IL-33 gene recombination and expression does not affect the phenotypic characteristics of rabies virus in vitro / 细胞与分子免疫学杂志

Objective To create a recombinant rabies virus overexpressing IL-33 and to clarify the effect of IL-33 overexpression on the phenotypic characteristics of recombinant virus in vitro. Methods The IL-33 gene was obtained and amplified from the brain of a highly virulent strain of rabies infected mouse. It was then inserted between the G and L genes of the parental virus LBNSE genome by reversing genetic manipulation and rescuing a recombinant virus overexpressing IL-33. BSR cells or mouse NA cells were infected with recombinant rabies virus (rLBNSE-IL33) and the parental strain LBNSE. Sequencing and fluorescent antibody virus neutralization assay was employed to detect the stability of recombinant virus at multiplicity of infection=0.01. Viral titres focal forming units (FFU) were detected to plot multi-step growth curves (multiplicity of infection=0.01). Cytotoxicity assay kit was used to detect cellular activity. ELISA was adopted to identify the IL-33 in the supernatant of infected cells of different multiplicity of infection. Results Rescued rLBNSE-IL33 overexpressing IL-33 remained stable for at least 10 consecutive generations and had virus titers of approximately 108 FFU/mL. rLBNSE-IL33 was able to express IL-33 at high levels in a dose-dependent manner, but no high expression of IL-33 was detected in the supernatant of cells infected by LBNSE. Examination of the titers of rLBNSE-IL33 and the parental strain LBNSE in BSR and NA cells over 5 days showed no significant differences and similar kinetic properties in growth. Overexpression of IL-33 had no significant effect on the proliferation and activity of infected cells. Conclusion Overexpression of IL-33 does not significantly affect the phenotypic characteristics of recombinant rabies virus in vitro.

Safety and immunogenicity of freeze-dried rabies vaccine (Vero-cells) for human use in healthy people aged 9-65 years / 中华预防医学杂志

Objective: To assess the safety and immunogenicity of freeze-dried rabies vaccine (Vero-cells) for human use on different immunization procedures in healthy people aged 9-65 years. Methods: A randomized, blind, positive-controlled clinical study was conducted in March 2015. The eligible residents aged 9-65 were recruited in Dengfeng city and Biyang County, Henan Province. A total of 1 956 subjects were enrolled. The subjects were randomly (1∶1∶1) assigned to 5-dose control group, 4-dose trial group and 5-dose trial group, with 652 subjects in each group. The subjects of 5-dose control group were immunized with control vaccine on days 0, 3, 7, 14 and 28. The subjects of 4-dose trial group were immunized with trial vaccine on days 0, 7 and 21 (2-1-1 phases) and the subjects of 5-dose trial group were immunized with trial vaccine on days 0, 3, 7, 14 and 28. A combination of regular follow-up and active reporting was used to observe local and systemic adverse reactions till 30 days after the first and full immunization, and the incidence rate of adverse reactions in three groups was analyzed and compared. The venous blood was collected before the first immunization, 7 days after the first immunization, 14 days after the first immunization and 14 days after the full immunization. The neutralizing antibody of rabies virus was detected by rapid fluorescent focus inhibition test (RFFIT), and the seropositive conversion rate and geometric mean concentration (GMC) of antibody were calculated. Results: The adverse reaction rates in 5-dose control group, 4-dose trial group and 5-dose trial group were 41.87% (273/652), 35.43% (231/652) and 34.97% (228/652), respectively. The adverse reaction rates of 4-dose trial group and 5-dose trial group were lower than those of the 5-dose control group (P<0.05). The local reactions were mainly pain, itching, swelling and redness in injection site, while the systemic reactions were mainly fever, fatigue, headache and muscle pain. The severity of adverse reactions was mainly mild (level 1), accounting for 85.33% (518/607), 89.02% (373/419) and 88.96% (427/480) of the total number of adverse reactions in each group. At 14 days after the first immunization and 14 days after the full immunization, the antibody positive conversion rates of three groups were all 100%. At 7 days, 14 days after the first immunization and 14 days after the full immunization, the GMCs of three groups were 0.60, 0.72, 0.59 IU/ml, 20.42, 23.99, 24.38 IU/ml and 22.95, 23.52, 24.72 IU/ml, respectively, with no significant difference (P>0.05). Conclusion: The freeze-dried rabies vaccine (Vero-cells) for human use has good safety and immunogenicity when inoculated according to 5-dose and 4-dose immunization procedures.

Lineamientos técnicos para la prevención y control de la rabia / Technical guidelines for the prevention and control of rabies

Los casos de rabia en animales no se registran en nuestro país desde el año 2018, pero es importante que el MINSAL continúe ejecutando acciones de promoción de salud y prevención de la enfermedad para lo cual contamos con documentación regulatoria relacionadas con la realización de las campañas de vacunación felina y canina con la participación intersectorial para mantener los logros alcanzados de cero casos de rabia en humanos en los últimos 13 años. Los presentes lineamientos técnicos establecen las directrices para que el abordaje integral al paciente expuesto al virus de la rabia, vigilancia epidemiológica y medida de prevención y control en los animales causantes de la exposición, para disminuir el riesgo de transmisión de rabia en la población

Cases of rabies in animals have not been registered in our country since 2018, but it is important that MINSAL continues to carry out health promotion and disease prevention actions, for which we have regulatory documentation related to carrying out rabies campaigns. feline and canine vaccination with intersectoral participation to maintain the achievements of zero cases of rabies in humans in the last 13 years. These technical guidelines establish the guidelines for a comprehensive approach to the patient exposed to the rabies virus, epidemiological surveillance and prevention and control measures in the animals causing the exposure, to reduce the risk of rabies transmission in the population

After-action review of rabies and anthrax outbreaks multisectoral response in Tanzania, challenges and lessons

After-action review uses experiences gained from past events to adopt best practices, thereby improving future interventions. In December 2016 and late 2018, the government of Tanzania with support from partners responded to anthrax and rabies outbreaks in Arusha and Morogoro regions respectively. The One Health Coordination Desk (OHCD) of the Prime Minister's Office (PMO) later coordinated after-action reviews to review the multi-sectoral preparedness and response to the outbreaks. To establish and describe actions undertaken by the multi-sectoral investigation and response teams during planning and deployment, execution of field activities, and outbreak investigation and response, system best practices and deficiencies. These were cross-sectional surveys. Semi-structured, open and closed-ended questionnaire and focus group discussions were administered to collect information from responders at the national and subnational levels. It was found that the surveillance and response systems were weak at community level, lack of enforcement of public health laws including vaccination of livestock and domestic animals and joint preparedness efforts were generally undermined by differential disease surveillance capacities among sectors. Lack of resources in particular funds for supplies, transport and deployment of response teams contributed to many shortfalls. The findings underpin the importance of after-action reviews in identifying critical areas for improvement in multi-sectoral prevention and control of disease outbreaks. Main sectors under the coordination of the OHCD should include after action reviews in their plans and budget it as a tool to continuously assess and improve multi-sectoral preparedness and response to public health emergencies.

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)

Influence of euthanasia, the intensity of inflammatory lesion and viral load in the laboratory diagnosis of rabies in cattle / Influência da eutanásia, intensidade da lesão inflamatória e carga viral no diagnóstico laboratorial da raiva em bovinos

This research reports the use of different diagnostic tests in cattle, naturally infected by Rabies lyssavirus (RABV), and correlates the positivity of the tests with the clinical moment of euthanasia, the intensity of the inflammatory lesion and viral load. It also highlights the possibility of euthanasia in early stages of the disease as a way to improve animal welfare. For that, samples of 34 bovine brains were collected for analysis, preserved in 10% buffered formaline and refrigerated with subsequent freezing. The samples were subjected to direct immunofluorescence antibody technique (DFAT) tests, viral isolation in cell culture (VICC), histopathology with hematoxylin and eosin staining (HE), immunohistochemistry (IHC), Shorr stainied neural tissue smears (DSS), Reverse transcription polymerase chain reaction (RT-PCR) and polymerase chain reaction by quantitative reverse transcriptase (qRT-PCR). The areas used for analysis were the cerebellum, parietal telencephalon and thalamus. Samples with Negri bodies (NBs) or immunostaining in at least one of the analyzed areas were considered positive. For the study of the intensity of histological lesions, the lesions were classified into grades 0, 1, 2 and 3 and the positivity of the test in the presence or absence of NBs in one of the three areas analyzed. To verify the influence of the disease clinical evolution, 4-four groups of analysis were created according to the animal's clinical status at moment of the euthanasia, being: M1 = animal euthanized while standing, M2 = euthanized when in sternal recumbence, M3 = euthanized when in lateral recumbence, M4 = animal with natural death. Of the 34 brains evaluated, IHC was positive in 100% of cases, DFAT was positive in 97.05% of them, and in this negative sample the presence of RABV was confirmed by VICC. NBs ere seen in 88.23% of the cases, and the DSS test was positive in 82.35% of them. All diagnostic techniques showed positive cases in all groups analyzed. Each case was positive in at least two diagnostic methods. All cases that contained NBs were positive for rabies in the other tests. In this study, it was observed that the variables analyzed (intensity of injury and clinical evolution at the moment of euthanasia) had an influence only on HE and DSS techniques, which are based on NB research to form the diagnosis, but did not interfere with the effectiveness of the diagnosis performed by detecting the viral antigen performed by DFAT and IHC. All isolated RABV samples included in the present study have a genetic lineage characteristic of hematophagous bats Desmodus rotundus. The evaluation of qRT-PCR showed that the amount of virus did not interfere in the positivity of the tests. This work shows that IHC and DFAT are safe diagnostic techniques. They are capable of detecting RABV even in euthanized animals in the early stages of clinical evolution with mild intensities of histological lesions.(AU)

Esta pesquisa relata a utilização de diferentes testes de diagnóstico em bovinos, naturalmente infectados pelo Rabies lyssavirus (RABV), e correlaciona a positividade dos testes com o momento clínico da eutanásia, a intensidade da lesão inflamatória, e a carga viral. Salienta também a possibilidade da eutanásia em estágios precoces da doença como forma de melhorar o bem-estar animal. Para isso amostras de 34 encéfalos bovinos foram coletados para análise, conservadas em formol tamponado 10% e sob refrigeração com posterior congelamento. As amostras foram submetidas aos testes de imunofluorescência direta (IFD), isolamento viral em cultivo de células (IVCC), histopatologia com coloração de hematoxilina e eosina (HE), imuno-histoquímica (IHQ), esfregaço direto com coloração de Shorr (EDS), reação da polimerase em cadeia por transcriptase reversa (RT-PCR) e reação da polimerase em cadeia por transcriptase reversa quantitativo (qRT-PCR). As áreas utilizadas para análise foram o cerebelo, telencéfalo parietal e tálamo. Foram consideradas positivas as amostras que apresentaram Corpúsculo de Negri (CNs) ou imuno-marcação em ao menos uma das áreas analisadas. Para o estudo da intensidade das lesões histológicas, as lesões foram classificadas em graus 0, 1, 2 e 3 e a positividade do teste na presença ou ausência de CN em uma das três áreas analisadas. Para verificar a influência da evolução clínica da doença foram criados 4 grupos de análise conforme o estado clínico do animal no momento da eutanásia, sendo: M1 = animal eutanasiado em estação, M2 = eutanasiado em decúbito esternal, M3 = eutanasiado em decúbito lateral, M4 = animal com morte natural. Dos 34 encéfalos avaliados a IHQ foi positiva em 100% dos casos, a IFD foi positiva em 97,05%, sendo que na amostra negativa a presença de RABV foi confirmada por IVCC. A histologia com HE, através da visualização das CNs, foi positiva em 88,23 % dos casos, e o teste de EDS, foi positivo em 82,35%. Todas as técnicas de diagnóstico apresentaram casos positivos em todos os grupos analisados. Cada caso foi positivo em, pelo menos, dois métodos de diagnóstico. Todos os casos que continham CN foram positivos para raiva nos demais testes. Nesse estudo observou-se que as variáveis analisadas intensidade de lesão e evolução clínica no momento da eutanásia tiveram influência somente nas técnicas de HE e EDS, que se baseiam na pesquisa do CN para formação do diagnóstico, mas não interferiram na eficácia do diagnóstico realizado através da detecção do antígeno viral realizado por IFD e IHQ. Todas as amostras RABV isoladas incluídas no presente estudo apresentam linhagem genética característica de morcegos hematófagos Desmodus rotundus. A avaliação de qRT-PCR demostrou que a quantidade de vírus não interferiu na positividade dos testes. Esse trabalho mostra que a IHQ e a IFD são técnicas seguras de diagnóstico e que mesmo em animais eutanasiados em estágios iniciais de evolução clínica com intensidades leve de lesões histológicas, são capazes de detectar o RABV.(AU)

Predictive risk model of livestock rabies occurrence in Peru / Modelo de risco preditivo para a ocorrência da raiva bovina no Peru

Livestock rabies is endemic in Peru. Hence, its persistence and annual dissemination represent an important economic impact, especially for impoverished farming communities. The disease is mostly transmitted by the hematophagous bat Desmodus rotundus. The present study aimed to adapt an existing predictive model of the occurrence of livestock rabies to Peru, in which the risk of rabies transmission from bats to livestock was estimated using decision-tree models of receptivity and vulnerability. Official rabies surveillance data between 2010 and 2015 were used along with possible risk factors, such as livestock biomass, environmental changes, and geomorphological characteristics. Several scenarios were established to evaluate the prediction of the occurrence of livestock rabies cases by determining more than one cut-off point of the receptivity variables. During the study period, the precision of the model was estimated through the sensitivity (39.46%) and specificity (98.64%) by using confusion matrices. Targeting control efforts, especially in districts with a high estimated risk, could represent the prevention of a significant proportion of livestock rabies cases, which would optimize the human and economic resources of the Peruvian surveillance service. However, the quality of data produced by the surveillance should be improved not only to obtain higher model precision but also to allow the adequate planning of control actions.(AU)

Raiva de herbívoros é endêmica no Peru. Consequentemente, sua disseminação persistente e anual representa um importante impacto econômico, especialmente às comunidades rurais empobrecidas. A doença é principalmente transmitida pelo morcego hematófago Desmodus rotundus. Este estudo tem por objetivo adaptar um modelo preditivo pré-existente às ocorrências de raiva de herbívoros no Peru, no qual o risco de transmissão de morcegos para os herbívoros foi estimado por meio de árvores de cenários de receptividade e vulnerabilidade. Foram usados os dados oficiais de vigilância da raiva entre 2010 e 2015, assim como os possíveis fatores de risco, tais quais a biomassa de animais, alterações ambientais e características geomorfológicas. Diversos cenários foram criados para avaliar a predição da ocorrência da raiva por meio da determinação de diversos pontos de corte das variáveis de receptividade. Durante o período de estudo, a precisão do modelo foi estimada por meio da sensibilidade (39,46%) e especificidade (98,64%), utilizando matrizes de confusão. Focando em esforços de controle, especialmente em distritos com elevado risco estimado, seria possível prevenir uma proporção significativa dos focos, o que poderia otimizar os recursos humanos e econômicos do serviço oficial peruano. Entretanto, a qualidade dos dados produzidos pelo sistema de vigilância deveria ser melhorada não somente para obter maior precisão do modelo, mas também para possibilitar o melhor planejamento das ações de controle desta doença.(AU)

Estudo de linhagens genética do vírus da raiva específicas aos morcegos desmodus rotundus e artibeus lituratus / Study of rabies virus genetic lines specific to desmodus rotundus and artibeus lituratus bats

No Estado de São Paulo, a linhagem Desmodus rotundus/Artibeus lituratus é prevalente em bovinos e equídeos na área rural, transmitida por D. rotundus, enquanto na área urbana ela é prevalente em cães e gatos, transmitida principalmente A. lituratus. Estudo baseado no gene N e G do RABV evidenciou uma possível diferenciação dessa linhagem. Com o objetivo de diferenciar a linhagem Desmodus rotundus/Artibeus lituratus utilizando todos os genes, foram utilizadas 90 amostras positivas para a raiva, 46 relacionadas epidemiologicamente à D. rotundus e 44 A. lituratus, todas do Estado de São Paulo. Essas amostras foram submetidas a síntese de DNAs randômicos dupla fita, NGS, as sequências foram montadas com software CLCBio e as árvores filogenéticas foram elaboradas por ML utilizando o programa GARLI v.0.96. Os resultados monstraram que os isolados da linhagem Desmodus rotundus/Artibeus lituratus foram agrupados em quatro sublinhagens filogenéticas, duas associadas ao D. rotundus e duas ao A. lituratus. A árvore filogenética com todos os genes concatenados mostra que a sublinhagem Artibeus 1 foi a primeira a se diferenciar, seguida da linhagem Desmodus 1. Desmodus 2 e Artibeus 2 são sublinhagens irmãs, sendo as últimas a se diferenciarem. Na análise filogenética do gene N com isolados da América Latina, todas as sublinhagens desse estudo tinham a mesma origem, mas diversos isolados de bovinos e D.

Clinical aspects of human rabies in the state of Ceará, Brazil: an overview of 63 cases

Abstract INTRODUCTION Rabies is considered one of the most relevant public health problems owing to its high fatality rate and the high number of deaths worldwide. METHODS We included patients with human rabies who attended a reference hospital in the state of Ceará during 1976-2019. RESULTS Data were available for 63 out of 171 (36.8%) patients. Of these patients, 48 (76.2%) were attacked by dogs. In recent years, wild animals have been the most common aggressor species (marmosets and bats). Only 39 (70%) patients were initially correctly suspected with rabies. Bites were the most frequent exposure (56; 96%), most commonly on the hands (21; 42%) and the head (9; 18.4%). Only 14 (22%) patients had sought medical assistance before the onset of symptoms, and only one completed post-exposure prophylaxis. The most prevalent signs and symptoms included aggressiveness/irritability (50; 79.4%), fever (42; 66.7%), sore throat/dysphagia (40; 63.5%), and myalgia (28; 44.4%). Hydrophobia was present in 17 patients (22.0%). CONCLUSIONS Most cases of human rabies in Ceará occurred due to the failure to seek medical assistance and/or the failure of the health system in initiating early post-exposure prophylaxis. There is a need for specific information and education campaigns focusing on the cycle of sylvatic rabies as well as prevention measures. Health professionals should undergo refresher training courses on the signs and symptoms of rabies and on the specific epidemiological features of the disease in Brazil.

Epidemiologia da raiva humana no estado do Ceará, 1970 a 2019 / Epidemiología de la rabia humana en el estado de Ceará, Brasil, 1970 a 2019 / Epidemiology of human rabies in the state of Ceará, Brazil, 1970 to 2019

Objetivo: Descrever os casos de raiva humana no estado do Ceará, Brasil, no período 1970-2019. Métodos: Estudo descritivo, sobre dados secundários da Secretaria da Saúde e do hospital de referência do Ceará. Resultados: Dos 171 casos, 75,7% ocorreram em homens, 60,0% nas idades até 19 anos e 56,0% em áreas urbanas. O cão foi agente transmissor em 74,0% dos casos; sagui em, 16,7%; e morcego, em 7,3%. Entre 1970 e 1978, houve crescimento do número de casos (pelo Joinpoint Regression Program, percentual da mudança anual [APC] = 13,7 - IC95% 4,6;41,5); e entre 1978 e 2019, redução (APC = -6,7 - IC95% -8,8;-5,9). Houve redução da transmissão por cães (71 casos; último caso em 2010) e aumento relativo por mamíferos silvestres (5 casos a partir de 2005). Conclusão: O estudo evidencia mudança na dinâmica da transmissão da raiva no período observado, com redução da transmissão por cão e incremento de casos por animais silvestres.

Objetivo: Describir los casos de la rabia humana en Ceará, Brasil, 1970-2019. Métodos: Estudio descriptivo con datos secundarios de la Secretaría de Salud y del hospital de referencia de Ceará. Resultados: De los 171 casos, 75,7% ocurrió en hombres, el 60,0% en los 19 años y el 56,0% en áreas urbanas. El perro fue transmisor en 74,0%, el mono tití en 16,7% y el murciélago el 7,3%. Entre 1970 y 1978, hubo un aumento de casos (por el Joinpoint Regression Program, cambio porcentual anual [APC] = 13,7 - IC95% 4,6; 41,5), entre 1978 y 2019 una disminución (APC= -6,7 - IC95% -8,8; -5,9). Hubo una reducción de la transmisión por perros (71 casos, el último en 2010) y un aumento por mamíferos salvajes (5 casos, desde 2005). Conclusión: El estudio muestra un cambio en la dinámica de la transmisión de la rabia en los últimos años, con reducción de la transmisión por perros y aumento de casos por animales salvajes.

Objective: To describe cases of human rabies in Ceará State, Brazil between 1970 and 2019. Methods: This was a descriptive study using secondary data from the Ceará State Department of Health and the state reference hospital. Results: Of 171 cases, 75.7% occurred in males, 60.0% in <19-year-olds, and 56.0% in urban areas. Rabies was transmitted by dogs in 74.0% of cases, marmosets in 16.7% and bats in 7.3%. Between 1970 and 1978, there was an increase of cases (using the Joinpoint Regression Program, annual percentage change [APC] = 13.7 - 95%CI 4.6;41.5), while between 1978 and 2019 there was a decrease (APC = -6.7 - 95%CI -8.8;-5.9). There was a reduction in transmission by dogs (71 cases, last case in 2010) and an increase by sylvatic animals (5 cases since 2005). Conclusion: This study demonstrates changes in rabies transmission dynamics during the period studied, with a reduction in transmission by dogs and an increase of transmission by sylvatic animals.

Mastocitoma felino. Reporte de caso / Feline mastocytoma. Case report

RESUMEN Los mastocitomas son tumores originarios de los mastocitos que usualmente afectan a los perros y los gatos. Pueden llegar a tener un comportamiento benigno, sin embargo, esto dependerá del grado de la neoplasia y su estadiaje. En felinos, clínicamente se han descrito dos patrones: visceral y cutáneo, de los cuales el cutáneo es el más frecuente, llegando a causar metástasis a órganos adyacentes e incluso afectar el bazo y/o intestino en estadios más diferenciados. Se presenta un caso de mastocitoma felino correspondiente a un ejemplar mestizo con cuadro clínico de inicio de más de dos meses de evolución, consistente en la aparición de una placa alopécica ulcerada y elevada en región interescapular, acompañada de prurito que presentó resolución espontánea. Mediante el curso clínico se imnunizó contra el virus de la rabia, posteriormente, se observó la aparición de una lesión nodular subcutánea de características inusuales de 2cm de diámetro. Acorde con el tiempo de evolución y el antecedente vacunal se decidió la realización de biopsia y resección quirúrgica. El reporte de la biopsia confirmó diagnóstico de mastocitoma grado histológico 3 de Patnaik, teniendo en cuenta las características histológicas, estructurales y su comportamiento clínico. Se realizó seguimiento del caso pasados ocho meses, donde se evidenció mejoría del cuadro clínico, sin aparición de nueva masa sugestiva de neoplasia, sin hallazgos de metástasis a otras estructuras, con cicatrización exitosa de herida quirúrgica y evolución satisfactoria.

ABSTRACT Mast cells are tumors originating from mast cells which usually affect cats and dogs. They may have benign behavior, however, this will depend on the degree of the neo-plasm and its staging. In cats, two patterns have been described clinically: visceral and cutaneous, of which the cutaneous form is the most frequent, reaching metastasis to adjacent organs and even affecting the spleen and / or intestine in more differentiated stages. A case of a mastocytoma is presented, a feline corresponding to a mongrel specimen with a clinical picture of onset of more than two months of evolution, consisting of the appearance of an allopecal plaque, ulcerated and elevated in the interscapular region, accompanied by pruritus that presented spontaneous resolution. Through the clinical course, he was immunized against the rabies virus, later the appearance of a nodular lesion of unusual subcutaneous characteristics, 2 cm in diameter, was observed. According to the evolution time and the vaccination history, it was decided to perform a biopsy and surgical resection. The biopsy report confirmed the diagnosis of Patnaik's histological grade 3 mastocytoma, taking into account the histological and structural characteristics and its clinical behavior. The case was followed up after eight months, where an improvement in the clinical picture was evident, without the appearance of a new mass suggestive of neoplasia, without metastatic findings to other structures, with successful healing of the surgical wound and satisfactory evolution.

Nota técnica sobre esquema de profilaxia da raiva / Technical note on rabies prophylaxis scheme

Critérios para esquema de prevenção de raiva no Estado do Tocantins. Controle sorológico. Restrito a pessoas com risco de exposição permanente ao vírus da raiva, como: Médicos veterinários, técnicos da Agência de Defesa Agropecuária, biólogos, funcionários do Naturatins que atuam em captura de mamíferos silvestres, espeleólogos.

Criteria for a rabies prevention scheme in the State of Tocantins. Serological control. Restricted to people at risk of permanent exposure to the rabies virus, such as: Veterinarians, technicians from the Agricultural Defense Agency, biologists, Naturatins employees who work in capturing wild mammals, cavers.

Criterios para un plan de prevención de la rabia en el estado de Tocantins. Control serológico. Restringido a personas en riesgo de exposición permanente al virus de la rabia, tales como: Veterinarios, técnicos de la Agencia de Defensa Agrícola, biólogos, empleados de Naturatins que trabajan en la captura de mamíferos silvestres, espeleólogos.

Algunos aspectos clínicos y epidemiológicos relacionados con mordeduras de perro en niños / Some clinical and epidemiological aspects related to dog bites in children

Introducción: Las mordeduras de perro afectan fundamentalmente a pacientes en la edad pediátrica, estas engendran peligros como secuelas estéticas y la posibilidad implícita de transmisibilidad del virus de la rabia a seres humanos. Objetivo: caracterizar el comportamiento clínico-epidemiológico de las mordeduras de perro en niños. Métodos: Se realizó un estudio observacional, longitudinal y prospectivo en pacientes con diagnóstico de mordedura de perro con necesidad de inmunización pasiva y activa, ingresados en el Servicio de Miscelánea del Hospital Infantil Sur Antonio María Béguez César de Santiago de Cuba, del 1ro de enero de 2017 al 31 de diciembre de 2018. Resultados: En los pacientes incluidos en el estudio predominaron los del sexo masculino (57,7 por ciento), los grupos de edades de 1 a 5 años 11 meses y 29 días, y de 6 a 10 años 11 meses y 29 días fueron los de mayor incidencia. Aunque no existió asociación estadística entre la localización anatómica de las lesiones y la edad, fueron las de miembros inferiores las más frecuentes en todas las edades con 63 pacientes (40,4 por ciento); destacándose como complicaciones la celulitis, las lesiones óseas y las secuelas estéticas; ningún niño presentó infección rábica. En el 50 por ciento de los casos la mordedura ocurrió en el horario nocturno y los perros de otro domicilio causaron la mayor parte de las agresiones. Conclusiones: El diagnóstico de mordeduras de perro se realizó con mayor frecuencia en niños del sexo masculino de uno y más años, en el horario nocturno y la principal complicación fue la celulitis(AU)

Introduction: Dog bites mainly affect patients in pediatric ages. They pose dangers such as esthetic sequels and the implicit possibility of transmission of the rabies virus to human beings. Objective: Characterize the clinical-epidemiological behavior of dog bites in children. Methods: An observational longitudinal prospective study was conducted of patients diagnosed with dog bite requiring passive and active immunization admitted to the Miscellany Service of Antonio María Béguez César South Children's Hospital in Santiago de Cuba from 1 January 2017 to 31 December 2018. Results: Among the patients included in the study there was a predominance of the male sex (57.7 percent). The age groups 1 to 5 years 11 months and 29 days and 6 to 10 years 11 months and 29 days showed the greatest incidence. Though no statistical association was found between anatomical location of the injuries and age, bites on the lower limbs were the most common at all ages with 63 patients (40.4 percent). Outstanding complications were cellulitis, bone lesions and esthetic sequels. No child had rabies infection. In 50 percent of the cases the bite occurred in the night hours. Most of the attacks were performed by dogs from other households. Conclusions: Dog bite diagnosis was more common among male children aged one year and over. Most bites occurred in the night hours. The main complication was cellulitis(AU)

Evaluation of data input in a rabies testing request form for herbivores / Avaliação da entrada de dados em um formulário de requisição de exame de raiva para herbívoros

Bovines and equines are the domestic animals with the highest incidence of rabies in Brazil. This study evaluated the data input in testing request forms for rabies in herbivores accompanying samples sent to a certified laboratory of rabies diagnosis in the state of Rio Grande do Sul, Brazil. Information was obtained systematically from all forms sent to the laboratory in 2013 and 2014 using a collection instrument that listed variables about the kind of form used, municipality of origin, description of the suspected animal, clinical signs, sample collection, and conservation procedure. The 11 most relevant variables (municipality of origin, geographic coordinates, species, gender, breed, age, herd size, clinical signs, persistence of clinical signs, biological material, and sample conservation) were assessed for the quality of the data entered, and percentage data input was calculated per form. In total, 603 forms were sent to the laboratory. The most used form was the FORM SN, (82.0%, 497/603). "Excellent" and "good" data inputs were observed only for one variable describing the location of suspected rabies cases or outbreaks and animals (species, gender, biological material). Quality of data input of variables describing geographic coordinates, age, breed, herd size, clinical signs, persistence of signs, and sample conservation method varied between "average" and "poor". The data input in testing request forms for herbivores are not dully supplied in suspected cases neurological syndromes, pointing to the need to increase awareness and improve training of field staff.(AU)

Bovinos e equinos são os animais domésticos com maior incidência de raiva no Brasil. Este estudo avaliou formulários de solicitação de testes para raiva em herbívoros acompanhando amostras enviadas a um laboratório certificado de diagnóstico de raiva no estado do Rio Grande do Sul, Brasil. As informações foram obtidas sistematicamente de todos os formulários enviados ao laboratório em 2013 e 2014 utilizando um instrumento de coleta que selecionou variáveis sobre o tipo de formulário utilizado, município de origem, descrição do animal suspeito, sinais clínicos, coleta de amostra e procedimento de conservação. As 11 variáveis mais relevantes (município de origem, coordenadas geográficas, espécie, gênero, raça, idade, tamanho do rebanho, sinais clínicos, persistência de sinais clínicos, material biológico e conservação da amostra) foram avaliadas quanto à qualidade dos dados inseridos, e os dados percentuais foram calculados por formulário. No total, 603 formulários foram enviados para o laboratório. O formulário mais utilizado foi o FORM SN, (82,0%, 497/603). Dados classificados como "excelentes" e "bons" foram observados apenas para uma variável que descreve a localização de casos suspeitos de raiva ou surtos e animais (espécie, gênero, material biológico). A qualidade da entrada dos dados das variáveis que descrevem coordenadas geográficas, idade, raça, tamanho do rebanho, sinais clínicos, persistência de sinais e método de conservação da amostra variou entre "regular" e "ruim". A qualidade dos dados dos formulários de solicitação de testes para herbívoros não foi devidamente fornecida em casos suspeitos de síndromes neurológicas, apontando para a necessidade de aumentar a conscientização e melhorar o treinamento do pessoal de campo.(AU)

Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife)

Abstract INTRODUCTION: Rabies is a major and seriously neglected public health problem worldwide. A treatment consisting of supportive therapy with the use of drugs that show antiviral activity is called the Milwaukee Protocol. In Brazil, this protocol was adapted to the national reality and called the Recife Protocol. In this study, we compared the Milwaukee Protocol with the Recife Protocol, assessing the differences and how these differences may change the course of clinical management. METHODS We searched electronic databases for the use of anti-rabies treatments. A total of 65 articles were published between 2004 and 2019. RESULTS: The protocols have similarities in care related to rabies patients and are important for the treatment of patients in intensive care units. Both protocols indicate deep sedation, antiviral use, constant concern with electrolyte balance, and vasoconstriction related to the condition. Many differences were observed in this study. For the Milwaukee Protocol, sedation should be gradually removed after the eighth day, and on the twelfth day, the patient should be without sedation. In the Recife Protocol, in order to avoid immunomodulation, it is recommended to remove sedation according to the titers of neutralizing antibodies to the rabies virus in the cerebral spinal fluid. CONCLUSIONS: In addition to the differences and similarities raised, our findings indicate that these protocols require a large center for rabies treatment, but the disease most often occurs in places where resources and hospital infrastructure are scarce.

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.

Guía técnica para la investigación y control de foco de rabia urbana / Technical guide for research and control of urban rabies focus

La guía técnica contiene: la finalidad, objetivos, ámbito de aplicación, disposiciones generales y específicas para la investigación y control de foco de rabia urbana.

La rabia como enfermedad re-emergente / Rabies as a re-emerging disease

RESUMEN En la actualidad, las enfermedades transmisibles afectan más de 14 millones de personas cada año, sobre todo en los países en desarrollo. Cerca del 50 % de las defunciones se producen por estas causas, de las cuales, el 90 % se atribuyen a las infecciones diarreicas y respiratorias agudas, el SIDA, la tuberculosis, el paludismo, el sarampión y la rabia. Esta última ha acompañado al hombre en toda su evolución, con una amplia distribución mundial y con la incorporación de un tratamiento exitoso desde el siglo XIX. Actualmente, sectores de la sanidad humana y animal establecen una alianza de colaboración en aras de eliminarla. En este artículo se realizó un recuento de la evolución epidemiológica de la rabia, su influencia en la humanidad y el desarrollo de la vacunación contra esta enfermedad; además de su re-emergencia como problema de salud.

ABSTRACT At present, communicable diseases affect more than 14 million people each year, especially in developing countries. Nearly 50% of deaths are caused by these causes; 90% of them are attributed to diarrheal and acute respiratory infections, AIDS, tuberculosis, malaria, measles and rabies. This latter disease has accompanied man throughout his evolution, with a wide global distribution and with the incorporation of a successful treatment since the 19th century. Currently, sectors of human and animal health establish a collaborative alliance in order to eliminate it. In this article, an account of the epidemiological evolution of rabies was made, its influence on humanity and the development of vaccination against this disease; in addition to its re-emergence as a health problem.

Transmisión vertical del virus de la rabia cría-madre, fenómeno que podría mantener al virus en especies reservorios de vida silvestre / Vertical transmission of the rabies virus from calf to mother, a phenomenon that could maintain the virus in reservoir species of wildlife

Resumen Introducción: La prueba biológica establecida por la Organización Mundial de la Salud para aislar y amplificar el virus de la rabia consiste en inocular vía intracraneal ratones lactantes para detectar signos de rabia en un periodo de 21 días. Objetivo: Constatar el contagio viral en las madres de ratones lactantes inoculados con virus de la rabia. Método: Veintisiete aislados mexicanos de virus de la rabia se inocularon vía intracraneal en ratones lactantes, los cuales fueron observados por 21 días y sus madres, por 60 días. El diagnóstico se llevó a cabo mediante inmunofluorescencia en cerebro. El virus se caracterizó por secuenciación y anticuerpos monoclonales. Resultados: Todas las camadas presentaron rabia entre siete y 15 días posinoculación (p. i.); tres de las 27 hembras (11 %), a los días 33, 37 y 39 p. i. de sus crías. La caracterización viral mostró que las madres se infectaron con la misma variante de sus crías, dos procedían de murciélago hematófago y una de perro. Las camadas que trasmitieron rabia a sus madres fueron nueve individuos. Conclusiones: En la naturaleza, el virus de la rabia podría preservarse mediante la transmisión de los neonatos (más susceptibles de contraer y amplificar el virus) a sus madres.

Abstract Introduction: The biological test established by the World Health Organization to isolate and amplify the rabies virus consists in inoculating lactating mice by intracranial route and detecting rabies signs for 21 days. Objective: To verify viral transmission in mothers of rabies virus-inoculated lactating mice. Method: Twenty-seven Mexican rabies virus isolates were inoculated by intracranial route in lactating mice, which were observed for 21 days. The mothers were observed for 60 days. The diagnosis was established by immunofluorescence in brain tissue. The virus was characterized by sequencing and with monoclonal antibodies. Results: All litters showed rabies at between 7 and 15 days post-inoculation (p. i.). Three of the 27 females (11 %) had developed rabies at days 33, 37 and 39 p. i. of their litters. Viral characterization showed that the mothers were infected with the same variant of their offspring, two of them stemming from hematophagous bat and one from dog. The liters that transmitted rabies to their mothers were nine individuals. Conclusions: In nature, the rabies virus could be preserved by transmission from neonates (more susceptible to contracting and amplifying the rabies virus) to their mothers.