DOCSLIB.ORG

Migration and Tuberculosis Transmission in A

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Migration and Tuberculosis Transmission in A Pescarini et al. BMC Medicine (2018) 16:62 https://doi.org/10.1186/s12916-018-1055-1 RESEARCH ARTICLE Open Access Migration and tuberculosis transmission in a middle-income country: a cross-sectional study in a central area of São Paulo, Brazil Julia Moreira Pescarini1,3*, Vera Simonsen2, Lucilaine Ferrazoli2, Laura C. Rodrigues3, Rosangela S. Oliveira2, Eliseu Alves Waldman1† and Rein Houben3,4† Abstract Background: Little is known about the impact of growing migration on the pattern of tuberculosis (TB) transmission in middle-income countries. We estimated TB recent transmission and its associated factors and investigated the presence of cross-transmission between South American migrants and Brazilians. Methods: We studied a convenient sample of cases of people with pulmonary TB in a central area of São Paulo, Brazil, diagnosed between 2013 and 2014. Cases with similar restriction fragment length polymorphism (IS6110- RFLP) patterns of their Mycobacterium tuberculosis complex isolates were grouped in clusters (recent transmission). Clusters with both Brazilian and South American migrants were considered mixed (cross-transmission). Risk factors for recent transmission were studied using logistic regression. Results: Isolates from 347 cases were included, 76.7% from Brazilians and 23.3% from South American migrants. Fifty clusters were identified, which included 43% South American migrants and 60.2% Brazilians (odds ratio = 0.50, 95% confidence interval = 0.30–0.83). Twelve cross-transmission clusters were identified, involving 24.6% of all clustered cases and 13.8% of all genotyped cases, with migrants accounting for either an equal part or fewer cases in 11/12 mixed clusters. Conclusions: Our results suggest that TB disease following recent transmission is more common among Brazilians, especially among those belonging to high-risk groups, such as drug users. Cross-transmission between migrants and Brazilians was present, but we found limited contributions from migrants to Brazilians in central areas of São Paulo and vice versa. Keywords: Tuberculosis, Molecular epidemiology, Transmission, Migration, Middle-income; disease control Background born population is often limited [4]. As former high burden Tuberculosis (TB) in high-income countries is often driven countries in the Global South grow economically and make by migration from countries with a higher TB burden, progress in TB control, they are facing a similar challenge which can account for up to 80% of the total TB burden through increasing South-South migration [5]. [1]. As a result, migrants tend to be seen as a potential Molecular epidemiology studies can estimate the number source of transmission to the local-born population [2, 3]. of TB cases due to recent transmission between local-born However, molecular research from high-income countries and migrant populations (cross-transmission) [6]. Results has shown that transmission from migrants to the local- from high-income countries suggest that cross-transmission is bidirectional, limited and has wide variation among study * Correspondence: [email protected] settings [7–9].Thereislittleevidenceavailablefrommiddle- †Equal contributors income countries [10, 11], where Mycobacterium tubercu- 1 Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil losis complex (Mtbc) transmission between migrants and 3Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, local-born people, in the South-South migration context, London, UK Full list of author information is available at the end of the article © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Pescarini et al. BMC Medicine (2018) 16:62 Page 2 of 10 might be more pronounced because of increased mixing a combination of squatting and informal dwellings, through cultural proximity and social integration [12]. including migrants under precarious work conditions Regional migration has increased significantly in South living in the workplace [24]. The mean pulmonary TB America over the past 15 years, with a predominance of (PTB) incidence rate for 2013/2014 ranged from 13 to young, healthy and more feminized populations involved 131/100,000 inhabitants/year in the districts, and the in labour migration towards large urban centres in proportion of new PTB cases among individuals of South Argentina, Brazil and Chile [13]. While regional migra- American origin in 2013 and 2014 ranged from 14% to tion in South America can contribute to more social in- 30% in each of the Administrative Regions studied. In this tegration, the vulnerability of migrants can be enhanced context, TB transmission is favourable in areas of by the already poor social context found in metropolitan overcrowding, poverty and inequality [17]. areas of South America [14–16]. The vulnerability of the The Brazilian TB Control Programme recommends fur- local-born population and the contexts in which mi- ther confirmation by both culture and drug susceptibility grants find themselves might contribute to more TB test for TB cases in high-risk groups for TB. This includes cross-transmission than what is evidenced in high- people living with HIV (PLHIV), drug users, people in income countries [4, 12, 13]. contact with drug-resistant TB cases, smear-positive cases While the World Health Organization (WHO) End TB after 2 months on TB treatment, retreatment TB cases Strategy recognizes migrants as one of the vulnerable popu- and other members of the ‘vulnerable population’ includ- lations who must be targeted [17], many middle-income ing migrants from South American countries [19, 25]. countries do not have specific TB policies for internal or ex- Our reference population was all PTB cases among ternal migrants [18–20]. For this to change, evidence is residents in the study area, and the study population in- needed to establish whether migration is contributing to cluded only patients with TB for whom there was a cul- the TB burden in middle-income countries and to ongoing ture available, without age or sex restrictions. All Mtbc transmission among the local population. Here, we esti- culture-positive PTB cases among Brazilians and mi- mated recent transmission of TB and its associated factors grants, available at the State Reference Laboratory for and investigated the presence of cross-transmission be- TB (Instituto Adolfo Lutz-São Paulo (IAL-SP)) between tween South American migrants and Brazilians in central 1 January 2013 and 31 December 2014, were eligible for districts of the city of São Paulo. the study. We included only the first available respira- tory sample with culture (including sputum and bron- Methods choalveolar lavage) from all the individuals and excluded Study design, area and population migrants from outside South America. We conducted a cross-sectional study in the municipal- ity of São Paulo, Brazil. The Brazilian Health System Data collection (SUS) guarantees access to free and universal healthcare Socio-demographic, clinical and epidemiological data services, irrespective of country of origin [19], which is were obtained from the São Paulo Tuberculosis Control important for TB treatment completion and cure among Program database (SINAN-TBWEB) and laboratory in- migrants [21]. Migration flows in SP are predominantly formation from the IAL-SP database (SIGH). from other parts of Brazil and other South American countries. The number of TB notifications among South Molecular characterization American migrants has increased in the last ten years We performed the molecular characterization of Mtbc [21]. Migrants coming from Bolivia accounted for almost isolates by restriction fragment length polymorphism half of the notified cases in some city districts [21], and (IS6110-RFLP) at the IAL-SP [26]. Analysis of the Mtbc this probably reflects the three times higher yearly inci- pattern was conducted in Bionumerics v.7.2 (Applied dence of TB in Bolivia than in Brazil (117/100,00 inhabi- Maths, Kortrijk, Belgium). We excluded similar patterns tants/year and 41 inhabitants/year in 2015) [22]. with less than five bands. Our study focused on the central area of São Paulo, where vulnerable populations including a significant num- Data analysis and definitions ber of recently arrived migrants live. We selected four Ad- Cases with a unique IS6110-RFLP pattern were identi- ministrative Regions (administrative division of the fied and considered to result from reactivation, not in a municipality based on grouped districts) with the highest transmission chain in the sample. Two or more cases absolute number of cases of TB among South American with identical patterns or with one band difference were migrants (study area). Almost 2 million individuals live in defined as a cluster (i.e. part of the same recent trans- this densely populated study area (11,934 residents/km2), mission chain). Clusters consisting of either all Brazilian where the proportion of
Load more

Recommended publications
  • Impact of the Household Environment Risk for Maintenance of Natural Foci
    medRxiv preprint doi: https://doi.org/10.1101/2021.05.18.21257380; this version posted May 22, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . 1 Impact of the household environment risk for maintenance of natural foci of Leishmania infantum transmission to human and animal hosts in endemic areas for visceral leishmaniasis in Sao Paulo State, Brazil Patricia Sayuri Silvestre Matsumoto1, Roberto Mitsuyoshi Hiramoto2 Virgínia Bodelão Richini Pereira3 Valéria Medina Camprigher4, Helena Hilomi Taniguchi5, José Eduardo de Raeffray Barbosa6, Luiz Ricardo Paes de Barros Cortez7, Elivelton da Silva Fonseca8, Raul Borges Guimarães9 and José Eduardo Tolezano10* 1 Parasitology and Mycology Center, Adolfo Lutz Institute (IAL), Sao Paulo, Sao Paulo, Brazil; [email protected] 2 Parasitology and Mycology Center, Adolfo Lutz Institute (IAL), Sao Paulo, Sao Paulo, Brazil; [email protected] 3 Adolfo Lutz Institute, Regional Laboratories Center II Bauru, Bauru, Sao Paulo, Brazil; [email protected] 4 Center for Zoonoses Control of Bauru. Health Secretariat of Bauru; [email protected] 5 Parasitology and Mycology Center, Adolfo Lutz Institute (IAL), Sao Paulo, Sao Paulo, Brazil; [email protected] 6 Bioterium nucleos, Adolfo Lutz Institute (IAL), Sao Paulo, Sao Paulo, Brazil; [email protected] 7 Center for Zoonoses Control of Bauru.
    [Show full text]
  • Vital Brazil E a Autonomia (Vital) Para a Educação Introdução Imagine Se
    Vital Brazil e a autonomia (vital) para a educação Sandra Delmonte Gallego Honda1 Universidade Nove de Julho - UNINOVE Resumo: O presente artigo tem o objetivo de explanar de forma sucinta a biografia de Vital Brazil e relacionar suas contribuições na medicina e na educação brasileira. A educação, conforme é sabido, sofre defasagens consideráveis no cerne de alunos de escolas públicas que almejam adentrar em cursos superiores considerados, ainda hoje, elitistas, tal qual a medicina, que nos serve de protagonista neste trabalho. Buscou-se, assim, conjugar a biografia de Vital Brazil com as colocações de Paulo Freire em "Pedagogia do Oprimido" (2010), concluindo que a autonomia e a perseverança do educando diante das opressões e obstáculos são de suma importância para a concretização e a construção do indivíduo. Palavras-chave: Educação brasileira; pedagogia do oprimido; Vital Brazil Abstract: This paper its purpose explain a summarized form the Vital Brazil's biography and relate to their contributions in medicine with the Brazilian education. The education, as is known, suffers considerable gaps at the heart of public school students that aims to enter in university courses considered, even today, such elitists which medicine that serves the protagonist of this paper. It attempted to thus combine the biography of Vital Brazil with the placement of Paulo Freire in "Pedagogy of the Oppressed" (2010) concluding that the autonomy and perseverance of the student in front of oppression and obstacles are of paramount importance to the implementation and construction of the individual. Keywords: Brazilian education; pedagogy of the oppressed; Vital Brazil Introdução "A única felicidade da vida está na consciência de ter realizado algo útil em benefício da comunidade”.
    [Show full text]
  • We Gratefully Acknowledge the Following Authors From
    We gratefully acknowledge the following Authors from the Originating laboratories responsible for obtaining the specimens, as well as the Submitting laboratories where the genome data were generated and shared via GISAID, on which this research is based. All Submitters of data may be contacted directly via www.gisaid.org Authors are sorted alphabetically. Accession ID Originating Laboratory Submitting Laboratory Authors EPI_ISL_1009676, EPI_ISL_1009677, Diagnósticos da América - DASA Instituto de Medicina Tropical de Sao Paulo Brazil-UK Centre for Arbovirus Discovery Diagnosis Genomics and Epidemiology (CADDE) Genomic Network - Instituto de Medicina Tropical EPI_ISL_1009678 EPI_ISL_1060880, EPI_ISL_1060899 CDL Laboratorio Santos e Vidal LTDA. Instituto de Medicina Tropical de Sao Paulo Brazil-UK Centre for Arbovirus Discovery Diagnosis Genomics and Epidemiology (CADDE) Genomic Network - Instituto de Medicina Tropical EPI_ISL_1068157 Laboratorio de Ecologia de Doencas Transmissiveis na Laboratorio de Ecologia de Doencas Transmissiveis na Valdinete Nascimento, Victor Souza, André Corado, Fernanda Nascimento, George Silva, Ágatha Costa, Debora Duarte, Karina Pessoa, Matilde Mejía, Amazonia, Instituto Leonidas e Maria Deane - Fiocruz Amazonia, Instituto Leonidas e Maria Deane - Fiocruz Luciana Gonçalves, Maria Júlia Brandão, Michele Jesus, Felipe Naveca on behalf of the Fiocruz COVID-19 Genomic Surveillance Network Amazonia Amazonia EPI_ISL_1079161 IAL Regional de Bauru Instituto Adolfo Lutz, Interdiciplinary Procedures Center, Claudio Tavares
    [Show full text]
  • COVID-19 in Latin America the Implications of the First Confirmed
    Travel Medicine and Infectious Disease xxx (xxxx) xxxx Contents lists available at ScienceDirect Travel Medicine and Infectious Disease journal homepage: www.elsevier.com/locate/tmaid COVID-19 in Latin America: The implications of the first confirmed case in Brazil ARTICLE INFO Keywords: 2019-New coronavirus COVID-19 SARS-CoV-2 Outbreak Transmission Latin America Over the past weeks the spread of the Coronavirus Disease 2019 passenger flights scheduled to 103 destinations in 30 countries, and52 (COVID-19), caused by the Severe Acute Respiratory Syndrome domestic flights, connecting not only with major cities in Latin America Coronavirus 2 (SARS-CoV-2) [1], has been steady in Asia and other but also with direct flights to North America, Europe, Africa andthe regions in the world. Latin America was an exception until February 25, Middle East (Dubai). There are also buses that offer a service to and 2020, when the Brazilian Ministry of Health, confirmed the first case. from the metropolitan centers of Paraguay, Argentina, Uruguay and This first case was a Brazilian man, 61 years-old, who traveled from Bolivia. Brazil also connects with the countries of Chile, Argentina and February 9 to 20, 2020, to Lombardy, northern Italy, where a sig- Bolivia through some rail connections. The main seaport of Brazil is in nificant outbreak is ongoing. He arrived home on February 21,2020, Rio de Janeiro, where many international cruises also arrive. Thus, over and was attended at the Hospital Albert Einstein in São Paulo, Brazil. At the course of the next few days, a significant expansion in the region this institution, an initial real-time RT-PCR was positive for SARS-CoV- would be possible.
    [Show full text]
  • CE122/14 (Eng.) 13 April 1998 ORIGINAL: ENGLISH
    122nd Session Washington, D.C. June 1998 Provisional Agenda Item 4.8 CE122/14 (Eng.) 13 April 1998 ORIGINAL: ENGLISH HANTAVIRUS Since 1993, when an outbreak of hantavirus pulmonary syndrome was detected for the first time in the southwestern United States of America, several outbreaks or sporadic cases have been notified in Argentina, Brazil, Canada, Chile, Paraguay, and Uruguay. Outbreaks of this disease produce high case-fatality rates and have aroused widespread fear in the affected communities and great concern among the national health authorities. In light of this situation, the 40th Directing Council of the Pan American Health Organization (September 1997) adopted a resolution (CD40.R14) calling on the Member States to strengthen the mechanisms for collaboration among the countries and promote information, education, and communication geared toward the community to ensure the adoption of good environmental sanitation practices. That same resolution requests the Secretariat to create a task force to issue recommendations on surveillance, diagnosis, treatment, and prevention of the infection. The task force met in March 1998 to review and approve the guidelines on hantavirus. This document summarizes the historical background and current epidemio- logical situation of hantavirus infection. It also reports on PAHO activities to date in this area and presents a proposal for ongoing activities. The Executive Committee is requested to review this document and to make recommendations on the progress of the surveillance and detection activities
    [Show full text]
  • Yellow Fever in Rio De Janeiro and the Pasteur Institute Mission (1901-1905): the Transfer of Science to the Periphery
    Medical History, 1990, 34: 144-163. YELLOW FEVER IN RIO DE JANEIRO AND THE PASTEUR INSTITUTE MISSION (1901-1905): THE TRANSFER OF SCIENCE TO THE PERIPHERY by ILANA LOWY * Science, a purely European enterprise, began to be exported to peripheral countries in the nineteenth century. The rapid expansion ofbacteriology is a striking example of this. But at the same time, the transformation of bacteriology into a well-established and codified scientific discipline hampered the diffusion ofbacteriological knowledge, because the laboratory practice that developed in peripheral countries in the first wave of enthusiasm for the "miracle-making" science often failed to conform to the discipline's new, more stringent professional standards. The problem was ofparticular importance in bacteriology, in whose birth the techniques which allowed appropriate visualization, isolation, and characterization ofmicro-organisms played a crucial role. Indeed, debates on technical aspects of bacteriological investigation were at the heart of early controversies in this field. The story ofthe search for the agent ofyellow fever in Rio de Janeiro illustrates this evolution ofbacteriology. In the 1880s and 90s numerous enthusiastic Latin American adepts ofthe new science started to look for the aetiological agents oftropical diseases. In Brazil, a favourite target of bacteriological studies was yellow fever. However, the efforts of many bacteriologists notwithstanding, both the epidemiology of the disease and the nature of its aetiological agent remained for long mysterious. There were a dozen or so triumphant announcements of the isolation of the "yellow fever germ" in the 1880s and 90s. Many of them came from physicians working in Rio de Janeiro, a city which suffered from regular outbreaks.
    [Show full text]
  • Spread of Human Retrovirus Infections in Individuals at the Second and Third Decades of Life in São Paulo, Brazil
    Open Access Austin Journal of HIV/AIDS Research Rapid Communication Spread of Human Retrovirus Infections in Individuals at the Second and Third Decades of Life in São Paulo, Brazil Caterino-de-Araujo A* and Campos KR Centro de Imunologia, Instituto Adolfo Lutz, Abstract Coordenadoria de Controle de Doenças, Secretaria de The authors comment the spread of the human immunodeficiency virus 1 Estado da Saúde de São Paulo, São Paulo, SP, Brazil (HIV-1) and the human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and *Corresponding author: Adele Caterino-de- HTLV-2, here named HTLV) in the last years (from 2010 to 2016) in individuals Araujo, Instituto Adolfo Lutz, Centro de Imunologia, at the second and third decades of life in Brazil and in São Paulo city. Data on Coordenadoria de Controle de Doenças, Secretaria de the age and gender of 1,715 HIV-1-infected individuals whose blood samples Estado da Saúde de São Paulo, São Paulo, SP, Brazil were sent to Instituto Adolfo Lutz for HTLV-1/-2 infections determination were analyzed, and they were compared with the facts described in the Brazilian Received: December 12, 2017; Accepted: December 27, scientific literature. These retroviruses in adolescents and young adults is on 2017; Published: December 29, 2017 the increase, and the unprotected sexual contact has been presently pointed as the probable risk factor associated with these retroviruses spread in this parcel of population. These data are of concern, and the surveillance study on these viruses is justified for properly controlling the retroviruses spread in the country. Keywords: Human retroviruses; HIV-1; HTLV; Risk factors; Surveillance Abbreviations The study population was divided into five age-groups (G1: 16 to 25 years, G2: 26 to 30 years, G3: 31 to 40 years, G4: 41 to 50 years, and AIDS: Acquired Immune Deficiency Syndrome; ELISA: Enzyme G5: >50 years old), and according to the gender.
    [Show full text]
  • Spread” of Jungle Yellow Fever
    doi: 10.5216/rpt.v47i1.52274 OPINION ARTICLE THE ‘SPREAD” OF JUNGLE YELLOW FEVER Fernando Dias de Avila-Pires ABSTRACT The saga of yellow fever has been recounted by several science historians. It is a chronicle of errors, fight for recognition, historical mis-interpretations, and human experiments that would be unacceptable today. But it is also a record of forecasts that would be later confirmed by sound field work and through laboratory and clinical research. It is also an example of the contribution of local native lore to sound scientific discoveries. In this paper we try to demonstrate how we are advancing towards the natural foci of the jungle cycles of a zoonosis, not the reverse. KEY WORDS: Yellow fever; geographical distribution; epizootiology; epidemics. The saga of yellow fever has been recounted by several science historians and is now known in great detail. It is a chronicle of errors (Nogush, 1920), fight for recognition, historical mis-interpretations, and experiments that would be unacceptable today (Kelly, 1906; de Kruif, 1926; Delaporte, 1989). But it is also a record of forecasts that were to be confirmed by sound field work (Lutz, 1930) and laboratory and clinical research. It is also an example of the contribution of local lore to scientific discoveries (Balfour, 1914). The reader of this paper deserves to be spared tiresome repetitions. It is enough to recall that it arrived in Brazil, in the State of Pernambuco in the year of 1685, and in Rio de Janeiro, in 1894. A few references will be enough to introduce the subject of the present contribution to the knowledge of the jungle cycle of yellow fever in Brazil.
    [Show full text]
  • Downloads.Ibge.Gov.Br/Downloads Geociencias.Html
    Lorenz et al. Malar J (2015) 14:408 DOI 10.1186/s12936-015-0934-6 RESEARCH Open Access Spatial and temporal epidemiology of malaria in extra‑Amazonian regions of Brazil Camila Lorenz1,2*†, Flávia Virginio1,2†, Breno S. Aguiar4, Lincoln Suesdek1,2,3 and Francisco Chiaravalloti‑Neto4 Abstract Background: Mosquitoes, Plasmodium parasites, and humans live in sympatry in some extra-Amazonian regions of Brazil. Recent migrations of people from Amazonia and other countries to extra-Amazonian regions have led to many malaria outbreaks. Lack of relevant expertise among health professionals in non-endemic areas can lead to a neglect of the disease, which can be dangerous given its high fatality rate. Therefore, understanding the spatial and temporal epidemiology of malaria is essential for developing strategies for disease control and elimination. This study aimed to characterize imported (IMP) and autochthonous/introduced (AU/IN) cases in the extra-Amazonian regions and identify risk areas and groups. Methods: Epidemiological data collected between 2007 and 2014 were obtained from the Notifiable Diseases Information System of the Ministry of Health (SINAN) and from the Department of the Unified Health System (DATA‑ SUS). High malaria risk areas were determined using the Local Indicator of Spatial Association. IMP and AU/IN malaria incidence rates were corrected by Local Empirical Bayesian rates. Results: A total of 6092 malaria cases (IMP: 5416, 88.9 %; AU/IN: 676, 11.1 %) was recorded in the extra-Amazonian regions in 2007–2014. The highest numbers of IMP and AU/IN cases were registered in 2007 (n 862) and 2010 (n 149), respectively.
    [Show full text]
  • Tetravalent Dengue Vaccine
    Tetravalent Dengue Vaccine - Butantan Institute Developing Countries Vaccine Manufacturers Network Hanoi, Vietnam 7-9th, Ocotber, 2013 Dengue Epidemiology and Clinical Disease • Mosquito-borne flavivirus disease - tropical and subtropical areas • The incidence of dengue has increased 30-fold over the last 50 years • Up to 50-100 million infections annually in over 100 endemic countries Instituto Butantan | 1 Dengue Vaccine Development • Based on the complexity of dengue immunology and pathogenesis several challanges to vaccine development have been identified; • In spite of these challenges, vaccine development has made remarkable progress in recent years, and the current dengue vaccine pipeline is advanced, diverse and, in overall, promising; Instituto Butantan | 2 Instituto Butantan | 3 PROSPECTS FOR A DENGUE VACCINE • Goals of Immunization • First, the vaccine must be protective against each of the four DENV serotypes; • Second, the DENV vaccine should provide lifelong protection; • Third, immunization should be safe and well tolerated; • Fourth, universal coverage should be a goal in endemic regions; • Fifth, the cost of the vaccine must be affordable to the countries most in need of it. Instituto Butantan | 4 Dengue Vaccine Development at Butantan • The production of a live attnuated tetravalent dengue vaccine in Brazil is the result of a partnership between the Laboratory of Infectious Diseases at The National Institutes of Allergy and Infectious Diseases - NIH and Butantan Institute. Instituto Butantan | 5 A live attenuated dengue vaccine approach was chosen by NIH for several reasons: 1) First, live vaccines are expected to stimulate both cellular and humoral immune responses, therefore are able to induce a strong memory response and durable immune response; 2) Second, LA vaccines for other related flaviviruses such as yellow fever and Japanese encephalitis virus have been successfully developed; 3) Third, LA vaccines can be very economical to produce, helping to ensure that the countries most in need of a dengue vaccine will have access.
    [Show full text]
  • Hypervirulent Klebsiella Pneumoniae As Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil Juliana Mariotti Guerra, Natália Coelho Couto De A
    Hypervirulent Klebsiella pneumoniae as Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil Juliana Mariotti Guerra, Natália Coelho Couto de A. Fernandes, Alessandra Loureiro Morales dos Santos, Joana de Souza Pereira Barrel, Bruno Simões Sergio Petri, Liliane Milanelo, Monique Ribeiro Tiba-Casas, Alcina Maria Liserre, Cláudia Regina Gonçalves, Cláudio Tavares Sacchi, José Luiz Catão-Dias, Carlos Henrique Camargo. After the sudden death of captive marmosets in São signs, including anorexia, prostration, fever, cough, Paulo, Brazil, we conducted a histologic and microbio- dyspnea, mucopurulent discharge, meningitis, pneu- logic study. We found hyperacute septicemia caused monia, peritonitis, and sepsis are strongly associated by hypermucoviscous sequence type 86 K2 Klebsiella with sporadic infections of K. pneumoniae in common pneumoniae. We implemented prophylactic antimicrobial marmosets research colonies (5,6). therapy, selected dedicated staff for marmoset interac- Despite the well-recognized zoonotic importance tions, and sanitized the animals’ fruit to successfully con- of hvKp and the public health risk of emerging multi- trol this outbreak. drug-resistant strains (7–9), information is incomplete about the genotypic and phenotypic characterization lebsiella pneumoniae is an opportunistic bacteria of the etiologic agent essential to adequately diagnose that is a normal part of the nasopharyngeal and K and treat this pathogen in captive and wild nonhu- gastrointestinal tract microbiome of humans and ani- man primates. The aim of this study was to report an mals (1). The hypermucoviscous variant of K. pneu- epizootic among common marmosets in a wildlife moniae (hvKp), initially described in Southeast Asia, rehabilitation center in Brazil and to describe the se- has emerged as a pathogen affecting young and rotype, sequence typing, virulence properties, and re- healthy persons worldwide (2).
    [Show full text]
  • Visceral Leishmaniasis in an Environmentally
    RESEARCH ARTICLE Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross- sectional investigation of phlebotomine fauna, wild hosts and canine cases Maria Rita Donalisio1☯, LaõÂs Moraes Paiz1☯*, Vanessa Gusmon da Silva2☯, VirgõÂnia a1111111111 Bodelão Richini-Pereira3☯, Andrea Paula Bruno von Zuben4³, Claudio Luiz Castagna4³, a1111111111 Gabriela Motoie2³, Roberto Mitsuyoshi Hiramoto2³, Jose Eduardo Tolezano2☯ a1111111111 a1111111111 1 Department of Public Health, State University of Campinas, Campinas, São Paulo, Brazil, 2 Center for Systemic Parasitic Diseases, Adolfo Lutz Institute, São Paulo, São Paulo, Brazil, 3 Bauru II Center of a1111111111 Regional Laboratories, Adolfo Lutz Institute, Bauru, São Paulo, Brazil, 4 Campinas Municipal Health Department, Campinas, São Paulo, Brazil ☯ These authors contributed equally to this work. ³ APBvZ, CLC, GM, and RMH also contributed equally to this work. * [email protected] OPEN ACCESS Citation: Donalisio MR, Paiz LM, da Silva VG, Richini-Pereira VB, von Zuben APB, Castagna CL, et al. (2017) Visceral leishmaniasis in an Abstract environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross- Background sectional investigation of phlebotomine fauna, wild hosts and canine cases. PLoS Negl Trop Dis 11(7): Leishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern e0005666. https://doi.org/10.1371/journal. exists regarding the role of wildlife in visceral leishmaniasis (VL) transmission, due to fre- pntd.0005666 quent natural or anthropogenic environmental changes that facilitate contact between wild- Editor: Ricardo Toshio Fujiwara, Universidade life, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially Federal de Minas Gerais, BRAZIL recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an Received: January 9, 2017 upscale residential condominium, located inside an environmentally protected area (EPA).
    [Show full text]