Vigilância para Febre do Nilo Ocidental (FNO) em aves de subsistência localizadas em sítio de aves migratórias do Complexo estuarino-lagunar de Ilha Comprida e Iguape/SP / Surveillance for West Nile Fever in backyard chickens located in a migratory bird site of the estuarine-lagoon complex of Ilha Comprida and Iguape/SP

A Febre do Nilo Ocidental (FNO), é uma arbovirose emergente, zoonótica, causada pelo Vírus do Nilo Ocidental (VNO), arbovírus da família Flaviviridae, do gênero Flavivírus, com ampla distribuição mundial. Vírus foi isolado pela primeira vez em 1937, em uma paciente febril, na província de West Nile, em Uganda, e documentado em 1951 em Israel, havendo registros de ocorrência em aves, equinos e no homem. Nas Américas, o primeiro surto ocorreu em 1999 na cidade de Nova York (EUA), com mortalidade de milhares de aves silvestres e 121 pessoas, um marco histórico para a doença e na construção das bases de vigilância do vírus. A doença se espalhou pelas Américas, com a primeira evidência na América do Sul, em equinos na Colômbia, em 2005. No Brasil, o primeiro registro ocorreu no Mato Grosso do Sul em equinos, no ano de 2010, e o primeiro caso humano em 2014, no Piauí, sendo comprovada a circulação viral em aves silvestres, galinhas e equinos nos últimos dez anos. A transmissão ocorre pela picada do mosquito infectado do Gênero Culex, mantendo um ciclo enzoótico de transmissão mosquito-ave silvestre-mosquito, sendo que as aves silvestres são hospedeiros primários, e destacam - se na disseminação viral entre as Américas, através de deslocamentos migratórios, sem haver elucidação dos mecanismos de dispersão. A infecção de galinhas, equinos e do homem é acidental, por apresentarem uma viremia rápida e curta, tornando os elos finais da cadeia de transmissão ou sentinelas, para a doença. A FNO é aguda, subclínica ou com quadro febril, que pode ocasionar síndrome neurológica grave em até 10% dos casos, com recuperação ou óbito em 1% dos casos, não havendo tratamento ou vacina disponível no Brasil. A FNO é de Notificação Obrigatória - IN n° 50/2013 - MAPA. Características inerentes à galinhas, de suscetibilidade à infecção, resistência à doença e alta sensibilidade à testes de detecção viral, tornam esta espécie um modelo de sentinela para o VNO, em sítios migratórios, aonde coexistem aves silvestres, culicídeos e criações de fundo de quintal que ficam vulneráveis à infecção, demonstrando a importância da vigilância para a FNO no Brasil. O presente estudo teve como objetivos a revisão de literatura sobre a FNO e o estudo de circulação viral em aves de fundo de quintal de 17 propriedades do entorno do sítio de aves migratórias do complexo estuarino-lagunar de Ilha Comprida e Iguape/SP, com colheita de amostras de sangue em 113 galinhas, para a detecção do VNO e outros flavivírus pela técnica RT-PCR. Não houve a detecção de atividade viral nas amostras analisadas. Contudo, a ações de vigilância para o VNO e o monitoramento contínuo dos sítios migratórios de aves devem ser rotineiros, para evitar a introdução e disseminação da doença, destacando - se as notificações de sinais clínicos neurológicos ou mortalidade em aves.

West Nile Fever (WNF) is an emerging zoonotic arbovirus caused by the West Nile Virus (WNV), a flavivirus of the Flaviviridae family with worldwide distribution. The virus was first isolated in 1937 from a febrile patient in the West Nile province of Uganda and documented in 1951 in Israel. WNV has been reported to occur in birds, horses, and humans. The first outbreak in the Americas occurred in 1999 in New York City, with thousands of wild birds dying and 121 human deaths. The disease has since spread throughout the Americas, with the first evidence in South America occurring in horses in Colombia in 2005. In Brazil, the first WNV record occurred in horses in Mato Grosso do Sul in 2010, and the first human case was reported in 2014 in Piauí. WNV circulation has been confirmed in wild birds, chickens, and horses in the past ten years. The virus is transmitted by infected Culex mosquitoes, maintaining an enzootic cycle of mosquito-wild bird-mosquito transmission. Wild birds are the primary hosts and play a significant role in viral dissemination across the Americas through migratory movements, with no elucidation of the dispersal mechanisms. Chickens, horses, and humans are accidental hosts due to their rapid and short viremia, making them the final links in the transmission chain or sentinels for the disease. WNF is acute or subclinical, with fever that can lead to severe neurological syndromes in up to 10% of cases, with recovery or death in 1% of cases. There is no treatment or vaccine available for WNF in Brazil. WNF is a mandatory reportable disease according to IN n° 50/2013 - MAPA. The susceptibility of chickens to infection, resistance to disease, and high sensitivity to viral detection tests make this species a sentinel model for WNV in migratory sites where wild birds, culicids, and backyard farming coexist and are vulnerable to infection. Therefore, continuous surveillance for WNF in Brazil is crucial. This study aimed to review the literature on WNF and to investigate viral circulation in backyard chickens in 17 properties around the migratory bird site of the estuarine-lagoon complex of Ilha Comprida and Iguape/SP, with blood samples collected from 113 chickens for WNV and other flavivirus detection by RT-PCR. No viral activity was detected in the analyzed samples. However, surveillance for WNV and continuous monitoring of migratory bird sites should be routine to prevent the introduction and spread of the disease, with notifications of clinical neurological signs or mortality in birds.

Febre do Nilo Ocidental / West Nile fever

A Febre do Nilo Ocidental (FNO) é uma infecção viral transmitida por meio da picada de mosquitos, principalmente do gênero Culex (pernilongo) infectados pelo agente etiológico, cujos hospedeiros naturais são algumas espécies de aves silvestres, que atuam como amplificadoras do vírus e como fonte de infecção para os vetores. Tal doença pode também infectar humanos, equinos, primatas e outros mamíferos sendo que, homem e equídeos são considerados hospedeiros acidentais e terminais, uma vez que a contaminação pelo vírus se dá por um curto período de tempo e em níveis insuficientes para infectar mosquitos, encerrando o ciclo de transmissão (WHO, 2017; ECDC , 2022a; CDC, 2017; BRASIL, 2021)

West Nile Fever (WNF) is a viral infection transmitted through the bite of mosquitoes, mainly of the Culex genus (legged mosquito) infected by the etiological agent, whose natural hosts are some species of wild birds, which act as amplifiers of the virus and as source of infection for the vectors. Such a disease can also infect humans, horses, primates and other mammals, and humans and horses are considered accidental and terminal hosts, since contamination by the virus occurs for a short period of time and at levels insufficient to infect mosquitoes, ending the transmission cycle (WHO, 2017; ECDC, 2022a; CDC, 2017). ; BRAZIL, 2021)

Controladores biológicos para la reducción de índices aédicos / Biological controllers for the reduction of aedic indices

Ante la ausencia de vacunas eficaces para las arbovirosis transmitidas por el vector A. aegypti y la resistencia a insecticidas se hace necesario buscar alternativas, donde resalta el control biológico con el uso del larvicida microbiológico Bacillus thuringiensis var. israelensis (Bti). Como objetivo, se propuso determinar los índices aédicos y el uso de Bacillus thuringiensis israelensis como controlador biológico de Aedes aegypti en la localidad de Huánuco, Perú durante el segundo semestre de 2019. La investigación fue experimental de corte transversal con una muestra de 263 viviendas distribuidas en cinco bloques. Como instrumento se usó la observación y reporte de fichas a través de la inspección de cada vivienda en dos momentos, inicial y final, separadas por un lapso de 90 días. Para el análisis de los datos se usó estadística descripctiva a través de Epidat 3.0, obteniendo IA, IR e IB. Como resultado, de las 236 casas inspeccionadas, 51% (120/236) fueron no intervenidas y 49% (116/236) fueron intervenidas con Bacillus thuringiensis, de las casas no intervenidas (120/236) en la fase inicial 59% fueron positivas (con la presencia de algún estadío de A. aegypti) y en la fase final fue de 63%, por otra parte, en las casas intervenidas con Bacillus thuringiensis (CCB) (116/236) en la fase inicial 61% (71/116) estaban positivas y la fase final hubo un descenso a 32% (37/116). En conclusión, se sugiere que la aplicación de Bti constituye un componente adecuado para el manejo de poblaciones larvales de A. aegypti, en la ciudad de Perú(AU)

In the absence of effective vaccines for arboviruses transmitted by the vector A. aegypti and resistance to insecticides, it is necessary to look for alternatives, where biological control stands out with the use of the microbiological larvicide Bacillus thuringiensis var. israelensis (Bti). As an objective, it was proposed to determine the aedic indices and the use of Bacillus thuringiensis israelensis as a biological controller of Aedes aegypti in the town of Huánuco, Peru during the second half of 2019. The research was experimental cross-sectional with a sample of 263 homes distributed in five blocks. As an instrument, the observation and reporting of records was used through the inspection of each dwelling in two moments, initial and final, separated by a period of 90 days. For data analysis, descriptive statistics were used through Epidat 3.0, obtaining IA, IR and IB. As a result, of the 236 houses inspected, 51% (120/236) were not intervened and 49% (116/236) were intervened with Bacillus thuringiensis, of the houses not intervened (120/236) in the initial phase, 59% were positive (with the presence of some stage of A. aegypti) and in the final phase it was 63%, on the other hand, in the houses intervened with Bacillus thuringiensis (CCB) (116/236) in the initial phase 61% (71 /116) were positive and the final phase there was a decrease to 32% (37/116). In conclusion, it is suggested that the application of Bti constitutes an adequate component for the management of larval populations of A. aegypti, in the city of Peru(AU)

Evidence for current circulation of an ancient West Nile virus strain (NY99) in Brazil

Abstract INTRODUCTION: In Brazil, West Nile virus (WNV) was first detected, in 2018, in horses with neurological disease. AIM: We report the first case of WNV infection in a horse from Ceará state and the complete genome sequence of an isolate from Espírito Santo state. Both infections occurred in 2019. METHODS: WNV was isolated from the tissues of a horse with neurological signs in Espírito Santo and sequenced by MiSeq. RESULTS: Phylogenetic analysis revealed that the isolate belongs to lineage 1a, clustering with the NY99 strain, a strain that has not circulated in the USA since 2005. CONCLUSIONS: Our findings reinforce the hypothesis that WNV has been silently circulating in Brazil for many years.

Febre do Nilo Ocidental: uma revisão da literatura / West Nile Fever: a literature review / Fiebre del Nilo Occidental: una revisión de la literatura

A partir de seu primeiro isolamento em Uganda, em 1937, até os dias de hoje, o vírus do Nilo Ocidental (WNV) tornou-se um alarmante agente etiológico em humanos e animais. O WNV é mantido e perpetuado na natureza através de um ciclo enzoótico, entre aves e mosquitos, e ocasionalmente causa surtos epizoóticos em razão de uma doença contagiosa em humanos e cavalos. Este vírus é amplamente difundido no mundo e, embora grande parte das infecções humanas causadas por WNV seja assintomática, a doença pode evoluir para um quadro neurológico grave, resultando em sequelas a longo prazo ou óbito do paciente. Este estudo tem por objetivo analisar a literatura específica sobre o WNV para apresentar uma revisão de artigos científicos, buscando explorar os aspectos mais importantes da doença. Foram realizadas buscas nas bases de dados PubMed e SciELO a partir dos seguintes descritores: "West Nile virus", "epidemiology" e "pathogenesi'". A linha temporal pesquisada abrange de 1998 a 2019, o que permitiu a localização de 293 artigos, dos quais, com base na leitura dos resumos, 88 foram selecionados para realização da leitura completa do artigo. Ao final da leitura dos artigos, 33 foram selecionados na análise final, tendo levado à conclusão de que a vigilância epidemiológica e as medidas preventivas são uma necessidade contínua para reduzir os impactos da doença na saúde pública.

From its first isolation in Uganda, in 1937, up to date, the West Nile virus (WNV) has become a major cause of disease in both humans and animals. Maintained in nature through an enzootic cycle involving birds and mosquitoes, the WNV is liable to occasional epizootic outbreaks, causing diseases in humans and horses. This virus is widely spread in the world and, although most human infections with WNV are asymptomatic, the disease may progress into a severe neurological disorder, resulting in long-term sequelae or death. This study comprises a literature review on scientific articles discussing the theme of WNV. For that, a search was conducted in the databases PubMed and Scientific Electronic Library Online (SciELO) for articles published between 1998 and 2019, using the following descriptors: "West Nile virus", "epidemiology", and "pathogenesis". From the 293 articles found, 88 were selected for full-text reading after abstract screening, 33 of which remained in the final analysis. To reduce the impact of the disease on public health, authorities must conduct epidemiological surveillance and develop preventive measures.

Desde su primer aislamiento en Uganda en 1937 hasta la actualidad, el virus del Nilo Occidental (WNV) se ha convertido en un importante agente etiológico en humanos y animales. El WNV es un virus mantenido y perpetuado en la naturaleza a través de un ciclo enzoótico, entre aves y mosquitos, y ocasionalmente ocurren brotes epizoóticos, causando enfermedad en humanos y caballos. Es un virus ampliamente difundido en el mundo, que causa infecciones asintomáticas en humanos en la mayoría de los casos, sin embargo, la enfermedad puede evolucionar a un cuadro neurológico grave, ocasionando secuelas a largo plazo o el óbito del paciente. Este estudio tiene por objetivo analizar la literatura específica sobre el WNV para presentar una revisión de artículos científicos referentes al tema. Se realizaron búsquedas en las bases de datos PubMed y SciELO a partir de los siguientes descriptores: "West Nilo virus", "epidemiology" y "pathogenesi". La línea temporal de estudio abarcaba de 1998 a 2019, en la cual se encontraron 293 artículos y con base en la lectura de los resúmenes se seleccionaron 88 para realizar la lectura completa. Al final de la lectura de los artículos, 33 artículos fueron seleccionados en el análisis final, lo que se concluye que la vigilancia epidemiológica y las medidas preventivas son una necesidad continua a fin de reducir los impactos de esa enfermedad en la salud pública.

West nile virus infections are here! are we prepared to face another flavivirus epidemic?

Abstract Emerging arthropod-borne viruses (arboviruses), such as chikungunya and Zika viruses, are a major threat to public health in countries like Brazil where biodiversity is high and medical care is sometimes precarious. West Nile fever is a disease caused by the West Nile Virus (WNV), an RNA virus belonging to the Flaviviridae family. It is transmitted by infected mosquitoes to numerous animals like birds, reptiles and mammals, including human and non-human primates. In the last decade, the number of reported cases of WNV infection in humans and animals has increased in the Americas. Circulation of WNV in forests and rural areas in Brazil has been detected based on serological surveys and, in 2014, the first case of West Nile fever was confirmed in a patient from Piauí State. In 2018, the virus was isolated for the first time from a horse from a rural area in the state of Espírito Santo presenting with a neurological disorder; this raises the possibility that other cases of WNV encephalitis may have occurred without clinical recognition and without laboratory diagnosis by specific assays. The imminent WNV outbreak poses a challenge for Brazilian clinicians and researchers. In this review, we summarize the basic biological and ecological characteristics of this virus and the clinical presentation and treatment of febrile illnesses caused by WNV. We also discuss the epidemiological aspects, prophylaxis of WNV infections, and monitoring strategies that could be applied in the possibility of a WNV outbreak in Brazil.

Diagnostic significance of immunoglobulin G avidity in symptomatic and asymptomatic West Nile virus infection

Abstract INTRODUCTION West Nile virus (WNV) immunoglobulin M (IgM) antibodies have been shown to persist for up to 500 days in certain patients. To evaluate the usefulness of immunoglobulin G (IgG) avidity assessment in the diagnosis of WNV infection, we analyzed 54 WNV IgM- and/or IgG-positive serum samples from 39 patients with neuroinvasive disease and 15 asymptomatic cases tested during a seroprevalence investigation. METHODS Serological tests (WNV IgM/IgG antibody detection, IgG avidity) were performed using commercially available enzyme-linked immunosorbent assays. RESULTS WNV IgM antibodies were detected in 47 (87%) samples. Acute/recent WNV infection was confirmed based on low/borderline avidity index (AI) in 44 IgM-positive samples (93.6%). In three IgM-positive samples (6.4%), high IgG AIs were detected, thus indicating persisting IgM antibodies from previous infections. All IgM-negative samples showed high AIs. Patients with WNV neuroinvasive disease tested within 30 days showed low AIs. In six patients tested 34-50 days after disease onset, AI was borderline (42%-60%), suggesting earlier WNV IgG maturation. Samples with the highest IgM values were associated with the lowest AIs (Spearman's rho coefficient -0.767, p < 0.001). CONCLUSIONS Our results indicate that IgG avidity differentiates current/recent WNV infection from persistent IgM seropositivity from the previous WNV transmission season both in patients with WNV neuroinvasive disease and in asymptomatic persons. A strong negative correlation between IgM antibody levels and AI indicates that in cases with very high IgM levels, determination of IgG avidity may not be necessary. As many patients showed rapid avidity maturation, low IgG avidity is indicative of WNV infection within the previous month.

Pandemic Influenza Severity Assessment [PISA] in EMR

The Eastern Mediterranean Regional Office of WHO, in collaboration with the Global Influenza Programme [GIP] of WHO/HQ and the Centers for Disease Control and Prevention [US-CDC], conducted a 4 day regional training workshop on determining influenza baselines and thresholds for Pandemic Influenza Severity Assessment [PISA] in Tunis, Tunisia, from 1 to 4 October 2018. The workshop was attended by 30 participants from 15 countries in the region

MERS in healthcare workers

Middle East respiratory syndrome [MERS] is an emerging viral respirato-ry disease caused by the MERS coro-navirus [MERS-Cov] that was first identified in Saudi Arabia in 2012. Human-to-human transmission has been observed to a limited extent from MERS-Cov and have primarily occurred in health care settings

Chikungunya update: Sudan

Sudan has had a major outbreak of Chikungunya since July 2018. A total of 20,110 cases have been reported since the outbreak began. No new cases of the disease were reported during the week ending 11th November 2018

Transition from EWARN to routine surveillance

A three days workshop was conducted in Damascus, Syria from 8-10 August 2018 to disseminate findings of Early Warning Alert and Response Network [EWARN] evaluation in Syria. Partici-pants included Ministry of Health [MOH] staff and technical EWARN officers. During this workshop the question of how and when to transition from EWARN to routine surveillance was examined

Influenza cases increase in recent weeks

The seasonal influenza [flu] viruses are detected year-round, however influenza activity, in the northern hemisphere, often begins to increase by the end of autumn. During the winter months, influ-enza may infect up to one fifth of the population and cause substantial mortality.

Estimation of the Outbreaks of Transfusion-Transmissible Emerging Infectious Diseases in Korean Blood Donors by Public Data / 대한수혈학회지

BACKGROUND: Transfusion transmissible emerging infectious diseases (EIDs) is a potential risk to the safety of blood transfusions due to the lack of donor screening assays. To prevent the spread of EIDs through blood transfusions, we attempted to predict the possibility of blood donations from people with EIDs using a public database. METHODS: We used the Disease Web Statistics System of the Korean Centers for Disease Control and Prevention and Korean Statistical Information Service. We estimated the possibility of blood donations from people with EIDs using the public database combined with the database made available by the Blood Information Management System of the Korean Red Cross. RESULTS: Among the transfusion transmissible EIDs, Babesiosis, Leishmaniasis, West Nile fever, Chikungunya, and Dengue fever were reported in Korea. All of them were cases imported from abroad. Although the number of reported cases of Babesiosis, Leishmaniasis, West Nile fever, and Chikungunya were less than 10 per year until 2016, the reported cases of Dengue fever gradually increased from 2001, and there were 318 cases of Dengue fever in 2016. CONCLUSION: The possibility of blood donation from people with transfusion-transmissible EIDs was low because all reported transfusion-transmissible EIDs in Korea were from foreigners and blood donation from Koreans who returned from abroad was restricted for a period of a month. Nonetheless, preventive strategy for donation from people is necessary given the recent increase in Dengue fever.

Aspectos clínicos de la infección en seres humanos por el Virus del Nilo Occidental / Clinical Features of West Nile Virus Infection in Humans

ResumenLa infección por el Virus del Nilo Occidental es endémica en Norteamérica desde 1999 y actualmente hay casos aislados en gran parte de América. Aunque el 80 % de los casos son asintomáticos, existe casi un 20 % que se presenta como una enfermedad febril aguda indistinguible de otras infecciones por flavivirus como el Dengue, y menos de 1 % se puede manifestar como un síndrome neurológico grave: meningitis, encefalitis o parálisis flácida; siendo esta la forma más severa y discapacitante de la enfermedad.El diagnóstico debe basarse en un alto índice de sospecha clínico y confirmarse por métodos de laboratorio que usualmente consisten en serología. No existe tratamiento específico, se debe dar manejo de soporte, y algunos autores recomiendan en las formas graves utilizar gammaglobulina. En Costa Rica se han presentado casos de la enfermedad en el año 2010, lo cual sin duda obedece a que se tienen todas las condiciones ambientales para que ocurran, por lo que se sugiere un abordaje multidisciplinario de esta infección.

AbstractThe West Nile Virus infection is endemic in North America since 1999, and nowadays sporadic cases are seen across America. Although 80 % cases are asymptomatic, the remaining 20 % appear as acute febrile illness like other flavivirus infections such as dengue, and less than 1 % may occur as a severe neurologic disease: meningitis, encephalitis or flaccid paralysis; the last being the most severe and disabling form of the disease.The diagnosis should be made when a high index of clinical suspicion is present and confirmed with laboratory tests, such as serology. There is no specific treatment, only support care; and some authors recommend that in severe cases gammaglobulin be used. In Costa Rica there were isolated cases in 2010, which occurred because all necessary environmental conditions were present; therefore a multidisciplinary approach is needed in the management of this infection.

South-South Cooperation: Brazilian experiences in South America and Africa / Cooperação Sul-Sul: experiências brasileiras na América do Sul e na África

Over recent years Brazil has played an increasingly active role internationally, the result of its model of integration and its foreign policy directives. The health sector is a valuable and strategic area for Brazilian technical cooperation to achieve various objectives, including its development goals. This article describes the main directives of Brazilian foreign policy, conceptually defining and characterizing South-South Cooperation, illustrated through an analysis of two Brazilian technical cooperation initiatives in healthcare: one in South America, the other in Africa. The study concludes that, irrespective of the interests and power asymmetries existing in South-South Cooperation, the objectives of this cooperation were achieved through the technical work.

Nos últimos anos, o Brasil foi ativo no âmbito internacional, tanto por seu modelo de inserção como pelas diretrizes de política externa. O setor saúde é uma ferramenta valiosa e estratégica utilizada pela cooperação técnica brasileira para lograr seus objetivos de desenvolvimento. Este artigo descreve as principais diretrizes de política externa brasileira, conceitua e caracteriza a Cooperação Sul-Sul, ilustrada mediante análise de duas iniciativas de cooperação técnica em saúde do Brasil: na América do Sul e na África. O estudo conclui que, independentemente dos interesses e das assimetrias de poder que existem na Cooperação Sul-Sul, os objetivos dessa cooperação foram alcançados por meio do trabalho técnico.

The First Reported Case of West Nile Encephalitis in Korea

West Nile encephalitis was first identified in 1937, but until now, it was never diagnosed in Korea. A 58-yr-old Korean man was admitted with headache and cognitive dysfunction. The patient had been on a business trip in Guinea. Cerebrospinal fluid (CSF) showed pleocytosis. The patient complained of both leg weakness,and arachnoiditis and myelitis were observed on lumbar magnetic resonance imaging (MRI). A specific neutralizing antibody for West Nile virus was positive in serum. After a treatment with interferon-alpha 3mu, follow up CSF findings recovered completely after 3 months later. The first case of West Nile encephalitis in Korea was imported from Guinea, and was cured successfully.

The First Reported Case of West Nile Encephalitis in Korea

West Nile encephalitis was first identified in 1937, but until now, it was never diagnosed in Korea. A 58-yr-old Korean man was admitted with headache and cognitive dysfunction. The patient had been on a business trip in Guinea. Cerebrospinal fluid (CSF) showed pleocytosis. The patient complained of both leg weakness,and arachnoiditis and myelitis were observed on lumbar magnetic resonance imaging (MRI). A specific neutralizing antibody for West Nile virus was positive in serum. After a treatment with interferon-alpha 3mu, follow up CSF findings recovered completely after 3 months later. The first case of West Nile encephalitis in Korea was imported from Guinea, and was cured successfully.