Febre Amarela: Representação Imagética de uma Epidemia no Rio De Janeiro no Século XIX / Fiebre Amarilla: Representación en imágenes de una epidemia en el Río de Janeiro del Siglo XIX / Yellow Fever: Imagetic Representation of an Epidemic in Rio De Janeiro in the 19th Century

Objetivo: analizar la imagen sobre la epidemia de Fiebre Amarilla en Río de Janeiro, en1850. Metodología: Se trata de un estudio en la perspectiva histórica, con base en análisis culturaly em imaginería. La fuente histórica fue la imagen de la décima tirada de la Revista Illustrada, en1876. Resultados: La imagen publicada el día 04 de marzo de 1876, en la página 07 del número10 del Año 01 de la Revista Ilustrada, denominada "Epidemia de la Fiebre Amarilla" como unbrote que causó altas tasas de mortalidad, representaciones sobre la dinámica de la epidemia, lamuerte, y la participación de Oswaldo Cruz en este contexto. Conclusiones: Las representaciones,en conjunto, demostraron la desesperación con la enfermedad, la muerte como desenlace de estaepidemia y acción sanitaria, pero también la esperanza y salvación por medio de la vacuna comodesdoblamiento de este brote.(AU)

Objective: to analyze the image about the Yellow Fever epidemic in Rio de Janeiro in 1850.Methodology: This is a historical perspective, based on cultural and imagery analysis. Thehistorical source was the image of the tenth issue of Illustrada Magazine, in 1876. Results: Theimage published on March 4, 1876, on page 07 of the number 10 of Year 01 of Revista Ilustrada,denominated "Yellow Fever Epidemic" translates as an outbreak that caused high mortality rates,representations on the dynamics of the epidemic, death, and Oswaldo Cruz's participation in thiscontext. Conclusions: The representations, together, demonstrated the despair with the disease, thedeath as an outcome of this epidemic and sanitary action, but also the hope and salvation throughthe vaccine as a result of this outbreak.(AU)

Objetivo: analisar a imagem sobre a epidemia de Febre Amarela no Rio de Janeiro, em1850. Metodologia: Trata-se de um estudo na perspectiva histórica, com base em análise culturale imagética. A fonte histórica foi a imagem da décima tiragem da Revista Illustrada, em 1876.Resultados: A imagem publicada no dia 04 de março de 1876, na página 07 do número 10 do Ano01 da Revista Ilustrada, denominada “Epidemia da Febre Amarela” traduz como um surto quecausou altas taxas de mortalidade, representações sobre a dinâmica da epidemia, a morte, e aparticipação de Oswaldo Cruz neste contexto. Conclusões: As representações, em conjunto,demonstraram o desespero com a doença, a morte como desfecho desta epidemia e ação sanitária,mas também a esperança e salvação por meio da vacina como desdobramento deste surto.(AU)

Posterior auricular lymphadenopathy in adult rubella.

•During 2012-2013 and 2018-2019, Japan had rubella large outbreaks.•Posterior auricular lymphadenopathy is one of the classical symptoms of rubella.•Clinicians need to pay attention to the lymphadenopathy, as well as fever and rash.

Mathematical Model of the Role of Asymptomatic Infection in Outbreaks of Some Emerging Pathogens.

Preparation for outbreaks of emerging infectious diseases is often predicated on beliefs that we will be able to understand the epidemiological nature of an outbreak early into its inception. However, since many rare emerging diseases exhibit different epidemiological behaviors from outbreak to outbreak, early and accurate estimation of the epidemiological situation may not be straightforward in all cases. Previous studies have proposed considering the role of active asymptomatic infections co-emerging and co-circulating as part of the process of emergence of a novel pathogen. Thus far, consideration of the role of asymptomatic infections in emerging disease dynamics have usually avoided considering some important sets of influences. In this paper, we present and analyze a mathematical model to explore the hypothetical scenario that some (re)emerging diseases may actually be able to maintain stable, endemic circulation successfully in an entirely asymptomatic state. We argue that an understanding of this potential mechanism for diversity in observed epidemiological dynamics may be of considerable importance in understanding and preparing for outbreaks of novel and/or emerging diseases.

Caracterización clinicoepidemiológica de pacientes con dengue ingresados en el Instituto de Medicina Tropical Pedro Kourí / Clinical epidemiological characterization of patients with dengue admitted to Pedro Kourí Tropical Medicine Institute

Introducción: El dengue es una infección viral endémica reemergente de notable preponderancia por su morbilidad y mortalidad, cuya incidencia se ha multiplicado en las últimos tiempos a nivel internacional. Objetivos: Caracterizar a pacientes con dengue según la clasificación revisada de la Organización Mundial de la Salud y determinar la correspondencia entre esta y la clasificación tradicional respecto a la gravedad de los casos. Métodos: Se realizó un estudio descriptivo y transversal en el Instituto de Medicina Tropical Pedro Kourí de La Habana durante el 2012, en el que se revisaron 247 historias clínicas seleccionadas por muestreo aleatorio estratificado. Resultados: En la casuística predominaron el dengue con signos de alarma, el grupo etario de 40-59 años, el sexo femenino y el síndrome de choque por dengue como principal forma clínica de gravedad. La fiebre estuvo presente en todos los afectados; también sobresalieron la cefalea, la astenia, las artromialgias, la exantema y el dolor retroocular. La leucopenia y la trombocitopenia constituyeron hallazgos muy frecuentes, al igual que la citólisis hepática; en tanto, las manifestaciones digestivas y hemorrágicas, entre otras, se asociaron significativamente con el desarrollo de dengue grave. Conclusiones: Se evidenció que utilizando la clasificación tradicional se hubiesen dejado de identificar y tratar adecuadamente a pacientes con dengue grave y dengue con signos de alarma, al catalogarse la mayoría de estos como fiebre del dengue, subestimando así la gravedad clínica de dichos casos.

Introduction: Dengue is a viral endemic reemerging infection of remarkable preponderance for its morbidity and mortality whose incidence has multiplied in the last times at international level. Objectives: To characterize patients with dengue according to the classification reviewed by the Health World Organization and to determine the correspondence between this and the traditional classification regarding the seriousness of the cases. Methods: A descriptive and cross-sectional study was carried out at Pedro Kourí Tropical Medicine Institute in Havana during 2012, in which 247 medical records were reviewed selected by stratified random sampling. Results: In the case material there was a prevalence of dengue with alarm signs, 40-59 age group, female sex and the shock syndrome due to dengue as the main clinic form of seriousness. The fever was present in all those affected; migraine, asthenia, artromialgias, exanthema and retroocular pain were also outstanding. The leukopenia and thrombocytopenia constituted very frequent findings, the same as hepatic cytolysis; as long as, the digestive and hemorrhagic manifestations, among others, were significantly associated with the development of serious dengue. Conclusions: It was evidenced that using the traditional classification the identification and appropriate treatment to patients with serious dengue and dengue with alarm signs would not be possible, when being classified most of these as fever of the dengue, underestimating this way the clinical seriousness of these cases.

Rift Valley Fever Reemergence after 7 Years of Quiescence, South Africa, May 2018.

Phylogenetic analysis of Rift Valley fever virus partial genomic sequences from a patient infected in South Africa in May 2018 suggests reemergence of an endemic lineage different from that of the epidemic in South Africa during 2010-2011. Surveillance during interepidemic periods should be intensified to better predict future epidemics.

Signos de alarma en pacientes cubanos con dengue según nueva clasificación revisada de la Organización Mundial de la Salud / Warning signs in Cuban patients with dengue fever according to new reviewed classification of the World Health Organization

Se realizó un estudio observacional, descriptivo y transversal en el Instituto de Medicina Tropical Pedro Kourí de La Habana, donde estuvieron ingresados 485 pacientes desde enero hasta diciembre de 2012 con diagnóstico de infección por dengue, de los cuales se escogió una muestra de 247. Entre los signos de alarma más comunes sobresalieron la cifra ascendente del hematocrito (54,6 por ciento y el dolor abdominal intenso o mantenido o de ambos tipos (46,1 por ciento . Las señales de alarma aparecieron por lo general al ceder la fiebre; del total de pacientes que las presentaron en algún momento de su evolución, 81,2 por ciento fueron tratados con hidratación intravenosa precoz y ninguno evolucionó hacia la forma grave de la enfermedad. La terapia hidratante parenteral se inició tardíamente en 18,8 por ciento de los afectados, incluidos todos aquellos en estado grave.

An observational, descriptive and cross sectional study was carried out in Pedro Kourí Tropical Medicine Institute from Havana, where 485 patients were admitted from January to December, 2012 with diagnosis of infection due to dengue fever, from whom a sample of 247 was chosen. Among the most common warning signs there were the increasing values of hematocrit (54.6 percent), and the intense or sustained abdominal pain or both types (46.1 percent). The warning signs generally appeared when fever ceased, and of the total of patients that presented it, 81.2 percent at some moment of their clinical course were treated with early intravenous hydration, and none developed the serious form of the disease. The parenteral hydration therapy began belatedly in 18.8 percent of the affected, including all those in severe state.

An overview of pertussis reemergence and evidence of ITS resurgence in Brazil

About two thousand cases of pertussis are reported in Brazil each year, with the highest incidence and mortality rates occurring in children under one year old. The disease is becoming common in Brazil; however the state of Rio de Janeiro has been showing low reporting figures in relation to other states in the Southeast region. This research work aimed to evaluate the difficulties faced by medical teams when confirming suspect cases of pertussis in healthcare units throughout the state of Rio de Janeiro and to use available data to confirm pertussis diagnosis within the last two years. Epidemiological surveys were conducted among medical personnel from healthcare units who presented the main obstacles to confirming suspect cases. Results show that a lack of laboratory diagnosis, poor differential diagnosis, low knowledge of the disease and a lack of clinical experience are, among other factors, relevant to the low reporting rates in the region...

Cerca de dois mil casos de coqueluche são relatados no Brasil a cada ano. Crianças com menos de 1 ano de idade pertencem ao grupo com maiores taxas de incidência e letalidade. Apesar de a doença estar se tornando cada vez mais frequente no Brasil, o estado do Rio de Janeiro vem apresentando baixos índices de informação comparativamente a outros estados da Região Sudeste. Portanto, este trabalho teve como objetivo avaliar tanto as dificuldades enfrentadas pelas equipes médicas ao confirmar casos suspeitos de coqueluche em unidades de saúde em todo o estado do Rio de Janeiro quanto a disponibilidade de dados para confirmar o diagnóstico da coqueluche nos últimos dois anos. O levantamento epidemiológico foi realizado entre o pessoal médico de unidades de saúde que apresentaram dificuldades para a confirmação de casos suspeitos. Os resultados indicaram alguns fatores relevantes para as baixas taxas de notificação na região: falta de diagnóstico laboratorial, inconsistência do diagnóstico diferencial, escassez de conhecimento sobre a doença e falta de experiência clínica...