IMPORTANCE: Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, ...most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects. OBJECTIVE: To describe the prenatal evolution and perinatal outcomes of 11 neonates who had developmental abnormalities and neurological damage associated with ZIKV infection in Brazil. DESIGN, SETTING, AND PARTICIPANTS: We observed 11 infants with congenital ZIKV infection from gestation to 6 months in the state of Paraíba, Brazil. Ten of 11 women included in this study presented with symptoms of ZIKV infection during the first half of pregnancy, and all 11 had laboratory evidence of the infection in several tissues by serology or polymerase chain reaction. Brain damage was confirmed through intrauterine ultrasonography and was complemented by magnetic resonance imaging. Histopathological analysis was performed on the placenta and brain tissue from infants who died. The ZIKV genome was investigated in several tissues and sequenced for further phylogenetic analysis. MAIN OUTCOMES AND MEASURES: Description of the major lesions caused by ZIKV congenital infection. RESULTS: Of the 11 infants, 7 (63.6%) were female, and the median (SD) maternal age at delivery was 25 (6) years. Three of 11 neonates died, giving a perinatal mortality rate of 27.3%. The median (SD) cephalic perimeter at birth was 31 (3) cm, a value lower than the limit to consider a microcephaly case. In all patients, neurological impairments were identified, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence (ie, arthrogryposis). Results of limited testing for other causes of microcephaly, such as genetic disorders and viral and bacterial infections, were negative, and the ZIKV genome was found in both maternal and neonatal tissues (eg, amniotic fluid, cord blood, placenta, and brain). Phylogenetic analyses showed an intrahost virus variation with some polymorphisms in envelope genes associated with different tissues. CONCLUSIONS AND RELEVANCE: Combined findings from clinical, laboratory, imaging, and pathological examinations provided a more complete picture of the severe damage and developmental abnormalities caused by ZIKV infection than has been previously reported. The term congenital Zika syndrome is preferable to refer to these cases, as microcephaly is just one of the clinical signs of this congenital malformation disorder.
Yellow fever (YF) is a severe, infectious, but non-communicable arboviral hemorrhagic disease. In the last decades, yellow fever virus (YFV) infections have been prevalent in endemic areas in Brazil, ...affecting human and non-human primate (NHP) populations. Monitoring of NHP infection started in 1999, and reports of epizootic diseases are considered important indicators of viral transmission, particularly in relation to the sylvatic cycle. This study presents the monitoring of YFV by real-time RT-PCR and the epidemiological findings related to the deaths of NHPs in the south-eastern states and in the north-eastern state of Bahia, during the outbreak of YF in Brazil during 2017 and 2018.
A total of 4198 samples from 2099 NHPs from south-eastern and north-eastern Brazilian states were analyzed by real-time reverse transcription polymerase chain reaction (rtRT-PCR).
A total of 4198 samples from 2099 NHPs from south-eastern and north-eastern Brazilian states were collected between 2017 and 2018. The samples were subjected to molecular diagnostics for YFV detection using real-time reverse transcription polymerase chain reaction (rtRT-PCR) techniques. Epizootics were coincident with human YF cases. Furthermore, our results showed that the YF frequency was higher among marmosets (Callithrix sp.) than in previous reports. Viremia in species of the genus Alouatta and Callithrix differed greatly.
Our results indicate a need for further investigation of the role of Callithrix spp. in the transmission cycles of YFV in Brazil. In particular, YFV transmission was observed in a region where viral circulation has not been recorded for decades and thus vaccination has not been previously recommended.
This highlights the need to straighten epizootic surveillance and evaluate the extent of vaccination programmes in Brazil in previously considered "YFV-free" areas of the country.
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Zika Virus Infection in Pregnant Women in Rio de Janeiro Brasil, Patrícia; Pereira, José P; Moreira, M. Elisabeth ...
New England journal of medicine/The New England journal of medicine,
12/2016, Volume:
375, Issue:
24
Journal Article
Peer reviewed
Open access
This final report updates preliminary data on Zika virus infection among pregnant women in Rio de Janeiro. ZIKV infection during pregnancy was associated with fetal death, fetal growth restriction, ...and central nervous system abnormalities.
We have been conducting active surveillance for dengue infection in the general population of Rio de Janeiro since 2007. In 2012, we established a prospective cohort for dengue surveillance in mother–infant pairs within the Manguinhos Rio de Janeiro area. In 2015, we noted an increase in cases of a denguelike illness that was characterized by a descending rash, generally without fever; this increase coincided with a surge in the number of cases of illness characterized by a pruriginous rash in northeastern Brazil.
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In early 2015, most cases were originally reported to surveillance systems as dengue; however, Zika virus (ZIKV) was . . .
(Abstracted from N Engl J Med 2016; DOI10.1056/NEJMoa1602412)Zika virus (ZIKV) was first identified in Brazil in 2015 by reverse transcriptase–polymerase chain reaction assays of serum specimens from ...patients who presented with a dengue-like illness that was characterized by rash, fever, myalgias, arthralgias, and conjunctivitis. Zika virus has been linked to neonatal microcephaly.
A 24-year-old housekeeper presented to hospital in Rio de Janeiro in June, 2014, with headache, fever, and a rash, 5 days after waking with a severe generalised headache, retro-orbital pain, ...weakness, and paraesthesia of the hands and feet. 2 days later she developed fever (axillary temperature 42°C), chills, and a pruritic rash on the face, abdomen, chest, and arms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Since December 2016, Brazil has experienced an unusually large outbreak of yellow fever (YF). Whether urban transmission may contribute to the extent of the outbreak is unclear. The objective of this ...study was to characterize YF virus (YFV) genomes and to identify spatial patterns to determine the distribution and origin of YF cases in Minas Gerais, Espírito Santo and Rio de Janeiro, the most affected Brazilian states during the current YFV outbreak.
We characterized near-complete YFV genomes from 14 human cases and two nonhuman primates (NHP), sampled from February to April 2017, retrieved epidemiologic data of cases and used a geographic information system to investigate the geospatial spread of YFV.
All YFV strains were closely related. On the basis of signature mutations, we identified two cocirculating YFV clusters. One was restricted to the hinterland of Espírito Santo state, and another formed a coastal cluster encompassing several hundred kilometers. Both clusters comprised strains from humans living in rural areas and NHP. Another NHP lineage clustered in a basal relationship. No signs of adaptation of YFV strains to human hosts were detected.
Our data suggest sylvatic transmission during the current outbreak. Additionally, cocirculation of two distinct YFV clades occurring in humans and NHP suggests the existence of multiple sylvatic transmission cycles. Increased detection of YFV might be facilitated by raised awareness for arbovirus-mediated disease after Zika and chikungunya virus outbreaks. Further surveillance is required, as reemergence of YFV from NHPs might continue and facilitate the appearance of urban transmission cycles.
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Perinatal Transmission of Dengue: A Report of 7 Cases Ribeiro, Christiane Fernandes, PhD; Lopes, Vânia Glória Silami, PhD; Brasil, Patrícia, PhD ...
The Journal of pediatrics,
11/2013, Volume:
163, Issue:
5
Journal Article
Peer reviewed
Open access
Perinatal transmission of dengue virus was confirmed by the evidence of virus in fetal tissue, newborn serum, and placenta of pregnant women. Abortion, several different clinical findings, and ...placental inflammatory findings were documented. No association was seen between severity of maternal dengue and disease of the newborn.
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Brazil, which is hyperendemic for dengue virus (DENV), has had recent Zika (ZIKV) and (CHIKV) Chikungunya virus outbreaks. Since March 2016, CHIKV is the arbovirus infection most frequently diagnosed ...in Rio de Janeiro. In the analysis of 1835 syndromic patients, screened by real time RT-PCR, 56.4% of the cases were attributed to CHIKV, 29.6% to ZIKV, and 14.1% to DENV-4. Sequence analyses of CHIKV from sixteen samples revealed that the East-Central-South-African (ECSA) genotype of CHIKV has been circulating in Brazil since 2013 95% bayesian credible interval (BCI): 03/2012-10/2013, almost a year before it was detected by arbovirus surveillance program. Brazilian cases are related to Central African Republic sequences from 1980's. To the best of our knowledge, given the available sequence published here and elsewhere, the ECSA genotype was likely introduced to Rio de Janeiro early on 2014 (02/2014; BCI: 07/2013-08/2014) through a single event, after primary circulation in the Bahia state at the Northestern Brazil in the previous year. The observation that the ECSA genotype of CHIKV was circulating undetected underscores the need for improvements in molecular methods for viral surveillance.
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The rapid hydrolysis of urea applied to the soil surface causes high rates of NH3 volatilization, leading to adverse environmental impacts and decreased uptake of N by crops. One approach that can be ...used to improve the efficiency of urea use involves strategies to control its release, such as the coating of granules with polymers. However, the effectiveness of this method can be limited by poor interaction between the coating and the granule surface. We, therefore, propose a novel class of nanocomposite fertilizers, based on clay exfoliation in urea matrices, with or without polymerization using formaldehyde as a strategy to increase the interaction between urea and the additives. A comparative study was performed using various slow-release fertilizers, determining the amounts of volatilized ammonia, dry matter production, and efficiency of urea-N uptake by ryegrass, in a trial carried out in a greenhouse. Interaction, such as solubility, thickness, and chemical composition of the composites revealed aspects of the interaction that affected the slow-release behavior of urea in soil and the availability of N for plants. It could be concluded that the controlled release of urea from the nanocomposites decreased NH3 volatilization, resulting in a more constant N availability in the soil and better synchronization with the nutritional demands of the plants. The new fertilizers offer a practical option for increasing urea-N efficiency, reducing environmental impacts caused by NH3 loss and improving the quality of forage grown on low fertility soils, such as oxisols.
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