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Falcão EMM, Romão AR, Magalhães MDAFM, de Lima Filho JB, do Valle ACF, Bastos FI, Gutierrez-Galhardo MC, Freitas DFS. A Spatial Analysis of the Spread of Hyperendemic Sporotrichosis in the State of Rio de Janeiro, Brazil. J Fungi (Basel) 2022; 8:jof8050434. [PMID: 35628690 PMCID: PMC9145434 DOI: 10.3390/jof8050434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 02/01/2023] Open
Abstract
Sporotrichosis is a subacute/chronic subcutaneous mycosis. Since the late 1990s, there has been a hyperendemic zoonotic transmission in the state of Rio de Janeiro, involving Sporothrix brasiliensis, the most virulent causative species, and a “belt” was described along the limits between the capital and its outskirts (“Baixada Fluminense”). This study analyzes the distribution of sporotrichosis using secondary data from the Notifiable Diseases Information System (Sinan) of the Rio de Janeiro State Health Department (SES/RJ) from 2011 to 2015 and from the INI Electronic Patient Record System (Sipec) from 2008 to 2015. Cases diagnosed since the onset of the hyperendemic exceed all previously reported case series of the disease and there is a progressive expansion in the state of Rio de Janeiro. The study suggests the spread of the mycosis to all regions of the state and the expansion of the previously described “belt”, despite public health measures and changes in its profile over the years, with great social impact.
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Affiliation(s)
- Eduardo Mastrangelo Marinho Falcão
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil;
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
- Correspondence:
| | - Anselmo Rocha Romão
- Instituto de Comunicação e Informação Científica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (A.R.R.); (M.d.A.F.M.M.); (F.I.B.)
| | | | - José Berilo de Lima Filho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Antonio Carlos Francesconi do Valle
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Francisco Inácio Bastos
- Instituto de Comunicação e Informação Científica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (A.R.R.); (M.d.A.F.M.M.); (F.I.B.)
| | - Maria Clara Gutierrez-Galhardo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Dayvison Francis Saraiva Freitas
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil;
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
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Abreu FVSD, de Andreazzi CS, Neves MSAS, Meneguete PS, Ribeiro MS, Dias CMG, de Albuquerque Motta M, Barcellos C, Romão AR, Magalhães MDAFM, Lourenço-de-Oliveira R. Ecological and environmental factors affecting transmission of sylvatic yellow fever in the 2017-2019 outbreak in the Atlantic Forest, Brazil. Parasit Vectors 2022; 15:23. [PMID: 35012637 PMCID: PMC8750868 DOI: 10.1186/s13071-021-05143-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Yellow fever virus (YFV) is an arbovirus that, despite the existence of a safe and effective vaccine, continues to cause outbreaks of varying dimensions in the Americas and Africa. Between 2017 and 2019, Brazil registered un unprecedented sylvatic YFV outbreak whose severity was the result of its spread into zones of the Atlantic Forest with no signals of viral circulation for nearly 80 years. METHODS To investigate the influence of climatic, environmental, and ecological factors governing the dispersion and force of infection of YFV in a naïve area such as the landscape mosaic of Rio de Janeiro (RJ), we combined the analyses of a large set of data including entomological sampling performed before and during the 2017-2019 outbreak, with the geolocation of human and nonhuman primates (NHP) and mosquito infections. RESULTS A greater abundance of Haemagogus mosquitoes combined with lower richness and diversity of mosquito fauna increased the probability of finding a YFV-infected mosquito. Furthermore, the analysis of functional traits showed that certain functional groups, composed mainly of Aedini mosquitoes which includes Aedes and Haemagogus mosquitoes, are also more representative in areas where infected mosquitoes were found. Human and NHP infections were more common in two types of landscapes: large and continuous forest, capable of harboring many YFV hosts, and patches of small forest fragments, where environmental imbalance can lead to a greater density of the primary vectors and high human exposure. In both, we show that most human infections (~ 62%) occurred within an 11-km radius of the finding of an infected NHP, which is in line with the flight range of the primary vectors. CONCLUSIONS Together, our data suggest that entomological data and landscape composition analyses may help to predict areas permissive to yellow fever outbreaks, allowing protective measures to be taken to avoid human cases.
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Affiliation(s)
- Filipe Vieira Santos de Abreu
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ Brazil
- Laboratório de Comportamento de Insetos, Instituto Federal do Norte de Minas Gerais, Salinas, MG Brazil
| | - Cecilia Siliansky de Andreazzi
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ Brazil
- Present Address: Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | | | - Patrícia Soares Meneguete
- Secretaria de Estado de Saúde, Subsecretaria de Vigilância e Atenção Primária À Saúde, Rio de Janeiro, RJ Brazil
| | - Mário Sérgio Ribeiro
- Secretaria de Estado de Saúde, Subsecretaria de Vigilância e Atenção Primária À Saúde, Rio de Janeiro, RJ Brazil
| | - Cristina Maria Giordano Dias
- Secretaria de Estado de Saúde, Subsecretaria de Vigilância e Atenção Primária À Saúde, Rio de Janeiro, RJ Brazil
| | - Monique de Albuquerque Motta
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ Brazil
| | - Christovam Barcellos
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, FIOCRUZ, Rio de Janeiro, RJ Brazil
| | - Anselmo Rocha Romão
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, FIOCRUZ, Rio de Janeiro, RJ Brazil
| | | | - Ricardo Lourenço-de-Oliveira
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ Brazil
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de Paula VS, Milagres FAP, Oliveira GDM, Miguel JC, Cruz HM, Scalioni LDP, Marques VA, Magalhães MDAFM, Romão AR, Gracie R, Villar LM. High prevalence of hepatitis A in indigenous population in north Brazil. BMC Res Notes 2020; 13:458. [PMID: 32993814 PMCID: PMC7526101 DOI: 10.1186/s13104-020-05303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives Little is known about hepatitis A virus (HAV) prevalence in indigenous communities. This study aims to evaluate the prevalence of HAV in indigenous community compared to urban population located at Western Amazon in Brazil. Results A total of 872 serum samples were obtained from 491 indigenous and 381 non indigenous individuals aging 0 to 90 years. Samples were tested for total and IgM anti-HAV and positive IgM samples were tested for HAV RNA. The overall prevalence of total anti-HAV was 87%, increased according age showing 100% of prevalence in those aging more than 30 years (p < 0.0001) and it was similar among indigenous and urban population. Total anti-HAV prevalence varied between tribes (p < 0.0001) and urban sites (p = 0.0014) and spatial distribution showed high prevalence in homes that received up to 100 dollars. IgM anti-HAV prevalence was 1.7% with predominance in males, those aging more than 41 years. No HAV RNA was detected. In conclusion, high overall anti-HAV prevalence was found in indigenous communities in North Brazil demonstrating the importance of universal vaccination in this group.
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Affiliation(s)
| | | | | | - Juliana Custódio Miguel
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, 210360-040, Brazil
| | - Helena Medina Cruz
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, 210360-040, Brazil
| | - Leticia de Paula Scalioni
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, 210360-040, Brazil.,Hepatology Research Group, University of Plymouth, Plymouth, Devon, UK
| | - Vanessa Alves Marques
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, 210360-040, Brazil
| | | | - Anselmo Rocha Romão
- Laboratory of Information in Health, Institute of Communication and Technological and Scientific Information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Renata Gracie
- Laboratory of Information in Health, Institute of Communication and Technological and Scientific Information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Livia Melo Villar
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, 210360-040, Brazil.
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Villar LM, Milagres FAP, Lampe E, Cruz HM, Scalioni LDP, Magalhães MDAFM, Romão AR, Gracie R, de Paula VS. Determination of hepatitis B, C and D prevalence among urban and Amerindian populations from the Eastern Brazilian Amazon: a cross sectional study. BMC Infect Dis 2018; 18:411. [PMID: 30126364 PMCID: PMC6102873 DOI: 10.1186/s12879-018-3279-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 07/30/2018] [Indexed: 12/04/2022] Open
Abstract
Background This study was conducted to determine the prevalence of HBV, HCV, and HDV in urban populations and Amerindians living in the state of Tocantins (Eastern Amazon). Methods A total of 948 individuals were recruited in Tocantinopolis city (Tocantins state) of whom 603 were Amerindians (from 6 tribes) and 345 were non-Amerindians (6 urban areas of Tocantinópolis city). Anti-HCV, HBsAg, anti-HBc, anti-HBs, anti-HBc IgM, anti-HBe, HBeAg, and anti-delta antibodies were determined using enzyme immunoassay. Results HBV cleared infection (both anti-HBc/anti-HBs+), chronic inactive/immune controlled HBV infection (anti-HBc + only), previous HBV vaccination (anti-HBs + only), active HBV infection (HBsAg+), individuals susceptible to HBV, and anti-HCV reactivity were found in 12.9, 1.8, 27.2, 0.5, 57.7, 1.2% in Amerindians and 12.1, 2.0, 37.1, 0.3, 55.4, 0.3% in non-Amerindians respectively. Out of 139 anti-HBc reactive individuals, 70 were anti-HBe reactive and none presented HBeAg or anti-HBc IgM. Anti-HBc prevalence was associated to older age (p < 0.0001). Overall anti-Delta prevalence was 0.3% and regarding anti-HBc reactive individuals, anti-delta prevalence was 3.4 and 0% in Amerindians and non-Amerindians respectively. Conclusions Overall low prevalence of HBV and HCV infection was found in the populations studied, but high HBV and HCV prevalence was observed in Amerindians compared to non-Amerindians suggesting that these individuals have a higher likelihood of acquiring to these infections. Anti-delta antibodies were found among Amerindians from Eastern Amazon suggesting a risk for this population. Of note is that nearly half of Amerindians had no anti-HBs, indicating a need for HBV vaccination campaigns in this population.
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Affiliation(s)
- Livia Melo Villar
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion - Ground Floor - Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos -, Rio de Janeiro, RJ, 210360-040, Brazil.
| | | | - Elisabeth Lampe
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion - Ground Floor - Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos -, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Helena Medina Cruz
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion - Ground Floor - Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos -, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Leticia de Paula Scalioni
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy Pereira Pavillion - Ground Floor - Room B09, FIOCRUZ Av. Brasil, 4365 - Manguinhos -, Rio de Janeiro, RJ, 210360-040, Brazil
| | | | - Anselmo Rocha Romão
- Laboratory of Information in Health, Institute of Communication and technological and scientific information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Renata Gracie
- Laboratory of Information in Health, Institute of Communication and technological and scientific information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
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Alves P, Pellegrini A, Ribeiro PT, Toledo LMD, Romão AR, Novaes LCM. Socio-spatial inequalities related to tuberculosis in the city of Itaboraí, Rio de Janeiro. Rev Bras Epidemiol 2017; 20:559-572. [PMID: 29267743 DOI: 10.1590/1980-5497201700040001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 07/06/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Tuberculosis remains as a global public health problem and its occurrence and distribution is associated with social inequalities. Itaboraí is among the priority Brazilian municipalities for tuberculosis control. The study aimed to combine social indicators into a composite indicator to measure differences in living conditions of the population in Itaboraí, as well as evidence of health inequalities related to tuberculosis. METHODS An ecological study, with spatial analysis of tuberculosis and its relation to socioeconomic and demographic status of households. Data were obtained from individuals declared in the Mortality Information System (SIM), notified in the Notification of Injury Information System - SINAN or Tuberculosis Special Treatment Information System - SITETB from 2007 to 2013. RESULTS Evidence indicates association between sociodemographic inequalities and occurrence of tuberculosis in the population. Findings point to a lower percentage of healing and a higher percentage of abandonment and death in areas with high social vulnerability, with a relative risk over twice as high than that found in areas of lower vulnerability. CONCLUSION The study showed strong evidence that the influence of unequal sociodemographic conditions have a negative impact on health conditions of the population in Itaboraí.
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Affiliation(s)
- Pedro Alves
- Subsecretaria de Vigilância em Saúde, Secretaria de Estado de Saúde - Rio de Janeiro (RJ), Brasil
| | - Alberto Pellegrini
- Centro de Estudos, Políticas e Informações sobre Determinantes Sociais de Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz - Manguinhos (RJ), Brasil
| | - Patrícia Tavares Ribeiro
- Centro de Estudos, Políticas e Informações sobre Determinantes Sociais de Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz - Manguinhos (RJ), Brasil
| | - Luciano Medeiros de Toledo
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz - Manguinhos (RJ), Brasil
| | - Anselmo Rocha Romão
- Núcleo de Geoprocessamento, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Manguinhos (RJ), Brasil
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de Macedo PM, Almeida-Paes R, Freitas DFS, Varon AG, Paixão AG, Romão AR, Coutinho ZF, Pizzini CV, Zancopé-Oliveira RM, Francesconi do Valle AC. Acute juvenile Paracoccidioidomycosis: A 9-year cohort study in the endemic area of Rio de Janeiro, Brazil. PLoS Negl Trop Dis 2017; 11:e0005500. [PMID: 28355221 PMCID: PMC5386294 DOI: 10.1371/journal.pntd.0005500] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 04/10/2017] [Accepted: 03/17/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Paracoccidioidomycosis (PCM) is a systemic mycosis caused by pathogenic dimorphic fungi of the genus Paracoccidioides. It is the most important systemic mycosis in Latin America and the leading cause of hospitalizations and death among them in Brazil. Acute PCM is less frequent but relevant because vulnerable young patients are affected and the severity is usually higher than that of the chronic type. METHODS The authors performed a retrospective cohort study from 2001 to 2009 including acute juvenile PCM patients from a reference center in Rio de Janeiro, Brazil. Clinical, epidemiological, diagnostic, therapeutic, and prognostic data were reported. RESULTS Twenty-nine patients were included. The average age was 23 years old and the male to female ratio was 1:1.07. All cases were referred from 3 of 9 existing health areas in the state of Rio de Janeiro, predominantly from urban areas (96.5%). Lymph nodes were the most affected organs (100%), followed by the skin and the spleen (31% each). Twenty-eight patients completed treatment (median 25 months) and progressed to clinical and serological cure; 1 death occurred. Twenty-four patients completed 48-month median follow-up. Four patients abandoned follow-up after the end of treatment. The most frequent sequela was low adrenal reserve. Paracoccidioides brasiliensis S1 was identified by partial sequencing of the arf and gp43 genes from 4 patients who presented a viable fungal culture. CONCLUSION Acute juvenile PCM is a severe disease with a high rate of complications. There are few cohort clinical studies of acute PCM in the literature. More studies should be developed to promote improvement in patients' healthcare.
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Affiliation(s)
- Priscila Marques de Macedo
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Dayvison Francis Saraiva Freitas
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Andréa Gina Varon
- Department of Inpatient Health Care, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Ariane Gomes Paixão
- Department of Inpatient Health Care, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Anselmo Rocha Romão
- Geoprocessing Laboratory, Institute of Scientific and Technological Communication and Information in Health, Fiocruz, Rio de Janeiro, Brazil
| | | | - Claudia Vera Pizzini
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | | | - Antonio Carlos Francesconi do Valle
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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Barcellos C, Xavier DR, Pavão AL, Boccolini CS, Pina MF, Pedroso M, Romero D, Romão AR. Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil. Emerg Infect Dis 2016; 22:1894-1899. [PMID: 27603576 PMCID: PMC5088029 DOI: 10.3201/eid2211.160901] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Neurologic manifestations of Zika infection must be adequately recognized and treated; our study methods can be used for monitoring and warning systems. Evidence is increasing that Zika virus can cause extensive damage to the central nervous system, affecting both fetuses and adults. We sought to identify traces of possible clinical manifestations of nervous system diseases among the registers of hospital admissions recorded in the Brazilian Unified Health System. Time series of several diagnoses from the International Classification of Diseases, 10th Revision, were analyzed by using control diagrams, during January 2008–February 2016. Beginning in mid-2014, we observed an unprecedented and significant rise in the hospitalization rate for congenital malformations of the nervous system, Guillain-Barré syndrome, encephalitis, myelitis, and encephalomyelitis. These conditions are compatible with viral infection and inflammation-associated manifestations and may have been due to the entrance of Zika virus into Brazil. These findings show the necessity of adequately diagnosing and treating suspected cases of Zika virus infection and also that health surveillance systems can be improved by using routine data.
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