ABSTRACT
Abstract Introduction: In 2016, Brazil presented an increase in the notifications related to neurological syndromes with previous register of a febrile illness compatible with arboviruses, including Guillain-Barré syndrome (GBS). Such disease is responsible for the most frequent occurrence of flaccid paralysis in the world, causing bilateral ascending muscle weakness that might affect the respiratory tract. Objective: To investigate the incidence of Guillain-Barré syndrome associated with arboviruses in Pernambuco in 2016 and to describe the confirmed/probable cases. Method: This is an observational retrospective study of GBS cases with a background of infection from dengue, chikungunya, or Zika virus notified to the Pernambuco Health State Secretariat (SES-PE). Cases notified from January 1st to December 31st, 2016 were included, which were considered as possible GBS at the time of notification. The suspect cases were investigated and classified as confirmed/probable by the positive laboratory test result, excluding the possibility of infection. Results: Forty-three suspect cases of GBS after previous arbovirus infection were notified. From these, 23 were classified as confirmed/probable for the etiological agents chikungunya and/or dengue. The mean age of the affected individuals was 37.22 ± 21.29 years and they were mostly female (56.5%). The annual incidence of GBS after arbovirus infection was 0.24 cases per 100 thousand inhabitants in the state. The neurological condition was mainly characterized by the presence of movement (91.3%) and walking (78.3%) alterations. Conclusion: The findings of this research confirm the current set of evidence and show the likelihood of GBS being a severe neurological complication of these arboviruses.
Resumo Introdução: No Brasil, em 2016, houve aumento das notificações relacionadas às síndromes neurológicas com registro anterior de doença febril compatível com infecção por arboviroses, dentre elas a Síndrome de Guillain- Barré (SGB). Trata-se da ocorrência mais frequente de paralisia flácida no mundo, causa fraqueza muscular bilateral ascendente e pode atingir as vias respiratórias. Objetivo: Analisar a incidência da Síndrome de Guillain- Barré associada à arboviroses em Pernambuco no ano de 2016 e descrever os casos confirmados/prováveis. Método: Trata-se de um estudo observacional retrospectivo dos casos de SGB com histórico de infecção prévia por dengue, chikungunya ou vírus Zika, notificados à Secretaria Estadual de Saúde de Pernambuco (SES-PE). Foram incluídos casos notificados de 1º de janeiro a 31 de dezembro de 2016 considerados suspeitos de SGB no momento da notificação. Os casos suspeitos foram investigados e classificados como confirmados/prováveis através de resultado de exame laboratorial positivo, excluída a possibilidade de infecção. Resultados: Foram notificados 43 casos suspeitos de SGB após infecção prévia por arbovírus. Destes, 23 foram classificados como confirmados/prováveis para os agentes etiológicos chikungunya e/ou dengue, sendo a média de idade igual a 37,22 ± 21,29 anos e maioria do sexo feminino (56,5%). A incidência anual de SGB após infecção por arbovírus foi de 0,24 casos por 100 mil habitantes no estado. O quadro neurológico foi caracterizado prioritariamente pela presença de alterações motoras (91,3%) e na marcha (78,3%). Conclusão: Os achados da presente pesquisa acrescentam ao conjunto de evidências sobre a possibilidade de a SGB se apresentar como uma grave complicação neurológica dessas arboviroses.
Resumen Introducción: En Brasil, en 2016, hubo aumento de las notificaciones relacionadas con los síndromes neurológicos con registro anterior de enfermedad febril compatible con infección por arbovirosis, entre ellas el Síndrome de Guillain-Barré (SGB). Se trata de la aparición más frecuente de parálisis flácida en el mundo, causa debilidad muscular bilateral ascendente y puede alcanzar las vías respiratorias. Objetivo: Analizar la incidencia del Síndrome de Guillain-Barré asociada a los arbovirosis en Pernambuco en el año 2016 y describir los casos confirmados / probables. Método: Se trata de un estudio observacional retrospectivo de los casos de SGB con antecedentes de infección previa por dengue, chikungunya o virus Zika, notificados a la Secretaría Estatal de Salud de Pernambuco (SES-PE). Se incluyeron casos notificados del 1 de enero al 31 de diciembre de 2016 considerados sospechosos de SGB en el momento de la notificación. Los casos sospechosos fueron investigados y clasificados como confirmados / probables a través del resultado de un examen de laboratorio positivo, excluida la posibilidad de infección por otros agentes virales. Resultados: Se han notificado 43 casos sospechosos de SGB tras la infección previa por arbovirus. De estos, 23 fueron clasificados como confirmados / probables para los agentes etiológicos chikungunya y / o dengue, siendo la media de edad igual a 37,22 ± 21,29 años y la mayoría del sexo femenino (56,5%). La incidencia anual de SGB tras infección por arbovirus fue de 0,24 casos por 100 mil habitantes en el estado. El cuadro neurológico fue caracterizado prioritariamente por la presencia de alteraciones motoras (91,3%) y en la marcha (78,3%). Conclusión: Los hallazgos de la presente investigación añaden al conjunto de evidencias sobre la posibilidad de que la SGB se presente como una grave complicación neurológica de esas arbovirosis.
Subject(s)
Humans , Male , Female , Arbovirus Infections/virology , Guillain-Barre Syndrome/complications , Motor Skills Disorders , Guillain-Barre Syndrome/virologyABSTRACT
BACKGROUND In this study, we evaluated the role of free-living domestic pigeons (Columba livia) as a reservoir of arboviruses in the city of Belém, state of Pará, Brazil. We investigated the presence of antibodies against the most prevalent arboviruses. OBJECTIVES This study was aimed at evaluating some clinical and physical parameters of domestic pigeons, including the presence of antibodies to Amazon-endemic arboviruses. METHODS Eighty-five healthy pigeons were captured in Mangal das Garças Park, in Belém, and were bled. Upon capture, the birds were subjected to a clinical examination in search of alterations that could indicate the presence of arboviruses. Blood samples were converted to serum and tested using the haemagglutination inhibition (HI) technique with a panel of 19 antigens of arboviruses circulating in the Amazon. The confirmation assay for the positive reactions to the viral species tested by HI was a neutralisation test in new-born Swiss albino mice (Mus musculus) [mouse neutralisation test (MNT)]. FINDINGS A total of 10 (11.8%) serum samples tested positive for antiflavivirus antibodies by HI. All the samples positive for the HI test were subjected to MNT for detection of viruses and yielded negative results (logarithmic neutralisation index < 1.7). MAIN CONCLUSION The results represent the first serological detection of antiarbovirus antibodies in domestic pigeons as potential hosts of arboviruses in Brazil. The detection of haemagglutination-inhibiting antibodies against genus Flavivirus indicated that there was recent contact between the analysed domestic pigeons and these arboviruses. Further studies are needed to evaluate the role of free-living pigeons in the maintenance cycle and spread of arboviruses in the Amazon.
Subject(s)
Animals , Male , Female , Mice , Arbovirus Infections/diagnosis , Arbovirus Infections/veterinary , Arbovirus Infections/virology , Columbidae/virology , Bird Diseases/diagnosis , Bird Diseases/virology , Brazil , Hemagglutination Inhibition Tests , Disease VectorsABSTRACT
O presente estudo descreve os aspectos eco-epidemiológicos sobre arbovírus nos Municípios de Novo Progresso e Trairão, Estado do Pará, Brasil, na área de influência da BR 163. Anticorpos IH foram detectados para diferentes arbovírus, com reações monotípicas para os VMAY e VORO, dois importantes arbovírus associados a epidemias na Amazônia. Anticorpos IgM para o VORO e VMAY foram detectados em soros humanos, sugerindo infecção recente por esses arbovírus. Duas cepas do VDEN-3 foram isoladas de pacientes febris residentes em Novo Progresso e identificadas como genótipo III. Em termos gerais, os dados obtidos sugerem uma área propícia para a circulação e manutenção de arbovírus e uma população pouco imunizada. Portanto, é importante um monitoramento dinâmico das populações locais e de imigrantes e de animais silvestres quanto à presença de anticorpos e isolamentos de arbovírus, o que permitirá um efetivo controle das infecções por esses agentes virais em residentes da área da rodovia dentro do território paraense.
The current study describes the eco-epidemiological aspects of arbovirus diseases in the municipalities (counties) of Novo Progresso and Trairão, Para State, Brazil, in the area affected by highway BR-163. Hemagglutination inhibition (HI) antibodies to different arboviruses were detected, with monotypic reactions to MAYV and OROV, two important arboviruses associated with epidemics in the Amazon. IgM antibodies to OROV and MAYV were found in human sera, suggesting recent infections by these viruses. Two DENV-3 strains were isolated from febrile patients in Novo Progresso and identified as genotype III strains. In general, the data suggest that the area displays ideal conditions for maintenance and circulation of arboviruses, plus a population with low immunization levels. Dynamic surveillance of local immigrants and wild animals is thus important, focusing on antibody prevalence and isolation of arboviruses, thereby allowing effective control of infections by these viral agents in the resident population along highway BR-163 in Pará State.