Patient-based dengue virus surveillance in Aedes aegypti from Recife, Brazil

Background & objectives: Dengue is currently one of the most important arthropod-borne diseasesand may be caused by four different dengue virus serotypes (DENV-1 to DENV-4), transmittedmainly by Aedes aegypti (Diptera: Culicidae) mosquitoes. With the lack of a dengue vaccine,vector control strategies constitute a crucial mode to prevent or reduce disease transmission. Inthis context, DENV detection in natural Ae. aegypti populations may serve as a potential additionaltool for early prediction systems of dengue outbreaks, leading to an intensification of vector controlmeasures, aimed at reducing disease transmission. In Brazil, this type of surveillance has beenperformed sporadically by a few groups and has not been incorporated as a routine activity incontrol programs. This study aimed at detecting DENV in natural Ae. aegypti from Recife,Pernambuco, to check the circulating serotypes and the occurrence of transovarial transmission inlocal mosquito populations.Methods: From January 2005 to June 2006, mosquitoes (adults and eggs) were collected in houseswhere people with clinical suspicion of dengue infection lived at. RNA was extracted from pooledmosquitoes and RT-PCR was performed in these samples for detection of the four DENV serotypes.Results & conclusion: Out of 83 pools of adult mosquitoes collected in the field, nine were positivefor DENV: five for DENV-1, two for DENV-2 and two for DENV-3. From 139 pools of adultmosquitoes reared from collected eggs, there were 17 positive pools: three for DENV-1, 10 forDENV-2, and four for DENV-3. These results are discussed in the paper in regard to the localdengue epidemiological data. The conclusions clearly point to the informative power and sensitivityof DENV entomological surveillance and to the importance of including mosquito immature formsin this strategy

Exaggerated blood pressure response during the exercise treadmill test as a risk factor for hypertension

Exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) has been considered to be a risk factor for hypertension. The relationship of polymorphisms of the renin-angiotensin system gene with hypertension has not been established. Our objective was to evaluate whether EBPR during exercise is a clinical marker for hypertension. The study concerned a historical cohort of normotensive individuals. The exposed individuals were those who presented EBPR. At the end of the observation period (41.7 months = 3.5 years), the development of hypertension was analyzed within the two groups. Genetic polymorphisms and blood pressure behavior were assessed as independent variables, together with the classical risk factors for hypertension. The I/D gene polymorphism of the angiotensin-converting enzyme and M235T of angiotensinogen were ruled out as risk factors for hypertension. EBPR during ETT is not an independent influence on the chances of developing hypertension. No differences were observed between the hypertensive and normotensive individuals regarding gender (P = 0.655), skin color (P = 0.636), family history of hypertension (P = 0.225), diabetes mellitus (P = 0.285), or hypertriglyceridemia (P = 0.734). The risk of developing hypertension increased with increasing body mass index (BMI) and advancing age. The risk factors, which independently influenced the development of hypertension, were age and BMI. EBPR did not constitute an independent risk factor for hypertension and is probably a preclinical phase in the spectrum of normotension and hypertension