Seroprevalence of arboviruses in Ecuador: Implications for improved surveillance / Seroprevalencia de arbovirus en Ecuador: implicaciones para mejorar su vigilancia

Abstract | Introduction: Arthropod-borne viruses (arboviruses) cause morbidity and mortality in humans and domestic animals worldwide. The percentage of population immunity or susceptibility to these viruses in Ecuador is unknown. Objectives: To investigate the proportion of Ecuadorian populations with IgG antibodies (Abs) (past exposure/immunity) and IgM Abs (current exposure) against flaviviruses and alphaviruses and to study the activity of these viruses in Ecuador. Materials and methods: During 2009-2011, we conducted a serosurvey for selected arboviruses in humans (n=1,842), equines (n=149), and sentinel hamsters (n=84) at two coastal locations and one in the Amazon basin (Eastern Ecuador) using enzyme-linked immunosorbent assay and hemagglutination inhibition test. Results: From 20.63% to 63.61% of humans showed IgG-antibodies for the flaviviruses: Dengue virus (DENV), yellow fever virus (YFV) Saint Louis encephalitis virus, and West Nile virus (WNV); from 4.67% to 8.63% showed IgG-Abs for the alphaviruses: Venezuelan equine encephalitis virus, eastern equine encephalitis virus, and western equine encephalitis virus. IgM-Abs were found for DENV and WNV. Equines and hamsters showed antibodies to alphaviruses in all locations; two hamsters seroconverted to YFV in the Amazonia. Conclusions: The results show a YFV vaccination history and suggest the activity of arboviruses not included in the current surveillance scheme. Enhanced arbovirus and mosquito surveillance, as well as continued YFV vaccination and evaluation of its coverage/ effectiveness, are recommended.

Resumen | Introducción. Los virus transmitidos por artrópodos (arbovirus) causan morbilidad y mortalidad en humanos y animales domésticos mundialmente. Se desconoce el porcentaje de inmunidad o vulnerabilidad de la población ecuatoriana ante estos virus. Objetivos. Investigar la proporción de poblaciones ecuatorianas con anticuerpos IgG (exposición o inmunidad pasada) y anticuerpos IgM (exposición reciente) contra flavivirus y alfavirus, e investigar su actividad en Ecuador. Materiales y métodos. Entre 2009 y 2011, se llevó a cabo una encuesta serológica para arbovirus en humanos (n=1.842), equinos (n=149) y hámsters centinela (n=84) en dos localidades costeras y en una en la Amazonía, utilizando la prueba ELISA (Enzyme-Linked ImmunoSorbent Assay) y la prueba de inhibición de la hemaglutinación. Resultados. Entre el 20,63 y el 63,61 % de los humanos registraron IgG contra el virus del dengue (DENV), el de la fiebre amarilla (YFV), el de la encefalitis de San Luis y el del Nilo Occidental (WNV); entre 4,67 y 8,63 % tenían IgG para los virus de la encefalitis equina venezolana, de la encefalitis equina del este y de la encefalitis equina del oeste. Se encontró IgM para DENV y WNV. En los equinos y en los hámsters se encontraron anticuerpos contra alfavirus en todas las localidades muestreadas; dos hámsters mostraron seroconversión a YFV en la Amazonía. Conclusiones. Los resultados del estudio evidenciaron los antecedentes de vacunación contra el YFV y sugieren la actividad de arbovirus no incluidos en el esquema de vigilancia actual. Se recomienda ampliar la vigilancia de arbovirus y mosquitos, continuar con la vacunación contra el YFV, y evaluar su cobertura y efectividad.

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.

Molecular diagnosis of avian viruses in grassland passerines and captive yellow cardinals Gubernatrix cristata in Brazil / Diagnóstico molecular de vírus aviários em passeriformes campestres e cardeais-amarelos Gubernatrix cristata cativos no Brasil

Avian influenza viruses (AIVs), Newcastle disease virus (NDV), West Nile virus (WNV), adenovirus (AV) and herpesvirus (HV) play an important role in the health of human and animal populations. However, knowledge of the prevalence of these viruses in wild birds is restricted to some groups (e.g. shorebirds) or regions worldwide. Information on grassland birds of South America, which is essential for their conservation, is scarce. The objectives of the present study were to evaluate occurrences of AIV, NDV, WNV, AV and HV for the first time in a bird community of a unique protected area in southern Brazil, which is home for the critically endangered yellow cardinal (Gubernatrix cristata), and captive yellow cardinals from fauna maintainers of the Brazilian Captive Program of the Yellow Cardinal. Passerine species of wild life were caught, identified and samples (swabs) were collected from the oropharynx and cloaca of 64 passerines of 26 species (including 3 yellow cardinals) and 30 yellow cardinals of captive, for molecular diagnosis. The samples were subjected to RNA and DNA extraction and the real-time polymerase chain reaction (RT-PCR) for AIV, NDV and WNV and nested PCR for AV and HV. One yellow cardinal of captive presented a positive result for AV, this result is important for planning, managing natural attributes and making decisions in relation to integrated conservation of threatened species. This is the first report of AV in yellow cardinal and epidemiological investigation of viruses in wild passerines of the Pampa biome, in Rio Grande do Sul, Brazil.(AU)

Os vírus da gripe aviária (VGA), vírus da doença de Newcastle (VDN), vírus do Nilo Ocidental (VNO), adenovírus (AV) e herpesvírus (HV) desempenham um papel importante na saúde das populações humana e animal. No entanto, o conhecimento da prevalência desses vírus em aves selvagens é restrito a alguns grupos (por exemplo, aves limícolas) ou regiões em todo o mundo. As informações sobre as aves campestres da América do Sul, essenciais para a sua conservação, são escassas. Os objetivos do presente estudo foram avaliar a ocorrência de VGA, VDN, VNO, AV e HV pela primeira vez em uma comunidade de aves de uma área única protegida no Sul do Brasil, que abriga o cardeal-amarelo (Gubernatrix cristata) criticamente ameaçado de extinção e em cardeais-amarelos de cativeiro dos mantenedores de fauna do Programa Brasileiro de Cativeiro do Cardeal-amarelo. Espécies de passeriformes silvestres foram capturadas, identificadas e amostras (swabs) foram coletadas da orofaringe e cloaca de 64 passeriformes de 26 espécies (incluindo 3 cardeais-amarelos) e 30 cardeais-amarelos de cativeiro, para diagnóstico molecular. As amostras foram submetidas à extração de RNA e DNA e à reação em cadeia da polimerase em tempo real (RT-PCR) para VGA, VDN e VNO e nested PCR para AV e HV. Um cardeal-amarelo de cativeiro apresentou resultado positivo para AV, este resultado é importante para o planejamento, manejo dos atributos naturais e tomada de decisões em relação à conservação integrada de espécies ameaçadas. Este é o primeiro relato de AV em cardeal-amarelo e de investigação epidemiológica de vírus em passeriformes silvestres do bioma Pampa, no Rio Grande do Sul, Brasil.(AU)

Vigilancia epidemiológica del virus Occidental del Nilo en las llanuras orientales de Colombia / Epidemiological surveillance of West Nile virus in the Eastern Plains of Colombia

RESUMEN Objetivo. Identificar la presencia del virus del Oeste del Nilo en equinos y mosquitos en ocho municipios del departamento del Meta. Materiales y métodos. La investigación contó con el aval del Comité de bioética de la Universidad de los Llanos. Se analizaron mediante pruebas serológicas y moleculares 613 muestras de equinos criollos y de raza cuarto de milla, destinados a actividades deportivas y de trabajo, con un rango de edad de 2 a 15 años, en los transectos: Villavicencio-Restrepo-Cumaral, San Martín - Castilla la Nueva-Granada y Puerto López-Puerto Gaitán, analizados en 62 pool y 213 mosquitos. Los pool de sueros de equinos y mosquitos fueron analizados por ELISA y PCR. Resultados. No se encontraron animales seropositivos mediante la prueba de ELISA y las pruebas moleculares también fueron negativas. Conclusiones. Aunque en este estudio no se evidenció la presencia de anticuerpos IgM por la técnica de Elisa y las pruebas moleculares (RT-PCR) también fueron negativas para circulación viral, en los municipios objeto de estudio, es importante indicar que la detección molecular en sueros, requiere unos niveles de viremia representativos y que el animal se encuentre en la fase aguda de la enfermedad. Aunque es posible que la población equina se mantenga libre de contacto con el virus, se debe mantener la vigilancia epidemiológica frente a este importante patógeno para la salud humana, especialmente por la presentación de brotes de otros virus zoonóticos como la Encefalitis Equina del Este y Encefalitis Equina Venezolana en los departamentos del Meta y Casanare, contiguo a este.

ABSTRACT Objective. Identify the presence of West Nile virus in horses and mosquitoes in eight municipalities of the department of Meta. Materials and methods. The research was supported by the Bioethics Committee of the University of Los Llanos. 613 samples of Creole and quarter-mile equine horses, intended for sports and work activities, with an age range of 2 to 15 years, were analyzed using serological and molecular tests in the transects: Villavicencio-Restrepo-Cumaral, San Martín- Castilla la Nueva-Granada and Puerto López-Puerto Gaitán, analyzed in 62 pools and 213 mosquitoes. The pool of sera of horses and mosquitoes were analyzed by ELISA and PCR. Results. No seropositive animals were found by the ELISA test and molecular tests were also negative. Conclusions. Although in this study the presence of IgM antibodies was not evidenced by the Elisa technique, and molecular tests (RT-PCR) were also negative for viral circulation, in the municipalities under study, it is important to indicate that the molecular detection in sera, it requires representative levels of viremia and that the animal is in the acute phase of the disease. Although it is possible that the equine population remains free of contact with the virus, epidemiological surveillance should be maintained against this important pathogen for human health, especially due to the outbreak of other zoonotic viruses such as Eastern Equine Encephalitis and Encephalitis Venezuelan Equine in the departments of Meta and Casanare, adjacent to this.

Superinfection exclusion studies using West Nile virus and Culex flavivirus strains from Argentina

In Argentina, many Flavivirus were recognised including West Nile virus (WNV). During 2009 several strains of Culex Flavivirus (CxFV), an insect-specific flavivirus, were isolated in the same region where circulation of WNV was detected. Hence, the objective of this study was to analyse the effect of co-infection in vitro assays using CxFV and WNV Argentinean strains in order to evaluate if CxFV could affect WNV replication. Our results showed that WNV replication was suppressed when multiplicity of infection (MOI) for CxFV was 10 or 100 times higher than WNV. Nevertheless, in vivo assays are necessary in order to evaluate the superinfection exclusion potential.

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 in Ecuador / Virus del Nilo Occidental en Ecuador

ABSTRACT Several studies have been carried out to determine the presence and circulation of West Nile Virus (WNV) in several species that interact in important ecosystems of Ecuador, such as the Galapagos Islands, where presence and surveillance studies of WNV have been carried out in wild and migratory birds (2003) (2008 to 2010), penguins (2003 to 2004). Studies have also been carried out on birds from different locations in Guayaquil (2011), and on Jauneche horses (2007), but no virus has been demonstrated in any of them. Nevertheless, in the Abras de Mantequilla wetland, two studies were conducted in equines aged between 3 months to 12 years, all of them mixed race, male and female, with no previous vaccination history and with presence of symptoms only in the first study. In the two studies the serum analysis was performed by the ELISA technique (reactivity determination) and Plaque Reduction Neutralization Test (PRNT). In the first study, 8.12% (13/160) of reactivity was determined in 13 horses and 22.22% of reactivity in 2 of 9 people; and only 3.12% (5/160 horses) of the presence of IgM antibodies against WNV. In relation to the second study, 12.6% (52/412) reactivity and 10.4% (43/412 horses) confirmed the serological evidence of WNV, with a final prevalence of 6.76%. Consequently, the WNV is present and circulating in the equines of the Ecuadorian coastal zone, which is a potential risk to the public health, nevertheless there is no updated information on investigations conducted in this regard.

RESUMEN El presente es una revisión bibliográfica sobre estudios realizados para determinar la presencia y circulación del Virus del Nilo Occidental (VNO) en diversas especies que interactúan en importantes ecosistemas del Ecuador, como son las Islas Galápagos, en donde, se han realizado estudios de presencia y vigilancia del VNO en aves silvestres y migratorias (2003) (2008 al 2010) y pingüinos (2003 al 2004). También, se ha realizado estudios en aves de diversos lugares de Guayaquil (2011), y en equinos de Jauneche (2007) pero en ninguno de los lugares se evidenció la presencia del virus. Por otro lado, en el humedal Abras de Mantequilla, Coello y colaboradores realizaron dos estudios en equinos de edades entre 3 meses a 12 años, todos de raza mestiza, sexo machos y hembras, sin antecedentes de vacunación y con presencia de síntomas solo en el primer estudio. El análisis de los sueros en los dos estudios se realizó mediante la técnica de ELISA (determinación de reactividad) y la confirmación a través de Neutralización por Reducción del Número de Placas (NTRP). En el primer estudio se determinó el 8.12% (13/160) de reactividad en 13 equinos y el 22.22% de reactividad en 2 de 9 personas (no se confirmaron); del total de muestras reactivas en equinos, solo se confirmó el 3.12% (5 equinos/160) de la presencia de anticuerpos IgM contra VNO. Respecto al segundo estudio estableció el 12.6% (52/412) de reactividad y el 10.4% (43/412 equinos) se confirmó la evidencia serológica del VNO, con una prevalencia final del 6.76%. Por lo consiguiente, el VNO está presente y circulando en los equinos de la zona costera ecuatoriana, lo cual es un riesgo potencial para la salud pública, sin embargo no hay información actualizada de investigaciones realizadas al respecto.

First isolation of West Nile virus in Brazil

BACKGROUND Serological evidence of West Nile virus (WNV) infection has been reported in different regions of Brazil from equine and human hosts but the virus had never been isolated in the country. OBJECTIVES We sought to identify the viral etiology of equine encephalitis in Espírito Santo state. METHODS We performed viral culture in C6/36 cells, molecular detection of WNV genome, histopathology and immunohistochemistry from horse cerebral tissue. We also carried out sequencing, phylogenetic analysis and molecular clock. FINDINGS Histopathologic analysis from horse cerebral tissue showed injury related to encephalitis and WNV infection was confirmed by immunohistochemistry. The virus was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) from brain tissue and subsequently isolated in C6/36 cells. WNV full-length genome was sequenced showing the isolated strain belongs to lineage 1a. The molecular clock indicated that Brazilian WNV strain share the same common ancestor that were circulating in US during 2002-2005. MAIN CONCLUSIONS Here we report the first isolation of WNV in Brazil from a horse with neurologic disease, which was clustered into lineage 1a with others US WNV strains isolated in beginning of 2000's decade.

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.

West Nile fever in Tunisia

As of 8 October 2018, the Ministry of Health of Tunisia reported 177 sus-pected cases of West Nile fever [WNF]. Out of these, 22 are probable and 17 are laboratory confirmed cases. One death has also been reported in a 27 year male who was hospitalized for meningo-encephalitis in September 2018

West Nile fever in Tunisia: update

As of 30 November 2018, the Ministry of Health of Tunisia reported 377 suspected cases of West Nile fever [WNF]. Out of these, 65 cases are probable and 49 cases are laboratory confirmed. Two related deaths have also been reported

El virus de nilo occidental y sus vectores: reseña histórica, biología y ecología de aedes albopictus, culex pipiens y cx. quinquefasciatus / Western Nile virus and its vectors: a historic review, biology and ecology of Aedes albopictus, Culex pipiens and Cx. Quinquefasciatus

Resumen Este trabajo obedece a la primera iniciativa para compilar el conocimiento de los mosquitos vectores del Virus del Nilo Occidental en Costa Rica, como parte del primer Congreso para el estudio de la epidemiología de este arbovirus. Se incluye la revisión de las bases de datos de mayor prestigio y mayor cantidad de artículos para completar la información referente a lo que se ha informado acerca de las especies de mosquitos en Costa Rica, acerca de los cuales la información es fragmentaria y de difícil acceso en muchos casos. Se recomienda incentivar la investigación en este importante grupo de insectos, además de la necesidad de estudios de la ecología de estas especies en nuestro país. Se incluye una clave para los principales géneros de mosquitos hallados en Costa Rica en los cuales hay especies informadas como posibles vectores en otras latitudes. Se hace una sinopsis de la necesidad de incluir factores psicosociales en el diseño de las campañas educativas.

Abstract This work is the first initiative to compile the knowledge of mosquito vectors of West Nile Virus in Costa Rica, as part of the first Congress to study the epidemiology of this arbovirus. It includes a review of the most prestigious databases and a greater number of articles to complete the information regarding what has been reported about mosquito species in Costa Rica, about which the information is fragmentary and difficult to access in many cases. It is recommended to encourage research in this important group of insects, in addition to the need for studies of the ecology of these species in our country. A key is included for the main genera of mosquitoes found in Costa Rica in which there are species reported as possible vectors in other latitudes. A synopsis is made of the need to include psychosocial factors in the design of educational campaigns.

Ecological characteristics and current status of infectious disease vectors in South Korea

In light of global climate change, the seasonal and geographical distribution of vector species, especially mosquitoes, chigger mites, and ticks, are of great importance for human beings residing in rural and urban environments. A total of 12 species belonging to 4 genera have been identified as vector mosquitoes in the Republic of Korea. The most common of the 56 mosquito species in this country from 2013 through 2015 was found to be a malaria vector, Anopheles sinensis s.l. (species ratio [SR] 52%); followed by a potential vector of West Nile virus, Aedes vexans nipponii (SR 38%); a Japanese encephalitis vector, Culex tritaeniorhynchus (SR 6%); a West Nile virus vector, Culex pipiens (SR 3%); and a dengue and Zika virus vector, Ae. albopictus (SR 0.3%). Of the scrub typhus vectors, Leptotrombidium scutellare is the predominant chigger mite in Gyongnam province and Jeju island, whereas L. pallidum is the predominant species in other areas of Korea. Ticks were found to be prevalent in most environmental conditions, and high levels of their activity were consistently observed from May to September. Haemaphysalis species of ticks were mostly collected in grasslands, whereas Ixodes species were frequently found in coniferous forests. Haemaphysalis longicornis, known as the main vector of severe fever with thrombocytopenia syndrome, was the predominant species and was widely distributed throughout the country.

Olympic Games Rio 2016 and the uninvited viruses: Potential consequences for Europe and North America / Juegos Olímpicos de Río 2016 y los virus no invitados: posibles consecuencias para Europa y América del Norte

In the Latin American tropics, we have witnessed the emergence of several pathogenic arboviruses in the last decade. These include Yellow Fever, West Nile virus, St. Louis encephalitis, Venezuelan equine encephalitis, Mayaro, Oropouche, Ilheus, and most recently, Chikungunya and Zika. Guillain-Barre syndrome (GBS), microcephaly and all the encephalitides, have been of concern to public health officials in Latin America since the arrival of emerging arboviruses. ¡Don't forget about dengue! Between 2014 and 2015 we received two unexpected and uninvited viruses: Chikungunya and Zika. Chikungunya, an alphavirus, appeared abruptly in developing countries of the Americas, revealing that we were not prepared to face it. While we were still recovering from Chikungunya, Zika virus arrived, only compounding the insult. One cannot imagine the potential impact of the introduction of a hemorrhagic virus of the likes of Marburg or Ebola in Latin America. This scenario would be catastrophic.

Suspected VHF in Sudan: Cases decline but not contained

The suspected cases of viral haemorrhagic fever [VHF] reported from Darfur region in Sudan continue to be reported sporadically. Although, cases have declined, there is yet no sign that the outbreak has been contained

First detection of West Nile virus in domestic pigeon in Korea

West Nile virus (WNV) is a mosquito-borne zoonotic pathogen that has spread throughout Europe and the United States. Recently, WNV spread to East and Southeast Asia, and great efforts have been made in South Korea to prevent the spread of WNV from neighboring countries. In this study, we diagnosed the first case of WNV in pigeons (Columba livia domestica) residing in cities using a competitive enzyme-linked immunosorbent assay and confirmed it with nested reverse transcription polymerase chain reaction analysis and sequencing. This is the first report to provide convincing evidence that WNV is present within South Korea.

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.

Evidencia serológica de circulación del virus de la encefalitis de San Luis en aves de la Ciudad Autónoma de Buenos Aires, Argentina / Serological evidence of St. Louis encephalitis virus circulation in birds from Buenos Aires City, Argentina

Nuestro objetivo fue conocer la presencia de anticuerpos neutralizantes contra el virus de la encefalitis de San Luis (St. Louis encephalitis virus [SLEV]) y el virus del Nilo Occidental (West Nile virus [WNV]) en sueros de aves silvestres y domésticas de la Ciudad Autónoma de Buenos Aires, Argentina. Desde octubre del 2012 hasta abril del 2013 se colectaron 180 muestras que fueron procesadas por la técnica de microneutralización. El 7,2% de las aves muestreadas resultaron seropositivas para SLEV, mientras que no se detectaron aves seropositivas para WNV

Our goal was to determine the presence of neutralizing antibodies against St. Louis encephalitis virus (SLEV) and West Nile virus (WNV) in sera of wild and domestic birds from Buenos Aires City, Argentina. From October 2012 to April 2013, 180 samples were collected and processed by the microneutralization technique. A 7.2 % of the sampled birds were seropositive for SLEV, while no seropositive birds for WNV were detected

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.