Unexpectedly long incubation period of Plasmodium vivax malaria, in the absence of chemoprophylaxis, in patients diagnosed outside the transmission area in Brazil

<p>Abstract</p> <p>Background</p> <p>In 2010, Brazil recorded 3343,599 cases of malaria, with 99.6% of them concentrated in the Amazon region. <it>Plasmodium vivax </it>accounts for 86% of the cases circulating in the country. The extra-Amazonian region, where transmission does not occur, recorded about 566 cases imported from the Amazonian area in Brazil and South America, from Central America, Asia and African countries. Prolonged incubation periods have been described for <it>P. vivax </it>malaria in temperate climates. The diversity in essential biological characteristics is traditionally considered as one possible explanation to the emergence of relapse in malaria and to the differences in the duration of the incubation period, which can also be explained by the use of chemoprophylaxis. Studying the reported cases of <it>P. vivax </it>malaria in Rio de Janeiro, where there is no vector transmission, has made it possible to evaluate the extension of the incubation period and to notice that it may be extended in some cases.</p> <p>Methods</p> <p>Descriptive study of every malaria patients who visited the clinic in the last five years. The mean, standard deviation, median, minimum and maximum of all incubation periods were analysed.</p> <p>Results</p> <p>From the total of 80 patients seen in the clinic during the study time, with confirmed diagnosis of malaria, 49 (63%) were infected with <it>P. vivax</it>. Between those, seven had an estimated incubation period varying from three to 12 months and were returned travellers from Brazilian Amazonian states (6) and Indonesia (1). None of them had taken malarial chemoprophylaxis.</p> <p>Conclusions</p> <p>The authors emphasize that considering malaria as a possible cause of febrile syndrome should be a post-travel routine, independent of the time elapsed after exposure in the transmission area, even in the absence of malaria chemoprophylaxis. They speculate that, since there is no current and detailed information about the biological cycle of human malaria plasmodia's in Brazil, it is possible that new strains are circulating in endemic regions or a change in cycle of preexisting strains is occurring. Considering that a prolonged incubation period may confer advantages on the survival of the parasite, difficulties in malaria control might arise.</p

Estimating the Global Clinical Burden of Plasmodium falciparum Malaria in 2007

Simon Hay and colleagues derive contemporary estimates of the global clinical burden of Plasmodium falciparum malaria (the deadliest form of malaria) using cartography-based techniques

Development of Hepatozoon caimani (Carini, 1909) Pessôa, De Biasi & De Souza, 1972 in the Caiman Caiman c. crocodilus, the Frog Rana catesbeiana and the Mosquito Culex fatigans

The sporogony of Hepatozoon caimani has been studied, by light microscopy, in the mosquito Culex fatigans fed on specimens of the caiman Caiman c. crocodilus showing gametocytes in their peripheral blood. Sporonts iniciate development in the space between the epithelium of the insect gut and the elastic membrane covering the haemocoele surface of the stomach. Sporulating oocysts are clustered on the gut, still invested by the gut surface membrane. Fully mature oocysts were first seen 21 days after the blood-meal. No sporogonic stages were found in some unidentified leeches fed on an infected caiman, up to 30 days following the blood-meal. When mosquitoes containing mature oocysts were fed to frogs (Leptodactylus fuscus and Rana catesbeiana), cysts containing cystozoites developed in the internal organs, principally the liver. Feeding these frogs to farm-bred caimans resulted in the appearance of gametocytes in their peripheral blood at some time between 59 and 79 days later, and the development of tissue cysts in the liver, spleen, lungs and kidneys. Transmission of the parasite was also obtained by feeding young caimans with infected mosquitoes and it is suggested that both methods occur in nature. The finding of similar cysts containing cystozoites in the semi-aquatic lizard Neusticurus bicarinatus, experimentally fed with infected C. fatigans, suggests that other secondary hosts may be involved

Fowlpox: identification and adoption of prophylactic measures in backyard chickens in Bahia, Brazil

This paper describes the identification of an outbreak of fowlpox in backyard chickens in two villages the state of Bahia, the intervention strategy to control the disease by adopting health measures and vaccination, as well as the impact of the intervention. The diagnosis was based in clinical and laboratory data. After the diagnosis was confirmed, control measures and the vaccination of non-infected birds were recommended. Finally, the impact of the intervention on re-incidence of the disease was evaluated. A number of 700 chickens was vaccinated, after which only 9% of the farmers reported the occurrence of new cases, and 70% informed the acquisition of new birds after vaccination. The information reported in this paper can be useful to design strategic plans to control fowlpox in backyard chickens

Electrophysiologic alterations in the excitability of the sciatic and vagus nerves during early stages of sepsis

L&uacute;cio Ricardo Leite Diniz,1 Viviane Gomes Portella,2 Kerly Shamira da Silva Alves,2 P&acirc;mella Cristina da Costa Ara&uacute;jo,2 Ricardo Luiz Cavalcanti de Albuquerque J&uacute;nior,3 Aline Alice Cavalcante de Albuquerque,2 Andrelina Noronha Coelho-de-Souza,2 Jos&eacute; Henrique Leal-Cardoso2 1Department of Physiology, Federal University of Sergipe, S&atilde;o Crist&oacute;v&atilde;o, Brazil; 2Department of Physiology, Superior Institute of Biomedical Sciences, State University of Cear&aacute;, Fortaleza, Brazil; 3Laboratory of Morphology and Structural Biology, Science and Technology Institute &ndash; ITP, Aracaju, Brazil Background: Nonspecific and delayed diagnosis of neurologic damage contributes to the development of neuropathies in patients with severe sepsis. The present study assessed the electrophysiologic parameters related to the excitability and conductibility of sciatic and vagus nerves during early stages of sepsis.Materials and methods: Twenty-four hours after sepsis induced by cecal ligation and puncture (CLP) model, sciatic and vagus nerves of septic (CLP group) and control (sham group) rats were removed, and selected electric stimulations were applied to measure the parameters of the first and second components of the compound action potential. The first component originated from fibers with motor and sensory functions (Types A&alpha; and A&beta; fibers) with a large conduction velocity (70&ndash;120 m/s), and the second component originated from fibers (Type A&gamma;) with sensorial function. To evaluate the presence of sensorial alterations, the sensitivity to non-noxious mechanical stimuli was measured by using the von Frey test. Hematoxylin and eosin staining of the nerves was performed. Results: We observed an increase of rheobase followed by a decrease in the first component amplitude and a higher paw withdrawal threshold in response to the application of von Frey filaments in sciatic nerves from the CLP group compared to the sham group. Differently, a decrease in rheobase and an increase in the first component amplitude of vagal C fibers from CLP group were registered. No significant morphologic alteration was observed. Conclusion: Our data showed that the electrophysiologic alterations in peripheral nerves vary with the fiber type and might be identified in the first 24 h of sepsis, before clinical signs of neuromuscular disorders. Keywords: sepsis, sciatic nerve, vagus nerve, neuronal excitability, neuropathy, peripheral nerve