Dennis Minoru Fujita

Entry routes for Zika virus in Brazil after 2014 world cup: New possibilities.

In the beginning of 2015, several cases of Dengue and Chikungunya virus infections were reported in Brazil [1]. Dengue epidemics are located in the states of São Paulo (637,029 confirmed cases), Minas Gerais (166,360 confirmed cases), Goiás (121,501 confirmed cases), Pernambuco (68,510 confirmed cases), Ceará (59,074 confirmed cases), Rio de Janeiro (49,480 confirmed cases), Paraná (46,694 confirmed cases), Bahia (42,476 confirmed cases), Rio Grande do Norte (21,194 confirmed cases), Mato Grosso do Sul (18,663 confirmed cases), Paraı́ba (18,018 confirmed cases), Espı́rito Santo (16,477 confirmed cases), Alagoas (13,846 confirmed cases) e Mato Grosso (13,700 confirmed cases). For Chikungunya virus infection, the state of Bahia appears as first in number of confirmed cases (7820), followed by Amapá (1070) and Federal District (194). Zika virus infections presented clinical pictures very similar to dengue, and the number of cases reported officially are low, provided by problems in detection as it occurs in a dengue virus area and co -infection of these viruses is not uncommon [2]. The strongest hypothesis of the introduction of Zika virus in Brazil has bought by African travelers during the 2014 World Cup has virus transmission by asymptomatic patients, aside to significant increase of

Potential measles transmission risk in mass gatherings: Are we safe for the Olympic games--Rio 2016?

The measles virus, genus Morbillivirus of the Paramyxoviridae family, only infects humans. Measles is transmitted by droplets when the infected individual is coughing or sneezing. It is highly infectious (R0 = 15–20 in a completely susceptible population),1 especially in closed environments such as shopping malls, schools and other confined places. Infected individuals can shed the virus up to 4 days before the appearance of their symptoms and up to 4 days after the onset of symptoms.2 Also, its RNA is still detected in biological samples for many weeks.3 Measles is characterized by its high infectivity. The initial clinical manifestations include runny nose, cough, red and watery eyes and small white spots inside the cheeks. After several days, a maculo-papular exanthema erupts.4 Measles was controlled in some regions, including Brazil. Recently, some outbreaks were reported in the country in the past few years and may represent a risk for transmission during mass gathering events, such as the Olympic Games. For that reason, the aim of this article is to discuss the potential risk for Measles transmission in the country during the Olympic Games and also preventive measures in order to avoid other outbreaks. The number of suspected and confirmed measles cases in 2015 reported by WHO5 indicates a frame, in which the African Region presents the highest number of confirmed cases, whereas Region of Americas presents the lowest: African Region (54 374 suspect/35 557 confirmed), Region of the Americas (13 083 suspect/366 confirmed), Eastern Mediterranean Region (26 178 suspect/11 610 confirmed), European Region (6642 suspect/6023 confirmed), South-East Asia Region (79 713 suspect/67 233 confirmed) and Western Pacific Region (120 319 suspect/61 493 confirmed). This represents a total of 300.309 suspect cases and 182.282 confirmed cases in the world until October 2015. WHO indicates that from June 2014 to June 2015 in the European Continent, there were more …

Reemergence of mumps in São Paulo, Brazil - the urgent need for booster shot campaign to prevent a serious infectious disease

INTRODUCTION: Neglected infectious diseases like mumps may be opportunistic in controlled areas with low vaccine coverage, particularly in developed and emerging countries. METHODS: A retrospective analysis of mumps-related data from 2001 to 2016 for São Paulo State, Brazil was conducted. RESULTS: From 2014 to 2015, there was an increase of 82% in reported mumps cases in São Paulo, with prevalence of n=49 and 297, respectively in young adults aged 15-29 years. CONCLUSIONS: A booster-shot campaign on MMR vaccination is recommended to prevent the spread of mumps in unvaccinated children and recipients of only the first dose.

The silent spread of West Nile virus in Brazil: non-human positive case in a beach tourist destination—Espirito Santo

Dear Editor, West Nile virus (WNV) is an emerging arbovirus related to a neurotropic flavivirus that usually infects birds, and can be accidentally transmitted to other animals, including humans. Positive cases in humans are mainly asymptomatic (8 of 10 infected individuals), but a small portion present fever (1 in 5 infected individuals) with headache, myalgia, arthralgia, vomiting, diarrhoea or rash, common symptoms of other flaviviruses. The severe illness, with important neurological consequences, may affect only 1 in 150 of infected patients. Specific diagnostic tests are crucial for surveillance and local control. Evidence of the viral circulation in Brazil was reported in equids in Amazon and Pantanal areas in 2009. The spread to the northeast region of the country, with positive cases in equids and birds, occurred in 2013. One year later, the first human case was detected (Piauí State). WNV was silently transmitted, arriving now in Brazilian’s Southeast Region (Figure 1) according to the report of one equid death in 2018, June in Espírito Santo State, an important domestic tourist destination in Brazil, which currently presents other arboviruses’ outbreaks as Zika (n = 219 reported cases), Chikungunya (n = 482 reported cases) and Dengue (n = 6.945 reported cases). The persistence of other arboviruses in the autumn/winter period points to the vectors population increasing in the region (including Aedes aegypti, Culex quinquefasciatus and others), a similar condition that affects other Brazilian states. Considering that the virus infects birds, equids and also humans, areas with high-population density may be in alert (previous cases occurred in uninhabited locations) due to the fast spread of other arboviruses in the state. The existence of a similar favourable causal network in the USA contributed to the WNV epidemic in 1999. We recommend, especially for domestic travellers, the use of mosquito repellents, especially icaridin, and to wear pants and shirts with long sleeves when visiting natural areas in Espírito Santo State. Unfortunately, there is no cure or vaccine for humans against WNV, only palliative treatment for the symptoms. Other protective measures may be established such as public campaigns for mass information (including preventive instructions to avoid the disease) and the elimination of mosquito breeding sites in the urban areas (to reduce the transmission of arboviruses). Other actions of eco-epidemiological surveillance by the municipal and state government, aiming at fast identification of probable hosts in urban and peri-urban areas may become urgent.