from the Togaviridae family and is transmitted mainly by Hemagogus mosquitoes. This virus circulates in high-density tropical forests or rural areas of Central and South America causing a disease characterized by high-grade fever, maculopapular skin rash and marked arthralgia that, in some patients, can persist for long periods after infection and may be misinterpreted as chikungunya. Although only a few outbreaks involving this virus have been reported, in the last years the number of Mayaro virus infections has increased in the central and northern regions of Brazil. In this review, we describe the reported prevalence of this infection over the years and discuss the circumstances that can contribute to the establishment of an urban mayaro virus epidemic in Brazil and the problems encountered with the specific diagnosis, especially the antigenic cross-reactivity of this pathogen with other viruses of the same family.


Subject(s)
Humans , Animals , Alphavirus Infections/epidemiology , Alphavirus/classification , Urban Population , Brazil/epidemiology , Disease Outbreaks , Mosquito Vectors/virology
7.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 15(2): 30-36, ago. 2017. ilus
Article in Spanish | LILACS, BDNPAR | ID: biblio-869122

ABSTRACT

El género Alphavirus está constituido por virus de ARN de los cuales, varias especies son causantes de enfermedades humanas y animales como los virus chikungunya, Mayaro y los virus de encefalitis equinas, por lo que son considerados un problema de salud pública a nivel regional. En Paraguay han sido reportadas infecciones humanas por chikungunya pero son necesarios más estudios para ampliar conocimientos sobre circulación y ecoepidemiología de los alfavirus. La transcripción reversa de ARN seguida de una reacción en cadena de la polimerasa (RT-PCR) anidada es de gran utilidad como herramienta diagnóstica y en la vigilancia epidemiológica. El objetivo de este estudio fue definir las condiciones óptimas de reacción y determinar el límite de detección para una RT-PCR anidada para la detección genérica de alfavirus. El límite de detección obtenido, de 0,47 UFP/mL, indica una alta sensibilidad, pudiéndose aplicar la técnica a muestras humanas y animales de suero, líquido cefalorraquídeo, órganos y a pooles de mosquitos. Este trabajo servirá de base a otros estudios de detección e identificación de especies de alfavirus circulantes en nuestro país, lo que contribuiría a fortalecer su vigilancia y prevención.


The genus Alphavirus consists of RNA viruses of which several species areresponsible for human and animal diseases, such as chikungunya, Mayaro and equineencephalitis viruses, and are therefore considered a regional public health problem. InParaguay, human infections have been reported by chikungunya, but more studies areneeded to increase knowledge on the circulation and ecoepidemiology of alphaviruses.Reverse RNA transcription followed by a nested polymerase chain reaction (RT-PCR) isvery useful as a diagnostic tool and in epidemiological surveillance. The objective ofthis study was to define optimal reaction conditions and to determine the limit ofdetection for a nested RT-PCR for generic alphavirus detection. The detection limitobtained, of 0,47 PFU/mL, indicate high sensitivity, and the possibility of applying thetechnique to human and animals samples of serum, cerebrospinal fluid, organs andmosquito pools. This work will serve as a basis for other studies of detection andidentification of alphavirus species circulating in our country, which would helpstrengthen the surveillance and prevention.


Subject(s)
Humans , Alphavirus , Alphavirus Infections , Reverse Transcriptase Polymerase Chain Reaction , Public Health
8.
Mem. Inst. Oswaldo Cruz ; 112(7): 510-513, July 2017. tab, graf
Article in English | LILACS | ID: biblio-841812

ABSTRACT

ABSTRACT We describe a sensitive method for simultaneous detection of Oropouche and Oropouche-like viruses carrying the Oropouche S segment, as well as the Mayaro virus, using a multiplexed one-step reverse transcription real-time polymerase chain reaction (RT-qPCR). A chimeric plasmid containing both Mayaro and Oropouche targets was designed and evaluated for the in vitro production of transcribed RNA, which could be easily used as a non-infectious external control. To track false-negative results due to PCR inhibition or equipment malfunction, the MS2 bacteriophage was also included in the multiplex assay as an internal positive control. The specificity of the multiplex assay was evaluated by Primer-Blast analysis against the entire GenBank database, and further against a panel of 17 RNA arboviruses. The results indicated an accurate and highly sensitive assay with amplification efficiency greater than 98% for both targets, and a limit of detection between two and 20 copies per reaction. We believe that the assay described here will provide a tool for Mayaro and Oropouche virus detection, especially in areas where differential diagnosis of Dengue, Zika and Chikungunya viruses should be performed.


Subject(s)
Humans , Orthobunyavirus/classification , Orthobunyavirus/genetics , Bunyaviridae Infections/diagnosis , Bunyaviridae Infections/virology , Alphavirus Infections/diagnosis , Alphavirus Infections/virology , Alphavirus/classification , Alphavirus/genetics , Reverse Transcriptase Polymerase Chain Reaction , Multiplex Polymerase Chain Reaction
9.
Rev. fac. cienc. méd. (Impr.) ; 14(1): 44-57, ene.-jun. 2017. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-859061

ABSTRACT

El dengue es una enfermedad prevalente con antigüedad en Honduras, la cual dejó de ser la arbovirosis exclusiva del país con la aparición del chikungunya y del zika, debido al limitado control logrado frente al vector. Se considera asimismo la posibilidad de la introducción de nuevas enfermedades como la fiebre del mayaro. Objetivo: describir la condición actual de las arbovirosis presentes en Honduras y un posible surgimiento de la fiebre mayaro en el país. Material y Métodos: Se realizó una revisión a partir de artículos en español e inglés en las bases de datos HINARI, PUBMED y ESCOB-HOST, con los descriptores dengue, mayaro, chinkungunya, virus, zika virus y epidemiología. Conclusión: Honduras se encuentra en una frágil situación referente al desarrollo de nuevas arbovirosis y presenta factores que favorecen el surgimiento de nuevas variedades de virus entre la salud pública hondureña...(AU)


Subject(s)
Humans , Alphavirus Infections , Arbovirus Infections/complications , Chikungunya virus , Public Health , Zika Virus
10.
Braz. j. microbiol ; 47(supl.1): 38-50, Oct.-Dec. 2016. graf
Article in English | LILACS | ID: biblio-839330

ABSTRACT

ABSTRACT Arboviruses pose a serious threat to public health worldwide, overloading the healthcare system and causing economic losses. These viruses form a very diverse group, and in Brazil, arboviruses belonging to the families Flaviviridae and Togaviridae are predominant. Unfortunately, the number of arboviruses increases in proportion with factors such as deforestation, poor sanitation, climate changes, and introduction of new viruses like Chikungunya virus and Zika virus. In Brazil, dengue is endemic, along with the presence of other arboviruses. The situation is complicated by the scarcity of diagnostic infrastructure and the absence of approved vaccines for these diseases. Disease control, thus, relies solely on vector control. Therefore, enhanced clinical knowledge and improved general awareness about these arboviruses are indispensable to tackle diagnostic inadequacies.


Subject(s)
Humans , Animals , Virus Diseases/transmission , Virus Diseases/virology , Insect Vectors/virology , Culicidae/virology , Brazil/epidemiology , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Alphavirus Infections/diagnosis , Alphavirus Infections/transmission , Alphavirus Infections/epidemiology , Alphavirus Infections/virology , Alphavirus/classification , Alphavirus/physiology , Dengue/transmission , Dengue/epidemiology , Dengue/virology , Dengue Virus/classification , Dengue Virus/physiology , Zika Virus Infection/diagnosis , Zika Virus Infection/transmission , Zika Virus Infection/epidemiology , Zika Virus Infection/virology
11.
Rev. Soc. Bras. Med. Trop ; 49(5): 648-652, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: lil-798121

ABSTRACT

Abstract Arboviruses impose a serious threat to public health services. We report a case of a patient returning from a work trip to the Amazon basin with myalgia, arthralgia, fever, and headache. During this travel, the patient visited riverside communities. Both dengue and Chikungunya fevers were first suspected, tested for, and excluded. Mayaro fever was then confirmed by reverse transcription polymerase chain reaction followed by next-generation sequencing and phylogenetic reconstruction. The increased awareness of physicians and consequent detection of Mayaro virus in this case was only possible due a previous surveillance program with specific health personnel training about these neglected arboviruses.


Subject(s)
Humans , Male , Adult , HIV Infections , Alphavirus Infections/diagnosis , Alphavirus/genetics , Phylogeny , Alphavirus Infections/virology , Alphavirus/classification , Reverse Transcriptase Polymerase Chain Reaction , Diagnosis, Differential , Chikungunya Fever/diagnosis
12.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 23 sept. 2016. a) f: 21 l:24 p. mapas, tab.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 1, 5).
Monography in Spanish | UNISALUD, BINACIS, InstitutionalDB, LILACS | ID: biblio-1116240

ABSTRACT

La Fiebre Chikungunya es una enfermedad provocada por el virus Chikungunya (CHIKV) que pertenece al género Alphavirus (familia Togaviridae). A partir de 2004 se produjeron epidemias en África, Asia y Europa, con las que se inició una expansión global de la infección. Desde finales de 2013 la enfermedad está presente en las Américas, y no existe hasta el momento vacuna ni tratamiento con medicamentos antivirales contra esta enfermedad. El presente informe analiza sus vías de transmisión, manifestaciones clínicas, la situación epidemiológica internacional, argentina, y en Ciudad de Buenos Aires


Subject(s)
Epidemiologic Studies , Alphavirus Infections/epidemiology , Disease Transmission, Infectious/statistics & numerical data , Chikungunya Fever/diagnosis , Chikungunya Fever/pathology , Chikungunya Fever/prevention & control , Chikungunya Fever/transmission , Chikungunya Fever/epidemiology , Hospitals, Municipal/statistics & numerical data
13.
Córdoba; s.n; 2016. 112 p. ilus, graf.
Thesis in Spanish | LILACS | ID: biblio-971386

ABSTRACT

El género Alphavirus es de gran interés epidemiológico ya que sus miembros, incluyendo los virus del "Complejo de Encefalitis Equina Venezolana", pueden provocar importantes enfermedades, tanto en animales domésticos con en el hombre. Durante las últimas décadas se ha registrado un aumento en la incidencia mundial de virus transmitidos por artrópodos (arbovirus), particularmente aquellos transmitidos por mosquitos, como los virus de Encefalitis Equina Venezolana, el Virus Rio Negro, Moyaro, PIXV y Chikunguya, entre otros.


Abstract: The present work is based on the study of the replication mechanisms of Pixuna virus (PIXV), including the participation of the endosomal pathway during viral stripping as well as the mitochondria and cytoskeleton, both microtubules (MTs) and microbilaments (MFLS), in the replication process for the correct location on your replication sites.


Subject(s)
Male , Female , Humans , Alphavirus Infections , Encephalitis Virus, Venezuelan Equine/immunology , Virus Replication , Encephalitis, Arbovirus/immunology , Argentina/epidemiology
15.
Rev. Soc. Bras. Med. Trop ; 47(6): 677-683, Nov-Dec/2014. graf
Article in English | LILACS | ID: lil-732989

ABSTRACT

Chikungunya virus (CHIKV) and Mayaro virus (MAYV) are emergent arthropod-borne viruses that produce outbreaks of acute febrile illness with arthropathy. Despite their different continental origins, CHIKV and MAYV are closely related and are components of the Semliki Forest Complex of the Alphavirus (Togaviridae). MAYV and, more recently, CHIKV, which are both transmitted by Aedes mosquitoes, have resulted in severe public health problems in the Americas, including Brazil. In this review, we present aspects of the pathogenesis, clinical presentation and treatment of febrile illnesses produced by CHIKV and MAYV. We also discuss the epidemiological aspects and effects related to the prophylaxis of infections by both viruses.


Subject(s)
Animals , Humans , Alphavirus Infections/virology , Alphavirus/genetics , Communicable Diseases, Emerging/virology , Americas , Alphavirus Infections/epidemiology , Alphavirus/classification , Alphavirus/physiology , Chikungunya virus/genetics , Chikungunya virus/physiology , Communicable Diseases, Emerging/epidemiology , Insect Vectors/classification , Virus Replication
17.
Mem. Inst. Oswaldo Cruz ; 109(6): 820-823, 09/09/2014. tab, graf
Article in English | LILACS | ID: lil-723986

ABSTRACT

Mayaro virus (MAYV) is frequently reported in Pan-Amazonia. The aim of this study was to investigate the circulation of alphaviruses during a dengue outbreak in the state of Mato Grosso, Brazil. Serum samples from dengue-suspected patients were subjected to multiplex semi-nested reverse transcriptase polymerase chain reaction for 11 flaviviruses and five alphaviruses, to nucleotide sequencing and to viral isolation. MAYV was detected in 15 (2.5%) of 604 patients. Twelve were co-infected with dengue virus 4, which was isolated from 10 patients. The molecular detection of MAYV in dengue-suspected patients suggests that other arboviruses may be silently circulating during dengue outbreaks in Brazil.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Alphavirus Infections/epidemiology , Alphavirus/isolation & purification , Asymptomatic Infections/epidemiology , Disease Outbreaks , Dengue Virus/isolation & purification , Dengue/epidemiology , Alphavirus/classification , Alphavirus/genetics , Base Sequence/genetics , Brazil/epidemiology , Coinfection/epidemiology , Coinfection/virology , Dengue/blood , Dengue/virology , Multiplex Polymerase Chain Reaction , Molecular Diagnostic Techniques/methods , Reverse Transcriptase Polymerase Chain Reaction
18.
Medisan ; 18(6): 848-856, jun. 2014.
Article in Spanish | LILACS | ID: lil-712632

ABSTRACT

Debido a la emergencia en el Caribe por fiebre de Chikungunya, y teniendo en cuenta que no tiene antecedentes en Cuba, además de la situación entomológica que presenta la provincia de Santiago de Cuba, donde existen vectores transmisores de enfermedades, tales como mosquitos Aedes aegypti y Aedes albopictus; se realizó una revisión bibliográfica exhaustiva, para contribuir a la actualización sobre el tema de toda la comunidad médica de la provincia.


Due to the emergency in the Caribbean caused by Chikungunya fever, and keeping in mind that it has no history in Cuba, besides the entomological situation that presents Santiago de Cuba province, where vectors transmitting diseases exist, such as Aedes aegypti and Aedes albopictus mosquitoes, an exhaustive literature review was carried out, to contribute to the updating on the topic of the whole medical community from the province.


Subject(s)
Aedes , Chikungunya virus , Insect Vectors , Alphavirus Infections/epidemiology , Vector Control of Diseases , Cuba , Alphavirus Infections/prevention & control , Alphavirus Infections/transmission
20.
Brasilia; Brasília. Ministério da Saúde; 2014. 102 p. ilus, tab.
Monography in Portuguese | LILACS | ID: lil-716030

ABSTRACT

O CHIKV é um vírus RNA que pertence ao gênero Alphavírus da família Togaviridae. O nome chikungunya deriva de uma palavra em Makonde que significa aproximadamente “aqueles que se dobram”, descrevendo a aparência encurvada de pacientes que sofrem de artralgia intensa. Casos humanos com febre, exantema e artrite aparentando ser CHIKV foram relatados no início de 1770. Porém, o vírus não foi isolado do soro humano ou de mosquitos até a epidemia na Tanzânia de 1952-53. Outros surtos ocorreram subsequentemente na África e na Ásia. Muitos ocorreram em pequenas comunidades ou comunidades rurais. No entanto,na Ásia, cepas de CHIKV foram isoladas durante grandes surtos urbanos em Bangkok eTailândia em 1960 e em Calcutá e Vellore, na Índia, durante as décadas de 60 e 70.


Subject(s)
Humans , Male , Female , Aedes , Vector Control of Diseases , Dengue/epidemiology , Alphavirus Infections/epidemiology , Insect Vectors , Chikungunya virus , Brazil/epidemiology , Dengue/diagnosis , Diagnosis, Differential , Alphavirus Infections/diagnosis , Alphavirus Infections/prevention & control , Alphavirus Infections/transmission , Population Surveillance
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