Importation and early local transmission of COVID-19 in Brazil, 2020

We conducted the genome sequencing and analysis of the first confirmed COVID-19 infections in Brazil. Rapid sequencing coupled with phylogenetic analyses in the context of travel history corroborate multiple independent importations from Italy and local spread during the initial stage of COVID-19 transmission in Brazil.

Acute hemorrhagic conjunctivitis epidemic in São Paulo State, Brazil, 2011

Acute hemorrhagic conjunctivitis (AHC) infection is highly contagious and can lead to explosive epidemics. In early February 2011, the Center for Epidemiologic Surveillance of the State of São Paulo Health Secretariat (SES-SP) in Brazil received reports of conjunctivitis outbreaks from rural areas of the state that subsequently spread statewide. This report describes that AHC epidemic and its etiologic agent. Data from the Ministry of Health Information System for Notifiable Diseases (SinanNet) and the SES-SP epidemiologic surveillance system for conjunctivitis, developed to detect outbreaks, confirm the etiologic agent, and carry out control measures, were analyzed. Eye (conjunctival swab) samples were taken from patients with clinical presentation of viral conjunctivitis to perform viral laboratory diagnosis. A total of 1 067 981 conjunctivitis cases were reported to the surveillance system for 2011; there was an increase in the number of cases in epidemiologic weeks 6-26 (summer season) versus previous years. Most cases occurred in the metropolitan region of Greater São Paulo. Of 93 collected samples, 57 tested positive for coxsackievirus-A24 (CV-A24), based on virus isolation in tissue-culture cell lines, reverse transcription polymerase chain reaction (RT-PCR), and enterovirus sequencing of RT-PCR. The data analysis showed that the fast-spreading etiologic agent of the AHC epidemic that occurred in the summer of 2011 was CV-A24. The AHC epidemic was due to an enterovirus that occurred sporadically, spread rapidly and with great magnitude, and had substantial socioeconomic impact due to the high level of absenteeism at work and school.

Astrovirus detection in sporadic cases of diarrhea among hospitalized and non-hospitalized children in Rio De Janeiro, Brazil, from 1998 to 2004

We analyzed 379 stool samples collected from January 1998 through December 2004, from hospitalized and non-hospitalized children with diarrhea in Rio de Janeiro, Brazil. These samples had prior negative results for other enteric viruses and bacterial pathogens. The specimens were analyzed for HAstV detection by RT-PCR. HAstV genotypes were determined by sequence analysis of the RT-PCR products. Twenty (5.3%) out of 379 samples were positive for astrovirus. Astrovirus was equally common among inpatients and outpatients and among different age groups. Of 20 HAstV-infected children, 13 (65%) were either hospitalized or received medical care in the emergence department, which suggests that they had a more severe illness. Only 7 (35%) of the 20 HAstV-infected children attended walk-in clinics, which suggests that they had mild disease. Other then diarrhea, fever was the most common symptom among the HAstV-positive patients, followed by vomit and bloody diarrhea. HAstV-1 was the predominant strain although genotypes 2 and 4 were also found. There was no obvious difference among HAstV strains detected from inpatients or outpatients or among different age groups. The study documented that astrovirus is an agent of acute diarrhea in children who are inpatients or outpatients in Rio de Janeiro, Brazil although it seems to be less common as a single cause of childhood diarrhea then rotavirus.