Detection of hantavirus in bats from remaining rain forest in São Paulo, Brazil

Background\ud The significant biodiversity found in Brazil is a potential for the emergence of new zoonoses. Study in some places of the world suggest of the presence to hantavirus in tissues of bats. Researches of hantavirus in wildlife, out rodents, are very scarce in Brazil. Therefore we decided to investigate in tissues of different species of wild animals captured in the same region where rodents were detected positive for this virus. The present work analyzed ninety-one animals (64 rodents, 19 opossums, and 8 bats) from a region of the Atlantic forest in Biritiba Mirin City, São Paulo State, Brazil. Lungs and kidneys were used for RNA extraction.\ud \ud Findings\ud The samples were screened for evidence of hantavirus infection by SYBR-Green-based real-time RT-PCR. Sixteen samples positive were encountered among the wild rodents, bats, and opossums. The detection of hantavirus in the lungs and kidneys of three marsupial species (Micoureus paraguayanus, Monodelphis ihering, and Didelphis aurita) as well in two species of bats (Diphylla ecaudata and Anoura caudifer) is of significance because these new hosts could represent an important virus reservoirs.This work was supported by Fundação de Amparo a Pesquisa do Estado de São Paulo - FAPESP. The field support and animals identification was made at Museum of Zoology, Universidade de Sao Paulo, USP and Universidade Bandeirante, UNIBAN, Brazil

Humoral immunity profile against the yellow fever virus of two asymptomatic populations from the Atlantic Forest rural region of São Paulo state, Brazil.

A Febre Amarela (FA) é uma doença viral infecciosa, não contagiosa que pode se manifestar desde um quadro febril até a forma clássica íctero-hemorrágica, cujo agente etiológico é o vírus da febre amarela (VFA). A doença tem avançando para as regiões Sudeste e Sul com um aumento de 4 vezes no número de vítimas fatais. O presente trabalho teve como objetivos avaliar a possível circulação do vírus da febre amarela silvestre, através da detecção de anticorpos IgM por meio da técnica de MAC-ELISA, e anticorpos IgG, pelas técnicas de Inibição da hemaglutinação e Neutralização; detecção do genoma viral utilizando a técnica de RT-PCR no soro de indivíduos assintomáticos; bem como avaliar a proteção vacinal, por meio da técnica de neutralização em soros de indivíduos das zonas rurais do município de Jacupiranga e Teodoro Sampaio. Um total de 238 soros foram coletados, 152 (Jacupiranga) e 86 (Teodoro Sampaio). Foram detectados um total 15,9% (38/238) de anticorpos IH contra o vírus selvagem e/ou vacinal. Destes 13,16% (5/38) anticorpos IH foram provenientes dos soros de Jacupiranga e 86,84 (33/38) de Teodoro Sampaio. Anticorpos neutralizantes foram detectados em 34% (13N/38IH) dos IH reativos, destes 15,38% (2/13) foram oriundos deJacupiranga e 84,62% (11/13). A detecçção de anticorpos neutralizantes nos indivíduos de Jacupiranga levantam a necessidade de pesquisas futuras na busca do vírus da febre amarela nos seus reservatórios selvagens e vetores. Não houve a detecção do genoma viral por RTPCR nas duas populações, bem como a detecção de anticorpos IgM específicos, por meio das reações de MACELISA, o que evidencia a não circulação recente deste vírus na população estudada. O grau de imunizaçao na população de Teodoro Sampaio, com histórico de vacinação, por meio das reações de IH e Neutralização foi baixo, uma vez que somente 42,30% da população apresentou anticorpos inibidores da hemaglutinação e o grau de proteção pela reação de neutralização foi de apenas 33,33%. Este trabalho aponta não só para a necessidade de monitoramento pós-vacinal em áreas endêmicas de febre amarela, com indicação de vacinação, como também a necessidade de estudos epidemiológicos, uma vez que se detectou reação monotípica no teste do IH, além de anticorpos neutralizantes para o vírus selvagem da febre amarela em um indivíduo residente em município de risco para a febre amarela.Yellow fever (YF) is an non-contagious infection disease. The clinical signs can be a nonspecific fever or the classical ictero-hemorrhagic form as a result of the Yellow Fever virus (YFV) infection. Considering the recent spread of the disease to the South and Southeast of Brazilian regions and the increased number of fatal cases, the aim of this study was to evaluate the possible circulation of the YFV, using the IgM enzyme-linked immnunosorbent assay (MACELISA) and Reverse transcriptase polymerase chain reaction (RT-PCR), as well as, to conduct a serological inquire and evaluate the protective vaccine response, by the hemagglutination inhibition test (HI) and serum neutralization test (SN), in the rural population of Jacupiranga and Teodoro Sampaio, located in the southern region of Brazil. A total of 238 serum samples were tested, 152 from Jacupirang and 86 from Teodoro Sampaio. Of the serum collected, 15,9% (38/238) were positive by HI, using wild and vaccine strains of YF, and out of these 13,16% (5/38) were from Jacupiranga and 86,84% (33/38) were from Teodoro Sampaio. Neutralizing antibodies were detected in 34% of the HI positive samples (13SN/38HI) and out of these 15,38% (2/13) were from Jacupiranga and 84,62% (11/13) were from Teodoro Sampaio. None of the samples were positive by MACELISA and RT-PCR indicating no evidences of recent virus circulation in the population analyzed in this study. However, the YF neutralizing antibodies detection in samples from Jacupiranga indicates the necessity of further researches in order to detect the YFV in its wild reservoirs and vectors. On the other hand, considering that 42,30% of the Teodoro Sampaio samples were positive by HI and out of these only 33,33% had neutralizing antibodies to the YFV, our results also pointed out to the importance of pos-vaccination protective immunity surveys, in order to evaluate the efficiency of the vaccines in endemic areas

Serological Survey of Hantavirus in Inhabitants from Tropical and Subtropical Areas of Brazil

Brazil has reported more than 1,600 cases of hantavirus cardiopulmonary syndrome (HPS) since 1993, with a 39% rate of reported fatalities. Using a recombinant nucleocapsid protein of Araraquara virus, we performed ELISA to detect IgG antibodies against hantavirus in human sera. The aim of this study was to analyze hantavirus antibody levels in inhabitants from a tropical area (Amazon region) in Rondônia state and a subtropical (Atlantic Rain Forest) region in São Paulo state, Brazil. A total of 1,310 serum samples were obtained between 2003 and 2008 and tested by IgG-ELISA, and 82 samples (6.2%), of which 62 were from the tropical area (5.8%) and 20 from the subtropical area (8.3%), tested positive. Higher levels of hantavirus antibody were observed in inhabitants of the populous subtropical areas compared with those from the tropical areas in Brazil

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk

Núcleos de Ensino da Unesp: artigos 2008

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