Mucormycosis: A Rare disease to Notifiable Disease.

Mucormycosis is the third most frequent invasive mycosis, following candidiasis and aspergillosis. It is frequently neglected due to its rare occurrence; but recently attend the status of notifiable disease due to its higher incidence in both developed and developing nations. India has received global notice since its estimated instances were greater than the global estimated figures. Mucormycosis has several clinical manifestations, including rhino-orbital-cerebral (ROCM), pulmonary, gastrointestinal, cutaneous, renal, and diffuse Mucormycosis. ROCM is the most frequent clinical manifestation in India, although pulmonary mucormycosis is prevalent worldwide. This review also discusses host defenses, pre disposing risk factors and fungal virulence factors that impair host's ability to prevent fungus invasion and disease establishment. The diagnosis of the disease depends on clinical interventions, histological or microbiological procedures along with molecular methods to obtain timely results. But there are still unmet challenges for rapid diagnosis of the disease. Treatment of the disease is achieved by multimodal approaches such as reversal of underlying predisposing factors, rapid administration of antifungals in optimal doses and surgical procedures to remove infected tissues. Liposomal Amphotericin B, Posaconazole and Isavuconazoles are preferred as the first line of treatment procedures. clinical trials. Different studies have improved the existing drug and under clinical trials while several studies predicted the new potential targets as CotH and Ftr1 as shown in infection and in vitro models. Therefore, current scenario demands a multidisciplinary approach is needed to investigate the prevalence, pathogenesis which is highly important for the advancement of rapid diagnosis and effective treatment.

Text mining analysis to understand the impact of online news on public health response: case of syphilis epidemic in Brazil.

Background: To effectively combat the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) created a National Rapid Response to Syphilis with actions aimed at bolstering epidemiological surveillance of acquired, congenital syphilis, and syphilis during pregnancy complemented with communication activities to raise population awareness and to increase uptake of testing that targeted mass media outlets from November 2018 to March 2019 throughout Brazil, and mainly areas with high rates of syphilis. This study analyzes the volume and quality of online news content on syphilis in Brazil between 2015 and 2019 and examines its effect on testing. Methods: The collection and processing of online news were automated by means of a proprietary digital health ecosystem established for the study. We applied text data mining techniques to online news to extract patterns from categories of text. The presence and combination of such categories in collected texts determined the quality of news that were analyzed to classify them as high-, medium-and low-quality news. We examined the correlation between the quality of news and the volume of syphilis testing using Spearman's Rank Correlation Coefficient. Results: 1,049 web pages were collected using a Google Search API, of which 630 were categorized as earned media. We observed a steady increase in the number of news on syphilis in 2015 (n = 18), 2016 (n = 26), and 2017 (n = 42), with a substantial rise in the number of news in 2018 (n = 107) and 2019 (n = 437), although the relative proportion of high-quality news remained consistently high (77.6 and 70.5% respectively) and in line with similar years. We found a correlation between news quality and syphilis testing performed in primary health care with an increase of 82.32, 78.13, and 73.20%, respectively, in the three types of treponemal tests used to confirm an infection. Conclusion: Effective communication strategies that lead to dissemination of high quality of information are important to increase uptake of public health policy actions.

Use of Interrupted Time Series Analysis in Understanding the Course of the Congenital Syphilis Epidemic in Brazil.

Background: To fight against the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) launched the "Syphilis No!" Project (SNP), with specific resources funded by a parliamentary amendment. Then, in 2018, a national rapid response started to be implemented on the Brazilian Unified Health System (SUS, Sistema Único de Saúde) in two strategic lines (1) to reinforce SUS's universal actions and (2) to implement specific ones to 100 municipalities chosen by the MoH as priorities for syphilis congenital response. In 2015, such localities represented 6895% of congenital syphilis cases in Brazil. In this context, SNP has implemented actions to strengthen epidemiological surveillance of acquired syphilis and congenital syphilis by instituting an integrated and collaborative response through health services networks and reinforcing interstate relations. Methods: A quasi-experimental study using time series analysis was conducted to assess immediate impacts and changes to the trend in national congenital syphilis before and after the project, from September 2016 to December 2019. Data were assessed considering rates of congenital syphilis per 1,000 live births in all priority municipalities (n=100) covered by the project and in non-priority municipalities (n=5,470) from all five macro-regions of Brazil. Findings: Priority municipalities showed a greater reduction (change in trend) in comparison to non-priority. The linear regression model revealed trend changes after the intervention, with both groups of municipalities showing a drop in the average monthly number of cases per 1,000 live births, with a reduction of -0·21 (CI 95% -0·33 to -0·09; p=0·0011) in priority municipalities and of -0·10 (CI 95% -0.19 to -0.02; p=0·0216) in non-priority municipalities. Interpretation: The study using ITS provides important evidence on the direction, timing, and magnitude of the effects of interventions introduced as part of the SNP on congenital syphilis in Brazil. Our results suggest that the Syphilis No! Project influenced the trends of congenital syphilis in Brazil from 2018, with higher reductions achieved in the priority municipalities. Funding: The research is funded by a grant to the Syphilis No! Project from Brazilian Ministry of Health (Project Number: 54/2017). The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

Morbilidad por infecciones de partes blandas superficiales en el servicio de clínicas pediátricas de Manzanillo, Granma 2018 / Morbidity caused by soft tissue infections in the services of pediatric clinic in Manzanillo, Granma, 2018

RESUMEN Introducción: Las infecciones de la piel y partes blandas son frecuentes en los niños, con un amplio espectro de gravedad. Objetivo: Describir las características clínico-epidemiológicas de los pacientes con infecciones de partes blandas superficiales hospitalizados en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové". Método: Se realizó un estudio observacional, descriptivo y transversal en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", de Manzanillo durante el 2018.Se estudiaron todos los pacientes egresados (n=298) con el diagnóstico confirmado de este tipo de infecciones. Se tomaron en cuenta las siguientes variables: localización anatómica, clasificación del tipo deinfección de piel y tejidos blandos, terapéutica utilizada y estadía hospitalaria. Resultados: Predominó el sexo masculino (57,7 %) y el grupo de edad de 10-14 años (34,9 %). Las infecciones en las extremidades estuvieron presentes en 113 pacientes (37,9 %). El impétigo fue la entidad clínica más frecuente (42,3 %), la cefazolina fue el antibiótico más utilizado (77,2 %). Se observó que la mayoría de los pacientes (293) solo permaneció hasta 7 días ingresados, con una evolución satisfactoria. Conclusiones: En el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", los pacientes con IPTB se caracterizan por ser sobre todo varones, más comúnmente con edad entre 10 y 14 años, las lesiones predominaron en las extremidades y la más común fue el impétigo. La cefazolina resultó eficaz para el tratamiento estas infecciones, lo que hizo posible que la estadía hospitalaria generalmente no excediera de siete días.

ABSTRACT Introduction: Infections in the skin and soft tissues are common health concerns in children, with a wide range of severity from patient to patient. Objective: To describe the clinical-epidemiological characteristics of the patients with soft tissue infections hospitalized in the Pediatric Teaching Hospital "Hermanos Cordové". Method: An observational, descriptive, cross-sectional study was carried out in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové", in Manzanillo, Cuba, during the year 2018. All discharged patients who had a confirmed diagnosis of this type of infection were studied (n=298). The following variables were taken into account: anatomical location, classifications of the different types of skin and soft tissue infections, treatment used and hospitalization. Results: Male gender prevailed in the patients (57.7 %), and also the ages ranging between 10 to 14 years old (34.9 %). Infections located on the limbs were described in 113 patients (37.9 %). Impetigo was the most common diagnosis (42.3 %), and the most frequently used antibiotic was cefazolin (77.2 %). Most of the patients were hospitalized up to 7 days (293), with a satisfactory evolution of the disease. Conclusions: Patients with soft tissue infections in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové" are mainly characterized for being male, especially from ages raging between 10 to 14 years old, with impetigo being the most common infection, mostly located on the limbs. Cefalozin resulted very effective for the treatment of these infections, making possible the hospitalization time to be lesser than a week.

Burkholderia mallei isolation from milk of a mare and evidence of congenital transmission of glanders in equids: case reports / Isolamento de Burkholderia mallei de leite de égua e evidência de transmissão congênita de mormo em equinos: relatos de casos

This is the first report of Burkholderia mallei isolation in milk from a mare diagnosed with glanders and of transplacental transmission of the bacteria in a seropositive pregnant mare, both from São Paulo State, Brazil, 2016 and 2019. After necropsy, the horses were evaluated for macroscopic lesions, and organ samples were removed for histological, bacteriological, and molecular analysis. B.mallei was identified in milk samples by culture isolation and PCR, whereas in the fetus of the pregnant mare by PCR of the stomach fluid. These findings will contribute to the epidemiological knowledge of glanders life cycle in Brazil.(AU)

Este é o primeiro relato de isolamento de Burkholderia mallei no leite de uma égua com diagnóstico de mormo e de transmissão transplacentária da bactéria em uma égua prenhe soropositiva, ambas do Estado de São Paulo, Brasil, 2016 e 2019. Após a necropsia, os cavalos foi verificada a presença de lesões macroscópicas e amostras de órgãos foram coletadas para posterior análise histológica, bacteriológica e molecular. B.mallei foi identificada em amostras de leite por isolamento bacteriano e PCR, enquanto no feto de égua prenhe por PCR do fluido estomacal. Esses achados contribuirão para o conhecimento epidemiológico do ciclo de vida do mormo no Brasil.(AU)

Burkholderia mallei isolation from milk of a mare and evidence of congenital transmission of glanders in equids: case reports / Isolamento de Burkholderia mallei de leite de égua e evidência de transmissão congênita de mormo em equinos: relatos de casos

This is the first report of Burkholderia mallei isolation in milk from a mare diagnosed with glanders and of transplacental transmission of the bacteria in a seropositive pregnant mare, both from São Paulo State, Brazil, 2016 and 2019. After necropsy, the horses were evaluated for macroscopic lesions, and organ samples were removed for histological, bacteriological, and molecular analysis. B.mallei was identified in milk samples by culture isolation and PCR, whereas in the fetus of the pregnant mare by PCR of the stomach fluid. These findings will contribute to the epidemiological knowledge of glanders life cycle in Brazil.

Este é o primeiro relato de isolamento de Burkholderia mallei no leite de uma égua com diagnóstico de mormo e de transmissão transplacentária da bactéria em uma égua prenhe soropositiva, ambas do Estado de São Paulo, Brasil, 2016 e 2019. Após a necropsia, os cavalos foi verificada a presença de lesões macroscópicas e amostras de órgãos foram coletadas para posterior análise histológica, bacteriológica e molecular. B.mallei foi identificada em amostras de leite por isolamento bacteriano e PCR, enquanto no feto de égua prenhe por PCR do fluido estomacal. Esses achados contribuirão para o conhecimento epidemiológico do ciclo de vida do mormo no Brasil.

Uncovering the spatial pattern of invasion of the honeybee pest small hive beetle, Aethina tumida, in Italy

ABSTRACT The fast tracking of invasion spatial patterns of alien species is crucial for the implementation of preventive and management strategies of those species. Recently, a honeybee pest, the small hive beetle Aethina tumida (hereafter SHB), has been reported in Italy, where it colonized more than 50 apiaries in an area of about 300 km2. SHB is a nest parasite and scavenger of honeybee colonies native of Sub-Saharian Africa. Likely being helped by the globalization of apiculture, SHB underwent several invasions in the last twenty years, causing locally relevant economic impact. While many features of its biology have been addressed, an important knowledge gap concerns the spatial invasion dynamics in invaded areas. In this paper we coupled two spatial analysis techniques (geographic profiling and a density-based spatial clustering algorithm) to uncover the possible invasion pattern of SHB in Italy. We identified the port town of Gioia Tauro as the most likely point from which SHB may have spread and suggested the possible successive axes of diffusion. These putative diffusion paths suggest that the SHB spread in south Italy might have been due to a mix of natural dispersal between close apiaries and longer distance movement through faster, likely human-mediated, communication routes.

Intoxicações por agrotóxicos no estado do Tocantins: 2010­2014 / Intoxications by pesticides in the State of Tocantins: 2010­2014

Introdução: O Brasil é o maior consumidor mundial de agrotóxicos, que é um sério problema de saúde pública pela exposição da população e do ambiente a estes produtos. Objetivo: Caracterizar as intoxicações por agrotóxicos no Tocantins no período 2010­2014. Método: Estudo descritivo e exploratório, tendo como fonte de dados secundários o Sistema de Informação de Agravos de Notificação (SINAN), utilizando-se variáveis selecionadas. Resultados: No total das intoxicações exógenas, o sexo feminino é o mais afetado e nas intoxicações, já por agrotóxicos, é o masculino, principalmente a categoria ocupacional dos "trabalhadores da agropecuária diversos". As faixas etárias mais atingidas por agrotóxico de uso agrícola são: 20­29 anos e 30­39 anos. Os agentes tóxicos mais referidos foram os inseticidas (29,28%) e os herbicidas (27,07%). As atividades mais frequentes foram a pulverização (29,28%) e a diluição (15,47%); e as principais vias de exposição/contaminação foram a digestiva e a respiratória. Quanto à exposição/contaminação, as mais presentes foram a acidental (49,17%), a tentativa de suicídio (32,60%) e a ambiental (14,64%). Conclusões: Os dados revelam uma situação preocupante que demanda atenção dos gestores no enfrentamento deste problema de saúde pública. Esse cenário é desafiador especialmente no componente assistencial, nas vigilâncias sanitárias, epidemiológica e em saúde ambiental e do trabalhador.

Introduction: Brazil is the world's largest consumer of agricultural pesticides. That represents a serious public health problem caused by the population and environment exposure to those products. Purpose: To identify intoxications by agricultural pesticides in Tocantins during the years 2010­2014. Method: descriptive and exploratory study, having as a secondary data source the Notifiable Disease Information System (SINAN), making use of selected variables. Results: In the total, women are shown as the most affected by exogenous intoxications and men by agriculture pesticides, mainly the general farmer workers. The age groups most affected by agriculture pesticides are 20-29 years and 30-39 years. The most commonly reported toxic agents were insecticides (29.28%) and herbicides (27.07%). The most frequent activities were spraying (29.28%) and dilution (15.47%) and the main routes of exposure/contamination were the digestive and respiratory ones. In terms of exposure/contamination the accidental (49.17%), suicide attempt (32.60%) and environmental (14.64%) were the most present ones. Conclusions: The data reveal a serious picture that requires attention from the managers in facing that public health problem. This scenario represents a great and challenging issue for Brazil, the public health system ­ SUS, especially concerning health care, sanitary and epidemiological surveillance and environmental and worker health.