La viruela de mono. ¿Una zoonosis emergente? / Monkeypox virus. An emergent zoonosis?

Resumen La viruela de mono es una enfermedad zoonótica propia de roedores y primates no humanos que producen casos esporádicos de monopox, el cual se caracteriza por lesiones exantemáticas en la piel. La viruela del mono es endémica en países del África Central y del Oeste, especialmente en la República Democrática del Congo. En 2003 se detectó por primera vez en el occidente y en el 2022 reaparece en Estados Unidos y otros países del mundo. Aunque cualquier persona que se exponga al virus puede desarrollar la enfermedad, este brote se ha caracterizado por presentar características epidemiológicas distintas ya que los grupos de riesgo más frecuente son los de los hombres que tienen sexo con hombres. Los nuevos brotes de esta enfermedad se han caracterizado por cambios importantes en la presentación clínica ya que el exantema no se presenta generalizado. Por el contrario, ha mostrado muchas variantes como la presentación de lesiones vesiculares únicas en la región genital, lo que hace difícil su diagnóstico clínico. Por ser una enfermedad emergente y presentar cambios en su comportamiento es importante estar consultando las recomendaciones de las organizaciones competentes para el manejo, tratamiento y diagnóstico de esta enfermedad.

Abstract Human monkeypox is a rare viral zoonosis endemic to central and western Africa. It was detected for the first time in the western Hemisphere in 2003. Recently it has re-emerged in USA and has spread rapidly to many countries of the world. Even though any person could contract the disease if expose to it, the populations most vulnerable to the infection are homosexuals, bisexuals and men that have sex with men. The virus produces an exanthem in the skin, which is clinically indistinguishable from other pox-like illnesses, particularly smallpox and chickenpox. Furthermore, clinical findings in recent studies have reported single vesicular lesions in the anogenital areas making the laboratory diagnosis an essential tool to be able to differentiate it from other venereal diseases. Since Human monkeypox is an emergent disease that presents very important epidemiological and clinical features, different from past outbreaks, it is recommended to be in constant communication with the competent health organizations and be aware of changes in case definitions, treatment and diagnostic procedures.

Experimental Frog Virus 3 infection using Brazilian strain: amphibians susceptibility / Infecção experimental utilizando estirpe brasileira de Frog Virus 3: suceptibilidade de anfíbios

An alarming number of global warnings concerning amphibian mortality outbreaks have been released in recent years. Emerging diseases stand out as the main potential causes. Ranavirus is a worldwide-spread highly infectious disease capable of affecting even other ectothermic animals such as fish and reptiles. One major issue regarding this pathology is the lack of clinical signs before it leads up to death. Aiming at having a better understanding of anurans susceptibility, this study analyzed bullfrog (Lithobates catesbeianus) survival rate, when challenged with three doses of a Brazilian strain of Frog Virus 3 (FV3). The qPCR analysis indicated a low infectivity rate in these animals both as larvae and as adults. To elucidate the results, the following hypothesis was performed: 1) The amount of inoculum used on the frogs was insufficient to trigger an infection; 2) For the FV3 to produce clinical signs in this species, there is the need for a cofactor; 3) The animals did undergo FV3 infection but recovered in the course of the experiment, and 4) The inoculum utilized might have been low-virulence. Finally, the presence of actual clinical signs of ranavirus is discussed, with the more likely hypothesis.(AU)

Um número alarmante de notificações globais sobre surtos de mortalidade de anfíbios tem sido realizado nos últimos anos. As doenças emergentes destacam-se como as principais causas potenciais. O ranavírus é uma doença altamente infecciosa disseminada em todo o mundo, capaz de afetar até outros animais ectotérmicos como peixes e répteis. Uma questão importante em relação a essa patologia é a falta de sinais clínicos antes de levar à morte. Com o objetivo de compreender melhor a suscetibilidade dos anuros, o presente trabalho analisou a taxa de sobrevivência de rãs-touro (Lithobates catesbeianus), desafiadas com três doses de uma estirpe brasileira do Frog virus 3 (FV3). A análise de qPCR indicou baixa taxa de infectividade nesses animais, tanto como larvas quanto como adultos. Procurando esclarecer os resultados, foram formuladas as seguintes hipóteses: 1) A quantidade de inóculo aplicada nas rãs foi insuficiente para desencadear uma infecção; 2) Para que o FV3 dê sinais clínicos nesta espécie, é necessário um cofator; 3) Os animais sofreram infecção por FV3, mas se recuperaram no decorrer do experimento, e 4) O inóculo utilizado pode ter sido de baixa virulência. Finalmente, foi discutida a presença de sinais clínicos reais de ranavírus e levantada a hipótese mais provável(AU)

Fiebre causada por el virus Chikungunya, enfermedad emergente que demanda prevención y control / Fever caused by Chikungunya virus, an emergent disease demanding prevention and control

En la región de las Américas, la fiebre causada por el virus chikungunya, ha sido notificada recientemente. Al ser una enfermedad emergente y ante la presencia del mosquito transmisor, el Aedes aegypti, en Cuba y casi toda el área geográfica, resulta necesario su prevención y control, para evitar que se registren brotes de la misma. Se realizó una revisión bibliográfica de los principales artículos publicados sobre el tema, resumiendo los aspectos fundamentales de este problema de salud.

In the region of the Americas, the fever caused by the Chikungunya virus has been notified recently. Being an emergent disease, and because of the presence of the transmitting mosquito, the Aedes aegypti, in Cuba and at around almost all the geographic area, it is necessary its prevention and control, to avoid disease outbreaks. We carried out a bibliographic review of the main articles published on the theme, reviewing the main aspects of this health problem.

Las epidemias de erisipela en Chile / Erysipelas outbreaks in Chile

Historical antecedents of erysipelas outbreaks in Chile, registered by national bibliography at years 1822 and 1873 are reviewed. The first one, after an earthquake, with numerous severe ataxo-adynamic manifestations and the second, more attenuated with few severe cases. Remembers of treatments utilized at XIX Century for the disease and the beginning of sulphamides prescription at the thirty decade are presented. Afterwards penicillin and other antimicrobial agents treatments were implemented. Finally, we comment the severe presentation of soft tissues streptococcal diseases that appeared in the end of XX Century.

Se revisa los antecedentes históricos de las epidemias de erisipela en Chile, que anota la bibliografía nacional, en los años 1822 y 1873. La primera, a continuación de un terremoto, con numerosas formas graves ataxo-adinámicas y la segunda, más benigna, con pocos casos graves. Se recuerda los tratamientos de la enfermedad utilizados en el siglo XIX y la iniciación de los antimicrobianos sulfamidados, en la década de los años 30. Posteriormente penicilina y otros antimicrobianos. Finalmente, se comenta la gravedad emergente de las infecciones estreptocóccicas de tejidos blandos, en los últimos años del siglo XX.

La peste, enfermedad infectocontagiosa reemergente / Re-emergence of the plague: an infectious and contagious disease

La peste es una enfermedad infectocontagiosa reemergente. Su reservorio natural en los vertebrados son los roedores silvestres. Los conejos y las liebres, los carnívoros silvestres y los gatos dométicos también pueden ser fuente de infección para los seres humanos. Es causada por la bacteria Yersinia pestis y transmitida por la pulga Xenopsylla cheopis que afecta tanto a animales como a humanos. Causó una devastadora pandemia que asoló Europa en el siglo XIV. Es una zoonosis muy virulenta y potencialmente letal enfermedad bacteriana. Sigue persistiendo en focos naturales que producen brotes recurrentes en muchos lugares del mundo La peste se contrae de manera natural por la intromisión de las personas en el ciclo zoonótico, o por la introducción de roedores silvestres o sus pulgas infectadas en el habitad de los seres humanos. La prevención y las medidas de control van encaminadas a la disminución y el control de roedores y pulgas

Plague is a re-emergent infectious and contagious disease. Its natural reservoirs in vertebrates are the wild rodents. Rabbits and hares, the wild carnivores and the domestic cats also may be an infection source for human beings. It is caused by Yersinia pestis and transmitted by the flea Xenopsylla cheopis affecting both animals and humans. In Europe during XIX century it caused a devastating pandemic. It is a zoonosis very virulent and a potentially lethal bacterial disease. It persists in natural foci producing recurrent outbreak in many world places. Plague is acquired in a natural way due to interference of people in the zoonosis cycle or due to introduction of wild rodents or their infected fleas in human beings habitat. Prevention and control measures must to be aimed to decrease and the control of rodents and fleas

Comparison of gastropod mollusc (Apogastropoda: Hydrobiidae) habitats in two crater lakes in Nicaragua

The aquatic gastropod mollusc, Pyrgophorus coronatus, may perform an important role in the transmission of an emergent ocular pathology among fishes in Lake Apoyo, Nicaragua. This disease emerged after an introduction of tilapia (Oreochromis niloticus) and the subsequent loss of Chara sp. beds in the lake. We compared the mollusc population densities in three habitats (sandy/muddy substrates, rocks, and Chara vegetation) at varying depths (1.5, 10, 20, and 30 m) in two volcanic crater lakes in Nicaragua: Lake Apoyo and Lake Xiloa. where lower numbers of affected fishes were found and tilapia has not been introduced. Duplicate samples at 1.5 m depth were taken in each habitat monthly for a year, and triplicate samples for bathymetric analysis of snail populations were performed during August, 2005. Samples of fixed surface area were filtered in a 0.4 cm size screen and live snails were counted from each sample. The preferred snail habitat in both lakes, Chara beds, was vastly reduced in Lake Apoyo via consumption by introduced Nile tilapia (Oreochromis niloticus). Structureless sandy substrates (mean +/- standard error 3.1+/-1.3 ind/m2) had lower population densities than other habitats in Lake Xiloa (rocks 590.9+/-185.3 ind/m2; vegetation 3 686.5+/-698.2 ind/m2; ANOVA 1, p<0.01 in both cases) but this difference was attenuated in Lake Apoyo (sand 384.4+/-111.1 ind/m2; rocks 1 480.4+/-384.8 ind/m2: 0.0 1

El gasterópodo acuático, Pyrgophorus coronatus, podría jugar un papel importante en la transmisión de una patología ocular emergente entre los peces de la laguna de Apoyo, Nicaragua. Esta enfermedad surgió después de una introducción de tilapia (Oreochromis niloticus) y la subsecuente pérdida de lechos de Chara sp. en la laguna. Comparamos las densidades poblacionales del caracol en tres hábitats (substratos arenosos/lodosos, rocas y vegetación de Chara) en dos lagunas cratéricas volcánicas en Nicaragua: La laguna de Apoyo y la laguna de Xiloá, donde no se encuentraron grandes cantidades de peces afectados y donde no se han introducido tilapias. Mensualmente, por un año tomamos muestras duplicadas a 1.5 m profundidad mensualmente por un año, y durante agosto de 2005, muestreos triplicados de las poblaciones del molusco, para análisis batimétrico (1.5, 10, 20 y 30 m). Para determinar el número de individuos por unidad de área superficial, las muestras fueron filtradas en un colador de 0.4 cm de apertura de malla y contamos los moluscos vivos en cada muestra. El hábitat preferido de los caracoles en ambas lagunas fue la vegetación de Chara, que en la laguna de Apoyo fue vastamente reducida al ser consumida por las tilapias nilóticas introducidas (Oreochromis niloticus). Los substratos arenosos, menos estructurados que los otros sustratos estudiados, tuvieron densidades poblacionales más bajas (media ± error estándar 3.1±1.3 ind/m2) que en los otros hábitats en la laguna de Xiloá (vegetation 590.9±185.3 ind/m2; rocas 3 686.5±698.2 ind/m2; ANOVA I, p<0.01 en ambos casos) pero esta diferencia fue atenuada en la laguna de Apoyo (arena 384.4±111.1 ind/m2; rocas 1 480.4±384.8 ind/ m2; 0.01

A questão ambiental na promoção da saúde: uma oportunidade de ação multiprofissional sobre doenças emergentes / Environmental issues on health promotion: a multi-professional action on emerging diseases

A discussão sobre a emergência de agravos à saúde coloca todos os profissionais de saúde em alerta. Através de uma revisão sobre os conceitos de doença emergente, relacionando-a com uma situação concreta, a emergência da hantavirose em Santa Catarina, Brasil, constatou-se a necessidade de um enfoque sobre as condições ambientais em tais situações. O melhor conhecimento sobre os fatores ambientais envolvidos e contextualizados torna possível um melhor posicionamento para a elaboração das políticas de controle e prevenção a serem adotadas. Tal posicionamento possibilita a ação multiprofissional, sob a forma de orientação às comunidades, como necessidade de um modelo assistencial diferenciado.

The discussion on the emergence of health injuries preoccupies all health workers. In a review on the concepts of emerging disease, related to a concrete situation, the emergence of the Hantaviruses in the State of Santa Catarina, Brazil, the author highlights the need for focusing on environmental conditions in such situations. The best knowledge on environmental factors makes it possible to elaborate controlling and preventive policies. This enables the multi-professional action in providing community information, as the need for a differentiated assistance model.