1
|
Sampaio MPDS, do Rosário MS, Martins LC, Trindade LVL, Francisco MVLDO, Costa BGG, Vasconcelos GA, Lima IAB, Macêdo YSF, Carvalho FML, de Santana MBR, Khouri R, Fritsch H, Xavier J, Fonseca V, Giovanetti M, de Mello ALES, Pereira FM, Campos GS, de Jesus PAP, Farias DS, de Souza MS, Galvão AJP, Costa FO, Bessa MC, Chagas JRLP, Silvany C, Teles JMM, de Lima MM, Farias TLA, Gräf T, de Siqueira IC. Detection of encephalitis-causing viruses reveals predominance of chikungunya virus in the state of Bahia, Brazil. Int J Infect Dis 2024; 145:107090. [PMID: 38762045 PMCID: PMC11183300 DOI: 10.1016/j.ijid.2024.107090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/11/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES Encephalitis is a severe neurological syndrome for which herpesvirus and enteroviruses are the most common etiological agents. Arboviruses, a wildly diverse group of pathogens, are also critical epidemiological agents associated with encephalitis. In Brazil, little is known about the causative agents of encephalitis. METHODS We conducted a hospital surveillance for encephalitis between 2020 and 2022. Molecular (RT-PCR and qPCR) and serological (virus-specific IgM and viral antigens) techniques were performed in cerebrospinal fluid and serum samples obtained from study participants. RESULTS In the 43 participants evaluated, the etiologic agent or the presence of IgM was detected in 16 (37.2%). Nine (20.9%) cases were positive for chikungunya virus (CHIKV), three (7.0%) for dengue virus, two (4.7%) for human adenovirus, one (2.3%) for varicella-zoster virus, and one (2.3%) for enterovirus. Whole-genome sequencing revealed that the CHIKV identified belongs to the East/Central/South African lineage. CONCLUSION Herein, CHIKV is a common pathogen identified in encephalitis cases. Our results reinforce previous evidence that chikungunya represents a significant cause of encephalitis during CHIKV outbreaks and epidemics and add to existing information on the epidemiology of encephalitis in Brazil.
Collapse
Affiliation(s)
- Maria Paula de Souza Sampaio
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Mateus Santana do Rosário
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil; Hospital Santa Izabel, Salvador, Brazil; Hospital Santo Antonio-Obras Sociais Irmã Dulce, Salvador, Brazil
| | - Lorena Cunha Martins
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Luiza Vieira Luedy Trindade
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | | | - Bernardo Gratival Gouvea Costa
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Gessica Almeida Vasconcelos
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Italo Andrade Barbosa Lima
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Yasmin Santos Freitas Macêdo
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Fernanda Maria Lessa Carvalho
- Laboratório de Enfermidades Infecciosas Transmitidas por Vetores, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | | | - Ricardo Khouri
- Laboratório de Enfermidades Infecciosas Transmitidas por Vetores, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Hegger Fritsch
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Joilson Xavier
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vagner Fonseca
- Department of Exact and Earth Sciences, University of the State of Bahia, Salvador, Brazil; Coordenação de Vigilância, Preparação e Resposta à Emergências e Desastres (PHE), Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), Brasilia, Brazil
| | - Marta Giovanetti
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil; Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Roma, Italy
| | | | | | - Gubio Soares Campos
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Pedro Antonio Pereira de Jesus
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; Hospital Geral Roberto Santos, Salvador, Brazil
| | | | | | | | | | | | | | - Celia Silvany
- Hospital da Criança, Obras Sociais Irmã Dulce, Salvador, Brazil
| | | | | | | | - Tiago Gräf
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Isadora Cristina de Siqueira
- Laboratório de Investigação em Saúde Global e Doenças Negligenciadas, Instituto Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil.
| |
Collapse
|
2
|
Wesselmann KM, Postigo-Hidalgo I, Pezzi L, de Oliveira-Filho EF, Fischer C, de Lamballerie X, Drexler JF. Emergence of Oropouche fever in Latin America: a narrative review. THE LANCET. INFECTIOUS DISEASES 2024; 24:e439-e452. [PMID: 38281494 DOI: 10.1016/s1473-3099(23)00740-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 01/30/2024]
Abstract
Since its discovery in 1955, the incidence and geographical spread of reported Oropouche virus (OROV) infections have increased. Oropouche fever has been suggested to be one of the most important vector-borne diseases in Latin America. However, both literature on OROV and genomic sequence availability are scarce, with few contributing laboratories worldwide. Three reassortant OROV glycoprotein gene variants termed Iquitos, Madre de Dios, and Perdões virus have been described from humans and non-human primates. OROV predominantly causes acute febrile illness, but severe neurological disease such as meningoencephalitis can occur. Due to unspecific symptoms, laboratory diagnostics are crucial. Several laboratory tests have been developed but robust commercial tests are hardly available. Although OROV is mainly transmitted by biting midges, it has also been detected in several mosquito species and a wide range of vertebrate hosts, which likely facilitates its widespread emergence. However, potential non-human vertebrate reservoirs have not been systematically studied. Robust animal models to investigate pathogenesis and immune responses are not available. Epidemiology, pathogenesis, transmission cycle, cross-protection from infections with OROV reassortants, and the natural history of infection remain unclear. This Review identifies Oropouche fever as a neglected disease and offers recommendations to address existing knowledge gaps, enable risk assessments, and ensure effective public health responses.
Collapse
Affiliation(s)
- Konrad M Wesselmann
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Ignacio Postigo-Hidalgo
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Laura Pezzi
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France; Centre National de Référence (CNR) des Arbovirus, Marseille, France
| | - Edmilson F de Oliveira-Filho
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carlo Fischer
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France; Centre National de Référence (CNR) des Arbovirus, Marseille, France
| | - Jan Felix Drexler
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Infection Research (DZIF), Berlin, Germany.
| |
Collapse
|
3
|
de Lima RC, Dias HG, de Souza TMA, Familiar-Macedo D, Ribeiro ED, Corrêa VCE, Pauvolid-Corrêa A, de Azeredo EL, dos Santos FB. Oropouche Virus Exposure in Febrile Patients during Chikungunya Virus Introduction in the State of Amapá, Amazon Region, Brazil. Pathogens 2024; 13:469. [PMID: 38921767 PMCID: PMC11206884 DOI: 10.3390/pathogens13060469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/21/2024] [Accepted: 05/02/2024] [Indexed: 06/27/2024] Open
Abstract
Oropouche orthobunyavirus (OROV) is an arbovirus transmitted by midges that has been involved in outbreaks throughout Central and South America. In Brazil, human cases have been historically concentrated in the northern region of the country. Oropouche fever in humans range from mild clinical signs to rare neurological events, and is considered a neglected tropical disease in Brazil. Due to the clinical similarities to other arboviruses, such as chikungunya and dengue viruses, OROV infections are likely to be underreported. Chikungunya virus (CHIKV) cases in Brazil were first recognized in 2014 in the states of Amapá and Bahia in the north and northeast regions, respectively. Both OROV and CHIKV cause nonspecific symptoms, making clinical diagnosis difficult in a scenario of arbovirus cocirculation. Aiming to investigate OROV transmission during the CHIKV introduction in the state of Amapá located in the Brazilian Amazon, we conducted a retrospective molecular (RT-qPCR) and serological investigation in febrile cases (N = 166) collected between August 2014 and May 2015. All acute serum samples were negative for OROV RNA using RT-qPCR. However, neutralizing antibodies for OROV were detected using a plaque reduction neutralization test (PRNT90) in 10.24% (17/166) of the patients, with neutralizing antibody titers ranging from 20 to ≥640, suggesting the previous exposure of patients to OROV. Regarding CHIKV, recent exposure was confirmed by the detection of CHIKV RNA in 20.25% (33/163) of the patients and by the detection of anti-CHIKV IgM in 28.57% (44/154) of the patients. The additional detection of anti-CHIKV IgG in 12.58% (19/151) of the febrile patients suggests that some individuals had been previously exposed to CHIKV. Whether the OROV exposure reported here occurred prior or during the CHIKV circulation in Amapá, is unknown, but because those arboviral infections share similar clinical signs and symptoms, a silent circulation of enzootic arboviruses during the introduction of exotic arboviruses may occur, and highlights the importance of syndromic cases' surveillance to arboviruses in Brazil.
Collapse
Affiliation(s)
- Raquel Curtinhas de Lima
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| | - Helver Gonçalves Dias
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| | - Thiara Manuele Alves de Souza
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| | - Débora Familiar-Macedo
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| | | | | | - Alex Pauvolid-Corrêa
- Laboratório de Virologia Veterinária de Viçosa, Departamento de Veterinária, Universidade Federal de Viçosa (UFV), Viçosa 36570-900, Brazil;
| | - Elzinandes Leal de Azeredo
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| | - Flávia Barreto dos Santos
- Laboratório das Interações Vírus-Hospedeiros, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.C.d.L.); (H.G.D.); (T.M.A.d.S.); (D.F.-M.); (E.L.d.A.)
| |
Collapse
|
4
|
Moreira HM, Sgorlon G, Queiroz JAS, Roca TP, Ribeiro J, Teixeira KS, Passos-Silva AM, Araújo A, Gasparelo NWF, Dos Santos ADO, Lugtenburg CAB, Roque RA, Villalobos Salcedo JM, Pereira DB, Vieira D. Outbreak of Oropouche virus in frontier regions in western Amazon. Microbiol Spectr 2024; 12:e0162923. [PMID: 38323826 PMCID: PMC10913433 DOI: 10.1128/spectrum.01629-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/21/2023] [Indexed: 02/08/2024] Open
Abstract
Oropouche virus (OROV) is characterized as a re-emerging arbovirus of great concern for public health, being responsible for several outbreaks of acute fever identified in Latin American countries, registering more than half a million reported cases. The incidence of reports of this virus is intrinsically favored by environmental conditions, in which such characteristics are related to the increase and distribution of the vector population to areas of human traffic. Moreover, there is a problem regarding the lack of diagnosis in Brazil that aggregates the success of the etiologic agent. Thus, by means of molecular techniques, we identified 27 positive cases of the OROV circulating in border locations in western Amazon, with 44.44% (12/27) of the cohort characterized as infected individuals with reported symptoms, mainly ranging from fever, myalgia, and back pain. Among the positive samples, it was possible to obtain a total of 48.14% (13/27) samples to analyze the S and M segments of Oropouche, which showed similarities among the Brazilian sequences. Thus, it was possible to verify the circulation of the OROV in Rondonia and border areas, in which the tracking of neglected arboviruses is necessary for the genomic surveillance of emerging and re-emerging viruses.IMPORTANCEThe western Amazon region is known for outbreaks of acute febrile illnesses, to which the lack of specific diagnostics for different pathogens hinders the management of patients in healthcare units. The Oropouche virus has already been recorded in the region in the 1990s. However, this is the first study, after this record, to perform the detection of individuals with acute febrile illness using a screening test to exclude Zika, dengue, and chikungunya, confirmed by sequencing the circulation of the virus in the state of Rondonia and border areas. We emphasize the importance of including diagnostics for viruses such as Oropouche, which suffers underreporting for years and is related to seasonal periods in Western Amazon locations, a factor that has a direct influence on public health in the region. In addition, we emphasize the importance of genomic surveillance in the elucidation of outbreaks that affect the resident population of these locations.
Collapse
Affiliation(s)
- Hillquias Monteiro Moreira
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Gabriella Sgorlon
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Jackson A. S. Queiroz
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Tarcio P. Roca
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Jessiane Ribeiro
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Karolaine S. Teixeira
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Ana Maísa Passos-Silva
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Adrhyan Araújo
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Nadson Willian Felipe Gasparelo
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | | | | | | | | | - Dhelio B. Pereira
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| | - Deusilene Vieira
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondonia - FIOCRUZ/RO, Porto Velho, Rondonia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Universidade Federal de Rondonia - UNIR, Porto Velho, Rondonia, Brazil
- Centro de Pesquisa em Medicina Tropical, CEPEM, Porto Velho, Rondonia, Brazil
| |
Collapse
|
5
|
Zhang Y, Liu X, Wu Z, Feng S, Lu K, Zhu W, Sun H, Niu G. Oropouche virus: A neglected global arboviral threat. Virus Res 2024; 341:199318. [PMID: 38224842 PMCID: PMC10827532 DOI: 10.1016/j.virusres.2024.199318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/02/2024] [Accepted: 01/12/2024] [Indexed: 01/17/2024]
Abstract
The Oropouche virus is an important arthropod-borne virus in the Peribunyaviridae family that can cause febrile illnesses, and it is widely distributed in tropical regions such as Central and South America. Since the virus was first identified, a large number of related cases are reported every year. No deaths have been reported to date, however, the virus can cause systemic infections, including the nervous and blood systems, leading to serious complications. The transmission of Oropouche virus occurs through both urban and sylvatic cycles, with the anthropophilic biting midge Culicoides paraensis serving as the primary vector in urban areas. Direct human-to-human transmission of Oropouche virus has not been observed. Oropouche virus consists of three segments, and the proteins encoded by the different segments enables the virus to replicate efficiently in the host and to resist the host's immune response. Phylogenetic analyses showed that Oropouche virus sequences are geographically distinct and have closer homologies with Iquitos virus and Perdoes virus, which belong to the family Peribunyaviridae. Despite the enormous threat it poses to public health, there are currently no licensed vaccines or specific antiviral treatments for the disease it causes. Recent studies have utilised imJatobal virusmunoinformatics approaches to develop epitope-based peptide vaccines, which have laid the groundwork for the clinical use of vaccines. The present review focuses on the structure, epidemiology, immunity and phylogeny of Oropouche virus, as well as the progress of vaccine development, thereby attracting wider attention and research, particularly with regard to potential vaccine programs.
Collapse
Affiliation(s)
- Yuli Zhang
- Shandong Second Medical University, Weifang, 261053, China
| | - Xiao Liu
- Shandong Second Medical University, Weifang, 261053, China
| | - Zhen Wu
- Shandong Second Medical University, Weifang, 261053, China
| | - Shuo Feng
- Shandong Second Medical University, Weifang, 261053, China
| | - Ke Lu
- Shandong Second Medical University, Weifang, 261053, China
| | - Wenbing Zhu
- Shandong Second Medical University, Weifang, 261053, China
| | - Hengyi Sun
- Shandong Second Medical University, Weifang, 261053, China.
| | - Guoyu Niu
- Shandong Second Medical University, Weifang, 261053, China.
| |
Collapse
|
6
|
Honorato L, Ferreira NE, Domingues RB, Senne C, Leite FBVDM, Santos MVD, Fernandes GBP, Paião HGO, Vilas Boas LS, da Costa AC, Tozetto-Mendoza TR, Witkin SS, Mendes-Correa MC. Evaluation of enterovirus concentration, species identification, and cerebrospinal fluid parameters in patients of different ages with aseptic meningitis in São Paulo, Brazil. J Med Virol 2024; 96:e29471. [PMID: 38353496 DOI: 10.1002/jmv.29471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
Human enteroviruses (EV) are the most common cause of aseptic meningitis worldwide. Data on EV viral load in cerebrospinal fluid (CSF) and related epidemiological studies are scarce in Brazil. This study investigated the influence of EV viral load on CSF parameters, as well as identifying the involved species. CSF samples were collected in 2018-2019 from 140 individuals at The Hospital das Clínicas, São Paulo. The EV viral load was determined using real-time quantitative polymerase chain reaction, while EV species were identified by 5'UTR region sequencing. Median viral load was 5.72 log10 copies/mL and did not differ by subjects' age and EV species. Pleocytosis was observed in 94.3% of cases, with the highest white blood cell (WBC) counts in younger individuals. Viral load and WBC count were correlated in children (p = 0.0172). Elevated lactate levels were observed in 60% of cases and correlated with the viral load in preteen-teenagers (p = 0.0120) and adults (p = 0.0184). Most individuals had normal total protein levels (70.7%), with higher in preteen-teenagers and adults (p < 0.0001). By sequencing, 8.2% were identified as EV species A and 91.8% as species B. Age-specific variations in CSF characteristics suggest distinct inflammatory responses in each group.
Collapse
Affiliation(s)
- Layla Honorato
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Noely Evangelista Ferreira
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | | | - Heuder Gustavo Oliveira Paião
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Lucy Santos Vilas Boas
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Antonio Charlys da Costa
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Tânia Regina Tozetto-Mendoza
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Steven S Witkin
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Department of Obstetrics and Gynecology, Weill Cornel Medicine, New York, New York, USA
| | - Maria Cássia Mendes-Correa
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
7
|
Saivish MV, Menezes GDL, da Silva RA, de Assis LR, Teixeira IDS, Fulco UL, Avilla CMS, Eberle RJ, Santos IDA, Korostov K, Webber ML, da Silva GCD, Nogueira ML, Jardim ACG, Regasin LO, Coronado MA, Pacca CC. Acridones as promising drug candidates against Oropouche virus. CURRENT RESEARCH IN MICROBIAL SCIENCES 2023; 6:100217. [PMID: 38234431 PMCID: PMC10792649 DOI: 10.1016/j.crmicr.2023.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
Oropouche virus (OROV) is an emerging vector-borne arbovirus found in South America that causes Oropouche fever, a febrile infection similar to dengue fever. It has a high epidemic potential, causing illness in over 500,000 cases diagnosed since the virus was first discovered in 1955. Currently, the prevention of human viral infection depends on vaccination, but availability for many viruses is limited, and they are classified as neglected viruses. At present, there are no vaccines or antiviral treatments available. An alternative approach to limiting the spread of the virus is to selectively disrupt viral replication mechanisms. Here, we demonstrate the inhibitory effect of acridones, which efficiently inhibited viral replication by 99.9 % in vitro. To evaluate possible mechanisms of action, we conducted tests with dsRNA, an intermediate in virus replication, as well as MD simulations, docking, and binding free energy analysis. The results showed a strong interaction between FAC21 and the OROV endonuclease, which possibly limits the interaction of viral RNA with other proteins. Therefore, our results suggest a dual mechanism of antiviral action, possibly caused by ds-RNA intercalation. In summary, our findings demonstrate that a new generation of antiviral drugs could be developed based on the selective optimization of molecules.
Collapse
Affiliation(s)
- Marielena Vogel Saivish
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
| | - Gabriela de Lima Menezes
- Unidade Especial de Ciências Exatas, Universidade Federal de Jataí, Jataí, GO 75801-615, Brazil
- Bioinformatics Multidisciplinary Environment, Programa de Pós-graduação em Bioinformática, Universidade Federal do Rio Grande do Norte, Natal 59078-400, RN, Brazil
| | | | - Leticia Ribeiro de Assis
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
| | - Igor da Silva Teixeira
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
| | - Umberto Laino Fulco
- Bioinformatics Multidisciplinary Environment, Programa de Pós-graduação em Bioinformática, Universidade Federal do Rio Grande do Norte, Natal 59078-400, RN, Brazil
| | - Clarita Maria Secco Avilla
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
| | - Raphael Josef Eberle
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich 52428, Germany
- Heinrich Heine University Düsseldorf, Faculty of Mathematics and Natural Sciences, Institute of Physical Biology, Universitätsstraße, Düsseldorf 40225, Germany
| | - Igor de Andrade Santos
- Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia-MG 38405-302, Brazil
| | - Karolina Korostov
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich 52428, Germany
| | - Mayara Lucia Webber
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
| | - Gislaine Celestino Dutra da Silva
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
| | - Maurício Lacerda Nogueira
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
| | - Ana Carolina Gomes Jardim
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
- Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia-MG 38405-302, Brazil
| | - Luis Octavio Regasin
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
| | - Mônika Aparecida Coronado
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich 52428, Germany
| | - Carolina Colombelli Pacca
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP 15090-000, Brazil
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
| |
Collapse
|
8
|
Presence and Multi-Species Spatial Distribution of Oropouche Virus in Brazil within the One Health Framework. Trop Med Infect Dis 2022; 7:tropicalmed7060111. [PMID: 35736989 PMCID: PMC9230142 DOI: 10.3390/tropicalmed7060111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Oropouche virus (OROV) is an emerging vector-borne arbovirus with high epidemic potential, causing illness in more than 500,000 people. Primarily contracted through its midge and mosquito vectors, OROV remains prevalent in its wild, non-human primate and sloth reservoir hosts as well. This virus is spreading across Latin America; however, the majority of cases occur in Brazil. The aim of this research is to document OROV’s presence in Brazil using the One Health approach and geospatial techniques. A scoping review of the literature (2000 to 2021) was conducted to collect reports of this disease in humans and animal species. Data were then geocoded by first and second subnational levels and species to map OROV’s spread. In total, 14 of 27 states reported OROV presence across 67 municipalities (second subnational level). However, most of the cases were in the northern region, within the tropical and subtropical moist broadleaf forests biome. OROV was identified in humans, four vector species, four genera of non-human primates, one sloth species, and others. Utilizing One Health was important to understand the distribution of OROV across several species and to suggest possible environmental, socioeconomic, and demographic drivers of the virus’s presence. As deforestation, climate change, and migration rates increase, further study into the spillover potential of this disease is needed.
Collapse
|
9
|
Taherkhani R, Farshadpour F. Molecular identification and clinical characteristics of mumps virus and human herpesviruses associated with aseptic meningitis in South of Iran. Virusdisease 2021; 32:666-673. [PMID: 34901323 DOI: 10.1007/s13337-021-00718-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022] Open
Abstract
Viral infections are the major etiological agent of aseptic meningitis; though, limited data exist on the prevalence and molecular epidemiology of viral pathogens responsible for the occurrence of aseptic meningitis in Iran. Therefore, this study aimed to elucidate the prevalence and clinical features of mumps virus and human herpesviruses associated with aseptic meningitis in the South of Iran. A total of 73 patients with aseptic meningitis were enrolled in this study. Cerebral spinal fluid (CSF) samples were tested for detection of HSV, CMV, VZV and mumps virus using nested PCR assay. Mumps virus, HSV-1 and VZV were found in 4 (5.5%), 4 (5.5%) and 3 (4.1%) of the CSF samples, respectively. The highest rates of mumps virus and HSV infections were observed in infants less than one year, and VZV was more prevalent in patients under 5 years of age. The majority of mumps virus and VZV infections were found among male patients, while HSV was more prevalent among female patients. The highest incidence of aseptic meningitis associated with mumps virus was observed in summer, while HSV and VZV were more prevalent during spring. Headache was the most common symptom in mumps meningitis. About HSV and VZV, the most predominant clinical symptom was fever. The results of this study indicate the importance of molecular assay in the diagnosis of etiological agents of aseptic meningitis. Prompt detection of viral pathogens provides a better chance of managing viral meningitis in health care settings. Supplementary Information The online version contains supplementary material available at 10.1007/s13337-021-00718-y.
Collapse
Affiliation(s)
- Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Moallem Street, 7514633341 Bushehr, Iran
| | - Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Moallem Street, 7514633341 Bushehr, Iran
| |
Collapse
|
10
|
Neurological infection by chikungunya and a triple Arbovirus co-infection in Mato Grosso, Central Western Brazil during 2019. J Clin Virol 2021; 146:105056. [PMID: 34923322 DOI: 10.1016/j.jcv.2021.105056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/27/2021] [Accepted: 12/11/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Neurological viral infection is frequently associated to enterovirus, herpesvirus and arboviruses. These infections may cause severe clinical outcomes, long lasting sequelae or death. Few studies have addressed viral neurological infections etiology in Brazil. OBJECTIVES Identification of viruses in the cerebral spinal fluid (CSF) of human neurological infections suspected of viral etiology during January and May 2019 in Midwestern Brazil. MATERIALS AND METHODS Clinical, laboratory and epidemiological information was gathered from medical records. In addition, an aliquot of the sampled CSF was subjected to viral RNA/DNA extraction, randomic dscDNA amplification by PCR, DNA purification and Ilumina HiSeq 2500 sequencing. RESULTS Six viral genomes belonging to Chikungunya virus (CHIKV) East-Central-South African (ECSA) genotype (10.834-11.804 nt in length) confirmed lately by RT-PCR for CHIKV envelope were present in all six liquor samples. These genomes present two mutations, nsP2:T31I and nsP3:A388V, shared with other Mato Grosso State strains from 2019, not present in sequences of the virus from previous years obtained in the State. One case was a triple co-infection also confirmed through RT-PCR, with Dengue virus serotype 4 genotype II (NS5; 874 nt) and Oropouche virus genotype IA (segment S; 302 nt). CSF was clear and colorless (5/6 patients), with >10% of lymphomononuclear cells (6/6), 1-99 erythrocytes/mm3 (5/6), glucose levels >50 mg/dl (4/5) e > 10 mg/dl of proteins (4/4). One patient evolved to death, and another, a newborn, presented sequelae after recovery. CONCLUSIONS Despite herpesviruses and enteroviruses are frequent etiologies of neurological infections, the casuistic here reported was associated to arboviruses already known to be responsible for acute febrile illness outbreaks in the state of Mato Grosso, Midwestern Brazil.
Collapse
|
11
|
Leon LL, Lima RGD, Boffi LC, Bindilatti RN, Garlipp CR, Costa SCB, Bonon SHA. Arbovirus, herpesvirus, and enterovirus associated with neurological syndromes in adult patients of a university hospital, 2017-2018. Rev Soc Bras Med Trop 2021; 54:e0127. [PMID: 34787257 PMCID: PMC8582960 DOI: 10.1590/0037-8682-0127-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/31/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Herpesviruses, enteroviruses, and arboviruses are important because of their clinical relevance and ability to cause meningitis, encephalitis, meningoencephalitis, and other diseases. The clinical virology associated with diagnostic technologies can reduce the morbidity and mortality of such neurological manifestations. Here we aimed to identify the genomes of agents that cause neurological syndromes in cerebrospinal fluid (CSF) samples from patients with suspected nervous system infections admitted to the University Hospital of the University of Campinas, São Paulo, Brazil, in 2017-2018. METHODS: CSF samples collected from adult patients with neurological syndrome symptoms and negative CSF culture results were analyzed using polymerase chain reaction (PCR), reverse transcriptase-PCR, and real-time PCR, and their results were compared with their clinical symptoms. One CSF sample was obtained from each patient. RESULTS: Viral genomes were detected in 148/420 (35.2%) CSF samples: one of 148 (0.2%) was positive for herpes simplex virus-1; two (0.5%) for herpes simplex virus-2; eight (1.9%) for varicella-zoster virus; four (1%) for Epstein-Barr virus; one (0.2%) for cytomegalovirus; 32 (7.6%) for human herpesvirus-6; 30 (7.1%) for non-polio enterovirus; 67 (16.0%) for dengue virus, three (0.7%) for yellow fever virus, and 21 (5%) for Zika virus. CONCLUSIONS: The viral genomes were found in 35.2% of all analyzed samples, showing the high prevalence of viruses in the nervous system and the importance of using a nucleic acid amplification test to detect viral agents in CSF samples.
Collapse
Affiliation(s)
- Lucas Lopes Leon
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| | - Rodrigo Gonçalves de Lima
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| | - Lídia Cristian Boffi
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| | - Raissa Nery Bindilatti
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| | - Célia Regina Garlipp
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Patologia Clínica, Campinas, SP, Brasil
| | - Sandra Cecília Botelho Costa
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| | - Sandra Helena Alves Bonon
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Virologia, Campinas, SP, Brasil
| |
Collapse
|
12
|
Pereira LMS, Dos Santos França E, Costa IB, Lima IT, Freire ABC, de Paula Ramos FL, Monteiro TAF, Macedo O, Sousa RCM, Freitas FB, Costa IB, Vallinoto ACR. Epidemiological risk factors associated with primary infection by Epstein-Barr virus in HIV-1-positive subjects in the Brazilian Amazon region. Sci Rep 2021; 11:18476. [PMID: 34531433 PMCID: PMC8446016 DOI: 10.1038/s41598-021-97707-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.
Collapse
Affiliation(s)
| | - Eliane Dos Santos França
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Iran Barros Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Igor Tenório Lima
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | | | | | | | - Olinda Macedo
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Rita Catarina Medeiros Sousa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,School of Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Felipe Bonfim Freitas
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Igor Brasil Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil. .,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil.
| |
Collapse
|
13
|
Walsh CES, Robert MA, Christofferson RC. Observational Characterization of the Ecological and Environmental Features Associated with the Presence of Oropouche Virus and the Primary Vector Culicoides paraenesis: Data Synthesis and Systematic Review. Trop Med Infect Dis 2021; 6:tropicalmed6030143. [PMID: 34449725 PMCID: PMC8396275 DOI: 10.3390/tropicalmed6030143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022] Open
Abstract
Oropouche virus (OROV), a member of the Orthobunyavirus genus, is an arthropod-borne virus (arbovirus) and is the etiologic agent of human and animal disease. The primary vector of OROV is presumed to be the biting midge, Culicoides paraenesis, though Culex quinquefasciatus, Cq. venezuelensis, and Aedes serratus mosquitoes are considered secondary vectors. The objective of this systematic review is to characterize locations where OROV and/or its primary vector have been detected. Synthesis of known data through review of published literature regarding OROV and vectors was carried out through two independent searches: one search targeted to OROV, and another targeted towards the primary vector. A total of 911 records were returned, but only 90 (9.9%) articles satisfied all inclusion criteria. When locations were characterized, some common features were noted more frequently than others, though no one characteristic was significantly associated with presence of OROV using a logistic classification model. In a separate correlation analysis, vector presence was significantly correlated only with the presence of restingas. The lack of significant relationships is likely due to the paucity of data regarding OROV and its eco-epidemiology and highlights the importance of continued focus on characterizing this and other neglected tropical diseases.
Collapse
Affiliation(s)
- Christine E. S. Walsh
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Michael A. Robert
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Rebecca C. Christofferson
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
- Correspondence:
| |
Collapse
|
14
|
Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil. Viruses 2021; 13:v13071370. [PMID: 34372576 PMCID: PMC8310075 DOI: 10.3390/v13071370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022] Open
Abstract
Virus-induced infections of the central nervous system (CNS) are among the most serious problems in public health and can be associated with high rates of morbidity and mortality, mainly in low- and middle-income countries, where these manifestations have been neglected. Typically, herpes simplex virus 1 and 2, varicella-zoster, and enterovirus are responsible for a high number of cases in immunocompetent hosts, whereas other herpesviruses (for example, cytomegalovirus) are the most common in immunocompromised individuals. Arboviruses have also been associated with outbreaks with a high burden of neurological disorders, such as the Zika virus epidemic in Brazil. There is a current lack of understanding in Brazil about the most common viruses involved in CNS infections. In this review, we briefly summarize the most recent studies and findings associated with the CNS, in addition to epidemiological data that provide extensive information on the circulation and diversity of the most common neuro-invasive viruses in Brazil. We also highlight important aspects of the prion-associated diseases. This review provides readers with better knowledge of virus-associated CNS infections. A deeper understanding of these infections will support the improvement of the current surveillance strategies to allow the timely monitoring of the emergence/re-emergence of neurotropic viruses.
Collapse
|
15
|
Farshadpour F, Taherkhani R. Molecular epidemiology of enteroviruses and predominance of echovirus 30 in an Iranian population with aseptic meningitis. J Neurovirol 2021; 27:444-451. [PMID: 33788142 DOI: 10.1007/s13365-021-00973-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
Human enteroviruses are the most prevalent causes of aseptic meningitis worldwide. However, despite such predominancy, defining the enteroviral etiology of aseptic meningitis remains a diagnostic dilemma for the clinician in Iran. Therefore, this study was conducted to characterize the prevalence and clinical significance of enteroviral aseptic meningitis as well as the predominant enterovirus serotypes among patients with aseptic meningitis in the South of Iran.Cerebrospinal fluid (CSF) specimens were obtained from 73 patients with aseptic meningitis (52.1% males and 47.9% females), ages ranging from 1 month to 88 years. Following the extraction of nucleic acid, the detection of enteroviruses was performed by RT-PCR, targeting the 5' untranslated region of the genome, and sequencing. Enteroviruses were found in 46.6% of samples (34/73). The most predominant serotype was echovirus 30, followed by coxsackievirus B5 and poliovirus type 1 Sabin strain. The enterovirus infections were more prevalent among female patients (58.8%) and those below 5 years of age (52.9%). Although enterovirus infections were observed throughout the year, the infections were more prevalent during autumn with fever as the predominant clinical symptom. The outcomes revealed that enteroviruses are significant causes of aseptic meningitis in the South of Iran, while suspected cases of aseptic meningitis are usually monitored by bacterial culture and biochemical testing of CSF samples. Therefore, the etiology remains unknown in most cases. Molecular detection of viral pathogens should be included as a common approach in the screening of patients with aseptic meningitis to prevent unnecessary treatment and to improve clinical management.
Collapse
MESH Headings
- Adolescent
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Child
- Child, Preschool
- Enterovirus B, Human/classification
- Enterovirus B, Human/genetics
- Enterovirus B, Human/isolation & purification
- Enterovirus Infections/cerebrospinal fluid
- Enterovirus Infections/diagnosis
- Enterovirus Infections/epidemiology
- Enterovirus Infections/virology
- Female
- Genome, Viral
- Humans
- Infant
- Infant, Newborn
- Iran/epidemiology
- Male
- Meningitis, Aseptic/cerebrospinal fluid
- Meningitis, Aseptic/diagnosis
- Meningitis, Aseptic/epidemiology
- Meningitis, Aseptic/virology
- Meningitis, Viral/cerebrospinal fluid
- Meningitis, Viral/diagnosis
- Meningitis, Viral/epidemiology
- Meningitis, Viral/virology
- Middle Aged
- Molecular Epidemiology
- Phylogeny
- Poliomyelitis/cerebrospinal fluid
- Poliomyelitis/diagnosis
- Poliomyelitis/epidemiology
- Poliomyelitis/virology
- Poliovirus/classification
- Poliovirus/genetics
- Poliovirus/isolation & purification
- Prevalence
- RNA, Viral/genetics
Collapse
Affiliation(s)
- Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Moallem Street, 7514633341, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Moallem Street, 7514633341, Bushehr, Iran.
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
| |
Collapse
|
16
|
Rocha LCD, Estofolete CF, Milhim BHGDA, Augusto MT, Zini N, Silva GCDD, Ferraz-Junior HC, Brienze VMS, Liso E, Cunha MS, Sabino EC, da Costa AC, Nogueira ML, Luchs A, Terzian ACB. Enteric viruses circulating in undiagnosed central nervous system infections at tertiary hospital in São José do Rio Preto, São Paulo, Brazil. J Med Virol 2021; 93:3539-3548. [PMID: 32579291 DOI: 10.1002/jmv.26216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/20/2020] [Indexed: 12/18/2022]
Abstract
Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including rotavirus (RVA), human astrovirus (HAstV), and norovirus (NoV), have also been associated with CNS neurological disorders. The aim of the present study was to investigate the presence of EV, RVA, HAst, and NoV associated to CNS infections with undiagnosed etiology in Northwest region of São Paulo State, Brazil, and to conduct the molecular characterization of the positive samples detected. A total of 288 cerebrospinal fluid samples collected from July to December 2017 were tested for EV and NoV by quantitative real-time polymerase chain reaction (RT-qPCR), HAstV by conventional RT-PCR, and RVA by enzyme-linked immunosorbent assay. Positive-EV samples were inoculated in cells lines, amplified by RT-PCR and sequenced. RVA, NoV, and HAstV were not detected. EV infection was detected in 5.5% (16/288), and five samples successful genotyped: echovirus 3 (E3) (1/5), coxsackie virus A6 (CVA6) (1/5), and coxsackie virus B4 (CVB4) (3/5). Meningitis was the main syndrome observed (12/16; 75%). CVA6, CVB4, and E3 were identified associated with aseptic meningitis. Reports of CVA6 associated with aseptic meningitis are rare, E3 had not been previously reported in Brazil, and epidemiological data on CVB4 in the country is virtually unknown. The present investigation illustrates the circulation of diverse EV types in a small regional sample set and in a short period of time, highlighting the importance of an active EV surveillance system in CNS infections. Enhanced understanding of undiagnosed CNS infections will assist in public health and health care planning.
Collapse
Affiliation(s)
| | | | | | | | - Nathalia Zini
- São José do Rio Preto School of Medicine (FAMERP), São Paulo, Brazil
| | | | | | | | | | - Mariana Sequetin Cunha
- Vector Borne Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | - Ester Cerdeira Sabino
- LIM/46, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Adriana Luchs
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | | |
Collapse
|
17
|
Garcia E, Fajardo QF, Figueroa R, Chavarría V, Castañeda AV, Salazar A, de la Cruz VP, Sotelo J, Pineda B. Herpesvirus encephalitis diagnosed by polymerase chain reaction at the National Institute of Neurology of Mexico. J Neurovirol 2021; 27:397-402. [PMID: 33830465 DOI: 10.1007/s13365-020-00839-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/28/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022]
Abstract
The frequency of central nervous system infections due to herpesvirus have been studied in various populations; however, studies in Mexican mestizo patients are scant. This paper documents the frequency of herpesvirus encephalitis in Mexican mestizo patients from the National Institute of Neurology and Neurosurgery (NINN) of Mexico. To study the frequency of herpetic viral encephalitis at the NINN in the period from 2004 to 2009. We reviewed clinical records from patients with clinically suspected encephalitis; polymerase chain reaction assays were done for detection of herpesviruses in cerebrospinal fluid (CSF) samples. The total number of patients studied was 502; in 59 (12%), the diagnosis of herpetic encephalitis was confirmed by PCR-based testing of CSF. Of them, 21 (36%) were positive for herpes simplex virus type 1, 15 (25%) for Epstein-Barr virus, 10 (17%) for varicella zoster virus, 8 (14%) for cytomegalovirus, 3 (5%) for human herpesvirus 6, and 2 (3%) for herpes simplex virus 2. Our results show a varied frequency of viral encephalitis in mestizo patients due to herpesviruses in a tertiary neurological center and point out the importance of modern molecular technology to reach the etiological diagnosis in cases of encephalitis.
Collapse
Affiliation(s)
- Esperanza Garcia
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico
| | | | - Rubén Figueroa
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico
| | - Víctor Chavarría
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico
| | | | - Aleli Salazar
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico
| | - Verónica Pérez de la Cruz
- Neurobiochemistry laboratory, National Institute of Neurology and Neurosurgery (NINN), Mexico City, Mexico
| | - Julio Sotelo
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico
| | - Benjamín Pineda
- Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico.
| |
Collapse
|
18
|
Pereira-Silva JW, Ríos-Velásquez CM, Lima GRD, Marialva Dos Santos EF, Belchior HCM, Luz SLB, Naveca FG, Pessoa FAC. Distribution and diversity of mosquitoes and Oropouche-like virus infection rates in an Amazonian rural settlement. PLoS One 2021; 16:e0246932. [PMID: 33592052 PMCID: PMC7886159 DOI: 10.1371/journal.pone.0246932] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/28/2021] [Indexed: 02/02/2023] Open
Abstract
Mosquito diversity and disease transmission are influenced by landscape modifications, i.e., vectors and pathogens previously found only in forests are now found close to human environments due to anthropic changes. This study determined the diversity and distribution of mosquitoes in forest environments in order to analyze the potential vectors of Amazonian forest arboviruses. Mosquitoes were collected by 1) vertical stratification from forest canopy and ground areas using Hooper Pugedo (HP) light traps and human attraction and 2) horizontal stratification using HP light traps in peridomicile, forest edge, and forest environments near the Rio Pardo rural settlement, Amazonas, Brazil. A total of 3,750 mosquitoes were collected, representing 46 species. 3,139 individuals representing 46 species were sampled by vertical stratification. Both the Shannon-Weaver diversity index (H’) and equitability (J’) were higher in the canopy than on the ground. 611 individuals representing 13 species were sampled by horizontal stratification. H’ decreased in the following order: forest edge > forest > peridomicile, and J’ was greater at the forest edge and smaller in the peridomicile environment. Moreover, H’ was higher for the human attraction collection method than the HP traps. A total of 671 pools were analyzed by RT-qPCR; three species were positive for Oropouche-like viruses (Ochlerotatus serratus, Psorophora cingulata, and Haemagogus tropicalis) and the minimum infection rate was 0.8%. The composition of mosquito species did not differ significantly between anthropic and forest environments in Rio Pardo. Some mosquito species, due to their abundance, dispersion in the three environments, and record of natural infection, were hypothesized to participate in the arbovirus transmission cycle in this Amazonian rural settlement.
Collapse
Affiliation(s)
- Jordam William Pereira-Silva
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brasil
| | - Claudia María Ríos-Velásquez
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Gervilane Ribeiro de Lima
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Eric Fabrício Marialva Dos Santos
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Heliana Christy Matos Belchior
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Sergio Luiz Bessa Luz
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Felipe Gomes Naveca
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Felipe Arley Costa Pessoa
- Laboratório Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil.,Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas, Brasil
| |
Collapse
|
19
|
Eustaquio Do Imperio G, Lye P, Bloise E, Matthews SG. Function of Multidrug Resistance Transporters is Disrupted by Infection Mimics in Human Brain Endothelial Cells. Tissue Barriers 2021; 9:1860616. [PMID: 33427563 PMCID: PMC8078541 DOI: 10.1080/21688370.2020.1860616] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
P-glycoprotein (P-gp/ABCB1) and breast cancer resistance protein (BCRP/ABCG2) modulate the distribution of drugs and toxins across the blood-brain barrier (BBB). Animal studies reported that infection-induced disruption of these transporters in the developing BBB impairs fetal brain protection. However, the impact of infection mimics on P-gp/BCRP function in human brain endothelium is less well understood. We hypothesized that Toll-like receptor ligands mimicking bacterial and viral infection would modify the expression and function of P-gp and BCRP in human brain endothelial cells (BECs). Human cerebral microvascular endothelial cells (hCMEC/D3) were challenged with bacterial [Lipopolysaccharide (LPS)] and viral-mimics [polyinosinic:polycytidylic acid (PolyI:C) or single-stranded RNA (ssRNA)], or pro-inflammatory cytokines interleukin (IL)-6, tumor necrosis factor (TNF)-α and interferon gamma (IFN)-ɣ. P-gp and BCRP function was assessed after 4 or 24 h, using Calcein-AM and Chlorin-6 assays, respectively. Western blot and qPCR quantified P-gp/ABCB1 and BCRP/ABCG2 expression following treatments. Infection mimics are potent modulators of drug transporters in human BECs in vitro. LPS and PolyI:C increased, while ssRNA exposure reduced P-gp activity. In contrast, LPS and PolyI:C decreased, while ssRNA increased BCRP activity (P < .05). There was little correlation between drug transporter function, gene expression and total protein level. Altered plasma membrane BCRP may suggest modified intracellular trafficking induced by infection in human BECs. Bacterial and viral infection mimics modify P-gp and BCRP transport function in human BECs, in vitro. This knowledge may contribute and have important implications for human brain protection and possible altered biodistribution of drugs and xenobiotics in the brain following exposure to TLR agonists.
Collapse
Affiliation(s)
| | - Phetcharawan Lye
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Enrrico Bloise
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Stephen G Matthews
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Department of Obstetrics and Gynecology and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
20
|
Limbic Encephalitis Brain Damage Induced by Cocal Virus in Adult Mice Is Reduced by Environmental Enrichment: Neuropathological and Behavioral Studies. Viruses 2020; 13:v13010048. [PMID: 33396704 PMCID: PMC7824630 DOI: 10.3390/v13010048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 12/26/2022] Open
Abstract
We previously demonstrated, using the Piry virus model, that environmental enrichment promotes higher T-cell infiltration, fewer microglial changes, and faster central nervous system (CNS) virus clearance in adult mice. However, little is known about disease progression, behavioral changes, CNS cytokine concentration, and neuropathology in limbic encephalitis in experimental models. Using Cocal virus, we infected C57Bl6 adult mice and studied the neuroanatomical distribution of viral antigens in correlation with the microglial morphological response, measured the CNS cytokine concentration, and assessed behavioral changes. C57Bl6 adult mice were maintained in an impoverished environment (IE) or enriched environment (EE) for four months and then subjected to the open field test. Afterwards, an equal volume of normal or virus-infected brain homogenate was nasally instilled. The brains were processed to detect viral antigens and microglial morphological changes using selective immunolabeling. We demonstrated earlier significant weight loss and higher mortality in IE mice. Additionally, behavioral analysis revealed a significant influence of the environment on locomotor and exploratory activity that was associated with less neuroinvasion and a reduced microglial response. Thus, environmental enrichment was associated with a more effective immune response in a mouse model of limbic encephalitis, allowing faster viral clearance/decreased viral dissemination, reduced disease progression, and less CNS damage.
Collapse
|
21
|
Compagnoli Carmona RDC, Caetano Machado B, Aparecida de Sousa C, Vieira HR, Moraes Alves MR, Farias de Souza KA, de Souza Gregório D, Costa Vilanova B, Sampaio Tavares Timenetsky MDC. Distribution of species enterovirus B in patients with central nervous system infections in São Paulo State, Brazil. J Med Virol 2020; 92:3849-3856. [PMID: 32492248 DOI: 10.1002/jmv.26131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023]
Abstract
Enteroviruses (EV) are most common cause of central nervous system (CNS) infection, mainly aseptic meningitis. In Brazil, data available concerning the distribution of EV types are scarce. The aim of this study was to describe of types EV in patients with infection of the CNS in São Paulo State. This retrospective study was conducted in clinical samples collected from patients with infections of the CNS from 2004 to 2014. We investigated the presence of EV by virus isolation in cell culture. The samples that showed cytopathic effect in the cell culture were submitted by indirect immunofluorescence assay, reverse transcription polymerase chain reaction and VP1 partial sequencing to identification of EV isolated. A total of 176 EV isolated in cell culture was detected and typed in 14.5% (n = 176/1215) of clinical samples analyzed; corresponding to 71.0% of AM, and 19.3% of encephalitis and meningoencephalitis. Echoviruses (E) were isolated most frequently, with 155 strains (88.1%), Coxsackievirus B (CV-B), with 20 cases (11.4%), CV-A, with 01 case (0.6%). E-6 was the most commonly identified followed in decreasing order by E-30; E-18; CV-B5; E-4; E-11; CV-B2 and E-9; E-7; CV-A9, CV-B1, CV-B3, CV-B4, E-13, E-14, and E-21. EV detected were classified as belonging to the species enterovirus B. EV were detected in all the period of the year with the highest rate in the spring and summer months. Data obtained in this study contribute to the knowledge about EV circulation implicated in CNS infections over a 11-year period in São Paulo State, Brazil.
Collapse
Affiliation(s)
| | | | | | - Heloisa Rosa Vieira
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
22
|
Tagnouokam-Ngoupo PA, Toby R, Bomba Ebede MO, Kenmoe S, Ngo-Malabo ET, Sadeuh-Mba SA, Biwole-Sida M, Njouom R. Detection of herpesviruses and enteroviruses in patients with suspected infectious meningoencephalitis in three referral hospitals in Yaounde, Cameroon. J Med Virol 2020; 92:3843-3848. [PMID: 32492202 DOI: 10.1002/jmv.26109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/24/2020] [Accepted: 05/31/2020] [Indexed: 11/10/2022]
Abstract
In Cameroon, routine diagnosis of central nervous system (CNS) infections is based on the detection of bacteria, fungi, parasites, and mycobacteria in cerebrospinal fluids. Therefore, there is no data on viral etiologies of meningoencephalitis (ME) in the country. We aim to identify viral etiologies (herpesviruses and enteroviruses) of ME in Cameroon, to provide useful information to physicians that will help improving management of ME. From February to May 2018, adult patients with clinical signs of ME in three referral hospitals in Yaounde were included. Detection of herpesviruses and enteroviruses was performed using reverse transcriptase polymerase chain reaction. P value of 5% was chosen as the threshold for statistical significance in statistical analyses. Eighty-one patients were included and 15 (18.51%) were positive for herpesviruses. No enterovirus was detected. The most prevalent virus was Epstein-Barr virus (8.6%) and most of herpesviruses were detected from human immunodefeciency virus (HIV)-positive patients (86.7%). The overall mortality rate was high, 60.5% (49/81) and analysis of risk factors showed that HIV-positive status and altered state of consciousness were associated with higher risk of death (odds ratio [OR], 5.41; confidence interval [CI]: 1.91-16.88; P = .002 and OR, 3.24; CI: 1.11-0.13; P = .036 respectively). We showed that herpesviruses are present in patients with ME symptoms in Yaounde and can be sometimes in coinfection with others common pathogens of CNS infections. There is therefore a need for increased clinician awareness and education regarding the diagnostic and management of CNS infections in Cameroon to limit unnecessary use of antibiotics.
Collapse
Affiliation(s)
| | - Roselyne Toby
- Infectious Disease Ward, Yaounde Central Hospital, Yaounde, Cameroon
| | | | - Sebastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | | | | | - Magloire Biwole-Sida
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, Yaounde, Cameroon
| |
Collapse
|
23
|
Lima ECBD, Montarroyos UR, Magalhães JJFD, Dimech GS, Lacerda HR. Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil. Rev Inst Med Trop Sao Paulo 2020; 62:e69. [PMID: 33027393 PMCID: PMC7534407 DOI: 10.1590/s1678-9946202062069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/25/2020] [Indexed: 11/28/2022] Open
Abstract
The Northeast of Brazil has experienced a triple epidemic, with the simultaneous circulation of dengue virus (DENV), chikungunya virus (CHIKV) and Zika virus (ZIKV), which may have contributed to the observed increase across this region of atypical forms of disease and deaths. In view of this fact, non-congenital neurological disorders related to arboviruses were compared with other etiologies, mortality and survival rates of patients admitted to referral neurology hospitals in Pernambuco State, Northeast Brazil, from 2015 to 2018. Blood and cerebrospinal fluid samples were collected and tested using molecular and serological assays. The arbovirus-exposed groups were compared with respect to epidemiological, clinical and neurologic characteristics by using the Pearson’s chi-square test. For the survival analysis, the Kaplan-Meier and Hazard Ratio (HR) tests were used, with a 95% confidence interval (CI). Encephalitis and encephalomyelitis were more frequent in arboviruses, while myelitis predominated in the neurological disorders of other etiologies. Guillain-Barré Syndrome (GBS) was similarly distributed amongst the groups. Exposure to one of the arboviruses caused a six-fold increase in the risk of death (HR: 6.37; CI: 2.91 - 13.9). Amongst the arbovirus-exposed groups, infection (DENV/CHIKV) increased nine times the risk of death (HR: 9.07; CI: 3.67 - 22.4). The survival curve indicates that have been exposed to some arbovirus decreased the likelihood of survival compared to those with other etiologies (Log-Rank: p<0.001). Within this scenario, neurologic manifestations of DENV, CHIKV and ZIKV have the potential to increase mortality and decrease survival, and concomitant infection (DENV/CHIKV) is an aggravating factor in reducing the likelihood of survival when compared to monoinfections.
Collapse
Affiliation(s)
| | | | | | - George Santiago Dimech
- Secretaria de Saúde do Estado de Pernambuco, Departamento de Vigilância Epidemiológica, Recife, Pernambuco, Brazil
| | - Heloísa Ramos Lacerda
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Recife, Pernambuco, Brazil
| |
Collapse
|
24
|
Li J, Wang X, Cai J, Ge Y, Wang C, Qiu Y, Xia A, Zeng M. Non-polio enterovirus infections in children with central nervous system disorders in Shanghai, 2016-2018: Serotypes and clinical characteristics. J Clin Virol 2020; 129:104516. [PMID: 32585621 DOI: 10.1016/j.jcv.2020.104516] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Non-polio enrerovirus causes a wide spectrum of neurologic syndromes. The epidemiological and clinical profiles of non-polio enrerovirus-associated central nervous system infections vary by regions and over year. OBJECTIVES This study aimed to understand the prevalence, serotypes and clinical characteristics of enterovirus-associated aseptic meningitis, encephalitis and meningo-encephalitis in children in Shanghai during 2016-2018. METHODS We collected the clinical data and the cerebrospinal fluid specimens from the pediatric patients with aseptic meningitis, encephalitis and meningo-encephalitis during 2016-2018. The nested RT-PCR and sequencing were performed to identify enterovirus and serotypes. RESULTS A total of 424 patients were included in this study and their non-duplicated cerebrospinal fluid specimens were collected during the acute stage of illness. Based on PCR assay, enterovirus was detected in 272 (64.15 %) patients, of whom, the ratio of male to female subjects was 1.99, and the mean age was 5.71 ± 3.55 years (range: 0.03-16 years). There were 17 serotypes identified. Echovirus 30 (24.63 %), Coxsackievirus A10 (20.96 %), Coxsackievirus A6 (18.01 %) accounted for 63.6 %, followed by Coxsackievirus B5 (7.72 %), Echovirus 6 (5.88 %), and other serotypes (22.8 %). Of the 10 (3.68 %) critically severe patients, all had refractory seizure, 8 required mechanical ventilation, 7 survivors had recurrent attacks of epilepsy and 3 abandoned treatment; Coxsackievirus A10, Echovirus 9, Coxsackievirus A2, Coxsackievirus A6 and Echovirus 6 were identified. CONCLUSIONS Non-polio enterovirus is the major pathogen causing aseptic meningitis, encephalitis and meningo-encephalitis in Chinese children and can cause life-threatening encephalitis and severe sequelae.
Collapse
Affiliation(s)
- Jingjing Li
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Xiangshi Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Jiehao Cai
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Yanling Ge
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Chuning Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Yue Qiu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Aimei Xia
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| |
Collapse
|
25
|
Rojas A, Stittleburg V, Cardozo F, Bopp N, Cantero C, López S, Bernal C, Mendoza L, Aguilar P, Pinsky BA, Guillén Y, Páez M, Waggoner JJ. Real-time RT-PCR for the detection and quantitation of Oropouche virus. Diagn Microbiol Infect Dis 2020; 96:114894. [PMID: 31727377 PMCID: PMC6906250 DOI: 10.1016/j.diagmicrobio.2019.114894] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/09/2019] [Accepted: 09/01/2019] [Indexed: 12/24/2022]
Abstract
Oropouche virus (OROV) causes an acute, systemic febrile illness, and in certain regions of South America, this represents the second most common human arboviral infection after dengue virus. A new real-time RT-PCR was developed for OROV and reassortant species. The new OROV rRT-PCR proved linear across 6-7 orders of magnitude with a lower limit of 95% detection of 5.6-10.8 copies/μL. Upon testing dilutions of OROV and Iquitos virus reference genomic RNA, all dilutions with >10 copies/μL were detected in both the OROV rRT-PCR and a comparator molecular assay, but the OROV rRT-PCR detected more samples with ≤10 copies/μL (8/14 vs 0/13, respectively, P = 0.002). In a set of 100 acute-phase clinical samples from Paraguay patients with a suspected arboviral illness, no patients tested positive for OROV RNA using either assay. The OROV rRT-PCR provides a sensitive molecular assay for the study of this important yet neglected tropical arboviral infection.
Collapse
Affiliation(s)
- Alejandra Rojas
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción, Paraguay
| | - Victoria Stittleburg
- Emory University, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, USA
| | - Fátima Cardozo
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Salud Pública, Paraguay
| | - Nathen Bopp
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - César Cantero
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción, Paraguay
| | - Sanny López
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción, Paraguay
| | - Cynthia Bernal
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción, Paraguay
| | - Laura Mendoza
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Salud Pública, Paraguay
| | - Patricia Aguilar
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Benjamin A Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, , Stanford, CA, USA
| | - Yvalena Guillén
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción, Paraguay
| | - Malvina Páez
- Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Salud Pública, Paraguay
| | - Jesse J Waggoner
- Emory University, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, USA; Rollins School of Public Health, Department of Global Health, Atlanta, GA, USA.
| |
Collapse
|
26
|
Vernal S, Martini CCR, da Fonseca BAL. Oropouche Virus-Associated Aseptic Meningoencephalitis, Southeastern Brazil. Emerg Infect Dis 2019; 25:380-382. [PMID: 30666950 PMCID: PMC6346467 DOI: 10.3201/eid2502.181189] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Oropouche fever is a neglected arthropodborne disease and zoonosis responsible for several outbreaks of a febrile disease in Central and South America. We present a clinical case of aseptic meningoencephalitis in an immunocompetent patient that resulted from Oropouche virus acquired in northern Brazil but diagnosed in a nonendemic region.
Collapse
|
27
|
Ferreira JE, Ferreira SC, Almeida-Neto C, Nishiya AS, Alencar CS, Gouveia GR, Caiaffa-Filho H, Gomes H, de Macedo Santos RT, Witkin SS, Mendrone-Junior A, Sabino EC. Molecular characterization of viruses associated with encephalitis in São Paulo, Brazil. PLoS One 2019; 14:e0209993. [PMID: 30640927 PMCID: PMC6331147 DOI: 10.1371/journal.pone.0209993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/14/2018] [Indexed: 01/01/2023] Open
Abstract
The objective of this study was to characterize the prevalence of viral encephalitis due to arbovirus infection of the Togaviridae and Flaviviridae families in São Paulo, Brazil. A total of 500 cerebrospinal fluid (CSF) samples collected between August 2012 and January 2013, from patients with symptoms of acute encephalitis were analyzed. Findings suggestive of viral encephalitis-elevations in cell concentration, glucose and total protein-were observed in 234 (46.8%) samples, designated as Group 1. The remaining 266 samples comprised Group 2. All samples were tested for Flaviviruses (dengue virus 1, 2, 3 and 4, yellow fever virus and West Nile virus), Alphavirus (NS5 region) and enterovirus by RT- PCR and for herpesviruses and enteroviruses using CLART-Entherpex. A presumptive viral etiological agent was detected in 26 samples (5.2%), 18 (8.0%) in Group 1 and 8 (3.0%) in Group 2. In Group 1 human herpesviruses were detected in 9 cases, enteroviruses in 7 cases, dengue viruses (DENV) in 2 CSFs and St. Louis encephalitis virus (SLEV) in one case. In Group 2 there were 3 CSFs positive for human herpesviruses, 2 for enteroviruses, 2 for DENV and 1 for SLEV. Detection of arboviruses, even though present in a minority of infected patients, identifies these viruses as a probable etiological agent of encephalitis. This is of special concern in regions where this class of viruses is endemic and has been linked to other recent epidemics.
Collapse
Affiliation(s)
- Jerenice E. Ferreira
- LIM / 46—Laboratory of Medical Parasitology, Institute of Tropical Medicine—IMT, University of São Paulo Medical School USP, São Paulo, Brazil
- Pathology Center, Adolf Lutz Institute–IAL, São Paulo, Brazil
| | | | - Cesar Almeida-Neto
- Fundação Pró-Sangue Hemocentro de São Paulo–FPS/HSP, São Paulo, Brazil
- Disciplina de Ciências Médicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anna S. Nishiya
- Fundação Pró-Sangue Hemocentro de São Paulo–FPS/HSP, São Paulo, Brazil
| | - Cecilia S. Alencar
- Central Laboratory Division—Hospital das Clínicas São Paulo–DLC-HCSP
- Clinical Laboratory and LIM 03–Department of Pathology, Clinical Hospital, University of São Paulo Medical School, São Paulo, Brazil
| | - Gisele R. Gouveia
- Faculty of Medicine, University of São Paulo–FMUSP, São Paulo, Brazil
| | - Helio Caiaffa-Filho
- Pathology Center, Adolf Lutz Institute–IAL, São Paulo, Brazil
- Central Laboratory Division—Hospital das Clínicas São Paulo–DLC-HCSP
| | - Helio Gomes
- Central Laboratory Division—Hospital das Clínicas São Paulo–DLC-HCSP
- Clinical Laboratory and LIM 03–Department of Pathology, Clinical Hospital, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Steven S. Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | | | - Ester C. Sabino
- LIM / 46—Laboratory of Medical Parasitology, Institute of Tropical Medicine—IMT, University of São Paulo Medical School USP, São Paulo, Brazil
| |
Collapse
|
28
|
Bastos MDS, Martins VDCA, Silva NLD, Jezine S, Pinto S, Aprigio V, Monte RL, Fragoso S, Puccioni-Sohler M. Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region. Mem Inst Oswaldo Cruz 2018; 114:e180450. [PMID: 30540031 PMCID: PMC6319028 DOI: 10.1590/0074-02760180450] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/21/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation: pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis.
Collapse
Affiliation(s)
| | | | | | - Samya Jezine
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
| | - Sérgio Pinto
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
| | - Valderjane Aprigio
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
| | | | - Silvio Fragoso
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
| | - Marzia Puccioni-Sohler
- Universidade Federal do Estado do Rio de Janeiro/Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
29
|
Nunes MRT, de Souza WM, Savji N, Figueiredo ML, Cardoso JF, da Silva SP, da Silva de Lima CP, Vasconcelos HB, Rodrigues SG, Ian Lipkin W, Vasconcelos PFC, Palacios G. Oropouche orthobunyavirus: Genetic characterization of full-length genomes and development of molecular methods to discriminate natural reassortments. INFECTION GENETICS AND EVOLUTION 2018; 68:16-22. [PMID: 30504003 DOI: 10.1016/j.meegid.2018.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 10/20/2018] [Accepted: 11/28/2018] [Indexed: 11/18/2022]
Abstract
Oropouche orthobunyavirus (OROV) has significant impact in public health in Amazon region. This arbovirus is one of the most common causes of febrile illness in Brazil, and is responsible for several epidemics since 1960's. In this study, we sequenced and characterized the complete coding sequences (S-, M- and L-RNA) of 35 OROV isolates from Brazil. Here, we classified 20 strains in genotype I from Pará and Maranhão states, nine as genotype II from Pará and Rondônia states confirmed, four classified into genotype III from Acre, Maranhão, Minas Gerais and Rondônia states and two genotype IV from Amazonas State. Also, we did not observe reassortment events involving the OROV isolates. In addition, we developed novel RT-PCR tools to identify reassortment events among OROV strains. These data will be useful to better understand the molecular epidemiology and diagnostic of OROV infections.
Collapse
Affiliation(s)
- Márcio Roberto Teixeira Nunes
- Center for Technological Innovations, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará, Brazil; Center for Biodefense and Emerging Infectious Diseases, Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
| | - William Marciel de Souza
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, São Paulo, Brazil; MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom
| | - Nazir Savji
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mário Luís Figueiredo
- Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jedson Ferreira Cardoso
- Center for Technological Innovations, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará, Brazil; Posgraduate Program in Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Sandro Patroca da Silva
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | | | - Helena Baldez Vasconcelos
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Sueli Guerreiro Rodrigues
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - W Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, New York, USA
| | | | - Gustavo Palacios
- The Center for Genome Science, US Army Medical Research Institute of Infectious Disease at Fort Detrick, MD, USA
| |
Collapse
|
30
|
Vieira MADCES, Costa CHN, Linhares ADC, Borba ADS, Henriques DF, Silva EVPD, Tavares FN, Batista FMDA, Guimarães HCL, Martins LC, Monteiro TAF, Cruz ACR, Azevedo RDSDS, Vasconcelos PFDC. Potential role of dengue virus, chikungunya virus and Zika virus in neurological diseases. Mem Inst Oswaldo Cruz 2018; 113:e170538. [PMID: 30379197 PMCID: PMC6204615 DOI: 10.1590/0074-02760170538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 09/11/2018] [Indexed: 12/23/2022] Open
Abstract
This study showed that laboratory markers of recent infection by dengue, Zika or chikungunya arboviruses were detected in the biological samples of approximately one-third of patients with encephalitis, myelitis, encephalomyelitis or Guillain-Barré syndrome, in a surveillance programme in Piauí state, Brazil, between 2015-2016. Fever and myalgia had been associated with these cases. Since in non-tropical countries most infections or parainfectious diseases associated with the nervous system are attributed to herpesviruses, enteroviruses, and Campylobacter jejuni, the present findings indicate that in tropical countries, arboviruses may now play a more important role and reinforce the need for their surveillance and systematic investigation in the tropics.
Collapse
Affiliation(s)
- Marcelo Adriano da Cunha E Silva Vieira
- Secretaria de Estado da Saúde do Piauí, Instituto de Doenças Tropicais Natan Portella, Departamento de Neurologia, Teresina, PI, Brasil.,Fundação Municipal de Saúde de Teresina, Diretoria de Vigilância em Saúde, Teresina, PI, Brasil.,Instituto Evandro Chagas, Programa de Pós-Graduação em Virologia, Ananindeua, PA, Brasil
| | - Carlos Henrique Nery Costa
- Secretaria de Estado da Saúde do Piauí, Instituto de Doenças Tropicais Natan Portella, Departamento de Infectologia, Teresina, PI, Brasil
| | | | - Amariles de Sousa Borba
- Fundação Municipal de Saúde de Teresina, Diretoria de Vigilância em Saúde, Teresina, PI, Brasil
| | | | | | | | | | | | - Lívia Carício Martins
- Instituto Evandro Chagas, Seção de Arbovirologia e Febres Hemorrágicas, Ananindeua, PA, Brasil
| | - Talita Antônia Furtado Monteiro
- Instituto Evandro Chagas, Programa de Pós-Graduação em Virologia, Ananindeua, PA, Brasil.,Instituto Evandro Chagas, Seção de Virologia Geral, Ananindeua, PA, Brasil
| | | | | | | |
Collapse
|
31
|
da Costa CF, da Silva AV, do Nascimento VA, de Souza VC, Monteiro DCDS, Terrazas WCM, dos Passos RA, Nascimento S, Lima JBP, Naveca FG. Evidence of vertical transmission of Zika virus in field-collected eggs of Aedes aegypti in the Brazilian Amazon. PLoS Negl Trop Dis 2018; 12:e0006594. [PMID: 30011278 PMCID: PMC6075777 DOI: 10.1371/journal.pntd.0006594] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 08/03/2018] [Accepted: 06/07/2018] [Indexed: 12/26/2022] Open
Abstract
Background Arboviruses are viruses transmitted to humans and other animals by the bite of hematophagous arthropods. Infections caused by chikungunya virus (CHIKV), dengue virus (DENV), Zika virus (ZIKV), and the deadlier yellow fever virus (YFV) are current public health problems in several countries, mainly those located in tropical and subtropical regions. One of the main prevention strategies continues to be vector control, with the elimination of breeding sites and surveillance of infested areas. The use of ovitraps for Aedes mosquitos monitoring has already demonstrated promising results, and maybe be also useful for arboviral surveillance. Methods This work aimed to detect natural vertical transmission of arboviruses in Aedes aegypti and Aedes albopictus. Mosquito egg collection was carried out using ovitraps in Itacoatiara, a mid-size city in Amazonas state, Brazil. Collected eggs were allowed to hatch and larvae were tested for CHIKV, DENV, and ZIKV RNA by RT-qPCR. Results A total of 2,057 specimens (1,793 Ae. aegypti and 264 Ae. albopictus), in 154 larvae pools were processed. Results showed one positive pool for CHIKV and one positive pool for ZIKV. The active ZIKV infection was further confirmed by the detection of the negative-strand viral RNA and nucleotide sequencing which confirmed the Asian genotype. The Infection Rate per 1,000 mosquitoes tested was assessed by Maximum Likelihood Estimation (MLE) with 0.45 and 0.44 for CHIKV and ZIKV, respectively, and by Minimum Infection Rate (MIR) with 0.45 for both viruses. Conclusion To our knowledge, this is the first detection of ZIKV in natural vertical transmission in the Ae. aegypti, a fact that may contribute to ZIKV maintenance in nature during epidemics periods. Furthermore, our results highlight that the use of ovitraps and the molecular detection of arbovirus may contribute to health surveillance, directing the efforts to more efficient transmission blockade. The control of the vast majority of arbovirus infections relies on entomological measures to reduce mosquito infestation. Therefore, this study analyzed the use of ovitraps for arboviral surveillance in a mid-size city of the Amazonas state, Brazil. We found one larva pool infected with chikungunya virus, before the first human case confirmed in this municipality. Another pool was infected with Zika virus, demonstrating the first evidence that vertical transmission occurs in naturally infected Aedes aegypti mosquito populations.
Collapse
Affiliation(s)
- Cristiano Fernandes da Costa
- Health Surveillance Foundation of Amazonas State FVS, Department of Environmental Surveillance, Manaus, Amazonas, Brazil
| | - Arlesson Viana da Silva
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- Programa de Iniciação Científica, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
| | - Valdinete Alves do Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Biologia Celular e Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Victor Costa de Souza
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Biologia Celular e Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Dana Cristina da Silva Monteiro
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
| | - Wagner Cosme Morhy Terrazas
- Health Surveillance Foundation of Amazonas State FVS, Department of Environmental Surveillance, Manaus, Amazonas, Brazil
| | - Ricardo Augusto dos Passos
- Health Surveillance Foundation of Amazonas State FVS, Department of Environmental Surveillance, Manaus, Amazonas, Brazil
- Laboratory of Physiology and Control of Arthropod Vectors - Oswaldo Cruz Institute - FIOCRUZ, Rio de Janeiro, Brazil
| | - Suzete Nascimento
- Health Surveillance Foundation of Amazonas State FVS, Department of Environmental Surveillance, Manaus, Amazonas, Brazil
| | - José Bento Pereira Lima
- Laboratory of Physiology and Control of Arthropod Vectors - Oswaldo Cruz Institute - FIOCRUZ, Rio de Janeiro, Brazil
- * E-mail: (JBPL); (FGN)
| | - Felipe Gomes Naveca
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Biologia Celular e Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- * E-mail: (JBPL); (FGN)
| |
Collapse
|
32
|
Abstract
Oropouche fever is an emerging zoonotic disease caused by Oropouche virus (OROV), an arthropod transmitted Orthobunyavirus circulating in South and Central America. During the last 60 years, more than 30 epidemics and over half a million clinical cases attributed to OROV infection have been reported in Brazil, Peru, Panama, Trinidad and Tobago. OROV fever is considered the second most frequent arboviral febrile disease in Brazil after dengue fever. OROV is transmitted through both urban and sylvatic transmission cycles, with the primary vector in the urban cycle being the anthropophilic biting midge Culicoides paraensis. Currently, there is no evidence of direct human-to-human OROV transmission. OROV fever is usually either undiagnosed due to its mild, self-limited manifestations or misdiagnosed because its clinical characteristics are similar to dengue, chikungunya, Zika and yellow fever, including malaria as well. At present, there is no specific antiviral treatment, and in the absence of a vaccine for effective prophylaxis of human populations in endemic areas, the disease prevention relies solely on vector control strategies and personal protection measures. OROV fever is considered to have the potential to spread across the American continent and under favorable climatic conditions may expand its geographic distribution to other continents. In view of OROV's emergence, increased interest for formerly neglected tropical diseases and within the One Health concept, the existing knowledge and gaps of knowledge on OROV fever are reviewed.
Collapse
|
33
|
Anti-Epstein-Barr virus antibodies in Beijing during 2013-2017: What we have found in the different patients. PLoS One 2018; 13:e0193171. [PMID: 29494658 PMCID: PMC5832223 DOI: 10.1371/journal.pone.0193171] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/06/2018] [Indexed: 12/11/2022] Open
Abstract
Background Epstein–Barr virus (EBV) is associated with nasopharyngeal carcinoma (NPC) which is prevalent in South China, and its association with systemic lupus erythematosus (SLE) or other autoimmune diseases has not been studied in the mainland of China. The EBV serological tests have been performed on patients with various diseases or manifestations for years at our institution and their values need to be evaluated. Methods For routine medical purposes, anti-EB viral capsid antigen (VCA) IgG, IgA and IgM antibodies, anti-EBV diffuse early antigen (EA-D) IgA antibodies, and anti-EBV nuclear antigen-1(EBNA-1) IgG antibodies were tested with commercial enzyme-linked immunosorbent assay (ELISA) in patients visiting Peking Union Medical College Hospital between 2013 and 2017. The test results were analyzed in this retrospective study. Results There were a total of 11122 serum samples available to be tested in the study. As indicators of past EBV infection, the prevalence of VCA-IgG/EBNA1-IgG were 66.6%/58.5%, 84.3%/78.8%, 92.9%/87.0% and 98.5%/95.4% in patients aged under 5 years, 6–10 years, 11–20 years and 21–30 years old, respectively, and these values maintained at this highest rate as age increased further. The prevalence of VCA-IgM, as a parameter of acute EBV infection, was 14.6%, 10.2%, 10.4%, 6.3% and 3.1% in patients aged under 5 years, 6–10 years,11–20 years, 21–30 years, 31–40 years old, respectively, and decreased to 2%~3% in older patients. Patients with elevated serum liver enzymes were more likely to have a higher prevalence of EA/D IgA antibody (P < 0.01) and young patients (≤30 years) with lymphadenopathy were more likely to have higher prevalence of VCA-IgM antibody (P < 0.01). The prevalence of VCA-IgA and EAD-IgA were 87.0% and 59.2% in NPC patients, respectively, and both were significantly higher (P < 0.001) than that in non-NPC patients. The prevalence of VCA-IgA was 45.4% and 25.6% in SLE patients and patients with other autoimmune diseases, respectively, which were significantly (P < 0.001) and mildly (P = 0.039) higher than their controls. In pediatric SLE patients between 6 and10 years old, the prevalence of VCA-IgG, VCA-IgA and EBNA1-IgG was 100%, 59.5% and 100%, respectively, all being significantly higher than the age (6-10y) related controls (P< 0.01). In the 705 cerebral spinal fluid (CSF) specimens, VCA-IgG, VCA-IgM, VCA-IgA and EAD-IgA were found to be positive in 12.1%, 0.15%, 0.25% and 0.25%, respectively. There were 157 paired specimens (CSF and serum were collected simultaneously) and VCA-IgG was identified as positive in 12.7% of the CSF and 100% of the serum specimens. Conclusions Around 98% of Chinese patients were infected with EBV before 30 years of age and the highest rate of acute EBV infection were observed in patients under 5 years old. EBV infection was found to be associated with elevated serum liver enzymes, NPC and SLE. Acute anti-EBV antibody was valued for young patients with lymphadenopathy but limited value for CNS neuropathy.
Collapse
|
34
|
Dahm T, Adams O, Boettcher S, Diedrich S, Morozov V, Hansman G, Fallier-Becker P, Schädler S, Burkhardt CJ, Weiss C, Stump-Guthier C, Ishikawa H, Schroten H, Schwerk C, Tenenbaum T, Rudolph H. Strain-dependent effects of clinical echovirus 30 outbreak isolates at the blood-CSF barrier. J Neuroinflammation 2018; 15:50. [PMID: 29463289 PMCID: PMC5819246 DOI: 10.1186/s12974-018-1061-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 01/09/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Echovirus (E) 30 (E-30) meningitis is characterized by neuroinflammation involving immune cell pleocytosis at the protective barriers of the central nervous system (CNS). In this context, infection of the blood-cerebrospinal fluid barrier (BCSFB), which has been demonstrated to be involved in enteroviral CNS pathogenesis, may affect the tight junction (TJ) and adherens junction (AJ) function and morphology. METHODS We used an in vitro human choroid plexus epithelial (HIBCPP) cell model to investigate the effect of three clinical outbreak strains (13-311, 13-759, and 14-397) isolated in Germany in 2013, and compared them to E-30 Bastianni. Conducting transepithelial electrical resistance (TEER), paracellular dextran flux measurement, quantitative real-time polymerase chain reaction (qPCR), western blot, and immunofluorescence analysis, we investigated TJ and AJ function and morphology as well as strain-specific E-30 infection patterns. Additionally, transmission electron and focused ion beam microscopy electron microscopy (FIB-SEM) was used to evaluate the mode of leukocyte transmigration. Genome sequencing and phylogenetic analyses were performed to discriminate potential genetic differences among the outbreak strains. RESULTS We observed a significant strain-dependent decrease in TEER with strains E-30 Bastianni and 13-311, whereas paracellular dextran flux was only affected by E-30 Bastianni. Despite strong similarities among the outbreak strains in replication characteristics and particle distribution, strain 13-311 was the only outbreak isolate revealing comparable disruptive effects on TJ (Zonula Occludens (ZO) 1 and occludin) and AJ (E-cadherin) morphology to E-30 Bastianni. Notwithstanding significant junctional alterations upon E-30 infection, we observed both para- and transcellular leukocyte migration across HIBCPP cells. Complete genome sequencing revealed differences between the strains analyzed, but no explicit correlation with the observed strain-dependent effects on HIBCPP cells was possible. CONCLUSION The findings revealed distinct E-30 strain-specific effects on barrier integrity and junctional morphology. Despite E-30-induced barrier alterations leukocyte trafficking did not exclusively occur via the paracellular route.
Collapse
Affiliation(s)
- Tobias Dahm
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ortwin Adams
- Institute of Virology, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sindy Boettcher
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch-Institute, Berlin, Germany
| | - Sabine Diedrich
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch-Institute, Berlin, Germany
| | - Vasily Morozov
- Schaller Research Group, University of Heidelberg and the DKFZ, Heidelberg, Germany
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany
| | - Grant Hansman
- Schaller Research Group, University of Heidelberg and the DKFZ, Heidelberg, Germany
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany
| | - Petra Fallier-Becker
- Institute of Pathology and Neuropathology, University Hospital of Tübingen, Tübingen, Germany
| | | | - Claus J. Burkhardt
- NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen, Germany
| | - Christel Weiss
- Institute of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carolin Stump-Guthier
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Department of NDU Life Sciences, School of life Dentistry, The Nippon Dental University, Tokyo, Japan
| | - Horst Schroten
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schwerk
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Tenenbaum
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Henriette Rudolph
- Pediatric Infectious Diseases, University Children’s Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
35
|
CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF SEROUS MENINGITIS IN ADULTS IN THE KHMELNYTSKYI REGION. WORLD OF MEDICINE AND BIOLOGY 2018. [DOI: 10.26724/2079-8334-2018-3-65-110-115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
36
|
Silva GS, Richards GA, Baker T, Amin PR. Encephalitis and myelitis in tropical countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care 2017; 42:355-359. [PMID: 29157660 DOI: 10.1016/j.jcrc.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
Tropical diseases are those that occur primarily or solely in the tropics, and as such include infectious diseases that are particularly prevalent in hot, humid conditions. The incidence of encephalitis in tropical countries is reported to be as high as 6.34/100,000/year. The term encephalitis implies inflammation of the brain and includes the presence of encephalopathy with two and more of the following features: fever, seizures and/or focal neurological findings; a cerebrospinal fluid pleocytosis; electroencephalographic findings or abnormal neuroimaging suggestive of encephalitis. Transverse myelitis (TM) is an inflammation of the spinal cord which has a wide variety of clinical presentations depending on the degree (severity of myelin and neuronal injury) and site of spinal cord involvement. In the present article we discuss the various forms of tropical, viral encephalitides and myelitis and the diagnosis and management.
Collapse
Affiliation(s)
- Gisele Sampaio Silva
- Departament of Neurology and Neurosurgery, Universidade Federal de São Paulo and Programa Integrado de Neurologia and Instituto de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Guy A Richards
- Division of Critical Care, Charlotte Maxeke Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Tim Baker
- Department of Anaesthesia & Intensive Care, Queen Elizabeth Central Hospital, Blantyre, Malawi; Global Health - Health Systems & Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Pravin R Amin
- Head of Department of Critical Care Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, India.
| | | |
Collapse
|
37
|
Stone JA, Knoll BM, Farmakiotis D. Relapsing EBV encephalitis in a renal transplant recipient. IDCases 2017; 10:83-87. [PMID: 29021960 PMCID: PMC5633254 DOI: 10.1016/j.idcr.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/26/2017] [Accepted: 09/26/2017] [Indexed: 11/06/2022] Open
Abstract
In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-related CNS syndromes is controversial, as they have no effect on latent virus. We report an unusual case of relapsing EBV encephalitis in a donor-positive, EBV-negative renal transplant recipient, with response to valganciclovir. Our report supports the utility of antiviral treatment for EBV encephalitis, as adjunct to reducing immunosuppression, and highlights the need for a systematic approach and long-term, multi-disciplinary follow-up of such patients.
Collapse
Affiliation(s)
- Joshua A Stone
- Department of Neurology, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Bettina M Knoll
- Transplant Infectious Diseases, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Dimitrios Farmakiotis
- Division of Infectious Diseases, Department of Internal Medicine, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, RI, United States
| |
Collapse
|
38
|
de Oliveira DB, Candiani TM, Franco-Luiz APM, Almeida GMF, Abrahão JS, Rios M, Coimbra RS, Kroon EG. Etiological agents of viral meningitis in children from a dengue-endemic area, Southeast region of Brazil. J Neurol Sci 2017; 375:390-394. [PMID: 28320174 DOI: 10.1016/j.jns.2017.02.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 02/06/2017] [Accepted: 02/09/2017] [Indexed: 11/19/2022]
Abstract
Meningitis is a disease with a global distribution that constitutes a worldwide burden, with viruses as the primary etiologic agents. The range of viral meningitis severity depends mainly on age, immune status and etiological agent. The aim of this work was to investigate the suspected cases of viral meningitis using molecular techniques to confirm the viral infection. The diagnosed virus was correlated with clinical findings and cytochemical parameters in cerebrospinal liquid (CSF) of patients. CSF of 70 children with the presumptive diagnosis of viral meningitis was analyzed by real time PCR (qPCR). Viruses were identified by qPCR in 44 CSF samples (62.9%). Among them, 31 were identified as Enterovirus (ENTV) (70.4%), six as Human herpes virus 3 (HHV-3) (13.6%), five as Dengue virus (DENV) (11.7%), one as Human herpes virus 1-2 (2.3%) and one as Human herpes virus 5 (2.3%). Patients in the HHV-positive groups had increased percentage of polymorphonuclear neutrophils (PMN) (mean of 81%) while the groups of patients with DENV and ENTV had a mean of 30.9%. This study contributes to the knowledge of the epidemiological distribution of viral agents in CNS infections in children. In addition, it raises the relevance of DENV as an agent of CNS infection, and reinforces the importance for molecular in the cases of CNV infection.
Collapse
Affiliation(s)
- Danilo B de Oliveira
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; Faculdade de Medicina de Diamantina, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, Brazil
| | - Talitah M Candiani
- Hospital Infantil João Paulo II, FHEMIG, Belo Horizonte 30130-110, Brazil
| | - Ana Paula M Franco-Luiz
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Gabriel M F Almeida
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Jônatas S Abrahão
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Maria Rios
- Center for Biologics Research and Review, Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Roney S Coimbra
- Neurogenômica, Centro de Pesquisas René Rachou, FIOCRUZ, Belo Horizonte 30190-002, Brazil
| | - Erna G Kroon
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil.
| |
Collapse
|
39
|
Rahhal H, Nunes JT, Lopes LDC, Prokopowitsch AS. Simultaneous genital ulcer and meningitis: a case of EBV infection. AUTOPSY AND CASE REPORTS 2016; 6:45-9. [PMID: 27547743 PMCID: PMC4982784 DOI: 10.4322/acr.2016.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/14/2016] [Indexed: 12/05/2022] Open
Abstract
The Epstein-Barr virus (EBV) is associated with a broad spectrum of diseases, mainly because of its genomic characteristics, which result in different latency patterns in immune cells and infective mechanisms. The patient described in this report is a previously healthy young man who presented to the emergency department with clinical features consistent with meningitis and genital ulcers, which raised concern that the herpes simplex virus was the causative agent. However, the polymerase chain reaction of cerebral spinal fluid was positive for EBV. The authors highlight the importance of this infection among the differential diagnosis of central nervous system involvement and genital ulceration.
Collapse
Affiliation(s)
- Hassan Rahhal
- Internal Medicine Department - Hospital das Clínicas - Universidade de São Paulo - São Paulo/SP - Brazil
| | - Jairo Tavares Nunes
- Internal Medicine Department - Hospital das Clínicas - Universidade de São Paulo - São Paulo/SP - Brazil
| | - Leonardo da Costa Lopes
- Internal Medicine Division - Hospital Universitário - Universidade de São Paulo - São Paulo/SP - Brazil
| | | |
Collapse
|
40
|
MONTANO SM, MORI N, NELSON CA, TON TGN, CELIS V, TICONA E, SIHUINCHA M, TILLEY DH, KOCHEL T, ZUNT JR. Herpes simplex virus encephalitis in Peru: a multicentre prospective study. Epidemiol Infect 2016; 144:1673-8. [PMID: 26733400 PMCID: PMC9150612 DOI: 10.1017/s0950268815003222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/02/2015] [Indexed: 01/30/2023] Open
Abstract
Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.
Collapse
Affiliation(s)
| | - N. MORI
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
- Hospital Daniel Alcides Carrion, Callao, Peru
| | - C. A. NELSON
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - T. G. N. TON
- Department of Neurology, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - E. TICONA
- Hospital Dos de Mayo, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | - T. KOCHEL
- US Naval Medical Research Unit-6, Callao, Peru
| | - J. R. ZUNT
- Department of Neurology, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Global Health, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | | |
Collapse
|
41
|
Christo PP. Encephalitis by dengue virus and other arboviruses. ARQUIVOS DE NEURO-PSIQUIATRIA 2016. [PMID: 26222352 DOI: 10.1590/0004-282x20150108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Paulo Pereira Christo
- Departamento de Neurologia, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| |
Collapse
|
42
|
Puccioni-Sohler M, Rosadas C. Advances and new insights in the neuropathogenesis of dengue infection. ARQUIVOS DE NEURO-PSIQUIATRIA 2016. [PMID: 26222363 DOI: 10.1590/0004-282x20150074] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dengue virus (DENV) infects approximately 390 million persons every year in more than 100 countries. Reports of neurological complications are more frequently. The objective of this narrative review is to bring up the advances in the dengue neuropathogenesis. DENV can access the nervous system through blood-brain barrier disturbance mediated by cytokine. The blood-cerebrospinal fluid (CSF) barrier seems to be also involved, considering the presence of the virus in the CSF of patients with neurological manifestations. As for neurotropism, several studies showed the presence of RNA and viral antigens in brain tissue and CSF in humans. In murine model, different virus mutations were associated to neurovirulence. Despite the advances in the dengue neuropathogenesis, it is still necessary to determine a more appropriate animal model and increase the number of cases of autopsy. The detection of neurovirulence markers may contribute to establish a prognosis, the disease control and vaccine development.
Collapse
Affiliation(s)
- Marzia Puccioni-Sohler
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carolina Rosadas
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
43
|
|
44
|
Akya A, Ahmadi K, Zehtabian S, Salimi A, Elahi A, Madani SH. Study of the Frequency of Herpesvirus Infections Among Patients Suspected Aseptic Meningitis in the West of Iran. Jundishapur J Microbiol 2015; 8:e22639. [PMID: 26568804 PMCID: PMC4641434 DOI: 10.5812/jjm.22639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 01/12/2015] [Accepted: 02/14/2015] [Indexed: 12/18/2022] Open
Abstract
Background: Aseptic meningitis is the most common type of meningitis and is characterized by meningeal inflammation that is not linked to identifiable bacterial pathogens in cerebrospinal fluid (CSF). Objectives: This study aimed to evaluate the frequency of aseptic meningitis caused by herpesviruses, namely herpes simplex types I and II (HSV-1, HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and varicella-zoster virus (VZV). Patients and Methods: A total of 196 CSF samples were collected from patients with suspected meningitis. All samples were smear- and culture-negative for bacterial pathogens. The biochemical and cytological findings of CSF samples were also recorded. DNA was extracted from samples and PCR with specific primers was carried out to detect viruses. Results: The 196 samples derived from 100 (52%) men and 96 (48%) women ranging in age from one day to 86 years with an average age of 32.3 ± 25.3 years. Of them, 8 (4.08%) samples yielded positive results, including 5 (2.55%) cases of VZV infection and 3 (1.53%) cases of HSV-1 infection. No cases of HSV-2, CMV or EBV infection were detected. CSF protein and glucose levels among positive cases were all in the normal range. Conclusions: The results indicate a considerable rate of herpesvirus infection in patients with aseptic meningitis, and that VZV is the most common herpesvirus to cause infection followed by HSV-1. Our results also showed that a moderate increase in the WBC count and predominance of lymphocytes can be valuable clues in diagnosing viral meningitis. Given the different approaches of drug therapy in bacterial and viral meningitis, use of molecular methods is necessary in hospitals to rapidly discriminate between them.
Collapse
Affiliation(s)
- Alisha Akya
- Nosocomial Infection Research Centre, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
- Corresponding author: Alisha Akya, Nosocomial Infection Research Centre, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-8334274618, Fax: +98-8334276477, E-mail:
| | - Kamal Ahmadi
- MSc Student of Medical Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Shahram Zehtabian
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Afsaneh Salimi
- MSc Student of Medical Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Azam Elahi
- MSc Student of Medical Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Sayed Hamid Madani
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| |
Collapse
|
45
|
Interferon-Regulatory Factor 5-Dependent Signaling Restricts Orthobunyavirus Dissemination to the Central Nervous System. J Virol 2015; 90:189-205. [PMID: 26468541 DOI: 10.1128/jvi.02276-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/03/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Interferon (IFN)-regulatory factor 5 (IRF-5) is a transcription factor that induces inflammatory responses after engagement and signaling by pattern recognition receptors. To define the role of IRF-5 during bunyavirus infection, we evaluated Oropouche virus (OROV) and La Crosse virus (LACV) pathogenesis and immune responses in primary cells and in mice with gene deletions in Irf3, Irf5, and Irf7 or in Irf5 alone. Deletion of Irf3, Irf5, and Irf7 together resulted in uncontrolled viral replication in the liver and spleen, hypercytokinemia, extensive liver injury, and an early-death phenotype. Remarkably, deletion of Irf5 alone resulted in meningoencephalitis and death on a more protracted timeline, 1 to 2 weeks after initial OROV or LACV infection. The clinical signs in OROV-infected Irf5(-/-) mice were associated with abundant viral antigen and terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling (TUNEL)-positive cells in several regions of the brain. Circulating dendritic cell (DC) subsets in Irf5(-/-) mice had higher levels of OROV RNA in vivo yet produced lower levels of type I IFN than wild-type (WT) cells. This result was supported by data obtained in vitro, since a deficiency of IRF-5 resulted in enhanced OROV infection and diminished type I IFN production in bone marrow-derived DCs. Collectively, these results indicate a key role for IRF-5 in modulating the host antiviral response in peripheral organs that controls bunyavirus neuroinvasion in mice. IMPORTANCE Oropouche virus (OROV) and La Crosse virus (LACV) are orthobunyaviruses that are transmitted by insects and cause meningitis and encephalitis in subsets of individuals in the Americas. Recently, we demonstrated that components of the type I interferon (IFN) induction pathway, particularly the regulatory transcription factors IRF-3 and IRF-7, have key protective roles during OROV infection. However, the lethality in Irf3(-/-) Irf7(-/-) (DKO) mice infected with OROV was not as rapid or complete as observed in Ifnar(-/-) mice, indicating that other transcriptional factors associated with an IFN response contribute to antiviral immunity against OROV. Here, we evaluated bunyavirus replication, tissue tropism, and cytokine production in primary cells and mice lacking IRF-5. We demonstrate an important role for IRF-5 in preventing neuroinvasion and the ensuing encephalitis caused by OROV and LACV.
Collapse
|
46
|
Saraiva MDGG, Santos ECS, Saraceni V, Rocha LLDS, Monte RL, Albuquerque BCD, Bastos MDS, Santos MCD, Monteiro WM, Mourão MPG, Guerra MVDF, Lacerda MVGD. Epidemiology of infectious meningitis in the State of Amazonas, Brazil. Rev Soc Bras Med Trop 2015; 48 Suppl 1:79-86. [PMID: 26061374 DOI: 10.1590/0037-8682-0116-2014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/21/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.
Collapse
Affiliation(s)
| | - Eyde Cristianne Saraiva Santos
- Departamento de Engenharia Agrícola e Solos, Faculdade de Ciências Agrárias, Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - Valéria Saraceni
- Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Oropouche virus infection and pathogenesis are restricted by MAVS, IRF-3, IRF-7, and type I interferon signaling pathways in nonmyeloid cells. J Virol 2015; 89:4720-37. [PMID: 25717109 DOI: 10.1128/jvi.00077-15] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 02/18/2015] [Indexed: 01/05/2023] Open
Abstract
UNLABELLED Oropouche virus (OROV) is a member of the Orthobunyavirus genus in the Bunyaviridae family and a prominent cause of insect-transmitted viral disease in Central and South America. Despite its clinical relevance, little is known about OROV pathogenesis. To define the host defense pathways that control OROV infection and disease, we evaluated OROV pathogenesis and immune responses in primary cells and mice that were deficient in the RIG-I-like receptor signaling pathway (MDA5, RIG-I, or MAVS), downstream regulatory transcription factors (IRF-3 or IRF-7), beta interferon (IFN-β), or the receptor for type I IFN signaling (IFNAR). OROV replicated to higher levels in primary fibroblasts and dendritic cells lacking MAVS signaling, the transcription factors IRF-3 and IRF-7, or IFNAR than in wild-type (WT) cells. In mice, deletion of IFNAR, MAVS, or IRF-3 and IRF-7 resulted in uncontrolled OROV replication, hypercytokinemia, extensive liver damage, and death, whereas WT congenic animals failed to develop disease. Unexpectedly, mice with a selective deletion of IFNAR on myeloid cells (CD11c Cre(+) Ifnar(f/f) or LysM Cre(+) Ifnar(f/f)) did not sustain enhanced disease with OROV or a selective (flox/flox) deletion La Crosse virus, a closely related encephalitic orthobunyavirus. In bone marrow chimera studies, recipient irradiated Ifnar(-/-) mice reconstituted with WT hematopoietic cells sustained high levels of OROV replication and liver damage, whereas WT mice reconstituted with Ifnar(-/-) bone marrow were resistant to disease. Collectively, these results establish a dominant protective role for MAVS, IRF-3 and IRF-7, and IFNAR in restricting OROV infection and tissue injury and suggest that IFN signaling in nonmyeloid cells contributes to the host defense against orthobunyaviruses. IMPORTANCE Oropouche virus (OROV) is an emerging arthropod-transmitted orthobunyavirus that causes episodic outbreaks of a debilitating febrile illness in humans in countries of South and Central America. The continued expansion of the range and number of its arthropod vectors increases the likelihood that OROV will spread into new regions. At present, the pathogenesis of OROV in humans or other vertebrate animals remains poorly understood. To define cellular mechanisms of control of OROV infection, we performed infection studies in a series of primary cells and mice that were deficient in key innate immune genes involved in pathogen recognition and control. Our results establish that a MAVS-dependent type I IFN signaling pathway has a dominant role in restricting OROV infection and pathogenesis in vivo.
Collapse
|
48
|
Santos RI, Bueno-Júnior LS, Ruggiero RN, Almeida MF, Silva ML, Paula FE, Correa VMA, Arruda E. Spread of Oropouche virus into the central nervous system in mouse. Viruses 2014; 6:3827-36. [PMID: 25310583 PMCID: PMC4213564 DOI: 10.3390/v6103827] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 12/25/2022] Open
Abstract
Oropouche virus (OROV) is an important cause of arboviral illness in Brazil and other Latin American countries, with most cases clinically manifested as acute febrile illness referred to as Oropouche fever, including myalgia, headache, arthralgia and malaise. However, OROV can also affect the central nervous system (CNS) with clinical neurological implications. Little is known regarding OROV pathogenesis, especially how OROV gains access to the CNS. In the present study, neonatal BALB/c mice were inoculated with OROV by the subcutaneous route and the progression of OROV spread into the CNS was evaluated. Immunohistochemistry revealed that OROV infection advances from posterior parts of the brain, including the periaqueductal gray, toward the forebrain. In the early phases of the infection OROV gains access to neural routes, reaching the spinal cord and ascending to the brain through brainstem regions, with little inflammation. Later, as infection progresses, OROV crosses the blood-brain barrier, resulting in more intense spread into the brain parenchyma, with more severe manifestations of encephalitis.
Collapse
Affiliation(s)
- Rodrigo I. Santos
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Lézio S. Bueno-Júnior
- Department of Neurology and Behavioral Sciences, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (L.S.B.-J.); (R.N.R.)
| | - Rafael N. Ruggiero
- Department of Neurology and Behavioral Sciences, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (L.S.B.-J.); (R.N.R.)
| | - Mariana F. Almeida
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Maria L. Silva
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Flávia E. Paula
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Vani M. A. Correa
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Eurico Arruda
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +55-1636023337
| |
Collapse
|