Luiz Jacintho da Silva

O conceito de espaço na epidemiologia das doenças infecciosas

This article analyzes how space is employed in infectious disease epidemiology, with a brief retrospective of the various definitions of space and its implications. Emphasis is given to the theory of natural foci of infectious diseases formulated by Pavlovsky and the interactions of epidemiology and geography.The current problem posed by emerging infections is seen as a determinant of the need for further discussion on the concept of space in infectious disease epidemiology.

[Brazilian response to the HIV/AIDS epidemic, 2001-2005].

The document from the United Nations General Assembly Special Session (UNGASS) on HIV/ AIDS forms a fundamental reference point for everyone working in this field. It encompasses a wide variety of perspectives from the formulation of public policies within the national continental and global spheres to the provision of clinical care and implementation of preventive strategies by governments and civil society and last but not least it relates to continuing dialogue with community leaders and the people who are living with HIV and AIDS. Thanks to an initiative coordinated by the Brazilian Institute of Health with support from the non-governmental organizations Gestos-PE and Gapa-SP the Ford Foundation and the National STD/AIDS Program of the Ministry of Health it was possible to quickly bring together a variety of researchers activists and managers of public programs for the prevention and treatment of HIV/AIDS for a meeting on November 21 and 22 2005 at the State of Sao Paulo Department of Health in the city of Sao Paulo. Given the importance of the topic and the quality of the contributions from the different authors it was decided to publish the communications presented: not in their original format which was very preliminary but fully incorporating the critiques and ideas arising from the discussions that followed the presentation of each text at the time of holding the seminar. It was decided in our view correctly to review each contribution in detail starting by designating editors who would be in charge of three thematic blocks related to their respective fields of activity. (excerpt)

Riquetsioses no Brasil e Portugal: ocorrência, distribuição e diagnóstico

O presente artigo e uma atualizacao sobre a ocorrencia e diagnostico das riquetsioses existentes no Brasil e Portugal, com o objetivo de incentivar e incrementar a vigilância epidemiologica dessas doencas nos dois paises. Realizou-se levantamento bibliografico e foram apresentados dados nao publicados de laboratorios e servicos de epidemiologia. Os resultados descreveram a ocorrencia das riquetsioses no Brasil e Portugal, inclusive aquelas recem-descritas, advindas de riquetsias de potencial patogenico ainda incerto. Os metodos diagnosticos atualmente empregados foram discutidos. Como em outros paises, as riquetsioses parecem assumir crescente importância em saude publica. Relegadas a um plano secundario por muitas decadas, o interesse por essas infeccoes tem aumentado nos dois paises, mas ainda carece de investigacao para esclarecer seu real significado em saude publica.

Desbravamento, agricultura e doença: a doença de Chagas no Estado de São Paulo

Faz-se uma reconstrucao do processo de surgimento, disseminacao e desaparecimento da endemia chagasica no Estado de Sao Paulo, interpretando-se as informacoes epidemiologicas existentes, dentro de uma perspectiva historico-materialista. Parte-se dos conceitos classicos que procuram explicar a distribuicao da doenca, demonstrando sua insuficiencia. Com a incorporacao de conceitos e metodos de analise utilizados em Geografia, chega-se a uma compreensao do que foi o processo de evolucao da doenca em Sao Paulo, e quais os seus determinantes, mostrando que se tratou de um processo peculiar ao Centro-Sul brasileiro, num periodo historico bem determinado. A doenca de Chagas, ainda que uma endemia de expressao nacional, nao pode ser vista como um todo indistinto, existindo diferentes padroes epidemiologicos em periodos historicos diferentes.

Detection of Brazilian spotted fever infection by polymerase chain reaction in a patient from the state of São Paulo

Brazilian spotted fever (BSF) cases have been increasing in the state of São Paulo but no genomic information about local rickettsia isolated from humans has been well documented. We recovered spotted-fever group rickettsiae from a sample of patient blood cultured in Vero cells using the shell vial technique. Rickettsial DNA fragments (gltA, ompA, and, ompB genes) were detected, and analysis of the ompB gene base sequences showed identity with the Rickettsia rickettsii ompB sequence available in the GenBank.

Vaccines under development: group B streptococcus, herpes-zoster, HIV, malaria and dengue

OBJECTIVES To review the current state of development of streptococcus B, herpes-zoster, HIV, malaria and dengue vaccines. These vaccines were selected both because of imminent commercial release and because of specific problems with their development. SOURCES OF DATA A review of the literature was performed by means of a MEDLINE search, on the period 1996 to 2006, for the epidemiology and immunology of these diseases, analyzing both the greatest obstacles to creating a vaccine and the current state of research, with emphasis on studies in the most advanced stages. SUMMARY OF THE FINDINGS Each of the five diseases chosen presents specific problems for vaccine development. Nevertheless, in the majority of cases these have been or are in sight of being resolved, allowing for the prediction that a safe and effective vaccine - or vaccines - will be available in the near future. CONCLUSIONS Despite the problems faced in developing these vaccines, advances in molecular biology and immunology have made it possible to overcome most obstacles, opening up the prospects for new vaccines.

Hepatites pós-transfusionais na cidade de Campinas, SP, Brasil: II. Presença dos anticorpos anti-HBc e anti-HCV em candidatos a doadores de sangue e ocorrência de hepatites pós-transfusionais pelo vírus C nos receptores de sangue ou derivados

We have analysed anti-HBc and anti-HCV antibodies in serum samples from 799 donors which had their blood or derivates transfused to 111 recipients. Anti-HBc and anti-HCV were reactive in respectively 9 and 2.1% of the donors tested. We have observed that among the 111 recipients, 44 had received at least one positive anti-HBc unit and 67 had been transfused only with negative anti-HBc, units. The risk of developing hepatitis C virus was 4.5 times higher for the recipients who received at least one positive anti-HBc unit. If the test for anti-HBc had been made for the blood donors in the serological screening, about 56% of the HCV cases in the recipients could have been avoided. The population of recipients who received at least one reacting unit of anti-HCV, presented a risk 29 times higher of developing this hepatitis, as compared to the transfused recipients with all anti-HCV negative units. Testing blood from donors for anti-HCV would avoid 79% of the post-transfusional HCV cases. Brazilian candidates to blood donors seem to be carriers either simultaneously or sequentially to hepatitis virus B and C, since 44.4% of the positive anti-HCV were also positive for anti-HBc. Testing for anti-HBc and anti-HCV in blood screening must be indicated in order to prevent post-transfusional hepatitis transmission in our community.

Biological warfare, bioterrorism and public health

O uso de agentes biologicos como arma nao e novidade para a humanidade. Durante seculos, ate a atualidade, a guerra biologica tem sido objeto de muita pesquisa e especulacao, mas de pouca acao. O medo de efeitos contrarios e duvidas sobre sua eficiencia como armas devem ter limitado seu uso. Recentemente, se verificou uma nova forma de terrorismo, empregando agentes infecciosos, devagar e sem muito alarde, ate as ocorrencias recentes com o Bacillus anthracis nos Estados Unidos. A variola e possivelmente o mais devastador desses agentes. Menos de 25 anos passados desde sua erradicacao, a saude publica tem que lidar com a possibilidade de sua re-introducao. O cenario da re-introducao da variola no Brasil e discutido.

Considerações acerca dos fundamentos teóricos da explicação em epidemiología

Sao analisadas as condicoes historicas do surgimento da epidemiologia como disciplina cientifica, em meados do seculo passado. E revista a evolucao das bases teoricas do processo explicativo em epidemiologia ate o momento atual. Especial atencao e dada ao papel da logica positivista de Stuart Mill como base teorica da Epidemiologia ate recentemente. Sao discutidas as alternativas teoricas correntes e proposta maior abertura da epidemiologia a diferentes correntes filosoficas como o caminho para o estabelecimento da epidemiologia como uma ciencia madura.

Detection of Rickettsia rickettsii and Rickettsia sp. in Blood Clots in 24 Patients from Different Municipalities of the State of São Paulo, Brazil

Abstract:  The authors detected Rickettsia genus organisms using shell vial and polymerase chain reaction (PCR)/sequencing analysis in blood clots in patients suspected of having Brazilian spotted fever (BSF). DNA was detected using PCR with three sets of primers to access the gltA, ompA, and ompB genes. Sequence analysis was carried out using an automatic sequencer with Bioedit® software. Seventy‐five percent of the culture samples were positive and all samples amplified rickettsial gene fragments. To date, 46% of the samples have been sequenced.