SARS-CoV-2 in the Amazon region

A medida que la pandemia del Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARS-CoV-2) continúa expandiéndose, los recursos de atención médica a nivel mundial se han reducido. Ahora, la enfermedad es extendiéndose rápidamente por América del Sur, con consecuencias mortales en áreas con ya sistemas de salud pública debilitados. La región amazónica es particularmente susceptible a la devastación generalizada de la enfermedad por coronavirus 2019 (COVID-19) debido a sus habitantes amerindios nativos inmunológicamente frágiles y vulnerabilidades epidemiológicas. Aquí, nosotros discutir la situación actual y el impacto potencial de COVID-19 en la región amazónica y cómo una mayor propagación de la ola epidémica podría resultar devastadora para muchas personas amerindias que viven en la selva amazónicaAs the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainfores

Tele-entomology and tele-parasitology: A citizen science-based approach for surveillance and control of Chagas disease in Venezuela.

Chagas Disease (CD), a chronic infection caused by the Trypanosoma cruzi parasite, is a Neglected Tropical Disease endemic to Latin America. With a re-emergence in Venezuela during the past two decades, the spread of CD has proved susceptible to, and inhibitable by a digital, real-time surveillance system effectuated by Citizen Scientists in communities throughout the country. The #TraeTuChipo (#BringYourKissingBug) campaign implemented in January 2020, has served as such a strategy counting on community engagement to define the current ecological distribution of CD vectors despite the absence of a functional national surveillance program. This pilot campaign collected data through online surveys, social media platforms, and/or telephone text messages. A total of 79 triatomine bugs were reported from eighteen Venezuelan states; 67 bugs were identified as Panstrongylus geniculatus, 1 as Rhodnius pictipes, 1 as Triatoma dimidiata, and 10 as Triatoma maculata. We analyzed 8 triatomine feces samples spotted from 4 Panstrongylus geniculatus which were confirmed positive by qPCR for T. cruzi. Further molecular characterization of discrete typing units (DTUs), revealed that all samples contained TcI, the most highly diverse and broadly distributed strain of T. cruzi. Moreover, analysis of the mitochondrial 12S gene revealed Myotis keaysi, Homo sapiens, and Gallus gallus as the main triatomine feeding sources. This study highlights a novel Citizen Science approach which may help improve the surveillance systems for CD in endemic countries

A rare case of spinal tuberculosis due to Mycobacterium bovis. Is zoonotic tuberculosis underdiagnosed?

We report a rare presentation of Pott's disease caused by M. bovis, suggesting transmission from infected cattle, and only the second case described so far in scientific reports. Noteworthy of this case was that the strain was only isolated on Stonebrink medium, a sodium pyruvate-containing culture medium for the isolation of mycobacteria. This medium is frequently ignored in diagnostic laboratories and in the laboratory manuals of most international health organizations. In general laboratories use a culture medium that contains glycerol, a carbon substrate considered inhibitory for the growth of M. bovis. The use of glycerol-containing medium therefore likely contributes towards underestimating zoonotic tuberculosis. Our case suggests that, in order to improved surveillance efforts for zoonotic TB and increase the notification rate for M. bovis to human TB, the use of pyruvate-containing media should be promoted, particularly in developing countries with a high prevalence of bovine TB, but also through the World Health Organization’ (WHO) End TB Strategy and the Roadmap for Zoonotic T

COVID-19 and helminth infection: Beyond the Th1/Th2 paradigm.

In un comentario reciente, Bradbury y sus colegas plantean preocupaciones con respecto a la influencia potencial de las infecciones por helmintos preexistentes en la gravedad de la enfermedad por coronavirus 2019 (COVID-19) en las regiones endémicas de helmintos [1]. Sugieren que la modulación de la respuesta inmunitaria debido a respuestas de citocinas similares a Th2 potenciadas en personas infectadas por helmintos podría regular la intensidad de la respuesta inflamatoria a COVID-19, que se ha atribuido a una respuesta de citocinas proinflamatorias Th1 descontrolada que se puede vincular directamente a la gravedad de la enfermedad. Sin embargo, los autores también señalan que, a diferencia de las infecciones por SARS y algunos otros virus, la respuesta en COVID-19 incluye la elevación de IL-4 e IL-10, consideradas citocinas de tipo 2 [1]. En respuesta, Hays y sus colegas [2] ofrecen la opinión de que las infecciones por helmintos preexistentes, al disminuir la probabilidad de síndrome metabólico y diabetes mellitus tipo 2, pueden reducir el riesgo de tormenta de citoquinas y COVID-19 grave [2]. En la misma línea, Siles-Lucas y sus colegas [3] brindan información hipotética sobre los posibles efectos de modulación mediante los cuales moléculas específicas derivadas de helmintos podrían modular la patología de COVID-19. Sin embargo, los autores también señalan con cautela que los estudios en animales sobre la coinfección viral con parásitos siguen siendo equívocos, y también destacan la necesidad de realizar más estudios para evaluar directamente el impacto potencial de las infecciones por helmintos en la gravedad de la COVID-19.In a recent commentary, Bradbury and colleagues raise concerns regarding the potential influence of preexisting helminth infections on Coronavirus Disease 2019 (COVID-19) disease severity in helminth-endemic regions [1]. They suggest that modulation of the immune response due to boosted Th2-like cytokine responses in helminth-infected persons could regulate the intensity of the inflammatory response to COVID-19, which has been attributed to an uncontrolled Th1 proinflammatory cytokine response that can be linked directly to disease severity. However, the authors also point out that in contrast to infections with SARS and some other viruses, the response in COVID-19 includes elevation of IL-4 and IL-10, considered to be type 2 cytokines [1]. In response, Hays and colleagues [2] offer the view that preexisting helminth infections, by decreasing the likelihood of metabolic syndrome and type 2 diabetes mellitus, may reduce the risk of cytokine storm and severe COVID-19 [2]. Along the same lines, Siles-Lucas and colleagues [3] provide hypothetical insights regarding potential modulating effects by which specific helminth-derived molecules might modulate COVID-19 pathology. However, the authors also cautiously note that animal studies on parasite-viral coinfection remain equivocal, and likewise highlight the need for further studies to directly assess the potential impact of helminth infections on COVID-19 severity

Correction: SARS-CoV-2 in the Amazon region: A harbinger of doom for Amerindians.

[This corrects the article DOI: 10.1371/journal.pntd.0008686.]

SARS-CoV-2 in the Amazon region: A harbinger of doom for Amerindians.

As the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainforest

Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina.

BackgroundTo date, there is no specific literature available on the determinants for therapeutic failure (TF) with meglumine antimoniate (MA) in Northwestern-Argentina. This study aimed to identify epidemiological, clinical, and treatment-related factors that could be involved in TF.Methodology/principal findingsWe performed a case-control study. Cases were represented by patients who showed TF after administration of the first course of MA treatment, whereas, controls were determined as patients who evolved towards healing after the first MA cycle received. Crude Odds Ratios and their corresponding 90% confidence intervals (CI) were calculated, and risk factors were then tested by multivariate analysis using logistic binary regression. Three hundred and eighty-four patients with a presumptive diagnosis of ACL were recruited, and 153 with a positive diagnosis were selected. We included in the study 71 patients, who underwent specific treatment with MA, presented complete data on response to treatment, and had a minimum post-treatment follow-up of 6 months in cutaneous leishmaniasis, and 12 months in mucosal leishmaniasis. Of these, 34 (47.9%) presented TF. In the initial analysis, TF was significantly associated with the geographical area of disease acquisition (p = 0.036), the presence of mucosal lesions (p = 0.042), the presence of concomitant skin and mucosal lesions (p = 0.002), and lesion age ≥ 6 months (p = 0.018). Risk factors influencing TF in the final multivariate model included the geographical area where the disease was acquired (adjusted Odd Ratio 8.062; 95% CI 1.914-33.959; p = 0.004), and lesion age ≥ 6 months (adjusted Odd Ratio 10.037; 95% CI 1.383-72.843; p = 0.023).Conclusions/significanceThe results of the present study suggest the existence of some risk factors linked to TF in Northwestern-Argentina, which deserve further investigation. Herein we recorded a high percentage of TF and we described clinical and epidemiological characteristics associated with TF that could be taken into account improving the clinical management of patients

SARS-CoV-2 en la región amazónica: un presagio de fatalidad para los amerindios

A medida que la pandemia del Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARS-CoV-2) continúa expandiéndose, los recursos de atención médica a nivel mundial se han reducido. Ahora, la enfermedad es extendiéndose rápidamente por América del Sur, con consecuencias mortales en áreas con ya sistemas de salud pública debilitados. La región amazónica es particularmente susceptible a la devastación generalizada de la enfermedad por coronavirus 2019 (COVID-19) debido a sus habitantes amerindios nativos inmunológicamente frágiles y vulnerabilidades epidemiológicas. Aquí, nosotros discutir la situación actual y el impacto potencial de COVID-19 en la región amazónica y cómo una mayor propagación de la ola epidémica podría resultar devastadora para muchas personas amerindias que viven en la selva amazónicaAs the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainfores