Simultaneous Dengue and Chikungunya Coinfection in Endemic Area in Brazil: Clinical Presentation and Implications for Public Health.

Background: Dengue virus (DENV) and Chikungunya virus (CHIKV) pose significant public health threats in Brazil, where favorable conditions facilitated the proliferation of Aedes mosquitoes. Since the mid-1980s, Brazil has experienced annual outbreaks of DENV, with recent increases in confirmed cases. In addition, CHIKV, which was first reported in 2014, has spread across the country. The concurrent presence of these viruses has triggered public health alerts in endemic regions, underscoring the complexity of managing vector-borne diseases. Case Presentation: This report details a case of simultaneous DENV and CHIKV infections. A 77-year-old female patient who has diabetes and arrhythmia exhibited symptoms including fever, myalgia, and severe arthralgia. Laboratory tests confirmed the coinfection through RNA detection. The patient received supportive care, showed gradual improvement, and was eventually discharged. Conclusions: Coinfection with DENV and CHIKV cases reported here developed with mild outcomes. However, one of the patients did not recover from the arthralgia after presenting diagnostic challenges, which underscores the need for accurate differentiation to manage symptoms effectively. The reported cases, amidst increasing DENV outbreaks, highlight the urgency for preparedness in the healthcare system. The Ribeirão Preto region's endemicity for DENV, coupled with the rising incidence of CHIKV, emphasizes the evolving landscape of arbovirus transmission. Studies on Aedes mosquitoes suggest potential implications for human infection dynamics, warranting further investigation into arbovirus transmission efficacy and coinfection dynamics.

Exploring the Chikungunya virus landscape in a dengue-endemic Brazilian area.

We aimed to describe the landscape, including molecular, epidemiological, and clinical aspects of CHIKV infections in the Ribeirao Preto region, an area endemic to dengue. We randomly screened 3744 plasma samples that had undergone DENV diagnosis to evaluate CHIKV-RNA using an in-house RT-PCR assay. Positive samples were followed clinically, and RNA samples were submitted to whole genome sequencing. Seventeen cases (0.5 %) were positive for CHIKV-RNA despite being negative for DENV-RNA. Notably, half of the patients experienced prolonged arthralgia lasting more than 90 days. Compared with the healthy control group, leukopenia and thrombocytopenia were observed in all CHIKV-positive individuals with statistically significant P values (P < 0.0001 and P = 0.0003, respectively). The genomic analysis revealed that the CHIKV strains being studied are classified within the East-Central-South-African (ECSA) genotype. This analysis identified new mutations, E1: K211E and E2: V264A, while the previously known mutation E1: A226V was not detected among these strains. This study highlights the need for epidemiological surveillance and preparedness for potential CHIKV epidemics in Brazil, particularly where other arboviruses co-circulate.

Identificação e condução de manifestação oftálmica de mpox pela vigilância epidemiológica: relato de experiência / Identification and management of ophthalmic manifestation of mpox by epidemiological surveillance: experience report / Identificación y manejo de la manifestación oftálmica del mpox mediante vigilancia epidemiológica: informe de una experiencia

Objetivo: descrever o processo de condução de um caso com manifestação oftálmica pela mpox, destacando o trabalho da enfermagem na prevenção de complicações da doença. Método: relato de experiência da condução de um caso de mpox ocorrido em setembro de 2022 com manifestação oftálmica. Resultados: a pronta identificação da complicação oftálmica, com a presença de conjuntivite e edema palpebral, apresentada por um paciente com suspeita de mpox pela equipe de enfermagem da vigilância epidemiológica durante as ações de monitoramento, e o envolvimento da equipe com outras equipes de diversos níveis da assistência à saúde permitiram a instituição precoce do tratamento com antiviral recomendado pelo Ministério da Saúde, o que contribuiu para um melhor desfecho. Conclusão: é importante que se dissemine o conhecimento sobre as manifestações oftálmicas associadas à mpox para que a equipe de enfermagem, que atua nos diversos níveis de atenção à saúde, esteja atenta para implementar, de forma precoce, medidas de prevenção, diagnóstico e tratamento adequados.

Objective: to describe the process of conducting a case with ophthalmic manifestation by mpox, highlighting the work of nursing in preventing complications of the disease. Method: experience report of managing a case of mpox that occurred in September 2022 with ophthalmic manifestation. Results: the prompt identification of the ophthalmic complication, with the presence of conjunctivitis and eyelid edema, presented by a patient with suspected mpox by the epidemiological surveillance nursing team during monitoring actions and the team's involvement with other teams from different levels of the health care allowed the early initiation of antiviral treatment recommended by the Ministry of Health, which contributed to a better outcome. Conclusion: it is important to disseminate knowledge about ophthalmic manifestations associated with mpox for the nursing team that works at different levels of health care to be attentive to implement preventive measures, diagnosis and adequate and early treatment.

Objetivo: describir el proceso de manejo de un caso con manifestación of- talmológica por mpox, destacando la labor de enfermería en la prevención de complica- ciones de la enfermedad. Material y método: relato de experiencia de manejo de un caso de mpox ocurrido en septiembre de 2022 con manifestación oftálmica. Resultados: la rápida identificación de la complicación oftálmica, con la presencia de conjuntivitis y edema de párpados, presentada por un paciente con sospecha de mpox por el equipo de enfermería de vigilancia epidemiológica durante las acciones de monitoreo y la partici- pación del equipo con otros equipos de diferentes niveles de la asistencia sanitaria per- mitió el inicio precoz del tratamiento antiviral recomendado por el Ministerio de Salud, lo que contribuyó a un mejor resultado. Conclusión: es importante difundir el conoci- miento sobre las manifestaciones oftálmicas asociadas a la viruela del mono para que el equipo de enfermería que actúa en los diferentes niveles de atención a la salud esté atento a implementar medidas preventivas, diagnósticas y de tratamiento adecuado y precoz.

Acidentes de trabalho, riscos ocupacionais e absenteísmo entre trabalhadores de enfermagem hospitalar / Accidentes laborales, riesgos laborales y absentismo entre trabajadores de enfermería hospitalaria / Occupational accidents, occupational risks and absenteeism among hospital nursing workers

Os objetivos deste estudo foram identificar acidentes de trabalho, absenteísmo e relacionar riscos ocupacionais com o absenteísmo referentes a trabalhadores de enfermagem de dois hospitais, na cidade de Ribeirão Preto (SP). O estudo foi descritivo, de abordagem quantitativa, tendo sida a coleta de dados realizada no Centro de Referência de Saúde do Trabalhador, em 2006. Foi utilizado um instrumento para a coleta dos dados sobre a Comunicação de Acidente de Trabalho (CAT). Foram identificados 140 acidentes de trabalho e destes, 85 por cento com mulheres, 81 por cento entre auxiliares de enfermagem e 92 por cento acidentes típicos. Entre os acidentes de trajeto acontecidos, a maioria ocorreu antes do início do turno laboral. Todos estes acidentes geraram 117 dias de afastamento. Na comparação das notificações, o hospital público superou o privado em número de notificações ao longo dos meses.

This study aimed to identify occupational accidents and absenteeism and to relate occupational risks to absenteeism among nursing workers at two hospitals in Ribeirão Preto City (São Paulo State). The study was descriptive and used a quantitative approach. Data were collected in 2006 at a reference center in workers’ health using an occupational accident notification form (Comunicação de Acidente de Trabalho, CAT). Of the 140 occupational accidents identified, 85 percent involved women, 81 percent nursing assistants and 92 percent were typical accidents. Among the commuting accidents, most occurred before the duty shift. In all, these accidents caused 117 days’ absence. When comparing notifications, the public hospital was found to surpass the private hospital in number of notifications over several months.

Este estudio tiene como objetivos la identificación de accidentes de trabajo, absentismo y relaciona riesgos laborales con el absentismo, refiriéndose a trabajadores de enfermería de dos hospitales, en la ciudad de Ribeirao Preto (SP)-Brasil. El estudio fue descriptivo de enfoque cuantitativo. La recogida de datos se realizó en el Centro de Referencia de Salud del Trabajador, en 2006. Fue utilizado un instrumento para recoger datos sobre Comunicación de Accidentes de Trabajo (CAT). Fueron identificados 140 accidentes de trabajo y de estos, 85 por ciento con mujeres, 81 por ciento entre auxiliares de enfermería y 92 por ciento accidentes típicos. Entre los accidentes ocurridos, la mayoría acaeció antes del comienzo del turno de trabajo. Todos estos accidentes causaron 117 días de ausencia. Al comparar las notificaciones, el hospital público superó el número de notificaciones del privado a lo largo de los meses.