Neurological complications in Chikungunya fever.

OBJECTIVE: The present prospective study was undertaken to study the clinical manifestations and mainly neurological complication of an acute febrile illness termed chikungunya which has recently attacked india after 43 years. METHOD: This prospective study has been conducted in hospitalised patients admitted in government and private hospitals of Kota city from August 2006 to October 2006. Patients showing neurological involvement with typical clinical picture of chikungunya infection were studied in detail and followed up for improvement and any permanent damage or death. RESULTS: Apart from typical clinical triad of high grade fever, arthralgia and rash of chikungunya infection we have observed a spectrum of neurological abnormalities in terms of altered mental functions, seizures, focal neurological deficit with abnormal CT scan of head and altered CSF biochemistry. Permanent neurological sequelae and even death has occurred. CONCLUSION: Typical clinical history of chikungunya infection, neurological complications with associated CSF abnormalities, supportive laboratory evidences, positive chikungunya IgM card test, exclusion of other causes and known predilection of arboviruses for CNS infection allows us to conclude the diagnosis of study cases as Chikungunya Encephalitis.

Rubéola congénita / Congenital rubella

El síndrome de la rubéola (SRC) o rubéola congénita se refiere a un grupo de anomalías físicas tales como cataratas, sordera, defectos del corazón, y retraso mental que el bebé manifiesta como resultado de la infección materna y posterior infección fetal con el virus de la rubéola. Lo más probable es que la rubéola materna provoque en la fase de viremia una infección de las vellosidades coriales o de la placenta y produzca una viremia fetal generalizada. El diagnostico se confirma por hallazgos de Ac. Ig M específicos en el suero del recién nacido o mediante cultivos del virus en muestras del lactante. El virus se puede eliminar por la orina durante al menos 1 año. El diagnóstico prenatal se puede establecer mediante aislamiento del virus en el líquido amniótico o por identificación de Ig.M en la sangre del cordón umbilical. Los efectos del virus sobre el feto dependen del momento de la infección; cuanto más joven es el feto, más severa es la enfermedad.

Congenital rubella syndrome (CRS) or congenital rubella refers to a group of physical anomalies such as cataract, deafness, heart conditions, mental retardation that the baby manifests as a result of a maternal infection and posterior fetus infection with rubella virus. It’s most probable that maternal rubella provoke an infection of chorionic villi or placenta in the viremic phase producing a generalized fetus viremia. Diagnosis is confirmed with IgM specific antibodies in newborns serum or culture samples of the virus on infants. Virus can be eliminated through urine at least in one year. Prenatal diagnosis can be established when isolating the virus from amniotic fluid or identification of IgM in umbilical cords blood. The effects the virus produce to the fetus depend of the moment of infection; while younger the fetus, the more severe will the disease be.

UNA virus: first report of human infection in Argentina

Una virus (UNAV), Togaviridae family, is widely distributed in South America, where infections have been detected in mosquitoes and vertebrate hosts (humans, birds and horses). We analyzed human sera from Córdoba inhabitants aged 44 to 89 years and using a neutralization test, we found a prevalence of UNAV antibodies of 3.8 percent (3/79). The low titers detected suggest past infections probably acquired in rural areas of the Province of Córdoba (central Argentina). None sera were found positive for MAYV neutralizing antibodies. This is the first report of human infections by UNAV in Argentina

Historical, epidemiological and ecological aspects of arboviruses in Argentina: Togaviridae, Alphavirus

This is a review of the arboviruses in Argentina belonging to families Flaviridae, Bunyaviridae and Rhabdoviridae. Of the many viruses belonging to these families, the flavivirus St. Louis encephalitis (SLE), has been most intensively studied. SLE virus strains have been recovered from three sources: 2 strains from humans with an undifferentiated, febrile disease; 6 from mosquitoes; and 2 from rodents. The viruses recovered from rodents are attenuated and those from mosquitoes are virulent based on a neuroinvasiveness test in mice; the degree of virulence of the mosquito strains remain to be analyzed. Serological surveys indicate a wide distribution and endemicity of SLE virus in the temperate and subtropical areas (central and northern Argentina), but no data are available from the andean region or from the South. The virulent SLE virus strains appear to be transmitted between Culex (Cx.)spp. from which they were isolated, and wild birds, based on antobody prevalence. A urban cycle may involve Cx. quinquefasciatus (source of a viral isolate and a competent experimental vector) and abundant birds (house sparrows, doves, and/or chickens), chickens are experimentally competent host species. Despite similarities in the ecology of SLE between Argentina and North America, urban outbreaks of SLE have not been recognized. Possible explanations for this discrepancy include virus strain differences in virulenc, ecologic factors determining the rate of virus transmission, and the lack of disease recognition and specific laboratory diagnosis of human meningoencephalitis. The transmission cycle of attenuated SLE virus strains isolated from rodentshas not been studied. Ilheus virus has isolated only once from a human being. The available serological data are difficult to interpret due to cross-reactivity with other flaviviruses, and the ecologyand medical importance of this agent remain uncertain. Dengue has not been recognized in Argentina since 1916, although is vector, Aedes aegypti, was not erradicated until 1963. Dengue was previously present in coastal localities of Chaco. Corrientes and Misiones Provinces. Within the last few years, Argentina was reinfested by Ae. aegypti. Although no human cases have vet been reported, outbreaks of dengue in bordering countries (Brazil, Paraguay, Bolivia) since 1986, cleary signal that the country in once againat risk of importantion ans spread of the virus

Isolation of Getah virus from mosquitos collected on Hainan Island, China, and results of a serosurvey.

An isolate of Getah virus was obtained from Culex mosquitos collected in Mao'an Village, Baoting County, Hainan Province, China, in 1964. The virus (strain M-1) replicated in laboratory-bred Aedes aegypti and Cx. fatigans (= quinquefasciatus), and was transmitted by laboratory-bred Ae. albopictus to healthy newborn albino mice. Skeletal muscles of newborn albino mice experimentally infected with the virus showed degeneration, atrophy, necrosis, and inflammatory changes of muscle fibers. Antibody prevalence in humans and animals ranged from 10.3% by neutralization tests of samples from healthy people in 1979 to 26.4% by CF tests of samples from people with febrile illnesses in 1982. The high prevalence of antibody in pigs, horses, and goats (17.6% to 37.5%) indicated that infection with Getah or a closely related virus is relatively common in domestic animals.

Outbreak of encephalitis in Bellary District of Karnataka & adjoining areas of Andhra Pradesh.

An outbreak of encephalitis in Bellary district of Karnataka state and adjoining areas of Andhra Pradesh which occurred during October 1986 to January, 1987, has been investigated. Out of the 219 patients reported, 110 were from Bellary district and the remaining 109 were from Anantapur and Kurnool districts of Andhra Pradesh; 131 (59.8%) were males and 88 (40.2%) females, while 192 (87.7%) patients were aged 10 yr and below. Sixty one patients died giving a case fatality rate of 27.9 per cent. Virological/serological investigations were carried out on 153 patients. Japanese encephalitis (JE) virus was isolated from the brain tissue of 2 cases. On the basis of the results of serological tests and virus isolation, a flavivirus (JE/WN/DEN) etiology could be established in 116 (75.8%) patients.

Epidemic of fever of unknown origin in rural Thailand, caused by influenza A (H1N1) and dengue fever.

In the late summer (rainy season) of 1987, a sharp outbreak of fever of unknown origin (FUO) in rural southern Thailand was investigated by a field epidemiology team. In a random survey of households, 40 percent of the children and 20 percent of adults were reported to have had febrile illnesses within the last month. There was at least one death, possibly from Reye's syndrome. Testing 34 pairs of acute and convalescent sera showed significant HI antibody titer rises to influenza A (Taiwan/(H1N1) (9 cases) and dengue virus (12 cases). Testing 79 single sera with the antibody capture ELISA test for dengue, revealed that 23 percent had high titers in the IgM serum fraction suggesting recent infection. There were also six antibody titer rises to coxsackie B viruses, three from well controls. Dengue has previously been observed as a cause of FUO in rural areas in the tropics, but finding a combined epidemic of dengue and influenza was unexpected. With cooperative villagers, adequate personnel and laboratory support, especially the antigen capture ELISA test for dengue infections, it is feasible to successfully investigate disease outbreaks with serologic methods in remote villages.

O uso do teste imunoenzimático na vigilância epidemiologica de arboviroses / The use of enzyme-linked immunosolvent assay in the epidemiologic surveillance of arbovirus

Realizou-se revisäo bibliográfica sobre a utilizaçäo do teste imunoenzimático, ELISA na vigilância Epidemiológica de infecçöes causadas por arbovírus da família Flaviviridae, gênero Flavivirus e da Família Togaviridae, gênero Alphavirus. O teste tem sido empregado na pesquisa de anticorpos humanos, de anticorpos e antígenos em reservatórios näo humanos e na identificaçäo de antígenos e da fonte alimentar de mosquitos vetores. Analisou-se o desempenho de ELISA comparando-o a técnicas empregadas para identificaçäo de anticorpos e antígenos de arbovirus. O teste apresentou 100,0 por cento de sensibilidade e especificidade média de 84,5 por cento na identificaçäo de anticorpos anti-Alphavirus em humanos. Foi muito sensível para Flavivirus, com valor médio de 95,2 por cento e especificidade média de 77,6 por cento. Na identificaçäo de anticorpos anti-arbovirus em reservatórios näo humanos, ELISA mostrou sensibilidade de 100,0 por cento e especificidade de 97,4 por cento e na pesquisa de antígenos virais em mosquitos vetores, especificidade média de 93,6 por cento e sensibilidade média de 76,5 por cento. Apresentou alto valor preditivo positivo, observado no cálculo da média dos valores apresentados nos trabalhos em que esse parâmetro foi pesquisado e obteve-se um resultado de 89,0 por cento. No estudo da reprodutividade do teste, observou-se coeficiente de variaçäo de 3,0 a 14,0 por cento nos resultados

Study of two different enzyme immunoassays for the detection of Mayaro virus antibodies

This paper presents the evaluation of an enzyme immunoassay in which Mayaro virus-infected cultured cells ara used as antigen (EIA-ICC) and an IgM antibody capture ELISA (MAC-ELISA) for Mayaro serologic diagnosis using 114 human sera obtained during a Mayaro outbreak occurred in Bolivia, in 1987. Results were compared with those obtained by haemagglutination-inhibition test (HAI). MAC-ELISA was the most sensitive technique for anti-Mayaro IgM detection. MAC-ELISA was twice sensitive as IgM EIA-ICC. The data shows that MAC-ELISA is a practical and valid technique for diagnosis of recent mayaro infection. IgG-ICC showed hight sensitivity and high specificity compared to HAI. The combination of anti-Mayaro IgG and IgM EIA-ICC results presented the highest sensitivity of the study. Anti-Mayaro IgG and IgM simultaneous detection by ELISA-ICC can be used for recent infection diagnosis (in spite of a less sensitive IgM detection than by MAC-ELISA), for surveillance and sero-epidemiologic studies, and for studies of IgG and IgM responses to Mayaro infection

Ocorrência recente de infecçäo humana por arbovírus Rocio na regiäo do Vale do Ribeira / Recent occurrence of human infection by Rocio arbovirus in Ribeira Valley, Brazil

Descreve-se o achado sorológico de anticorpos IgM para vírus Rocio em duas crianças da área rural do Vale do Ribeira, Estado de Säo Paulo. O vírus Rocio foi responsável por extensa epidemia de encefalite na regiäo na regiäo em 1975-1977. Desde 1980 näo têm sido diagnosticados casos de doença. Impöe-se a ativaçäo de medidas dirigidas a vigilância epidemiológica desta arbovirose

Identificacion de enteropatogenos en la diarrea de la infancia en un estudio realizado en la ciudad de Posadas, Misiones / Identification of enteropathogens in the infantile diarrhea in one study realized in the City of Posadas, Misiones

El presente trabajo informa de los resultados de aislamientos de Enteropatogenos en ninos menores de cinco anos, sin tratamiento antibiotico previo, con menos de siete dias de evolucion de su diarrea, internados o ambulatorios del Hospital R. Madariaga, desde junio de 1986 hasta enero de 1987. Estudio que continua hasta la fecha. Del total de 252 casos estudiados, resultaron 65,5%de aislamientos positivos para Esteropatogenos aislados. De la evaluacion realizada surge que Shigella flexneri serotipo 2 ocupa el primer lugar con respecto a Shigella, siendo el serotipo 2 el que produce cuadros mas severos de enteritis, datos que concuerdan con el resto del pais. Del analisis de Escherichia coli EPI, se destaca la mayor frecuencia del serotipo 0111:B4, como en otras publicaciones del pais. Se destaca el primer aislamiento de Salmonella zaiman en humanos, nueva sero variedad a nivel mundial. Se destaca ademas el primer aislamiento en humanos en la Provincia de Misiones de 1) Campylobacter yeyuni, 2) Cepas enterotoxigenicas de Eschericha coli y 3) Aeromonas hidrophyla. Se apunta la necesidad de continuar con este estudio a fin de colaborar con una mejor vigilancia epidemiologica de las enteritis