Ana A.M.C. Castro e Silva

Fiscalização de verduras comercializadas no município de Ribeirão Preto, SP

Resumo O consumo de verduras cruas constitui importante meio de transmissao de varias doencasinfecciosas. Este estudo tem como objetivo a avaliacao microbiologica e parasitologica de verdurascomercializadas no municipio de Ribeirao Preto, SP, abrangendo todos os pontos de venda ao consumidor.Do total de 172 estabelecimentos fixos ou ambulantes analisados, 115 (67%) apresentaram hortalicas comirregularidades: elevada concentracao de coliformes fecais em 63%, presenca de Salmonella em 9% e deenteroparasitas em 33%. Os pontos de venda com maior frequencia de hortalicas com resultados inadequadosforam: mercearias (92%), CEAGESP (75%), quitandas (71%), vendedores ambulantes (71%), feiras-livres(69%), supermercados (52%) e hortas (18%). O tipo de contaminacao apresentou distribuicao uniforme emrelacao aos locais de venda e a variedade da hortalica. A maioria (61%) das verduras contaminadas eraprocedente de hortas localizadas no municipio de Ribeirao Preto. Considerando a elevada frequencia decontaminacao fecal e o potencial risco de doencas veiculadas pelas hortalicas, sugerimos uma vigilânciasanitaria mais atuante na fiscalizacao de alimentos oferecidos a populacao.Palavras-chaves: Verduras. Coliformes fecais. Salmonella. Cisticercose.Abstract The ingestion of raw vegetables represents an important means of transmission of several infectiousdiseases. The objective of the present study was to perform a microbiological and parasitological evaluationof the vegetables commercially sold in the municipality of Ribeirao Preto, SP, Brazil. Of a total of 172 commercialconcerns analyzed, 115 (67%) presented irregularities in the vegetables they sold, such as elevatedconcentration of fecal coliforms in 63%, presence of Salmonella in 9%, and presence of enteroparasites in33%. The commercial concerns with the highest frequencies of vegetables showing inadequate results were:grocery stores (92%), CEAGESP (75%), fruit and vegetables stores (71%), traveling vendors (71%), fairs(69%), supermarkets (52%), and vegetable gardens (18%). The type of contamination was uniformly distributedamong these commercial concerns. Most of the contaminated vegetables (61%) were from gardens located inthe municipality of Ribeirao Preto. Considering the high frequency of fecal contamination and the potential riskof disease transmitted by vegetables, we suggest greater enforcement in the sanitary surveillance of the foodoffered to the population.Key-words: Lettuce. Vegetable. Fecal coliforms. Salmonella. Cysticercosis.The ingestion of raw vegetables represents an important means of transmission of several infectious diseases. The objective of the present study was to perform a microbiological and parasitological evaluation of the vegetables commercially sold in the municipality of Ribeirão Preto, SP, Brazil. Of a total of 172 commercial concerns analyzed, 115 (67%) presented irregularities in the vegetables they sold, such as elevated concentration of fecal coliforms in 63%, presence of Salmonella in 9%, and presence of enteroparasites in 33%. The commercial concerns with the highest frequencies of vegetables showing inadequate results were: grocery stores (92%), CEAGESP (75%), fruit and vegetables stores (71%), traveling vendors (71%), fairs (69%), supermarkets (52%), and vegetable gardens (18%). The type of contamination was uniformly distributed among these commercial concerns. Most of the contaminated vegetables (61%) were from gardens located in the municipality of Ribeirão Preto. Considering the high frequency of fecal contamination and the potential risk of disease transmitted by vegetables, we suggest greater enforcement in the sanitary surveillance of the food offered to the population.

Fiscalização de hortas produtoras de verduras do município de Ribeirão Preto, SP

The ingesting of raw vegetables plays an important role in the transmission of several infectious diseases due to the high frequency of irrigation with wastewater. The objective of this study was to evaluate the sanitary conditions of all lettuce producing crops in Ribeirao Preto through microbiological and parasitological analysis of both irrigation water and lettuce together with the implantation of an effective crop monitoring. Laboratory analysis of 129 crops showed irregularities in 26 (20.1%) of these: high concentration of fecal coliforms in 17% of the lettuce, presence of Salmonella in 3.1% and several enteroparasites (Ascaris sp, Ancylostomidae, Strongyloides sp, Hymenolepis nana, and Giardia sp ) in 13.1%. Persistent irregularities determined the definitive closing down of one producer; all of the remaining 128 crops were eventually approved, thus demonstrating the efficacy of lettuce crop monitoring. Crops approved in the laboratory analysis were awarded a Sanitary Inspection Certificate - an unprecedented procedure in our Country - that resulted in a better acceptance of the monitoring.The ingesting of raw vegetables plays an important role in the transmission of several infectious diseases due to the high frequency of irrigation with wastewater. The objective of this study was to evaluate the sanitary conditions of all lettuce producing crops in Ribeirão Preto through microbiological and parasitological analysis of both irrigation water and lettuce together with the implantation of an effective crop monitoring. Laboratory analysis of 129 crops showed irregularities in 26 (20.1%) of these: high concentration of fecal coliforms in 17% of the lettuce, presence of Salmonella in 3.1% and several enteroparasites (Ascaris sp, Ancylostomidae, Strongyloides sp, Hymenolepis nana, and Giardia sp ) in 13.1%. Persistent irregularities determined the definitive closing down of one producer; all of the remaining 128 crops were eventually approved, thus demonstrating the efficacy of lettuce crop monitoring. Crops approved in the laboratory analysis were awarded a Sanitary Inspection Certificate - an unprecedented procedure in our Country - that resulted in a better acceptance of the monitoring.

Notificação compulsória da cisticercose em Ribeirão Preto - SP

Cysticercosis is a severe public health problem in several regions of Asia, Africa and Latin America. Epidemiologic studies based on the frequency of cases observed in specialized neurology, neurosurgery and computed tomography services, at autopsy and in seroepidemiologic studies do not permit the determination of the true prevalence of the disease in the population. The objective of the present study was to investigate the prevalence of cysticercosis by compulsory notification. The coefficient of prevalence was 54 cases/100000 inhabitants in the municipality of Ribeirao Preto. The results also indicated that cysticercosis is not under control in our region since 21% of cases presented the active form of the disease. Compulsory notification proved to be a valuable resource for the epidemiologic study of cysticercosis, also permitting the mapping of more affected areas for a better direction of prevention strategies.

Avaliação da contaminação de hortas produtoras de verduras após a implantação do sistema de fiscalização em Ribeirão Preto, SP

This study evaluated the microbiological and parasitological contamination of 88 market gardens producing green vegetables, of which 47 had been investigated previously. The contamination rate was 38.3% in the market gardens previously evaluated and 43.9% in the new market gardens. Food safety requires a continuous and efficient sanitary surveillance system for market gardens.

Análise da cadeia de produção de verduras em Ribeirão Preto, SP

With the aim of assessing the cumulative risk of lettuce contamination, 45 production chains were investigated. The presence of thermotolerant coliforms, Salmonella and/or parasites was detected in 69% of these, in all steps of the production chain. Quality control in all steps of the lettuce production process should be intensified.

Monitoring of lettuce crops of Ribeirão Preto, SP, Brazil

The ingesting of raw vegetables plays an important role in the transmission of several infectious diseases due to the high frequency of irrigation with wastewater. The objective of this study was to evaluate the sanitary conditions of all lettuce producing crops in Ribeirao Preto through microbiological and parasitological analysis of both irrigation water and lettuce together with the implantation of an effective crop monitoring. Laboratory analysis of 129 crops showed irregularities in 26 (20.1%) of these: high concentration of fecal coliforms in 17% of the lettuce, presence of Salmonella in 3.1% and several enteroparasites (Ascaris sp, Ancylostomidae, Strongyloides sp, Hymenolepis nana, and Giardia sp ) in 13.1%. Persistent irregularities determined the definitive closing down of one producer; all of the remaining 128 crops were eventually approved, thus demonstrating the efficacy of lettuce crop monitoring. Crops approved in the laboratory analysis were awarded a Sanitary Inspection Certificate - an unprecedented procedure in our Country - that resulted in a better acceptance of the monitoring.The ingesting of raw vegetables plays an important role in the transmission of several infectious diseases due to the high frequency of irrigation with wastewater. The objective of this study was to evaluate the sanitary conditions of all lettuce producing crops in Ribeirão Preto through microbiological and parasitological analysis of both irrigation water and lettuce together with the implantation of an effective crop monitoring. Laboratory analysis of 129 crops showed irregularities in 26 (20.1%) of these: high concentration of fecal coliforms in 17% of the lettuce, presence of Salmonella in 3.1% and several enteroparasites (Ascaris sp, Ancylostomidae, Strongyloides sp, Hymenolepis nana, and Giardia sp ) in 13.1%. Persistent irregularities determined the definitive closing down of one producer; all of the remaining 128 crops were eventually approved, thus demonstrating the efficacy of lettuce crop monitoring. Crops approved in the laboratory analysis were awarded a Sanitary Inspection Certificate - an unprecedented procedure in our Country - that resulted in a better acceptance of the monitoring.

Multiple sclerosis with early childhood onset: a case report

A 2 year old boy was admitted owing to a subacute episode of ataxic gait and hearing deficit. Computerized tomography (CT) was normal and cerebrospinal fluid (CSF) analysis revealed gamma globulins level of 15.4% (normal 7 to 14%). There was spontaneous remission after 7 months. At 5 years of age the boy incurred a second episode with predominantly right appendicular ataxia and tonic gaze deviation to the right side. CT showed a low-density lesion in the white matter adjacent to the right frontal horn. Visual and auditory evoked potentials were abnormal. CSF revealed a mild increase in gamma globulins level of 14.5% with an abnormal T lymphocyte subsets study. The combination of visual, cerebellar, brain stem and paraventricular lesions with clear remissions and exacerbations, supported by CT, CSF and evoked potentials findings suggests the diagnosis of multiple sclerosis even at this early age.

Epizootia de raiva na área urbana de Ribeirão Preto, SP, Brasil

This report describes some epidemiological aspects of a rabies epizootic that started in 1995 in the urban area of Ribeirão Preto, SP, Brazil, and discusses its main causes. All laboratory confirmed cases were described according to a set of epidemiological variables. Simultaneously, information was raised concerning rabies vaccine coverage and epidemiological surveillance activities. In addition to one human case, 58 rabid animals were confirmed in 1995 (54 dogs, 3 cats. and 1 bat). There were 20 cases in 1996 (18 dogs and 2 cats). Geographical distribution was uneven in the city, with higher concentrations observed in the Western, Northern, and Southwestern sections, corresponding to the poorest areas. No seasonal variation was observed. The main reasons for the epizootic were low rabies vaccine coverage in animals and severe failures in epidemiological surveillance activities in the years immediately prior to 1995. This epizootic illustrates the risk of neglecting such activities, even in a city with a reasonably good health system, located in one of the most economically developed areas of the country. Vigorous preventive measures markedly reduced the number of cases.

A case of human rabies in the Urban Area of Ribeirão Preto, SP, Brazil

A 39-year old male patient was admitted to the University Hospital of the Faculty of Medicine of Ribeirão, Preto with signs and symptoms of sudden dyspnea, generalized myalgia and behavioral disorders. The initial suspicion was alcohol abstinence syndrome and the patient was referred for psychiatric and neurologic care. The evolution of the patient with a worsening of signs and symptoms, presence of crises of tachypnea, agitation, difficulty to swallow, irritability and hydrophobia, and his report of having been bitten by a suspected dog raised the hypothesis of rabies. The diagnosis was confirmed by examination of a corneal impression, biological tests in the cerebrospinal fluid (CSF) and saliva and visualization of Negri bodies in nervous tissue (direct immunofluorescence). The patient evolved with agitation, aggressiveness, and worsening tachypnea intercalating with apnea, and died on the 4th day after admission.