DOCSLIB.ORG

Suspected Brazilian Purpuric Fever, Brazilian Amazon Region

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Suspected Brazilian Purpuric Fever, Brazilian Amazon Region AMAZON REGION SPECIAL SECTION LETTERS Suspected elementary schools of Anajás dur- several days by open boat at ambient ing July–September 2007. We found temperature (≈35 ºC) in improvised Brazilian Purpuric 7 children with illnesses that met our containers without an incubator. Se- Fever, Brazilian case defi nition. rum and CSF samples were thawed Amazon Region From 2 children with nonfatal ill- and refrozen repeatedly for removal of ness, we collected blood, serum, con- aliquots before testing. Microbiologic To the Editor: Brazilian pur- junctival swabs, and cerebrospinal fl uid and virologic testing was conducted at puric fever (BPF), a Haemophilus (CSF). All specimens were submitted the Pará State Health Laboratory and aegyptius–caused febrile hemorrhagic for bacterial culture in half agar choco- Evandro Chagas Institute. Serum and illness of children that begins with late without bacitracin; serum and CSF CSF samples were tested by PCR at conjunctivitis and has a case-fatality were also subjected to real-time PCR Adolfo Lutz Institute. rate of 40%–90% (1,2), was fi rst rec- for detection of Neisseria meningitides, We identifi ed 7 case-patients (me- ognized during a 1984 outbreak. Be- Streptococcus pneumoniae, and Hae- dian age 4 years, range 2–8 years): 6 fore June 2007, 69 cases were reported mophilus infl uenzae serotypes a, b, c, from review of charts at the local hos- worldwide; 65 were from Brazil (1–3). and d and to conventional PCR for the pital and 1 from active search in the To our knowledge, the disease had not ompP2 gene of H. infl uenzae. All serum rural community. Onset of illness was been reported in the Amazon region samples were also tested by hemag- August 1 for the fi rst case-patient and until this investigation, which was glutination inhibition for Flavivirus, August 31 for the last. Five (71%) did precipitated by the report of 5 cases Oropouche, Catu, Caraparu, Tacaiuma, not receive antimicrobial drugs and of a compatible syndrome in Anajás, Mayaro, Mucambo, western equine en- died within 24 hours after fever onset; Pará State, Brazil, in August 2007. cephalitis, eastern equine encephalitis, 2 were treated with amoxicillin within To determine whether recent re- Guaroa, Maguari, Ilhéus, Rocio, and St. 24 hours after fever onset and survived ports of BPF were accurate, we re- Louis encephalitis; by immunoglobulin (Table). viewed medical records of the hospi- M antibody-capture ELISA for dengue Laboratory tests showed leuko- tal in Anajás. We identifi ed cases by and yellow fever; and, when reactive penia on the day of hospital admis- using the following defi nition: fever for dengue, by reverse transcription– sion (Table). All case-patients had >38.5ºC , abdominal pain, vomiting, PCR for dengue types 1, 2, 3, and 4. antecedent conjunctivitis. All except purpura, and antecedent conjuncti- Because of the remoteness of the fi rst case-patient had had physical vitis during July 1–September 30, the outbreak site, samples for bacte- contact with a previous case-patient 2007, in a child 3 months–10 years rial culture were collected on locally through school or family; 5 were re- of age; absence of signs or symptoms available blood agar enriched with lated (siblings or cousins). The period of meningitis in those children; and rabbit serum without antimicrobial from exposure to onset of fever was laboratory exclusion of meningococ- drug–selective agents, rather than on 8–21 days. cal infection. In addition, we searched the recommended chocolate agar en- Of 1,598 elementary school pu- retrospectively and prospectively for riched with horse serum and bacitra- pils investigated for conjunctivitis, 111 conjunctivitis among pupils of the cin (1). Samples were transported over (7%) reported symptoms of conjunc- Table. Characteristics of 7 case-patients with suspected Brazilian purpuric fever, Amazon region, Brazil, August 2007* Date of Antimicrobial Case- Sex/age, conjunctivitis Date admitted Hospitalization, drug Date of Type of sample(s) patient no. y onset to hospital d treatment death collected WBC/mL 1 M/2 Aug 1 Aug 5 <1 No Aug 5 NC NT 2 F/3 Aug 10 Aug 13 <1 No Aug 14 Blood 3,700 3 M/3 Aug 14 Unknown Unknown No Aug 21 NC NT 4 M/6 Jul 19 Aug 22 <1 No Aug 23 Blood 2,300 5† M/8 Unknown Sep 3 7 Yes – CSF, conjunctival 9,060 swab 6 F/4 Aug 23 Aug 26 <1 No Aug 26 CSF, blood‡ 2,000 7 F/4 Aug 31 Sept 3 12 Yes – Oropharyngeal 4,800 and conjunctival swabs, CSF, blood, serum *Case-patients 5 and 7 underwent testing for dengue and yellow fever by immunoglobulin M antibody-capture ELISA, for dengue by reverse transcription– PCR, and for Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae serotypes a, b, c, and d and conventional PCR for detecting the ompP2 gene. All tests were negative. WBC, white blood cells; NC, not collected; NT, not tested; CSF, cerebrospinal fluid. †Sample collected 20 days after admission. ‡Non-standard collection, transport, storage, or processing. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 4, April 2009 675 THE AMAZON REGION LETTERS tivitis during July–September 2007. preceded by conjunctivitis, immediate Address for correspondence: Eucilene Reported treatment included home treatment, contact prophylaxis, and A. Santana-Porto, Ministry of Health— remedies and a nonprescription, local- appropriate prompt laboratory testing Secretariat Surveillance of Health, SCS ly available, cream containing a sulfa are essential for continued control of quadra 04 Bloco A Edifi cio Central 6ª drug. Review of municipal hospital BPF in this region. andar, Brasilia, Distrito Federal 70304000, records during June 1–September 30, Brazil; e-mail: [email protected] 2007, identifi ed no additional cases of Eucilene A. Santana-Porto, conjunctivitis. After the last case-pa- Adriana A. Oliveira, tient died, 17 other persons were iden- Marcos R.M. da Costa, tifi ed with purulent conjunctivitis: 4 at Amiraldo Pinheiro, the municipal hospital and 13 during Consuelo Oliveira, active case-fi nding in schools and the Maria L. Lopes, Luiz E. Pereira, community. All were treated with oral Claudio Sacchi, amoxicillin and chloramphenicol optic Wildo N. Aráujo, Hepatitis C Virus solution, and 76 contacts were treated and Jeremy Sobel in Blood Donors, prophylactically with oral rifampin. Author affi liations: Ministry of Health, Brasí- Brazil No further suspected BPF cases were lia, Brazil (E.A. Santana-Porto, A.A. Olivei- detected. Test results for acute arbovi- ra, W.N. Aráujo, J. Sobel); Municipal Sec- To the Editor: The Fundação rus infection and PCR were negative retariat of Health, Anajás, Brazil (M.R.M. de Hematologia e Hemoterapia do for all patients (Table). da Costa); Secretariat of Health of Pará Amazonas is a public health service This outbreak of highly fatal ill- State, Belém, Brazil (A. Pinheiro); Ministry in Manaus, Brazil, that is responsible ness is clinically compatible with BPF. of Health, Belém (C. Oliveira, M.L. Lopes); for serologic screening the serum of Compatible features included young Instituto Adolfo Lutz, Secretariat of Health all blood donations in the region. In age, antecedent purulent conjunctivitis, of São Paulo State, São Paulo, Brazil (L.E. the state of Amazon, 9.0% of donated signs and symptoms (i.e., antecedent Pereira, C. Sacchi); and Centers for Dis- blood is discarded on the basis of se- conjunctivitis, fever 39.5Cº–41.0Cº, ease Control and Prevention, Atlanta, GA, rologic fi ndings; discarding because abdominal pain, nausea, vomiting, USA (J. Sobel) of hepatitis C virus (HCV) antibod- ies declined from 1.25% in 1995 to petechiae or ecchymoses), and high DOI: 10.3201/eid1504.090014 case-fatality rate. Epstein-Barr infec- 0.32% in 2007. The aim of this study was to characterize the serologic and tion has reportedly produced simi- References lar symptoms (4) but with an illness molecular profi le of HCV-antibody– lasting >7 days in contrast to the <24 1. Tondella ML, Paganelli CH, Bortolotto positive blood donors from the Funda- hours for our case-patients. IM, Takano OA, Irino K, Brandileone ção de Hematologia e Hemoterapia do MC, et al. Isolation of Haemophilus ae- Amazonas. We did not detect H. aegyptius in gyptius associated with Brazilian purpu- peripheral blood by culture or in se- ric fever, of Chloropidae (Diptera) of the For the study, 154 donors were rum or CSF by PCR in the 2 surviv- genera Hippelates and Liohippelates [in selected from a routine database of ing children and in contacts of case- Portuguese]. Rev Inst Med Trop Sao Pau- voluntary blood donors who had do- lo. 1994;36:105–9. DOI: 10.1590/S0036- nated from September 2005 through patients. One reason could be the 46651994000200002 remoteness of the investigation site, 2. Kerr-Pontes LR, Ruffi no-Neto A. Epi- April 2007 (82,851 donations). Fresh which resulted in improper sample demiological study of Brazilian purpuric plasma samples were sent to the labo- collection, storage, and processing fever. Epidemic in a locality of São Paulo ratory in Manaus through the usual state (Brazil), 1986 [in Portuguese]. Rev transportation systems for regular do- in the fi eld before samples reached Saude Publica. 1991;25:375–80. DOI: reference laboratories. Hemaggluti- 10.1590/S0034-89101991000500009 nations; i.e., samples from 27 cities nation tests for arboviruses have low 3. Harrison LH, Simonsen V, Waldman EA. are transported by air for ≈2 hours, specifi city. Therefore, another known Emergence and disappearance of a virulent and samples from 21 localities are clone of Haemophilus infl uenzae biogroup transported by boat or road, all under or novel pathogen could have caused aegyptius, cause of Brazilian purpuric these cases. fever. Clin Microbiol Rev. 2008;21:594– refrigerated conditions.
Load more

Recommended publications
  • Moraxella Catarrhalis and Haemophilus Influenzae
    The Other Siblings: Respiratory Infections Caused by Moraxella catarrhalis and Haemophilus influenzae Larry Lutwick, MD, and Laila Fernandes, MD Corresponding author Moraxella catarrhalis Larry Lutwick, MD Infectious Diseases (IIIE), VA Medical Center, 800 Poly Place, Bacteriology Brooklyn, NY 11219, USA. M. catarrhalis is a Gram negative, aerobic diplococcus E-mail: [email protected] that was initially described by Anton Ghon and Rich- Current Infectious Disease Reports 2006, 8:215–221 ard Pfeiffer as Micrococcus catarrhalis at the end of the Current Science Inc. ISSN 1523-3847 19th century. For most of the first century of its rec- Copyright © 2006 by Current Science Inc. ognition, M. catarrhalis is considered to be a human mucosal commensal organism based on its common finding as an inhabitant of the oropharynx of healthy Respiratory infections remain substantial causes of mor- adults. During a significant amount of this time, based bidity and mortality globally. In this paper, two substantial on phenotypic characteristics as well as microbiologic players in bacterial-associated respiratory disease are colony appearances, the diplococcus was referred to assessed as to their respective roles in children and adults as Neisseria catarrhalis. Of note, in 1963, N. catarrhalis and in the developed and developing world. Moraxella was found to contain two distinct species, catarrhalis catarrhalis, although initially thought to be a nonpathogen, and cinerea [1]. continues to emerge as a cause of upper respiratory Reclassification of the genus of this microorganism disease in children and pneumonia in adults. No vaccine occurred in 1970 when significant phylogenetic dispari- is currently available to prevent M.
    [Show full text]
  • Lineage-Specific Virulence Determinants of Haemophilus
    Lineage-specifi c Virulence Determinants of Haemophilus infl uenzae Biogroup aegyptius Fiona R. Strouts,1 Peter Power, Nicholas J. Croucher, Nicola Corton, Andries van Tonder, Michael A. Quail, Paul R. Langford, Michael J. Hudson, Julian Parkhill, J. Simon Kroll, and Stephen D. Bentley An emergent clone of Haemophilus infl uenzae and fatal. Invasive infection was preceded by purulent biogroup aegyptius (Hae) is responsible for outbreaks of conjunctivitis that resolved before the onset of an acute Brazilian purpuric fever (BPF). First recorded in Brazil in bacteremic illness, which rapidly evolved into septic shock 1984, the so-called BPF clone of Hae caused a fulminant complicated by purpura fulminans (3). In the 11 years disease that started with conjunctivitis but developed into to 1995, several hundred cases of BPF were reported, of septicemic shock; mortality rates were as high as 70%. which all but 3 were in Brazil (4,5); overall mortality rate To identify virulence determinants, we conducted a pan- genomic analysis. Sequencing of the genomes of the BPF was 40%. Cases occurred sporadically and in outbreaks, clone strain F3031 and a noninvasive conjunctivitis strain, mainly in small towns, although some were in the state F3047, and comparison of these sequences with 5 other capital, where an epidemic was feared because of crowding complete H. infl uenzae genomes showed that >77% of and deprivation. A collaborative task force by the Brazilian the F3031 genome is shared among all H. infl uenzae Health Authorities and the US Centers for Disease Control strains. Delineation of the Hae accessory genome enabled and Prevention was created to investigate this emergent characterization of 163 predicted protein-coding genes; infection and identifi ed the cause as the BPF clone of Hae identifi ed differences in established autotransporter (HaeBPF) (6).
    [Show full text]
  • Appendix: Important Anthroponoses, Zoonoses, and Sapronoses1
    CDC - Emerging Human Infectious Diseases: Anthroponoses, Zoonoses, and Sapronoses Appendix: Important Anthroponoses, Zoonoses, and Sapronoses1 Anthroponoses Measles*; rubella; mumps; influenza; common cold; viral hepatitis; poliomyelitis; AIDS*; infectious mononucleosis; herpes simplex; smallpox; trachoma; chlamydial pneumonia and cardiovascular disease*; mycoplasmal infections*; typhoid fever; cholera; peptic ulcer disease*; pneumococcal pneumonia; invasive group A streptococcal infections; vancomycin-resistant enterococcal disease*; meningococcal disease*; whooping cough*; diphtheria*; Haemophilus infections* (including Brazilian purpuric fever*); syphilis; gonorrhea; tuberculosis* (multidrug- resistant strains); candidiasis*; ringworm (Trichophyton rubrum); Pneumocystis pneumonia* (human genotype); microsporidial infections*; cryptosporidiosis* (human genotype); giardiasis* (human genotype); amebiasis; and trichomoniasis. Zoonoses Transmitted by Direct Contact, Alimentary (Foodborne and Waterborne), or Aerogenic (Airborne) Routes Rabies; hemorrhagic fever with renal syndrome*; hantavirus pulmonary syndrome*; Venezuelan*; Brazilian*; Argentinian and Bolivian hemorrhagic fevers; Lassa; Marburg; and Ebola hemorrhagic fevers*; Hendra and Nipah hemorrhagic bronchopneumonia*; hepatitis E*; herpesvirus simiae B infection; human monkeypox*;Q fever; sennetsu fever; cat scratch disease; psittacosis; mammalian chlamydiosis*; leptospirosis; zoonotic streptococcosis; listeriosis; erysipeloid; campylobacterosis*; salmonellosis*; hemorrhagic colitis*;
    [Show full text]
  • WO 2018/161000 Al 07 September 2018 (07.09.2018) W !P O PCT
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2018/161000 Al 07 September 2018 (07.09.2018) W !P O PCT (51) International Patent Classification: setts 02138 (US). SUN, Dexue; 1030 Massachusetts Av A 61K 38/1 6 (2006 .01) C12N 7/04 (2006 .01) enue, Fourth Floor, Cambridge, Massachusetts 02138 A 61K 38/1 7 (2006 .01) C12N 15/867 (2006 .0 1) (US). DELABARRE, Byron; 50 Candia Street, Arlington, A 61K 38/44 (2006.01) C12N 15/861 (2006.01) Massachusetts 02474 (US). BALAKRISHNAN, Vijaya; CI2Q 1/26 (2006.01) 142A Main Street, Groton, Massachusetts 01450 (US). DOLINSKI, Brian; 1030 Massachusetts Avenue, Fourth (21) International Application Number: Floor, Cambridge, Massachusetts 02138 (US). INNISS, PCT/US20 18/0207 18 Mara Christine; 11 Highland Ave. Unit 2, Beverly, Mass (22) International Filing Date: achusetts 01915 (US). OLINGER, Grace Y.; 22 Water 02 March 2018 (02.03.2018) Street #43 1, Cambridge, Massachusetts 02141 (US). (25) Filing Language: English (74) Agent: WARD, Donna T. et al; DT WARD, P.C., 142A Main Street, Groton, Massachusetts 01450 (US). (26) Publication Language: English (81) Designated States (unless otherwise indicated, for every (30) Priority Data: kind of national protection available): AE, AG, AL, AM, 62/466,603 03 March 2017 (03.03.2017) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, 62/484,047 11 April 2017 ( 11.04.2017) CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, 62/542,400 08 August 2017 (08.08.2017) DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, (71) Applicant: OBSIDIAN THERAPEUTICS, INC.
    [Show full text]
  • Pathogenic Diversity of Escherichia Coli and the Emergence of ’Exotic’ Islands in the Gene Stream Charles M
    Pathogenic diversity of Escherichia coli and the emergence of ’exotic’ islands in the gene stream Charles M. Dozois, Roy Curtiss To cite this version: Charles M. Dozois, Roy Curtiss. Pathogenic diversity of Escherichia coli and the emergence of ’exotic’ islands in the gene stream. Veterinary Research, BioMed Central, 1999, 30 (2-3), pp.157-179. hal- 00902564 HAL Id: hal-00902564 https://hal.archives-ouvertes.fr/hal-00902564 Submitted on 1 Jan 1999 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Review article Pathogenic diversity of Escherichia coli and the emergence of ’exotic’ islands in the gene stream Charles M. Dozois Roy Curtiss III* Department of Biology, Washington University, Campus Box 1 137, One Brookings Drive, Saint-Louis, MO 63130, USA (Received 27 October 1998; accepted 8 December 1998) Abstract - Escherichia coli is a highly adaptive bacterial species that is both a member of the com- mensal intestinal flora and a versatile pathogen associated with numerous types of intestinal and systemic infections in humans and other animals. The spectrum of diseases caused by E. coli is due to the acquisition of specific virulence genes harbored on plasmids, bacteriophages, or within distinct DNA segments termed pathogenicity islands (PAls) that are absent from the genomes of commen- sal E.
    [Show full text]
  • Infectious Diseases of Brazil
    INFECTIOUS DISEASES OF BRAZIL Stephen Berger, MD Infectious Diseases of Brazil - 2013 edition Infectious Diseases of Brazil - 2013 edition Stephen Berger, MD Copyright © 2013 by GIDEON Informatics, Inc. All rights reserved. Published by GIDEON Informatics, Inc, Los Angeles, California, USA. www.gideononline.com Cover design by GIDEON Informatics, Inc No part of this book may be reproduced or transmitted in any form or by any means without written permission from the publisher. Contact GIDEON Informatics at [email protected]. ISBN-13: 978-1-61755-449-0 ISBN-10: 1-61755-449-9 Visit http://www.gideononline.com/ebooks/ for the up to date list of GIDEON ebooks. DISCLAIMER: Publisher assumes no liability to patients with respect to the actions of physicians, health care facilities and other users, and is not responsible for any injury, death or damage resulting from the use, misuse or interpretation of information obtained through this book. Therapeutic options listed are limited to published studies and reviews. Therapy should not be undertaken without a thorough assessment of the indications, contraindications and side effects of any prospective drug or intervention. Furthermore, the data for the book are largely derived from incidence and prevalence statistics whose accuracy will vary widely for individual diseases and countries. Changes in endemicity, incidence, and drugs of choice may occur. The list of drugs, infectious diseases and even country names will vary with time. Scope of Content: Disease designations may reflect a specific pathogen (ie, Adenovirus infection), generic pathology (Pneumonia - bacterial) or etiologic grouping (Coltiviruses - Old world). Such classification reflects the clinical approach to disease allocation in the Infectious Diseases Module of the GIDEON web application.
    [Show full text]
  • Gram-Negative Small Rods
    The Gram-negative coccobacilli Prof. dr hab. Beata M. Sobieszczańska Department of Microbiology University of Medicine The Gram-Negative Coccobacilli This group includes: Haemophilus Francisella Neisseria Brucella Bordetella Pasteurella Moraxella Similar in bacterial shape and Gram stain They are very different with respect to: Diseases they cause & populations they infect Virulence factors & pathogenesis Their ability to infect animals as well as humans Invasive versus non-invasive pathogenesis Genus: Haemophilus H. influenzae (serotypes a – f), Hib H. parainfluenzae H. haemolyticus H. ducreyi - causes ulcus molle (soft chancre, chancroid) – a tropical venereal disease/painful readily bleeding ulcer occurring mainly in the genital area (endemic in Africa, Asia) H. aegypticus - causes a purulent conjunctivitis & Brazilian purpuric fever (endemic in Northern Africa/Egypt) Haemophilus influenzae Virulence factors: PRP (polyribitol phosphate) capsule – antiphagocytic LPS = endotoxin (fever, inflammation), impairs ciliary function IgA1 protease – role in colonization Pili & nonpilus adhesin – colonization of the oropharynx Survival in respiratory epithelial cells Haemophilus influenzae Reservoir: humans (carriers, infected individuals) – mostly endogenous/exogenous Transmission: close contact, via respiratory droplets (air-borne route) Enters upper respiratory tract: attaches to cells (fimbriae, IgA1 protease) Endotoxin stops respiratory tract cilia from beating & clearing the bacterial cells, & induces inflammation Local spread (ears, sinuses,
    [Show full text]
  • Appendix H Pediatric Quality Indicators Appendices
    AHRQ QI™ ICD-10-CM/PCS Specification v2020 Appendix H Pediatric Quality Indicators Appendices www.qualityindicators.ahrq.gov APPENDIX H: Infection Diagnosis Codes Infection diagnosis codes: (INFECID) A000 Cholera due to vibrio cholerae 01, biovar L03123 Acute lymphangitis of right upper limb cholerae A001 Cholera due to vibrio cholerae 01, biovar L03124 Acute lymphangitis of left upper limb eltor A009 Cholera, unspecified L03125 Acute lymphangitis of right lower limb A0100 Typhoid fever, unspecified L03126 Acute lymphangitis of left lower limb A0101 Typhoid meningitis L03129 Acute lymphangitis of Unspecified part of limb A0102 Typhoid fever with heart involvement L03211 Cellulitis of face A0103 Typhoid pneumonia L03212 Acute lymphangitis of face A0104 Typhoid arthritis L03213 Periorbital cellulitis A0105 Typhoid osteomyelitis L03221 Cellulitis of neck A0109 Typhoid fever with other complications L03222 Acute lymphangitis of neck A011 Paratyphoid fever A L03311 Cellulitis of abdominal wall A012 Paratyphoid fever B L03312 Cellulitis of back [any part except buttock] A013 Paratyphoid fever C L03313 Cellulitis of chest wall A014 Paratyphoid fever, unspecified L03314 Cellulitis of groin A020 Salmonella enteritis L03315 Cellulitis of perineum A021 Salmonella sepsis L03316 Cellulitis of umbilicus A0220 Localized salmonella infection, L03317 Cellulitis of buttock unspecified A0221 Salmonella meningitis L03319 Cellulitis of trunk, Unspecified A0222 Salmonella pneumonia L03321 Acute lymphangitis of abdominal wall A0223 Salmonella arthritis L03322
    [Show full text]
  • Brazilian Purpuric Fever
    experience needed to establish effective national fundamental knowledge and skills in this area as well as programs. various categories of health personnel who require less 4. To give leadership in developing the tools for surveil- intensive training programs. lance, monitoring and evaluation of programs for preven- tion of NCDs. 5. To provide leadership and assistance to the Member Countries (Source: Based on the report of the PAHO Advisory Group in meeting the spectrum of training needs, on Health Promotion and Prevention of Non-Communicable including highly specialized personnel who need Diseases. Health of Adults Program, PAHO.) I ,o' Brazilian Purpuric Fever Brazilian purpuric fever (BPF) is a life-threatening educational seminar on BPF for physicians and public pediatric infection that is preceded by conjunctivities and health workers. Health professionals were encouraged to caused by a specific strain of Haemophilus influenzae report all suspected BPF cases to the MGSDH. 1 biogroup aegyptius (BPF clone) (1-4). BPF was By April 1990, 26 cases (including the two definite and recognized during 1984 in the state of Sao Paulo, Brazil, three possible cases identified in December) that were when 10 children in a town of 20,000 persons died of an believed to be either definite or possible BPF had been acute febrile illness associated with purpura and vascular reported. Of these, 10 cases (from six widely separated collapse (5,6). Although the etiology could not be cities) were confirmed: three as definite and seven as determined at the time of the outbreak, the epidemiologic possible BPF. investigation indicated the disease was associated with The overall attack rate for the combined population of purulent conjunctivities.
    [Show full text]
  • Emerging Infectious Diseases
    Vol. 2, No. 1, January–March 1996 Emerging TrackingInfectious trends and analyzing new and reemerging Diseases infectious disease issues around the world Molecular Population Genetic James M. Musser Analysis of Emerged Bacterial Pathogens Emergence of the Ehrlichioses as David H. Walker Human Health Problems Surveillance for Pneumonic Plague Curtis L. Fritz Malaria Transmission Jane R. Zucker Cluster of Lyme Disease Cases G. Thomas Strickland Unexplained Deaths Due to Bradley A. Perkins Possibly Infectious Causes Trends in Bacteremic Infection Due Daniel M. Musher to S. pyogenes Infectious Diseases in Latin A. David America and the Caribbean Brandling-Bennet Microbial Threats and the Global Stuart B. Levy Society Xenotransplantation:Risks, Clinical Robert E. Michler Potential, and Future Prospects Another Human Case of Equine Morbillivirus Disease in Australia U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Emerging Infectious Diseases Emerging Infectious Diseases is indexed in Current Contents and in several electronic databases. Liaison Representatives Editors Anthony I. Adams, M.D. Gerald L. Mandell, M.D. Editor Chief Medical Adviser Liaison to Infectious Diseases Society Joseph E. McDade, Ph.D. Commonwealth Department of of America National Center for Infectious Diseases Human Services and Health Centers for Disease Control University of Virginia Medical Center and Prevention (CDC) Canberra, Australia Charlottesville, Virginia, USA Atlanta, Georgia, USA David Brandling-Bennett, M.D. Philip P. Mortimer, M.D. Deputy Director Director, Virus Reference Division Perspectives Editor Stephen S. Morse, Ph.D. Pan American Health Organization Central Public Health Laboratory The Rockefeller University World Health Organization London, United Kingdom New York, New York, USA Washington, D.C., USA Robert Shope, M.D.
    [Show full text]
  • Anthroponoses, Zoonoses, and Sapronoses Appendix: Important Anthroponoses, Zoonoses, and Sapronoses1
    LETTERS Emerging Human indiscriminately, and an expert commit- seum), some bacterial diseases (e.g., tee decided to abandon these two terms legionellosis), and protozoan (e.g., pri- Infectious Diseases: and recommended “zoonoses” as “dis- mary amebic meningoencephalitis). Anthroponoses, eases and infections which are naturally Intracellular parasites of animals (virus- transmitted between vertebrate animals es, rickettsiae, and chlamydiae) cannot Zoonoses, and and man” (3). A limited number of be sapronotic agents. The term “saprono- Sapronoses zoonotic agents can cause extensive out- sis” was introduced in epidemiology as a breaks; many zoonoses, however, attract useful concept (6–8). For these diseases To the Editor: The source of infection the public’s attention because of the high the expert committee applied the term has always been regarded as an utmost death rate associated with the infections. “sapro-zoonoses,” defined as “having factor in epidemiology. Human commu- In addition, zoonoses are sometimes con- both a vertebrate host and a nonanimal nicable diseases can be classified accord- tagious for hospital personnel (e.g., hem- developmental site or reservoir (organic ing to the source of infection as anthro- orrhagic fevers). Zoonotic diseases can matter, soil, and plants)” (3,9). However, ponoses (when the source is an infectious be classified according to the ecosystem the term sapronoses is more appropriate human; interhuman transfer is typical), in which they circulate. The classifica- because animals are not the source of zoonoses (the source is an infectious ani- tion is either synanthropic zoonoses, infection for humans. While anthro- mal; interhuman transfer is uncommon), with an urban (domestic) cycle in which ponoses and zoonoses are usually the and sapronoses (the source is an abiotic the source of infection are domestic and domains for professional activities of substrate, nonliving environment; inter- synanthropic animals (e.g., urban rabies, human and veterinary microbiologists, human transfer is exceptional).
    [Show full text]
  • Genetics and Molecular Biology, 44, 1, E20200029 (2021) Copyright © Sociedade Brasileira De Genética
    Genetics and Molecular Biology, 44, 1, e20200029 (2021) Copyright © Sociedade Brasileira de Genética. DOI: https://doi.org/10.1590/1678-4685-GMB-2020-0029 Research Article Genetics of Microorganisms Analysis of potential virulence genes and competence to transformation in Haemophilus influenzae biotype aegyptius associated with Brazilian Purpuric Fever Rafaella Fabiana Carneiro Pereira1, Thais Holtz Theizen1, Daisy Machado1, João Paulo de Oliveira Guarnieri2, Gabriel Piccirillo Gomide2, Luciana Maria de Hollanda1and Marcelo Lancellotti 1,2 1Universidade Estadual de Campinas, Departamento de Bioquímica e Biologia Tecidual, Instituto de Biologia, Campinas, SP, Brazil. 2Universidade Estadual de Campinas - UNICAMP, Faculdade de Ciências Farmacêuticas - FCF, Campinas, SP, Brazil. Abstract Brazilian Purpuric Fever (BPF) is a hemorrhagic pediatric illness caused by Haemophilus influenzae biogroup aegyptius (Hae), a bacterium that was formerly associated with self-limited purulent conjunctivitis. BPF is assumed to be eradicated. However, the virulence mechanisms inherent to Hae strains associated with BPF is still a mystery and deficient in studies. Here, we aim to analyze the role of the autotransporter genes related to adherence and colonization las, tabA1, and hadA genes through RT-qPCR expression profiling and knockout mutants. Relative quantification by real-time PCR after infection in human cells and infant rat model suggests that las was initially downregulated probably duo to immune evasion, tabA1, and hadA were overexpressed in general, suggesting an active role of TabA1 and HadA1 adhesins in Hae in vitro and in vivo. Transformation attempts were unsuccessful despite the use of multiple technical approaches and in silico analysis revealed that Hae lacks genes related to competence in Haemophilus, which could be part of the elucidation of the difficulty of genetically manipulating Hae strains.
    [Show full text]