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Carmona RDCC, Cilli A, da Costa AC, Reis FC, Leal É, dos Santos FCP, Machado BC, Lopes CS, Afonso AMS, Timenetsky MDCST. Pegivirus Detection in Cerebrospinal Fluid from Patients with Central Nervous System Infections of Unknown Etiology in Brazil by Viral Metagenomics. Microorganisms 2023; 12:19. [PMID: 38257846 PMCID: PMC10818654 DOI: 10.3390/microorganisms12010019] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
Metagenomic next-generation sequencing (mNGS) methodology serves as an excellent supplement in cases where diagnosis is challenging to establish through conventional laboratory tests, and its usage is increasingly prevalent. Examining the causes of infectious diseases in the central nervous system (CNS) is vital for understanding their spread, managing outbreaks, and effective patient care. In a study conducted in the state of São Paulo, Brazil, cerebrospinal fluid (CSF) samples from 500 patients with CNS diseases of indeterminate etiology, collected between 2017 and 2021, were analyzed. Employing a mNGS approach, we obtained the complete coding sequence of Pegivirus hominis (HPgV) genotype 2 in a sample from a patient with encephalitis (named IAL-425/BRA/SP/2019); no other pathogen was detected. Subsequently, to determine the extent of this virus's presence, both polymerase chain reaction (PCR) and/or real-time PCR assays were utilized on the entire collection. The presence of the virus was identified in 4.0% of the samples analyzed. This research constitutes the first report of HPgV detection in CSF samples in South America. Analysis of the IAL-425 genome (9107 nt) revealed a 90% nucleotide identity with HPgV strains from various countries. Evolutionary analyses suggest that HPgV is both endemic and extensively distributed. The direct involvement of HPgV in CNS infections in these patients remains uncertain.
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Affiliation(s)
| | - Audrey Cilli
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-900, Brazil; (A.C.); (F.C.R.); (B.C.M.)
| | | | - Fabricio Caldeira Reis
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-900, Brazil; (A.C.); (F.C.R.); (B.C.M.)
| | - Élcio Leal
- Institute of Biological Sciences, Federal University of Pará, Belem 66075-000, Brazil;
| | | | - Bráulio Caetano Machado
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-900, Brazil; (A.C.); (F.C.R.); (B.C.M.)
| | - Cristina Santiago Lopes
- Respiratory Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-900, Brazil; (F.C.P.d.S.); (C.S.L.); (A.M.S.A.)
| | - Ana Maria Sardinha Afonso
- Respiratory Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo 01246-900, Brazil; (F.C.P.d.S.); (C.S.L.); (A.M.S.A.)
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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: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
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Affiliation(s)
| | | | | | - Heloisa Rosa Vieira
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
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Luchs A, da Costa AC, Cilli A, Komninakis SCV, Carmona RDCC, Boen L, Morillo SG, Sabino EC, Timenetsky MDCST. Spread of the emerging equine-like G3P[8] DS-1-like genetic backbone rotavirus strain in Brazil and identification of potential genetic variants. J Gen Virol 2018; 100:7-25. [PMID: 30457517 DOI: 10.1099/jgv.0.001171] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In 2013, the equine-like G3P[8] DS-1-like rotavirus (RVA) strain emerged worldwide. In 2016, this strain was reported in northern Brazil. The aims of the study were to conduct a retrospective genetic investigation to identify the possible entry of these atypical strains in Brazil and to describe their distribution across a representative area of the country. From 2013 to 2017, a total of 4226 faecal samples were screened for RVA by ELISA, PAGE, RT-PCR and sequencing. G3P[8] represented 20.9 % (167/800) of all RVA-positive samples, further subdivided as equine-like G3P[8], DS-1-like (11.0 %; 88/800) and Wa-like G3P[8] (9.9 %; 79/800). Six equine-like G3P[8] DS-1-like samples were selected for whole-genome investigation, confirming the backbone I2-R2-C2-M2-A2-N2-T2-E2-H2. During 2013-2014, Wa-like G3P[8] was predominant and no equine-like G3P[8] DS-1-like was detected. Equine-like G3P[8] DS-1-like was first identified in Paraná in March/2015, suggesting that the strain entered Brazil through the Southern region. Equine-like G3P[8] rapidly spread across the area under surveillance and displayed a marked potential to replace Wa-like G3P[8] strains. Brazilian equine-like G3P[8] DS-1-like strains clustered with contemporary equine-like G3P[8] DS-1-like detected worldwide, but exhibited a distinct NSP2 genotype (N2) compared to the previously reported Amazon equine-like G3P[8] DS-1-like strain (N1). Two distinct NSP4 E2 genotype lineages were also identified. Taken together, these data suggest that different variants of equine-like G3P[8] DS-1-like strains might have been introduced into the country at distinct time points, and co-circulated in the period 2015-2017. The global emergence of equine-like G3P[8] DS-1-like strains, predominantly in countries using the Rotarix vaccine, raises the question of whether vaccines may be inducing selective pressures on zoonotic strains.
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Affiliation(s)
- Adriana Luchs
- 1Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | - Antonio Charlys da Costa
- 2LIM/46 - Laboratory of Medical Parasitology, Department of Infectious and Parasitic Diseases, College of Medicine, University of São Paulo, São Paulo, Brazil.,3Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Audrey Cilli
- 1Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | - Shirley Cavalcante Vasconcelos Komninakis
- 4Postgraduate Program in Health Science, Faculty of Medicine of ABC, Santo André, Brazil.,5Retrovirology Laboratory, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Lais Boen
- 1Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | | | - Ester Cerdeira Sabino
- 2LIM/46 - Laboratory of Medical Parasitology, Department of Infectious and Parasitic Diseases, College of Medicine, University of São Paulo, São Paulo, Brazil.,3Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
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Leite M, Carmona RDCC, Carraro E, Watanabe ASA, Granato CFH. Rotavirus genotypes as etiological agents of diarrhoea in general populations of two geographic regions of Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e45. [PMID: 28793016 PMCID: PMC5626221 DOI: 10.1590/s1678-9946201759045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/27/2016] [Accepted: 03/31/2017] [Indexed: 11/22/2022] Open
Abstract
Rotavirus is the main global cause of severe childhood diarrhoea among children. In
2006, Rotarix® (G1P[8]) was introduced into Brazil’s National Immunization
Program. The vaccine coverage rate was 84.4% in 2009. Evidences of increasing G2P[4]
after 2006 opened up the discussion about the vaccine effectiveness to non-G1
strains. The aim of this study was to identify the circulating rotavirus genotypes in
two Brazilian regions during 2009. A total of 223 positive samples by
immunochromatography and latex agglutination assay from the Northeast
(Bahia/Pernambuco States) and Southeast (São Paulo/Rio de Janeiro States) regions
were included in the study. The samples were submitted to genotyping by nested-PCR
according to VP7(G) and VP4(P) and 175 samples (78.5%) were able to be characterized.
Considering the characterization of VP7, the G-types detected were G1, G2, and G4 in
the Northeast, and G2, G3, G5, and G9 in the Southeast. Considering the
characterization of VP4, the P-types detected were P[4], P[8], and P[6]/P[9] in the
Northeast and the Southeast. The most frequent mixed types found were
G2P[4]/G2P[NT](81.4%), G2P[6](5.2%), G1P[6](5.2%) in the Northeast, and
G2P[4]/G2P[NT](78.8%), G2P[6](8.2%), G9P[8](4.7%) in the Southeast. Among immunized
individuals whose age ranged from 0-4 years, the G2P[4]/G2P[NT] genotype was
identified in 91,0% of cases, and among non-immunized individuals of the same age,
the G2P[4]/G2P[NT] genotype was identified in 85.7% of the cases. In accordance with
the high level of vaccine coverage, the data suggest that the circulation of G2P[4]
in these regions had a considerable increase after the introduction of
Rotarix®.
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Affiliation(s)
- Marcel Leite
- Grupo Fleury, Automação, São Paulo, São Paulo, Brazil.,Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia Clínica, Unidade de Doenças Infecciosas, São Paulo, São Paulo, Brazil
| | | | - Emerson Carraro
- Universidade Estadual do Centro-Oeste, Guarapuava, Paraná, Brazil
| | - Aripuanã Sakurada Aranha Watanabe
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia Clínica, Unidade de Doenças Infecciosas, São Paulo, São Paulo, Brazil
| | - Celso Francisco Hernandes Granato
- Grupo Fleury, Automação, São Paulo, São Paulo, Brazil.,Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia Clínica, Unidade de Doenças Infecciosas, São Paulo, São Paulo, Brazil
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Luchs A, Madalosso G, Cilli A, Morillo SG, Martins SR, de Souza KAF, Namiyama GM, Gonçalves CR, Carmona RDCC, Timenetsky MDCST. Outbreak of G2P[4] rotavirus gastroenteritis in a retirement community, Brazil, 2015: An important public health risk? Geriatr Nurs 2017; 38:283-290. [DOI: 10.1016/j.gerinurse.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 12/13/2022]
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Morillo SG, Luchs A, Cilli A, Ribeiro CD, de Cássia Compagnoli Carmona R, do Carmo Sampaio Tavares Timenetsky M. Norovirus GII.Pe Genotype: Tracking a Foodborne Outbreak on a Cruise Ship Through Molecular Epidemiology, Brazil, 2014. Food Environ Virol 2017; 9:142-148. [PMID: 27933493 DOI: 10.1007/s12560-016-9272-2] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
Norovirus (NoV) is recognized as the most common cause of foodborne outbreaks. In 2014, an outbreak of acute gastroenteritis occurred on a cruise ship in Brazil, and NoV became the suspected etiology. Here we present the molecular identification of the NoV strains and the use of sequence analysis to determine modes of virus transmission. Food (cream cheese, tuna salad, grilled fish, orange mousse, and vegetables soup) and clinical samples were analyzed by ELISA, conventional RT-PCR, qRT-PCR, and sequencing. Genogroup GII NoV was identified by ELISA and conventional RT-PCR in fecal samples from 5 of 12 patients tested (41.7%), and in the orange mousse food sample by conventional RT-PCR and qRT-PCR. Two fecal GII NoV samples and the orange mousse GII NoV sample were successfully genotyped as GII.Pe (ORF 1), revealed 98.0-98.8% identities among them, and shared phylogenetically distinct cluster. Establishing the source of a NoV outbreak can be a challenging task. In this report, the molecular analysis of the partial RdRp NoV gene provided a powerful tool for genotyping (GII.Pe) and tracking of outbreak-related samples. In addition, the same fast and simple extraction methods applied to clinical samples could be successfully used for complex food matrices, and have the potential to be introduced in routine laboratories for screening foods for presence of NoV.
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Affiliation(s)
- Simone Guadagnucci Morillo
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil.
| | - Adriana Luchs
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil.
| | - Audrey Cilli
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
| | - Cibele Daniel Ribeiro
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
| | - Rita de Cássia Compagnoli Carmona
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
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Luchs A, Cilli A, Morillo SG, Carmona RDCC, Timenetsky MDCST. ROTAVIRUS GENOTYPES CIRCULATING IN BRAZIL, 2007-2012: IMPLICATIONS FOR THE VACCINE PROGRAM. Rev Inst Med Trop Sao Paulo 2016; 57:305-13. [PMID: 26422154 PMCID: PMC4616915 DOI: 10.1590/s0036-46652015000400006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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] [Indexed: 01/19/2023] Open
Abstract
Regarding public health in Brazil, a new scenario emerged with the establishment of universal rotavirus (RV) vaccination programs. Herein, the data from the five years of surveillance (2007-2012) of G- and P-type RV strains isolated from individuals with acute gastroenteritis in Brazil are reported. A total of 6,196 fecal specimens were investigated by ELISA and RT-PCR. RVs were detected in 19.1% (1,181/6,196). The peak of RV incidence moved from June-August to September. RV was detected less frequently (19.5%) among children ≤ 5 years than in older children and adolescents (6-18 years) (40.6%). Genotype distribution showed a different profile for each year: G2P[4] strains were most prevalent during 2007-2010, G9P[8] in 2011, and G12P[8] in 2012. Mixed infections (G1+G2P[4], G2+G3P[4]+P[8], G2+G12P[8]), unusual combinations (G1P[4], G2P[6]), and rare strains (G3P[3]) were also identified throughout the study period. Widespread vaccination may alter the RV seasonal pattern. The finding of RV disease affecting older children and adolescents after vaccine implementation has been reported worldwide. G2P[4] emergence most likely follows a global trend seemingly unrelated to vaccination, and G12, apparently, is emerging in the Brazilian population. The rapidly changing RV genotype patterns detected during this study illustrate a dynamic population of co-circulating wildtype RVs in Brazil.
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Luchs A, Cilli A, Morillo SG, Gregório DDS, de Souza KAF, Vieira HR, Fernandes ADM, Carmona RDCC, Timenetsky MDCST. Detection of the emerging rotavirus G12P[8] genotype at high frequency in brazil in 2014: Successive replacement of predominant strains after vaccine introduction. Acta Trop 2016; 156:87-94. [PMID: 26748357 DOI: 10.1016/j.actatropica.2015.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/14/2015] [Accepted: 12/19/2015] [Indexed: 12/12/2022]
Abstract
The continuum characterization of rotavirus (RVA) genotypes is essential to understand how vaccine introduction could impact virus epidemiology. In the present study, an unexpected rapid changing pattern of RVA genotypes distribution in Brazilian population during three followed seasons is described. From January/2012 to December/2014, a total of 3441 fecal specimens were collected from collaborating centers across Southern, Southeastern and Midwest of Brazil. All specimens were screened for RVA using ELISA, and genotyped by RT-PCR. Differences in proportions were tested using Chi-Squares. A p-value of less than 0.05 was considered statistically significant. RVA was detected in 19.7% (677/3441). Among RVA positive cases (n=677), a total of 652 (96.3%) samples were successfully amplified by RT-PCR. G3P[8] remained prevalent in 2012 (37.6%, 69/185) and 2013 (40.1%, 74/186) (χ(2)=0.107, p=0.743), but declined markedly in 2014 (3.5%, 10/281) (χ(2)=71.770, p=0.000). G12P[8] was second highest strain in 2012 (22.7%, 42/185), decrease rapidly in 2013 (2.7%, 5/186) (χ(2)=26.224, p=0.000) and re-emerged as the predominant genotype in 2014 (86.6%, 243/281) (χ(2)=118.299, p=0.000). From July/2014, G12P[8] was the single genotype detected in all regions studied. The sudden emergence, spread and predominance of G12P[8] strain in Brazil, raised the hypothesis of a possible G12 outbreak being in progress. Nationally, the long term decline in gastroenteritis hospitalization observed in the country after RVA vaccine introduction was confirmed. Nevertheless, the sharp increase in diarrhea hospitalization prevalence from 2013 to 2014 observed in Southern and Southeastern regions is consistent with what appears to be an outbreak of G12P[8]. Continued surveillance is needed to verify the effectiveness of the RotarixTM vaccine in Brazil together with potential emergence of unusual genotypes.
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Affiliation(s)
- Adriana Luchs
- Enteric Disease Laboratory, Virology Centre, Adolfo Lutz Institute, São Paulo, Brazil.
| | - Audrey Cilli
- Enteric Disease Laboratory, Virology Centre, Adolfo Lutz Institute, São Paulo, Brazil
| | | | | | | | - Heloísa Rosa Vieira
- Enteric Disease Laboratory, Virology Centre, Adolfo Lutz Institute, São Paulo, Brazil
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Luchs A, Morillo SG, Ribeiro CD, Cilli A, Calux SJ, Carmona RDCC, Timenetsky MDCST. Rotavirus G2P[4] and G2P[4]+[6] infections during norovirus gastroenteritis outbreak: summer season 2010, Brazil. Rev Soc Bras Med Trop 2013; 46:227-30. [DOI: 10.1590/0037-8682-1162-2013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 08/08/2011] [Indexed: 11/22/2022] Open
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Luchs A, Cilli A, Morillo SG, Carmona RDCC, Timenetsky MDCST. Rare G3P[3] rotavirus strain detected in Brazil: Possible human–canine interspecies transmission. J Clin Virol 2012; 54:89-92. [DOI: 10.1016/j.jcv.2012.01.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 01/07/2012] [Accepted: 01/30/2012] [Indexed: 11/24/2022]
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Luchs A, Morillo SG, Ribeiro CD, Vilanova BC, Calux SJ, Carmona RDCC, Timenetsky MDCST. Gastroenteritis outbreak due to G2P[4] rotavirus and GII norovirus at two correctional facilities in Brazil, 2010. J Clin Virol 2011; 51:213-4. [PMID: 21570903 DOI: 10.1016/j.jcv.2011.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 04/11/2011] [Indexed: 10/18/2022]
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Morillo SG, Luchs A, Cilli A, Ribeiro CD, Calux SJ, Carmona RDCC, Timenetsky MDCST. Norovirus 3rd Generation kit: An improvement for rapid diagnosis of sporadic gastroenteritis cases and valuable for outbreak detection. J Virol Methods 2011; 173:13-6. [DOI: 10.1016/j.jviromet.2010.12.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 12/09/2010] [Accepted: 12/21/2010] [Indexed: 12/13/2022]
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Menezes FGD, Correa VMDSDP, Franco FGDM, Ribeiro MI, Cardoso MFDS, Morillo SG, Carmona RDCC, Timenetsky MDCST, Correa L, Pasternak J. An outbreak of norovirus infection in a long-term care facility in Brazil. Einstein (São Paulo) 2010; 8:410-3. [DOI: 10.1590/s1679-45082010ao1779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To describe a norovirus outbreak in a Brazilian long-term care facility from July 8 to 29, 2005. Methods: In the first 48 to 72 hours after onset of symptoms in inpatients and employees, the main infection control strategies were staff education, emphasis on hand washing, implementing contact precautions up to 48-72 hours after resolution of symptoms, complete cleaning of the rooms and exclusion of symptomatic employees from work until 48-72 hours after resolution of their symptoms. Epidemiological and clinical characteristics of the norovirus infections were described based on chart review. Results: The incidence among inpatients and employees was 41.3% and 16.25%, respectively. The main symptom was diarrhea, affecting 100% of inpatients and employees. Forty-four percent of specimens were positive by RIDASCREEN® Norovirus analyses, and identified as norovirus genogroup GII. Seventy percent of inpatients were women and their age range was 51-98 years. Inpatients had in average two comorbid conditions – 87.3% with cardiovascular or chronic pulmonary condition and 47.6% with dementia. There was not relapse or death. Conclusions: The early infection-control measures associated to surveillance are required to keep long-term care facilities free of noroviruses and to protect those who are most vulnerable.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Luci Correa
- Hospital Israelita Albert Einstein – HIAE, Brazil
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Luchs A, Morillo SG, Kisielius JJ, Ueda M, Carmona RDCC, Timenetsky MDCST. Group C rotavirus, detection in Southeastern Brazil after 15 years. J Clin Virol 2009; 46:389-90. [DOI: 10.1016/j.jcv.2009.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2009] [Accepted: 08/13/2009] [Indexed: 10/20/2022]
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Morilla SG, Cilli A, de Cássia Compagnoli Carmona R, Timenetsky MDCST. Identification and molecular characterization of norovirus in são paulo state, Brazil. Braz J Microbiol 2008; 39:619-22. [PMID: 24031277 PMCID: PMC3768465 DOI: 10.1590/s1517-83822008000400004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 08/20/2007] [Revised: 11/22/2007] [Accepted: 06/02/2008] [Indexed: 11/21/2022] Open
Abstract
Norovirus (NoV), previously called Norwalk-like virus, represents an important group of human pathogens associated with outbreaks of nonbacterial gastroenteritis. Epidemiological surveys of outbreaks have shown that the most important routes of transmission are person-to-person contacts and contaminated food and water, with the virus affecting adults and children. NoV is classified into genogroups, being genogroups GI, GII and GIV found in humans. In view of the high genetic diversity of NoV and the lack of information about this virus in Brazil, the aim of the present study was the molecular characterization of NoV isolated from diarrheic stool samples of patients from São Paulo State. In this study, 204 stool specimens collected during diarrhea outbreaks were analyzed by RT-PCR, and 12 were sequenced for genogroup confirmation. One-step PCR was performed in order to amplify the B region of ORF 1 using the MON 431, 432, 433 and 434 primer pool. From total, 32 (15.7%) stool specimens were positive for NoV genogroup GII. Comparison of the sequences of the PCR products to GenBank sequences showed 88.8% to 98.8% identity, suggesting the presence of genogroup GII in gastroenteritis outbreaks in São Paulo State.
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Santos APDT, Russo DH, Machado BC, Luchs A, Timenetsky MDCST, Carmona RDCC. Echovírus 6 associado à doença exantemática. Rev Soc Bras Med Trop 2008; 41:672-5. [DOI: 10.1590/s0037-86822008000600022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 10/09/2008] [Indexed: 11/22/2022] Open
Abstract
Exantema viral é considerado problema comum em regiões tropicais, afetando principalmente crianças. Diversos exantemas cutâneos estão associados a infecções por Enterovirus. Amostras biológicas provenientes de uma criança apresentando exantema generalizado foram enviadas ao Laboratório de Vírus Entéricos do Instituto Adolfo Lutz para a realização do diagnóstico laboratorial. Amostra viral isolada em RD (human rhabdomyosarcoma cells) foi submetida à reação em cadeia pela polimerase apresentando um produto de 437 pares de base, característico de gênero Enterovirus. O sorotipo echovirus 6 (E-6) foi identificado por ensaio de imunofluorescência indireta. Em adição, as amostras pareadas de soro apresentaram soroconversão para E-6. Até o momento, não há relatos do envolvimento de E-6 associado a doenças exantemáticas no Brasil, enfatizando a importância da vigilância epidemiológica para essas doenças e suas complicações.
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Luchs A, Russo DH, Cilli A, Costa FF, Morillo SG, Machado BC, Pellini ACG, de Cássia Compagnoli Carmona R, Timenetsky MDCST. Echovirus 6 associated to aseptic meningitis outbreak, in São Joaquim da Barra, São Paulo, Brazil. Braz J Microbiol 2008; 39:28-31. [PMID: 24031172 PMCID: PMC3768353 DOI: 10.1590/s1517-83822008000100007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 09/22/2007] [Accepted: 01/20/2008] [Indexed: 11/22/2022] Open
Abstract
An aseptic meningitis outbreak occurred during a period from February to May 2004 in São Joaquim da Barra, a town in the northern region of São Paulo State. A total of 40 cases were reported to the Epidemiological Surveillance Center of São Paulo State. Cerebrospinal fluid samples obtained from 23 patients were sent to the Adolfo Lutz Institute for isolation of the virus. These samples were inoculated into RD, HEp2 and Vero cell lineages and those presenting a cytopathogenic effect were selected for analysis by indirect immunofluorescence assay (IFA), neutralization testing (Nt) and reverse transcriptase-polymerase chain reaction (RT-PCR). Cytopathogenic effects were observed in 52.2% (12/23) of these samples. All isolated viruses were identified as human enterovirus by IFA and RT-PCR and echovirus 6 was typed by IFA and Nt. Our results confirmed the participation and importance of echovirus as the etiological agent responsible for this outbreak and the serotype diversity of human enteroviruses circulating in São Paulo State.
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Affiliation(s)
- Adriana Luchs
- Laboratório de Vírus Entéricos, Instituto Adolfo Lutz, São Paulo, SP, Brasil
| | - Denise Hage Russo
- Laboratório de Vírus Entéricos, Instituto Adolfo Lutz, São Paulo, SP, Brasil
| | - Audrey Cilli
- Laboratório de Vírus Entéricos, Instituto Adolfo Lutz, São Paulo, SP, Brasil
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