Endemismo urbano por COVID-19 en Petrópolis: Detección de un foco endémico mediante análisis espacial / Urban COVID-19 endemism in Petrópolis: detection of an endemic focus by spatial analysis

RESUMEN Se realizó un estudio con el objetivo de identificar un ecosistema de endemismo urbano que explique la persistencia del SARS-CoV-2 durante los primeros 18 meses de la pandemia en el municipio de Petrópolis, Río de Janeiro, Brasil. Se analizaron los registros oficiales de casos mensuales de COVID-19, georreferenciados según el domicilio de residencia de cada caso confirmado y se elaboraron mapas de calor mensuales que identifican puntos con diferentes densidades espaciales de la enfermedad mediante la aplicación de la metodología de kernel. Se identificaron puntos de calor con cinco niveles de intensidad para la densidad espacial de casos. Los puntos de mayor intensidad, conocidos como «hotspots¼, se mantuvieron constantes durante todo el período en un polígono de aproximadamente 4 km2 ubicado en el centro de la ciudad de Petrópolis. En conclusión, se encontró que la mayor concentración de casos se mantuvo en la misma ubicación a lo largo del tiempo, a pesar de la dispersión esporádica de los casos en el territorio municipal.

ABSTRACT This study aimed to identify an ecosystem of urban endemism that explains the persistence of SARS-CoV-2 during the first 18 months of the pandemic in the municipality of Petrópolis, Rio de Janeiro, Brazil. We analyzed official records of monthly COVID-19 cases, georeferenced according to the residence address of each confirmed case. Monthly heat maps identifying points with different spatial densities of the disease were constructed by applying the kernel methodology. Heat spots with five intensity levels were identified for the spatial density of cases. The points of highest intensity, known as hotspots, remained constant throughout the period in a polygon of approximately 4 km2 located in the center of the city of Petrópolis. In conclusion, we found that the highest concentration of cases remained in the same location over time, despite the sporadic dispersion of cases within the municipal territory.

Mortalidad por cáncer, arsénico y nitratos en aguas de consumo y superficies sembradas en Argentina

[RESUMEN]. Objetivo. La mortalidad por cáncer en la región centro de Argentina está dentro de las más elevadas del país. Dos posibles escenarios ambientales podrían explicar esta situación, su actividad agrícola y la calidad del agua de consumo. El objetivo del estudio es evaluar la interacción existente entre estas variables. Métodos. Estudio retrospectivo de diseño ecológico. Se analizaron decenios de superficies sembradas totales (SST) y el porcentaje de población expuesta a niveles elevados de arsénico y nitratos en aguas de consumo en relación con las tasas de mortalidad total (TMT) y órgano-específicas (TME); se calculó el coeficiente de correlación de Spearman. Resultados. Se hallaron correlaciones positivas y significativas entre los dos primeros decenios de SST y el primer decenio de TMT, así como correlaciones con cáncer de pulmón, páncreas y colon en hombres; y con cáncer de colon en mujeres. Los niveles elevados de arsénico se asocian con las TMT en ambos sexos y en todos los decenios, aunque de manera específica con cáncer de pulmón en hombres. No se hallaron correlaciones significativas con nitratos. Conclusiones. La asociación entre las SST y las TMT y TME presentan mayor intensidad cuanto más cerca están entre ellas temporalmente, y expresan un mayor impacto de los cultivos más antiguos. La asociación entre las TMT y el consumo de aguas arsenicales, así como la hallada en TME de pulmón en hombres y colon en mujeres, muestran que esta exposición histórica es central para entender las condiciones epidemiológicas regionales. Se deben explorar fuerzas sinérgicas entre estas variables.

[ABSTRACT]. Objective. Cancer mortality in the central region of Argentina is among the highest in the country. Two possible environmental factors could explain this situation: agricultural activity and drinking water quality. The objective of the study is to evaluate the interaction between these variables. Methods. This is a retrospective ecological study. Total cropland over 10-year periods as well as the percentage of the population exposed to high levels of arsenic and nitrates in drinking water were analyzed and compared to total mortality rates (TMR) and organ-specific mortality rates (SMR); the Spearman's rank correlation coefficient was then calculated. Results. Positive and significant correlations were found between the first two 10-year periods of total cropland and the first 10-year period of TMR, as well as correlations with lung, pancreatic, and colon cancers in men and colon cancer in women. Elevated arsenic levels are associated with TMR in both sexes across all 10-year periods but are specifically associated with lung cancer in men. No significant correlation was found with nitrates. Conclusions. The association between total cropland and TMR/SMR is stronger with proximity over time, with greater impact from the oldest crops. The association between TMR and consumption of water containing arsenic, as well as the association with lung SMR in men and colon SMR in women, show that exposure over time is essential to understanding regional epidemiological conditions. The synergy between these variables should be explored.

[RESUMO]. Objetivo. A mortalidade por câncer na região central da Argentina está entre as mais elevadas do país. Dois possíveis cenários ambientais poderiam explicar esta situação: a atividade agrícola e a qualidade da água para consumo humano. O objetivo do estudo é avaliar a interação entre essas variáveis. Métodos. Estudo ecológico retrospectivo. Foram analisadas a área semeada total (AST) em decênios e a porcentagem da população exposta a níveis elevados de arsênio e nitrato na água para consumo humano em relação às taxas de mortalidade total (TMT) e específica por órgão (TME). A correlação foi analisada mediante cálculo de coeficientes de Spearman. Resultados. Foram constatadas correlações positivas e significativas entre os dois primeiros decênios de AST e o primeiro decênio de TMT, bem como correlações com câncer de pulmão, de pâncreas e colorretal nos homens e com câncer colorretal nas mulheres. Níveis elevados de arsênio apresentaram associação com a TMT em ambos os sexos e em todos os decênios e, mais especificamente, com a mortalidade por câncer de pulmão em homens. Não foram constatadas correlações significativas com nitratos. Conclusões. A associação entre AST e as taxas de mortalidade total e específica por órgão é tanto mais forte quanto mais próximas estão uma da outra no tempo, e expressa um maior impacto dos cultivos mais antigos. A associação entre TMT e o consumo de águas arsenicais, bem como a associação encontrada na TME por câncer de pulmão em homens e na TME por câncer colorretal em mulheres, mostra que esta exposição histórica é fundamental para compreender as condições epidemiológicas regionais. Forças sinérgicas entre estas variáveis devem ser exploradas.

Isolamento ambiental e identificação bioquímica de Cryptococcus spp / Environmental isolation and biochemical identification of Cryptococcus spp

A Cryptococose é uma doença fúngica, oportunista, de caráter ubiquitária e crescente em número de casos nos últimos anos. Considerada atualmente como um problema de saúde pública, pode ocasionar doença em muitos hospedeiros, inclusive no homem. A infecção ocorre em decorrência da inalação de basidiósporos ou leveduras desidratadas infectantes presentes no ambiente. O gênero Cryptococcus caracteriza-se por ser uma levedura normalmente encapsulada, responsável por infecção sistêmica, causada principalmente pelas espécies, Cryptococcus neoformans e Cryptococcus gattii, comumente encontrada em substratos de origem animal, como excretas de aves, vegetais, e em troncos ocos de árvores, embora, com o avanço dos estudos, o envolvimento de outras espécies nas infecções humanas venha sendo cada vez mais relatada.Com o objetivo de conhecer a ecoepidemiologia do Cryptococcus spp em 30 amostras de material putrefado de árvores e 30 amostras excretas de aves de 10 locais representativos no perímetro do Instituto Lauro de Souza Lima-Bauru, buscamos conhecer a ecoepidemiologia desses agentes e posterior, profilaxia, minimizando riscos de contágio. As amostras foram processadas e semeadas em placas contendo ágar semente de níger e ágar Sabouraud Dextrose com cloranfenicol, incubadas a temperatura de 30°C e observadas diariamente por dez dias. O crescimento de leveduras com características de Cryptococcus spp foram avaliadas pelo aspecto colonial nos meios de cultivo e pela realização de exames diretos com tinta da China e com lactofenol azul de algodão através da análise dos aspectos micromorfológicos. As leveduras analisadas foram submetidas as provas bioquímicas como; produção de urease, produção de fenoloxidase no ágar semente de níger, termotolerância a 37°C e quimiotipagem em ágar CGB (L-canavanina-glicina-azul de bromotimol). Os dados obtidos foram avaliados estatisticamente pelo Teste exato de Fisher e pelo teste qui-quadrado, adotando o nível de significância de 5% e demonstrando crescimento de C.neoformans, C.gattii e C. Laurentii (Papiliotrema laurentii), concluindo que esses fungos podem infectar o ambiente.

Cryptococcosis is a fungal, opportunistic and ubiquitous disease which is increasing in number of cases in recent years. Currently considered as a public health problem, it can cause disease in many hosts, including humans. The infection occurs as a result of inhalation of basidiospores or dehydrated infective yeasts present in the environment. The genus Cryptococcus is characterized as a normally encapsulated yeast, responsible for systemic infection, mainly caused by the species, Cryptococcus neoformans and Cryptococcus gattii, commonly found in substrates of animal origin, such as Bird droppings, vegetables, and in tree hollows, although, with the advancement of studies, the involvement of other species in human infections has been increasingly reported. With the aim of knowing the ecoepidemiology of Cryptococcus spp in 30 samples of putrefying material from trees and 30 samples of bird droppings from 10 representative sites in the Instituto Lauro de Souza Lima-Bauru (ILSL), we sought to know the ecoepidemiology of these agents and later, prophylaxis, minimizing the risk of contagion. The samples were processed and seeded on plates containing niger seed agar and Sabouraud Dextrose agar with chloramphenicol, incubated at 30°C and observed daily for ten days. The growth of yeasts with characteristics of Cryptococcus spp were evaluated by the colonial appearance in the fungus culture and by performing direct examinations with China ink and cotton blue lactophenol through the analysis of micromorphological aspects. The analyzed yeasts were submitted to biochemical tests such as; urease production, phenoloxidase production on niger seed agar, thermotolerance at 37°C and chemotyping on CGB agar (L-canavanine-glycine-bromothymol blue). The data obtained were statistically evaluated using Fisher's exact test and the chi-square test, adopting a significance level of 5%. Cryptococcus neoformans, Cryptococcus gattii and Cryptococcus laurentii were isolated.

Escorpiones de la provincia de Misiones, Argentina: Un elenco de interés medico / Scorpions from the province of Misiones, Argentina: An assemblage of medical interest

INTRODUCCIÓN: Los envenenamientos producidos por escorpiones son un problema de salud pública en constante aumento en Argentina y el mundo. Por diversas causas, los ensambles de animales venenosos de una región varían en el tiempo. El objetivo de este trabajo fue presentar la información reciente y actualizar el elenco de escorpiones de la provincia de Misiones. MÉTODOS: Se realizó un estudio descriptivo observacional a partir de la revisión de los ejemplares depositados en la Colección de Herpetología y Arácnidos del Instituto Nacional de Medicina Tropical. RESULTADOS: Se obtuvieron los primeros registros para la provincia de Tityus confluens, mientras que nuevos registros de accidentes con Tityus trivittatus ampliaron la zona de presencia de la especie en la provincia. El ensamble de escorpiones de Misiones reúne a las cuatro especies de interés médico del país. DISCUSIÓN: La detección del elenco de escorpiones de interés médico más importante del país fue consecuencia del trabajo conjunto entre los especialistas de los distintos grupos de animales ponzoñosos y los profesionales de la salud. Es importante generar y profundizar los espacios de interacción de saberes, con el objetivo de mejorar la Vigilancia de la Salud

Ecoepidemiología de las lesiones causadas por medusas urticantes en el balneario de Monte Hermoso. Buenos Aires. Argentina / Ecoepidemiology of lesions caused by venomous jellyfish in Monte Hermoso beach. Buenos Aires. Argentina

En la costa sudoeste bonaerense uno de los principales desafíos para el turismo es el tratamiento y la prevención de envenenamientos por medusas. Hasta el momento se conocen tres especies de medusas urticantes que arriban a la costa: Chrysaora lactea, Liriope tetraphylla y Olindias sambaquiensis. Los objetivos de este trabajo fueron: calcular los parámetros poblacionales de las medusas urticantes, efectuar el diagnóstico diferencial de los síntomas causados por envenenamiento, analizar el número de afectados en relación a la abundancia de medusas urticantes, evaluar la elección diferencial del centro de atención primaria elegido por los afectados y confeccionar un algoritmo diagnóstico. El número de medusas urticantes en el año 2016 fue cinco veces mayor que en 2017. Liriope tetraphylla registró las mayores abundancias promedio, frecuencias y dominancias relativas. En 2016 coincidió su mayor abundancia con el mayor porcentaje de afectados. En 2016 se registraron 69 casos totales de envenenamiento y en 2017 se identificaron 79 casos. En 2017 el porcentaje de personas afectadas por O. sambaquiensis no presentó una correlación con la abundancia promedio de esta especie. Liriope tetraphylla causó lesiones eritematomaculo-papulares acompañadas de prurito sin dolor, C. lactea provocó lesiones eritemato-vesiculosas de dolor moderado y O. sambaquiensis lesiones eritemato-edematosas lineales de dolor intenso con hiperpigmentación residual. No existe tratamiento específico para el envenenamiento, la terapéutica diferencial es sintomática. Las primeras acciones son comunes para las tres especies: lavar con solución fisiológica o agua de mar limpia y aplicar compresas frías.

On the Southwest coast of Buenos Aires Province one of the main challenges for tourism is the treatment and prevention of poisoning by jellyfish. So far, three species of venomous jellyfish arriving to the coast have been identified: Chrysaora lactea, Liriope tetraphylla, and Olindias sambaquiensis. The objectives of this study were: to calculate the population parameters of the venomous jellyfish, to carry out a differential diagnosis of the symptoms caused by poisoning, to analyze the number of individuals affected in relation to the abundance of this jellyfish, to evaluate which primary care centers are chosen by those affected, and to develop a diagnostic algorithm. The number of venomous jellyfish in 2016 was five times higher than in 2017. The highest average abundance, frequency, and relative dominance were recorded for L. tetraphylla. In 2016, its greatest abundance coincided with the highest percentage of people affected by this species. A total of 69 confirmed cases of poisoning caused by the three species were recorded in 2016 and 79 cases in 2017. In 2017, the percentage of people affected by O. sambaquiensis was not correlated with the average abundance of this species. Liriope tetraphylla caused erythematous-maculopapular lesions accompanied by painless pruritus; C. lactea caused erythematous-vesicular lesions of moderate pain and O. sambaquiensis caused linear erythematous-edematous lesions with severe pain and residual hyperpigmentation. At present, there is no specific treatment for poisoning, the differential therapy is symptomatic. The recommended actions are common for all three species: wash the skin with physiological solution or clean sea water and apply cold compresses.

Importance of xenarthrans in the eco-epidemiology of Paracoccidioides brasiliensis

BACKGROUND: Several pathogens that cause important zoonotic diseases have been frequently associated with armadillos and other xenarthrans. This mammal group typically has evolved on the South American continent and many of its extant species are seriously threatened with extinction. Natural infection of armadillos with Paracoccidioides brasiliensis in hyperendemic areas has provided a valuable opportunity for understanding the role of this mammal in the eco-epidemiology of Paracoccidioidomycosis (PCM), one of the most important systemic mycoses in Latin America. FINDINGS: This study aimed to detect P. brasiliensis in different xenarthran species (Dasypus novemcinctus, Cabassous spp., Euphractus sexcinctus, Tamandua tetradactyla and Myrmecophaga tridactyla), by molecular and mycological approaches, in samples obtained by one of the following strategies i) from road-killed animals (n = 6); ii) from naturally dead animals (n = 8); iii) from animals that died in captivity (n = 9); and iv) from living animals captured from the wild (n = 2). Specific P. brasiliensis DNA was detected in several organs among 7/20 nine-banded armadillos (D. novemcinctus) and in 2/2 anteaters (M. tridactyla). The fungus was also cultured in tissue samples from one of two armadillos captured from the wild. CONCLUSION: Members of the Xenarthra Order, especially armadillos, have some characteristics, including a weak cellular immune response and low body temperature, which make them suitable models for studying host-pathogen interaction. P. brasiliensis infection in wild animals, from PCM endemic areas, may be more common than initially postulated and reinforces the use of these animals as sentinels for the pathogen in the environment.

Lyzomya (Nyssomyia) umbratilis y la ecoepidemiología de la leishmaniosis tegumentaria americana asociada a Leishmania (Viannia) guyanensis en Amazonia / Lyzomya (Nyssomyia) umbratilis and the eco-epidemiology of the leishmaniosis tegumentar americana associated to Leishmania (Viannia) guyanensis in Amazonia

Lutzomyia umbratilis has been incriminated as the principal vector of Leishmania (Viannia) guyanensis in the Amazon region, north of the Amazon river. The discovery of this sandfly naturally infected with L. (V.) braziliensis in the north of the State of Mato Grosso, where L. (V.) braziliensis has been isolated from humans, however, has reinforced an hypothesis that L. umbratilis could represent a complex of sibling species based on the apparent infrequency of human infection with L. (V.) guyanensis in Amazonian Brazil south of the Amazon river system. In order to ascertain wether or not L. umbratilis is in fact a complex of sibling species, studies were made on the morphology, morphometry and ecology of populations of this sandfly in Brazil (states of Amazonas, Amapá, Pará and Mato Grosso) and Venezuela (state of Bolívar). Analyzes of morphology (qualitative characters) for the populations from both countries failed to provide evidence of a complex of species, but 75% of the morphometric (quantitative) characters did reveal statistically significant differences separating the Brazilian and Velezuelan populations. The phenetic analysis did not provide evidence of heterogeneity among the Brazilian populations. In the state of Mato Grosso L. umbratilis was abundant in the forest canopy but could not be found on the trunks of the same trees. This contrasts greatly with past observations on the behaviour of this sandfly in the north of the Amazon River system, where there is a heavy concentration of the vector on the lower parts of the large trees, particularly in the early morning. Studies on the eco-epidemiology of cutaneos leishmaniasis in the State of Acre, Brazil, strongly suggest the participation of L. umbratilis in the transmission of L. (V.) guyanensis in the south of the Amazon river.

Lutzomya umbratilis es el principal transmisor de Leishmania (Viannia) guyanensis en la Amazonia, al norte del río Amazonas. El hallazgo de este flebótomo infectado naturalmente por L. (V.) braziliensis al norte del estado de Mato Grosso, donde el mismo parásito circula entre los humanos, refuerza la hipótesis de que L. umbratilis podría representar un complejo de especies, ya que este flebótomo nunca fue informado en asociación a L. (V.) guyanensis al sur del río Amazonas. Para conocer mejor este vector de la leishmaniosis tegumentaria americana (LTA) en Brasil y Venezuela, y verificar si de hecho representa un complejo de especies, se llevaron adelante estudios morfológicos, morfométricos y ecológicos. Los análisis de caracteres cualitativos (morfología) en poblaciones de Brasil (estados de Amazonia, Amapá, Pará y Mato Grosso) y de Venezuela (estado de Bolívar) no presentaron pruebas de un complejo de especies en las poblaciones investigadas. Mientras tanto, 75% de los caracteres morfométricos (cuantitativos), revelaron diferencias estadísticamente significativas que separan las poblaciones brasileñas y venezolanas. El análisis fenético no logró probar heterogeneidad entre las poblaciones brasileñas. EN el estado de Mato Grosso, aun habiendo encontrado ejemplares de L. umbratilis en la copa de los árboles y aunque esta especie es muy antropofílica, no se pudo encontrar ejemplares sobre el tronco de los árboles de gran porte, un típico comportamiento de la especie en Amazonia. Estudios sobre la epidemiología de la LTA en el estado de Acre sugieren fuertemente la participación de L. umbratilis en la cadena epidemiológica de L. (V.) guayanensis, al sur del río Amazonas.