Contribuição dos humanos, cães e gatos à transmissão do Trypanosoma cruzi na Região do Chaco Argentino

Foi determinada a prevalência da infecção por T. cruzi nos humanos, cães e gatos, pertencentes a 47 rancherías em três povoados rurais; Guanaco Muerto (Córdoba), La Invernada e Amamás (Santiago del Estero), mediante reações seroldgicas e xenodiagnóstico. Poram examinadas 245 pessoas, 123 cães e 14 gatos. A taxa de prevalência na população foi entre 58,7% (GM) e 49,6% (LI). Foram detectados 76% de cães infectados, o que resultou significativamente superior aos 51% encontrados nos humanos. As porcentagens de cães (64,2%) e gatos (63,6%) com parasitemia foram significativamente superiores à correspondente aos humanos (12,5%). Se bem que 79% dos gatos estavam infectados, sua pequena quantidade e seus hábitos de perambulação determinam que sua participação na transmissão doméstica do T. cruzi seja restrita. Não obstante existir em média um maior número de humanos que de cães em cada lar, tanto de sujeitos sãos como infectados (6,5 vs. 3,3 e 3,4 vs. 2,4, respectivamente), foram detectados também na média mais cães que humanos com parasitemia em cada casa (2,1 vs. 1,0). As altas porcentagens de cães infectados e com parasitemia, além do hábito de repouso intra-domiciliário o qual ocasiona estreito contacto entre eles e os barbeiros determinam que os cães sejam os principais provedores de parásitos à disposição para a transmissão, e os hospedeiros mais importantes para /nanutenção da doença de Chagas na Região do Chaco Argentino.Trypanosoma cruzi prevalence rates of human, dog and cat populations from 47 households of 3 rural localities of the phytogeographical Chaqueña area of Argentina were determined both by serological and xenodiagnostic procedures. Human prevalence rates were uniform and ranged from 49.6 to 58.7%. Overall prevalence rate in dogs (75.0%) was significantly higher than in humans (51.0%). The overall proportion of parasitemic individuals assessed by xenodiagnosis was significantly higher in either dog (64.2%) or cat (63.6%) populations than among humans (12.5%). Although both the average number of resident as well as infected individuals per household was higher for people than for dogs (6.5 vs. 3.3, and 3.4 vs. 2.4, respectively), the reverse was recorded when parasitemic individuals were considered (1.0 vs. 2.1). Results are discussed in relation to dog between dogs and people, and dogs and bugs. In the light of present data, dogs must be considered as the major donors of parasites to vector bugs and thus, principal contributors to transmission in this region of Argentina

Un brote inusual de Hantavirus en el sur de Argentina: ¿transmisión persona a persona?

El síndrome pulmonar por Hantavirus es una zoonosis sostenida por roedores reconocida primero en los Estados Unidos en 1993. La transmisión persona a persona no ha sido informada; sin embargo, en un brote de 20 casos informados aquí, la evidencia epidemiológica sugiere fuertemente esta ruta de transmisión.Facultad de Ciencias Veterinaria

Un brote inusual de Hantavirus en el sur de Argentina: ¿transmisión persona a persona?

El síndrome pulmonar por Hantavirus es una zoonosis sostenida por roedores reconocida primero en los Estados Unidos en 1993. La transmisión persona a persona no ha sido informada; sin embargo, en un brote de 20 casos informados aquí, la evidencia epidemiológica sugiere fuertemente esta ruta de transmisión.Facultad de Ciencias Veterinaria

Hantavirus reservoir hosts associated with peridomestic habitats in Argentina

Five species of sigmodontine rodents have been identified in Argentina as the putative reservoirs of six circulating hantavirus genotypes. Two species of Oligoryzomys are associated with the genotypes causing hantavirus pulmonary syndrome, Oligoryzomys flavescens for Lechiguanas and O. longicaudatusfor Andes and Oran genotypes. Reports of human cases of hantavirus pulmonary syndrome prompted rodent trapping (2,299 rodents of 32 species during 27,780 trap nights) at potential exposure sites in three disease-endemic areas. Antibody reactive to Sin Nombre virus was found in six species, including the known hantavirus reservoir species. Risk for peridomestic exposure to host species that carry recognized human pathogens was high in all three major disease-endemic areas.Fil: Calderón, Gladys. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Pini, Noemí. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Bolpe, Jorge. Departamento de Zoonosis Rurales de Azul; Argentina.Fil: Levis, Silvana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Mills, James. Centers for Disease Control and Prevention; Estados Unidos.Fil: Segura, Elsa. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Guthmann, Nadia. Universidad Nacional del Comahue; Argentina.Fil: Cantoni, Gustavo. Consejo Provincial de Salud Pública, Rio Negro; ArgentinaFil: Becker, José. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Fonollat, Ana. Fundación Lillo; Argentina.Fil: Ripoll, Carlos. Departamento de Chagas y Patologías Regionales; Argentina.Fil: Bortman, Marcelo. Subsecretaría de Salud, Neuquén; Argentina.Fil: Benedetti, Rosendo. Zona Sanitaria Noroeste; Argentina.Fil: Sabattini, Marta S. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Hantavirus Study Group; Argentina

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality