Sueko Takimoto

Enterovirus 71 infection and acute neurological disease among children in Brazil (1988–1990)

Surveillance for Enterovirus 71 (EV-71) infection in children up to 15 years of age was carried out in Brazil, from 1988 to 1990. Patients with acute neurological diseases (AND) such as flaccid paralysis, Bells palsy, acute cerebellar ataxia and Guillain-Barré syndrome were included in the study. EV-71 infection was detected in 24 of 426 children (5.6%) with AND. EV-71 infection was confirmed only by virus isolation in 13 children, by virus isolation and seroconversion in 4, and by seroconversion alone in 7. EV-71 was also isolated from 15 of the 427 household contacts (3.5%) of 165 AND patients. There was some evidence of high infectivity of EV-71: household clusters were detected in the case of 7 of 24 children (29.1%) infected with EV-71 and manifesting AND; EV-71 was isolated from 11/40 household contacts (27.5%) of the infected patients but from only 4/387 household contacts (1.0%) of children in whom it was not possible to demonstrate EV-71 infection. Seven of the 24 children infected with EV-71 exhibited residual motor deficiency when examined 6 months after the disease onset. The relevance of these results for the Plan for Global Eradication of Wild Poliovirus is discussed, as well as the need to increase knowledge about the behaviour of this virus and its possible association with AND.

An exanthematic disease epidemic associated with coxsackievirus B3 infection in a day care center

An epidemic of exanthematic illness in a day care center is described. Ten children aged 7 to 13 months were affected by the illness. The exanthem was characterized by nonconfluent macular or maculopapular lesions that appeared on the face, body and limbs. Fifty percent of the infected children had fever of up to 39 degrees C at the beginning of the disease. Coxsackievirus B3 (CB3) was isolated from the stool of one ill child. Paired serum samples were obtained from eight ill children and six of them presented seroconversion to CB3. Antibodies to CB3 were detected at titers higher than 16 in a single serum sample collected from the other two patients. Neutralizing antibodies to CB3 were detected in 71.0% of the contact children.

Enzyme linked immunosorbent assay: determination of anti-adenovirus antibodies in an infant population

In order to define an accurate assay for anti-adenovirus antibody detection, a recently developed ELISA was compared with IFA and CF. On 58 sera, the ELISA was more sensitive than both CF and IFA, which showed relative sensitivities of 63% and 94%, respectively. It was not possible to determine the exact specificity of the tests because of the lack of a gold standard. Furthermore, the ELISA was used to define the prevalence of adenovirus antibodies in 116 infants between 1 and 24 months old (mean 7.28). The data showed that maternal antibodies waned by the age of 5 to 6 months and that more than 80% of the children had been infected by adenoviruses by the age of 10 months.

Enterovírus-70 na região metropolitana de São Paulo, Brasil, de 1984 a 1987: aspectos da infecção em períodos epidêmico e endêmico

Sao apresentados os resultados de estudos sobre o comportamento do Enterovirus-70 (EV-70) na regiao metropolitana de Sao Paulo desde sua provavel introducao no verao de 1984, determinando extensa epidemia de conjuntivite hemorragica aguda (C.H.A.), ate o final de 1987 abrangendo periodo em que este agravo foi pouco notado. Na fase epidemica ocorrida no primeiro trimestre de 1984 foram estudados 291 individuos divididos em tres grupos denominados A, B e C, o primeiro formado por pessoas atingidas pela C.H.A. e os outros dois por individuos nao atingidos por este agravo mas que, respectivamente, referiam contato domiciliar com casos de C.H.A. e os que nao referiam o citado contato. A demonstracao de anticorpos se fez pela tecnica de imunofluorescencia indireta (IFI) para detectar IgM especifico para EV-70 e pela prova de neutralizacao em cultura de celulas BHK-21. Verificou-se que 56,7%, 33,3% e 20,6% dos individuos pertencentes, respectivamente, aos grupos A, B e C apresentavam anticorpos especificos da classe IgM. No grupo A a faixa etaria mais atingida foi a de 10 a 29 anos. No periodo que vai do fim da primeira e unica epidemia ate o final de 1987, identificaram-se tres casos esporadicos de C.H.A. e 10 pacientes com afeccao neurologica aguda associada a infeccao recente pelo EV-70. Nove, destes 10 casos, apresentaram paralisia de nervos cranianos, todos evoluindo sem sequelas clinicamente discerniveis. As formas assintomaticas e os casos esporadicos de C.H.A. e de afeccoes neurologicas mantiveram a circulacao do EV-70 no periodo nao epidemico.

Human enterovirus infection in stray dogs. Some aspects of interest to public health

To investigate the possible role of domestic animals as reservoirs of human enteroviruses, we studied 212 stray dogs captured in different areas of the municipality of São Paulo. The captured animals were divided into 19 groups of 10 to 20 dogs each; faeces of 126 of the 212 dogs were processed for enterovirus isolation. The following viruses were isolated from 12 dogs; poliovirus type 1 (2 dogs), poliovirus type 3 (1 dog), echovirus type 7 (8 dogs) and echovirus type 15 (1 dog). Of the 12 infected animals, four had specific homotypic neutralizing antibody titres > or = 16. All 212 animals were tested for the presence of neutralizing antibodies to human enteroviruses. The frequency of neutralizing antibodies present in titres of > or = 16 was 10.3%, 3.8% and 4.3% for vaccinal prototypes of polioviruses 1, 2 and 3 respectively; 1.9%, 1.4% and 1.5% for wild prototypes of the same viruses, 11.3% for echovirus 7, and 2.4% for echovirus 15. The proportion of dogs with neutralizing antibodies varied with the virus studied. Some indication of the susceptibility of dogs to infection with human enteroviruses was demonstrated, and the importance of this fact for the Plan for Global Eradication of the Wild Poliovirus is discussed.

Preliminar characterization of a new virus isolated from the spinal fluid of patients with meningitis in Säo Paulo, Brazil

De dezembro de 1982 a marco de 1983 um total de 138 pacientes com idade de 4 meses a 57 anos foram atendidos em diferentes hospitais de Sao Paulo com sintomas de meningite asseptica. Um agente transmissivel foi isolado de 35 das 53 amostras de liquor. A replicacao desse novo virus ou de um grupo de virus relacionados antigenicamente com caracteristicas semelhantes foi detectada atraves do efeito citopatico produzido em cultura de celulas de MDCK. O agente isolado demonstrou ter um diâmetro em torno de 40 nm quando examinado ao microscopio eletronico atraves da coloracao negativa. Nenhuma atividade hemaglutinante foi detectada em pH 7,2 com hemacias humanas de cobaias ou de galinha e em pH 6,0 - 7,2 com hemacias de ganso. Esse agente nao se mostrou patogenico ao camundongo recem-nascido e adulto, era sensivel ao cloroformio e nao foi inibido pelo BuDR, o que indica conter o genoma RNA.

Comparative study of adenoviruses with monoclonal antibodies

The obtainment of monoclonal antibodies for adenovirus species 4(Ad4) is described. The specificities of selected monoclonal antibodies were determined by means of viral neutralization test in cell culture, immunofluorescence and Enzyme-Linked Immunosorbent Assay (ELISA), in the presence of the following species of human adenovirus: 1, 2, 5 (subgenus C), 4 (subgenus E), 7 and 16 (subgenus B) and 9 (subgenus D). Two monoclonal antibodies species specific to adenovirus 4 (1CIII and 3DIII) and one monoclonal antibody that cross reacted with adenovirus species 4 and 7 (2HIII) were obtained.

Serologic studies on the behaviour of influenza virus type A in persons of greater São Paulo during 1976, 1978 and 1979

Sera of persons of different age groups collected in 1976, 1978 and 1979 were tested for the presence of HI antibodies against various strains of the H3N2 and H1N1 subtypes of influenza virus. The occurrence of infection by H3N2 subtype was recorded during the 1976-1978 period but in 1979, circulation of this subtype of virus was limited. The prevalence of antibody against A/Sao Paulo/1/78 (H1N1) was significantly higher than that of antibody to A/USSB/90/77 (HIND in 1978. However in 1979 the predominant strain was A/USSR/90/77 (HIND. Persons under 20 years of age were the most affected by H1N1 subtype. Antibodies to H1N1 subtype were detected in sera of individuals older than 20 years in 1976, before the re-emergence of this strain. Serological results indicate that infections by H3N2 subtype in 1978 occurred in 65.4% of young children (0-4 year group). About 47.0% of children from the 0-4 year group had antibodies to H1N1 subtype in 1979. Antibodies to swine influenza virus were detected in 60% of 60+ year old people.