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de Rezende IM, Cenachi ARC, Costa TA, Oliveira GFG, Rabelo L, Menezes LM, Penido I, Pereira LS, Arruda MS, Gonç alves AP, Alves PA, Kroon EG, Calzavara-Silva CE, Ramalho DB, Martins-Filho OA, Teixeira-Carvalho A, LaBeaud AD, Drumond BP. Wild-type Yellow fever virus in cerebrospinal fluid from fatal cases in Brazil, 2018. Front Virol 2022; 2:936191. [PMID: 37461745 PMCID: PMC10351615 DOI: 10.3389/fviro.2022.936191] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Yellow fever virus (YFV) is the causative agent of yellow fever (YF), a hemorrhagic and viscerotropic acute disease. Severe YF has been described in approximately 15-25% of YF patients, with 20-50% of severe YF cases being fatal. Here we analyzed cerebrospinal fluid (CSF) samples collected during the YF outbreak in Brazil in 2018, aiming to investigate CNS neuroinvasion in fatal YFV cases. YFV RNA was screened by RT-qPCR targeting the 3'UTR region of the YFV genome in CSF. CSF samples were tested for the presence of anti-YFV IgM and neutralizing antibodies, coupled with routine laboratory examinations. Among the 13 patients studied, we detected anti-YFV IgM in CSF from eight patients and YFV RNA in CSF from five patients. YFV RNA genomic load in CSF samples ranged from 1.75×103 to 5.42×103 RNA copies/mL. We genotyped YFV from three CSF samples that grouped with other YFV samples from the 2018 outbreak in Brazil within the South-American I genotype. Even though descriptions of neurologic manifestations due to wild type YFV (WT-YFV) infection are rare, since the last YF outbreak in Brazil in 2017-2018, a few studies have demonstrated WT-YFV RNA in CSF samples from YF fatal cases. Serological tests indicated the presence of IgM and neutralizing antibodies against YFV in CSF samples from two patients. Although the presence of viral RNA, IgM and neutralizing antibodies in CSF samples could indicate neuroinvasiveness, further studies are needed to better elucidate the role of YFV neuroinvasion and possible impacts in disease pathogenesis.
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Affiliation(s)
- Izabela Mauricio de Rezende
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
- Department of Pediatrics, Division of Infectious Disease, Stanford University School of Medicine, Stanford, CA, United States
| | | | - Thais Alkifeles Costa
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Gabriela Fernanda Garcia Oliveira
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Livia Rabelo
- Eduardo de Menezes Hospital, Belo Horizonte, Brazil
| | | | | | - Leonardo Soares Pereira
- Eduardo de Menezes Hospital, Belo Horizonte, Brazil
- Bendigo Heath Hospital, Bendigo, VIC, Australia
| | - Matheus Soares Arruda
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
| | | | - Pedro Augusto Alves
- Immunology of Viruses Diseases, René Rachou Institute, Oswaldo Cruz Foundation/FIOCRUZ, Minas Gerais, Brazil
| | - Erna Geessien Kroon
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
| | | | | | - Olindo Assis Martins-Filho
- Integrated Group of Biomarkers Research, René Rachou Institute, Oswaldo Cruz Foundation/FIOCRUZ, Minas Gerais, Brazil
| | - Andrea Teixeira-Carvalho
- Integrated Group of Biomarkers Research, René Rachou Institute, Oswaldo Cruz Foundation/FIOCRUZ, Minas Gerais, Brazil
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Disease, Stanford University School of Medicine, Stanford, CA, United States
| | - Betânia Paiva Drumond
- Laboratory of Viruses, Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Minas Gerais, Brazil
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