Virus Mayaro, un alphavirus olvidado en Colombia: posible efecto sobre la salud pública / Mayaro virus, an alphavirus forgotten in Colombia: possible effect on public health

Sobre el Mayaro virus poco se conoce sobre su transmisión y patogénesis. Se sabe que habita en diferentes zonas del hemisferio occidental y que es transmitido por los Aedes aegypti y albopictus (Diptera: Culicidae). Ya se han investigado escenarios donde su circulación puede superponerse y generar infecciones mixtas, y por ello ha ganado importancia en la salud pública, puesto que puede ocasionar alto riesgo de brotes con manifestaciones clínicas graves similares a la de los virus Zika, Chikungunya y el Dengue países como Trinidad, Brasil, México, Venezuela, Honduras, Salvador, Costa Rica, Panamá, Perú, Argentina, Surinam, Guyana, Venezuela, Ecuador y Bolivia. Colombia está expectante de una aparición concomitante junto con ZIKV y CHIKV. Se realizó una búsqueda exhaustiva en PubMed, Science Direct, Clinical Key y Ebsco sobre el Mayaro virus, epidemiología, su estructura molecular, ciclo de transmisión, sintomatología clínica, métodos diagnósticos, factores de riesgo, control y prevención, así como tratamiento actual, para conocer un panorama más amplio sobre su problemática..(Au)

About Mayaro virus, there is currently little knowledge of its transmission and pathogenesis. It is known to inhabit different areas of the Western Hemisphere and is transmitted by the Aedes aegypti and albopictus (Diptera: Culicidae). Numerous authors have focused their research given coexistence in scenarios where the circulations of all these viruses can somehow overlap and generate mixed infections. This agent has been gaining prominence at the public health level, due to the possibility of causing high risk of outbreaks with serious clinical manifestations similar to that of Zika viruses, Chikungunya virus and Dengue, in several countries, such as Trinidad, Brazil, Mexico, Venezuela, Honduras, Salvador, Costa Rica, Panama, Peru, Argentina, Suriname, Guyana, Venezuela, Ecuador and Bolivia. Colombia is looking forward to a concomitant onset in the near future along with ZIKV and CHIKV. Taking into account the above, a thorough search was carried out of the existing literature, on Mayaro virus, its molecular structure, transmission cycle, clinical symptomatology, diagnostic methods, risk factors, control and prevention, as well as treatment, to learn a broader picture of the problem that lurks. All this, through search engines like PubMed, Science Direct, Clinical Key and Ebsco..(Au)

Molecular and cellular evidence of natural Venezuelan equine encephalitis virus infection in frugivorous bats in Colombia.

BACKGROUND AND AIM: Venezuelan equine encephalitis virus (VEEV) is an alphavirus that causes encephalitis with a high impact on public health in Latin America. However, only in Guatemala, Trinidad and Tobago, and Mexico have found antibodies in VEEV in bats, using immunohistochemistry, the sensitivity and specificity are improved; thus, it is better for demonstrating natural infection in bats as potential hosts. This study aimed to determine the presence of VEEV in tissues of frugivorous bats. MATERIALS AND METHODS: A prospective descriptive cross-sectional study with a non-probabilistic sampling was carried out in 12 localities of Córdoba and Sucre area of the Colombian Caribbean. Two hundred and eighty-six bats were captured using fog nets, and the specimens according to taxonomic keys were classified. According to the Ethics Committee of the University of Córdoba, the bats were treated with analgesics and anesthetics. Blood samples were taken and then euthanized to obtain tissues and organs which were preserved in liquid N2 at -196°C. A portion of each organ was fixed in 10% buffered formalin for the detection of antigens by immunohistochemistry. Several pathological anatomy analyses were performed to determine the histological characteristics of tissue lesions of frugivorous bats naturally infected with the VEEV. RESULTS: Of the 286 bats captured, 23 species were identified. In samples of the brain, spleen, and lung of two frugivorous bats (2/286=0.70%) Artibeus planirostris and Sturnira lilium, the presence of VEEV was confirmed by immunohistochemistry. CONCLUSION: A fragment of the nsP4 non-structural protein gene corresponding to the alphavirus was amplified. Two samples were positive (2/286=0.70%) in frugivorous bats; A. planirostris (code GenBank: MG820274) and S. lilium (code GenBank: MG820275). The present study showed the first molecular evidence and cellular evidence (histopathology and immunohistochemistry) of natural VEEV infection in frugivorous bats in Colombia; these bats could be a host of this zoonosis.

Atypical clinical presentation of flavivirus. Case report / Presentación clínica atípica de infección por flavivirus. Reporte de caso

The first report of chikungunya virus (CHIKV) in Mexico was in may 2014, in Jalisco, and has disseminated along the country in such a way that now is considered a relevant emergent vector-transmitted infection. It is clinically diagnosed by abrupt onset fever, asthenia, arthralgias, myalgias, headache and rash. In the clinical case, we described a women from Guerrero that had pulmonary symptomatology associated to CHIKV, which is an atypical clinical presentation that has been reported only in a hundred cases worldwide. In the epidemiological context the only known tool that we have to prevent the disease is the eradication of vectors because we lack population immunity, thus the importance of avoiding water accumulation and using protective gear. In Mexico we are acting through media advertisements in order to avoid, in first place the acute infection, which in severe cases can cause death, and in second place the chronic complications.

El primer caso de infección por virus chikunguña (CHIKV) en México ocurrió en Jalisco, en mayo de 2014 y se ha ido diseminando a lo largo del país, por lo que hoy en día se considera una infección emergente transmitida por vectores. Se caracteriza por fiebre de inicio abrupto, astenia intensa, artralgias múltiples, simétricas, bilaterales y debilitantes, de predominio en brazos y piernas, mialgias, cefalea y rash maculopapular. En el caso expuesto describimos a una mujer originaria del estado de Guerrero, la cual presentó sintomatología pulmonar asociada a infección por CHIKV, lo que representa una manifestación atípica de esta enfermedad, ya que solo ha sido reportada en cerca de 100 casos a nivel mundial. En el contexto epidemiológico se sabe que la única herramienta que se tiene disponible en estos momentos es la erradicación de los vectores que promueven su transmisión, ya que carecemos de inmunidad poblacional, por lo que es de vital importancia evitar el estancamiento de agua y alentar el uso de ropa de protección. Por último, se debe hacer énfasis en la forma en la que se actúa en México, por medio de la difusión de información, para evitar, en primer lugar, la infección aguda que puede llevar a la muerte en casos extremos, y en segundo término, salvar las complicaciones crónicas.

[First case of chikungunya fever in Hermosillo, Sonora, Mexico]. / Primer caso de fiebre chikunguña en Hermosillo, Sonora, México.

The Chikungunya is an arbovirus first described during a 1952 outbreak of febrile exantematic disease in southern Tanganyika (now Tanzania). It is a virus within the alphavirus genus of the Togaviridae family, it is usually transmitted to humans by Aedes mosquitoes. Typically, the disease manifests as acute onset of fever and joint pains. This study describes the clinical characteristics the first imported case infected with chikungunya fever (CHIK) in Hermosillo, Sonora, Mexico. We report the case of a 30 years old man seen in our emergency department due to fever, polyarthralgia, rash and headache. This patient has been in Tapachula, Chiapas, a jungle area in southern México, and he returned from a 45 days trip before the onset his symptoms. The chikungunya viral infection (CHIK) was diagnosed by RT-PCR procedure. Paracetamol therapy was administered and his clinical course was self-limited. We concluded that with the increase of mosquito´s habitat by global warming and frequent traveling, CHIK reemerged and showed global distribution recently. This disease must be suspected in patients with compatible clinical symptoms returning from epidemic/endemic areas. CHIK must be diagnosed on the basis of clinical, epidemiological and laboratory criteria.

El virus de chikunguña es un arbovirus descrito en 1952 durante un brote de enfermedad febril exantemática en Tangañica. Es un virus del genero alfavirus, de la familia Togaviridae, transmitido a los humanos por los mosquitos Aedes. Típicamente la enfermedad se caracteriza por fiebre de inicio súbito y artralgias. Este estudio describe las características clínicas del primer caso importado con fiebre chikunguña (CHIK) en Hermosillo, Sonora, México. Se presenta el caso de un paciente de 30 años de edad, atendido en el servicio de Urgencias por fiebre, poliartralgias, cefalea y exantema. El paciente había visitado la ciudad de Tapachula, Chiapas por un período de 45 días antes del inicio de sus síntomas. La CHIK fue confirmada mediante RT-PCR, por lo que fue tratado con paracetamol; su evolución clínica fue satisfactoria y autolimitada. Con el incremento del hábitat del vector debido al calentamiento global y a la mayor frecuencia de viajes, se ha registrado una reemergencia global de la CHIK. Este padecimiento debe sospecharse en pacientes con características clínicas sugestivas que regresan de áreas epidémicas/endémicas. El diagnóstico de CHIK requiere el sustento de los datos clínico-epidemiológicos y del criterio por laboratorio.

Chikungunya risk for Brazil / Risco do chikungunya para o Brasil

This study aimed to show, based on the literature on the subject, the potential for dispersal and establishment of the chikungunya virus in Brazil. The chikungunya virus, a Togaviridae member of the genusAlphavirus, reached the Americas in 2013 and, the following year, more than a million cases were reported. In Brazil, indigenous transmission was registered in Amapa and Bahia States, even during the period of low rainfall, exposing the whole country to the risk of virus spreading. Brazil is historically infested by Ae. aegypti and Ae. albopictus, also dengue vectors. Chikungunya may spread, and it is important to take measures to prevent the virus from becoming endemic in the country. Adequate care for patients with chikungunya fever requires training general practitioners, rheumatologists, nurses, and experts in laboratory diagnosis. Up to November 2014, more than 1,000 cases of the virus were reported in Brazil. There is a need for experimental studies in animal models to understand the dynamics of infection and the pathogenesis as well as to identify pathophysiological mechanisms that may contribute to identifying effective drugs against the virus. Clinical trials are needed to identify the causal relationship between the virus and serious injuries observed in different organs and joints. In the absence of vaccines or effective drugs against the virus, currently the only way to prevent the disease is vector control, which will also reduce the number of cases of dengue fever.

o objetivo deste estudo foi mostrar, com base na literatura sobre o tema, o potencial de dispersão e estabelecimento do vírus chikungunya no brasil. O vírus chikungunya, um Togaviridae do gênero Alphavirus, atingiu as Américas em 2013 e, no ano seguinte, mais de um milhão de casos foram notificados. No Brasil, foi registrada transmissão autóctone no Amapá e Bahia, mesmo durante o período de baixo índice pluviométrico, expondo ao risco de propagação do vírus todo o território nacional. Historicamente, o Brasil é infestado por Ae. Aegypti e Ae. Albopictus, também vetores do dengue. É possível que o chikungunya se dissemine, sendo importante que medidas sejam tomadas para evitar que o vírus se torne endêmico no País. A adequada assistência a pacientes com febre de chikungunya requer treinamento de clínicos, reumatologistas, enfermeiros e especialistas em diagnóstico laboratorial. Até novembro de 2014 foram notificados no Brasil mais de 1.000 casos da virose. Estudos experimentais em modelos animais devem ser realizados para conhecer a dinâmica da infecção e a patogenia, bem como identificar mecanismos fisiopatológicos que possam contribuir para identificar drogas com efeito sobre o vírus. São necessários ensaios clínicos para identificar a relação causal do vírus com sérias lesões observadas em diferentes órgãos e nas articulações. Na ausência de vacinas ou drogas efetivas contra o vírus, a única forma de prevenir a doença é atualmente o controle vetorial, o que também reduzirá o número de casos de dengue.