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Naveca FG, Santiago GA, Maito RM, Ribeiro Meneses CA, do Nascimento VA, de Souza VC, do Nascimento FO, Silva D, Mejía M, Gonçalves L, de Figueiredo RMP, Ribeiro Cruz AC, Diniz Nunes BT, Presibella MM, Quallio Marques NF, Riediger IN, de Mendonça MCL, de Bruycker-Nogueira F, Sequeira PC, de Filippis AMB, Resende P, Campos T, Wallau GL, Gräf T, Delatorre E, Kopp E, Morrison A, Muñoz-Jordán JL, Bello G. Reemergence of Dengue Virus Serotype 3, Brazil, 2023. Emerg Infect Dis 2023; 29:1482-1484. [PMID: 37347884 PMCID: PMC10310385 DOI: 10.3201/eid2907.230595] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
We characterized 3 autochthonous dengue virus serotype 3 cases and 1 imported case from 2 states in the North and South Regions of Brazil, 15 years after Brazil's last outbreak involving this serotype. We also identified a new Asian lineage recently introduced into the Americas, raising concerns about future outbreaks.
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Espíndola OM, Fuller TL, de Araújo MF, Tort LFL, Guaraldo L, Calvet G, Resende P, Bonaldo M, Whitworth J, Smith C, Siqueira M, Brasil P. Reduced ability to neutralize the Omicron variant among adults after infection and complete vaccination with BNT162b2, ChAdOx1, or CoronaVac and heterologous boosting. Sci Rep 2023; 13:7437. [PMID: 37156846 PMCID: PMC10165291 DOI: 10.1038/s41598-023-34035-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/22/2023] [Indexed: 05/10/2023] Open
Abstract
COVID-19 vaccines have dramatically reduced rates of severe infection requiring hospitalization. However, SARS-CoV-2 variants have reduced vaccine effectiveness at preventing any symptomatic infection. This real-world study analyzed binding and neutralizing antibodies generated after complete vaccination and boosting across three vaccine platforms. Binding antibodies decayed most slowly in people under 60 with hybrid immunity. Neutralizing antibodies against Omicron BA.1 were reduced compared to other variants. The anamnestic anti-spike IgG response to the first boost was more pronounced than after the second boost. Monitoring of the effects of SARS-CoV-2 mutations on disease severity and the effectiveness of therapeutics is warranted.
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Affiliation(s)
- Otávio Melo Espíndola
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil.
| | - Trevon L Fuller
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, 90095, USA.
| | - Mia Ferreira de Araújo
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO)-Americas Regional Reference Lab for Measles and Rubella-Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute (IOC), Fiocruz, Rio de Janeiro, 21040-900, Brazil
| | - Luis Fernando Lopez Tort
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO)-Americas Regional Reference Lab for Measles and Rubella-Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute (IOC), Fiocruz, Rio de Janeiro, 21040-900, Brazil
- Laboratory of Molecular Virology, Biological Sciences Department, Universidad de la República, Salto, Uruguay
| | - Lusiele Guaraldo
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Guilherme Calvet
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Paola Resende
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO)-Americas Regional Reference Lab for Measles and Rubella-Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute (IOC), Fiocruz, Rio de Janeiro, 21040-900, Brazil
| | - Myrna Bonaldo
- Laboratory of Molecular Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, 21040-900, Brazil
| | - Jimmy Whitworth
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Chris Smith
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Marilda Siqueira
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO)-Americas Regional Reference Lab for Measles and Rubella-Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute (IOC), Fiocruz, Rio de Janeiro, 21040-900, Brazil
| | - Patrícia Brasil
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil.
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3
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Calvet G, Ogrzewalska M, Tassinari W, Guaraldo L, Resende P, Fuller T, Penetra S, Borges M, Pina-Costa A, Martins E, Moraes I, Santos H, Damasceno L, Medeiros-Filho F, Espindola O, Mota F, Nacife V, Pauvolid-Corrêa A, Whitworth J, Smith C, Siqueira M, Brasil P. Accuracy of saliva for SARS-CoV-2 detection in outpatients and their household contacts during the circulation of the Omicron variant of concern. BMC Infect Dis 2023; 23:295. [PMID: 37147601 PMCID: PMC10161980 DOI: 10.1186/s12879-023-08271-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/07/2022] [Accepted: 04/20/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND While nasopharyngeal (NP) swabs are considered the gold standard for severe acute respiratory coronavirus 2 (SARS-CoV-2) real-time reverse transcriptase-polymerase chain reaction (RT-PCR) detection, several studies have shown that saliva is an alternative specimen for COVID-19 diagnosis and screening. METHODS To analyze the utility of saliva for the diagnosis of COVID-19 during the circulation of the Omicron variant, participants were enrolled in an ongoing cohort designed to assess the natural history of SARS-CoV-2 infection in adults and children. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa coefficient were calculated to assess diagnostic performance. RESULTS Overall, 818 samples were collected from 365 outpatients from January 3 to February 2, 2022. The median age was 32.8 years (range: 3-94 years). RT-PCR for SARS-CoV-2 was confirmed in 97/121 symptomatic patients (80.2%) and 62/244 (25.4%) asymptomatic patients. Substantial agreement between saliva and combined nasopharyngeal/oropharyngeal samples was observed with a Cohen's kappa value of 0.74 [95% confidence interval (CI): 0.67-0.81]. Sensitivity was 77% (95% CI: 70.9-82.2), specificity 95% (95% CI: 91.9-97), PPV 89.8% (95% CI: 83.1-94.4), NPV 87.9% (95% CI: 83.6-91.5), and accuracy 88.5% (95% CI: 85.0-91.4). Sensitivity was higher among samples collected from symptomatic children aged three years and older and adolescents [84% (95% CI: 70.5-92)] with a Cohen's kappa value of 0.63 (95% CI: 0.35-0.91). CONCLUSIONS Saliva is a reliable fluid for detecting SARS-CoV-2, especially in symptomatic children and adolescents during the circulation of the Omicron variant.
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Affiliation(s)
- Guilherme Calvet
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil.
| | - Maria Ogrzewalska
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Wagner Tassinari
- Federal Rural University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lusiele Guaraldo
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Paola Resende
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Trevon Fuller
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Stephanie Penetra
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Michele Borges
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Anielle Pina-Costa
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Ezequias Martins
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Isabella Moraes
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Heloisa Santos
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Luana Damasceno
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Fernando Medeiros-Filho
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Otavio Espindola
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
| | - Fernando Mota
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Valéria Nacife
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Alex Pauvolid-Corrêa
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Jimmy Whitworth
- Departments of Clinical Research and Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Smith
- Departments of Clinical Research and Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Marilda Siqueira
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- SARS-CoV-2 National Reference Laboratory for the Brazilian Ministry of Health (MoH) and Regional Reference Laboratory in Americas for the Pan-American Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Patrícia Brasil
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro, 21045-900, Brazil
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Brasil P, Damasceno L, Fuller T, Bastos LS, Cruz OG, Medeiros F, Calvet GA, Resende P, Whitworth J, Smith C, Siqueira MM, Carvalho M. Cohort-profile: Household transmission of SARS-CoV-2 in a low-resource community in Rio de Janeiro, Brazil. BMJ Open 2022; 12:e067212. [PMID: 36600372 PMCID: PMC9729844 DOI: 10.1136/bmjopen-2022-067212] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To better understand the household transmission of SARS-COV-2 in a low-resource community in Rio de Janeiro during the COVID-19 pandemic (2020-2022). PARTICIPANTS This is an open prospective cohort study of children ≤12 years old and their household contacts. During home visits over 24 months, we collected data on sociodemographic characteristics, behavioural data, clinical manifestations of SARS-CoV-2, vaccination status, SARS-CoV-2 (reverse transcription-polymerase chain reaction) RT-PCR and anti-S antibody tests. Among adults, the majority of participants were women (62%). FINDINGS TO DATE We enrolled 845 families from May 2020 to May 2022. The median number of residents per household was four. The median household density, defined as the number of persons per room, was 0.95. The risk of SARS-CoV-2 occurrence was higher in households with a high number of persons per room. Children were not the principal source of SARS-CoV-2 infections in their households during the first wave of the pandemic. FUTURE PLANS Future studies will investigate cellular and humoral immune responses to locally circulating SARS-CoV-2 variants, which is relevant for the design of vaccines, antivirals and monoclonal antibodies. We will also engage in outreach to encourage vaccination as a means of limiting the transmission of novel SARS-CoV-2 variants and other emerging pathogens.
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Affiliation(s)
- Patrícia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luana Damasceno
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Trevon Fuller
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
- Institute of the Environment & Sustainability, University of California Los Angeles, Los Angeles, California, USA
| | - Leonardo S Bastos
- Scientific Computing Program, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Oswaldo G Cruz
- Scientific Computing Program, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fernando Medeiros
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Guilherme Amaral Calvet
- Acute Febrile Illnesses Clinical Research Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paola Resende
- Laboratory of Respiratory Viruses and Measles, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Chris Smith
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Marilda M Siqueira
- Laboratório de Vírus Respiratórios e do Sarampo, IOC, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marilia Carvalho
- Scientific Computing Program, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
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5
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Leite JA, Vicari A, Perez E, Siqueira M, Resende P, Motta FC, Freitas L, Fernandez J, Parra B, Castillo A, Fasce R, Martinez Caballero AA, Gresh L, Aldighieri S, Gabastou JM, Franco L, Mendez-Rico J. Implementation of a COVID-19 Genomic Surveillance Regional Network for Latin America and Caribbean region. PLoS One 2022; 17:e0252526. [PMID: 35239677 PMCID: PMC8893691 DOI: 10.1371/journal.pone.0252526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 10/13/2020] [Accepted: 01/27/2022] [Indexed: 11/25/2022] Open
Abstract
The timely release of SARS-CoV-2 first genomic sequences allowed the identification of the etiologic agent and development of diagnostic protocols. Genomic sequencing was a crucial step in generating data for driving laboratory response and detections of SARS-CoV-2 since the start of the COVID-19 pandemic. Because of all the progression and achievements that timely release of genetic sequence data represents in the public health response, the Pan American Health Organization (PAHO) in collaboration with countries' public health laboratories, started implementation of a network for strengthening the Latin America and Caribbean (LAC) region on timely generation of SARS-CoV-2 genomic data. Here we describe the implementation of the COVID-19 Genomic Surveillance Regional Network in the Americas region during the beginning of the pandemic. The establishment of this network has strengthened laboratory response capacity at the country level, as well as facilitated timely release of SARS-CoV-2 genomic information to be used to complement the multiple response strategies for COVID-19 pandemic mitigation. As genomic epidemiology is useful for guiding public health decisions on outbreak and response, we also analysed the first SARS-CoV-2 genomic sequence data from countries of the Latin America and Caribbean Region.
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Affiliation(s)
- Juliana Almeida Leite
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Andrea Vicari
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Enrique Perez
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Marilda Siqueira
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Paola Resende
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Fernando Couto Motta
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Lucas Freitas
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Jorge Fernandez
- Subdepartamento Genética Molecular, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Barbara Parra
- Subdepartamento Genética Molecular, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Andrés Castillo
- Subdepartamento Genética Molecular, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Rodrigo Fasce
- Subdepartamento Enfermidades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | | | | | - Lionel Gresh
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Sylvain Aldighieri
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Jean-Marc Gabastou
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Leticia Franco
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
| | - Jairo Mendez-Rico
- Health Emergencies Department, Pan American Health Organization, Washington, DC, United States of America
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6
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Penetra SLS, da Silva MFB, Resende P, Pina-Costa A, Santos HFP, Guaraldo L, Calvet GA, Ogrzewalska M, Arantes I, Zukeram K, de Araújo MF, Lima ABM, Lopes RS, Lira-Silva LR, Moraes IV, Wakimoto MD, Fuller TL, Gabaglia CR, Espíndola OM, Bonaldo MC, Daniel-Ribeiro CT, Whitworth J, Smith C, Nielsen-Saines K, Pauvolid-Correa A, Siqueira MM, Brasil P. Post-acute COVID-19 syndrome after reinfection and vaccine breakthrough by the SARS-CoV-2 Gamma variant in Brazil. Int J Infect Dis 2021; 114:58-61. [PMID: 34757006 PMCID: PMC8553653 DOI: 10.1016/j.ijid.2021.10.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/19/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/28/2022] Open
Abstract
We describe a case of prolonged COVID-19 caused by the SARS-CoV-2 Gamma variant in a fully vaccinated healthcare worker, 387 days after an infection caused by lineage B.1.1.33. Infections were confirmed by whole-genome sequencing and corroborated by the detection of neutralizing antibodies in convalescent serum samples. Considering the permanent exposure of this healthcare worker to SARS-CoV-2, the waning immunity after the first infection, the low efficacy of the inactivated vaccine at preventing COVID-19, the immune escape of the Gamma variant (VOC), and the burden of post-COVID syndrome, this individual would have benefited from an additional dose of a heterologous vaccine.
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Affiliation(s)
- Stephanie L S Penetra
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Michele F B da Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Paola Resende
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Anielle Pina-Costa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil; Serra dos Órgãos Education Foundation, Avenida Alberto Tôrres, 111 - Alto, Teresópolis, RJ, 25964-004, Brazil
| | - Heloisa F P Santos
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Lusiele Guaraldo
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Guilherme A Calvet
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Maria Ogrzewalska
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Ighor Arantes
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Ketiuce Zukeram
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Mia F de Araújo
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Ana Beatriz Machado Lima
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Renata Serrano Lopes
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Larissa R Lira-Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Isabella V Moraes
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Mayumi D Wakimoto
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Trevon L Fuller
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil; University of California, Los Angeles (UCLA), Box 951752, 10833 Le Conte Avenue 22-442 MDCC, Los Angeles, CA, 90095-1752, USA
| | - Claudia Raja Gabaglia
- Biomedical Research Institute of Southern California (BRISC), 4263 Oceanside Blvd#106-159, Oceanside, CA, 92056, USA
| | - Otávio M Espíndola
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Myrna C Bonaldo
- Laboratory of Molecular Biology, Oswaldo Cruz Institute, Fiocruz, Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ 21040-3608, Brazil
| | - Cláudio Tadeu Daniel-Ribeiro
- Department of Immunology, Oswaldo Cruz Institute, Fiocruz, Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Jimmy Whitworth
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Chris Smith
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Karin Nielsen-Saines
- University of California, Los Angeles (UCLA), Box 951752, 10833 Le Conte Avenue 22-442 MDCC, Los Angeles, CA, 90095-1752, USA
| | - Alex Pauvolid-Correa
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil; Texas A&M University, 400 Bizzell St, College Station, TX, 778434, USA
| | - Marilda M Siqueira
- Laboratory of Respiratory Viruses and Measles National Influenza Centre (GISRS-WHO) - Americas Regional Reference Lab for Measles and Rubella - Reference Laboratory for COVID-19 (WHO), Oswaldo Cruz Institute, (IOC), Fiocruz. Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil
| | - Patricia Brasil
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz) Avenida Brasil 4365 - Manguinhos, Rio de Janeiro, RJ, 21040-3608, Brazil.
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Konings F, Perkins MD, Kuhn JH, Pallen MJ, Alm EJ, Archer BN, Barakat A, Bedford T, Bhiman JN, Caly L, Carter LL, Cullinane A, de Oliveira T, Druce J, El Masry I, Evans R, Gao GF, Gorbalenya AE, Hamblion E, Herring BL, Hodcroft E, Holmes EC, Kakkar M, Khare S, Koopmans MPG, Korber B, Leite J, MacCannell D, Marklewitz M, Maurer-Stroh S, Rico JAM, Munster VJ, Neher R, Munnink BO, Pavlin BI, Peiris M, Poon L, Pybus O, Rambaut A, Resende P, Subissi L, Thiel V, Tong S, van der Werf S, von Gottberg A, Ziebuhr J, Van Kerkhove MD. SARS-CoV-2 Variants of Interest and Concern naming scheme conducive for global discourse. Nat Microbiol 2021; 6:821-823. [PMID: 34108654 DOI: 10.1038/s41564-021-00932-w] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, USA
| | - Mark J Pallen
- Quadram Institute Bioscience, University of East Anglia, Norwich, UK
| | - Erik J Alm
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jinal N Bhiman
- National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Melbourne, Victoria, Australia
| | | | - Anne Cullinane
- Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | | | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Melbourne, Victoria, Australia
| | - Ihab El Masry
- Emergency Centre for Transboundary Animal Disease, Food and Agriculture Organization of the United Nations (FAO), Cairo, Egypt
| | - Roger Evans
- World Health Organization, Geneva, Switzerland
| | - George F Gao
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Alexander E Gorbalenya
- Leiden University Medical Center, Leiden, The Netherlands.,Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, Russia
| | | | | | | | - Edward C Holmes
- The University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | - Bette Korber
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Duncan MacCannell
- United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Sebastian Maurer-Stroh
- The Global Initiative on Sharing All Influenza Data (GISAID), Munich, Germany.,Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Vincent J Munster
- Virus Ecology Unit, National Institute of Allergy and Infectious Diseases, Rockville, MA, USA
| | - Richard Neher
- Biozentrum, University of Basel, Switzerland Swiss Institute of Bioinformatics, Basel, Switzerland
| | | | | | | | - Leo Poon
- The University of Hong Kong, Hong Kong, China
| | | | - Andrew Rambaut
- Institute for Evolutionary Biology, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK
| | - Paola Resende
- Laboratory of Respiratory Viruses and Measles (LVRS), Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | - Volker Thiel
- University of Bern, Bern, Switzerland.,Institute of Virology and Immunology, Mittelhäusern, Switzerland
| | - Suxiang Tong
- United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Anne von Gottberg
- National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John Ziebuhr
- Institute of Medical Virology, Justus Liebig University Giessen, Giessen, Germany
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Leite JA, Resende P, Araya JL, Barrera GB, Baumeister E, Caicedo AB, Coppola L, de Mello WA, de Mora D, Cordeiro dos Santos M, Fasce R, Fernández J, Goñi N, Martínez IL, Mayhua JO, Motta F, Nuñez MCH, Ojeda J, Ortega MJ, Ospitia E, de Paiva TM, Pontoriero A, Porras HB, Quinonez JAD, Ramas V, Ramírez JB, Santos KCDO, Siqueira MM, Vàzquez C, Palekar R. Genetic evolution of influenza viruses among selected countries in Latin America, 2017-2018. PLoS One 2020; 15:e0227962. [PMID: 32155152 PMCID: PMC7064222 DOI: 10.1371/journal.pone.0227962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/11/2019] [Accepted: 01/03/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Since the 2009 influenza pandemic, Latin American (LA) countries have strengthened their influenza surveillance systems. We analyzed influenza genetic sequence data from the 2017 through 2018 Southern Hemisphere (SH) influenza season from selected LA countries, to map the availability of influenza genetic sequence data from, and to describe, the 2017 through 2018 SH influenza seasons in LA. METHODS We analyzed influenza A/H1pdm09, A/H3, B/Victoria and B/Yamagata hemagglutinin sequences from clinical samples from 12 National Influenza Centers (NICs) in ten countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Paraguay, Peru and Uruguay) with a collection date from epidemiologic week (EW) 18, 2017 through EW 43, 2018. These sequences were generated by the NIC or the WHO Collaborating Center (CC) at the U.S Centers for Disease Control and Prevention, uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) platform, and used for phylogenetic reconstruction. FINDINGS Influenza hemagglutinin sequences from the participating countries (A/H1pdm09 n = 326, A/H3 n = 636, B n = 433) were highly concordant with the genetic groups of the influenza vaccine-recommended viruses for influenza A/H1pdm09 and influenza B. For influenza A/H3, the concordance was variable. CONCLUSIONS Considering the constant evolution of influenza viruses, high-quality surveillance data-specifically genetic sequence data, are important to allow public health decision makers to make informed decisions about prevention and control strategies, such as influenza vaccine composition. Countries that conduct influenza genetic sequencing for surveillance in LA should continue to work with the WHO CCs to produce high-quality genetic sequence data and upload those sequences to open-access databases.
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Affiliation(s)
- Juliana Almeida Leite
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
| | - Paola Resende
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jenny Lara Araya
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Gisela Badillo Barrera
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | - Elsa Baumeister
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | - Leticia Coppola
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | - Domenica de Mora
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | | | - Rodrigo Fasce
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Jorge Fernández
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Natalia Goñi
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | - Irma López Martínez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | | | - Fernando Motta
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jenny Ojeda
- Ministerio de Salud Pública, Quito, Pichincha, Ecuador
| | - María José Ortega
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Erika Ospitia
- Instituto Nacional de Salud (INS), Bogota, Cundinamarca, Colombia
| | | | - Andrea Pontoriero
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Hebleen Brenes Porras
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Jose Alberto Diaz Quinonez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
- Division of Postgraduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Viviana Ramas
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | | | - Marilda Mendonça Siqueira
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cynthia Vàzquez
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Rakhee Palekar
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
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9
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Mesquita M, Resende P, Marttorelli A, Machado V, Sacramento CQ, Fintelman-Rodrigues N, Abrantes JL, Tavares R, Schirmer M, Siqueira MM, Souza TML. Detection of the influenza A(H1N1)pdm09 virus carrying the K-15E, P83S and Q293H mutations in patients who have undergone bone marrow transplant. PLoS One 2014; 9:e94822. [PMID: 24740088 PMCID: PMC3989246 DOI: 10.1371/journal.pone.0094822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/05/2013] [Accepted: 03/20/2014] [Indexed: 12/17/2022] Open
Abstract
The 2009 pandemic influenza A(H1N1)pdm09 virus emerged and caused considerable morbidity and mortality in the third world, especially in Brazil. Although circulating strains of A(H1N1)pdm09 are A/California/04/2009-like (CA-04-like) viruses, various studies have suggested that some mutations in the viral hemagglutinin (HA) may be associated with enhanced severity and fatality. This phenomenon is particularly challenging for immunocompromised individuals, such as those who have undergone bone marrow transplant (BMT), because they are more likely to display worse clinical outcomes to influenza infection than non-immunocompromised individuals. We studied the clinical and viral aspects of post-BMT patients with confirmed A(H1N1)pdm09 diagnosis in the largest cancer hospital in Brazil. We found a viral strain with K-15E, P83S and Q293H polymorphisms in the HA, which is presumably more virulent, in these individuals. Despite that, these patients showed only mild symptoms of infection. Our findings complement the discovery of mild cases of infection with the A(H1N1)pdm09 virus with the K-15E, P83S and Q293H mutations in Brazil and oppose other studies that have linked these changes with increased disease severity. These results could be important for a better comprehension of the impact of the pandemic influenza in the context of BMT.
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Affiliation(s)
- Milene Mesquita
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Paola Resende
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Andressa Marttorelli
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Viviane Machado
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Carolina Q. Sacramento
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Natalia Fintelman-Rodrigues
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Juliana L. Abrantes
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Rita Tavares
- Center for Bone Marrow Transplantation (CEMO), National Cancer Institute (INCa), Rio de Janeiro, RJ, Brazil
| | - Marcelo Schirmer
- Center for Bone Marrow Transplantation (CEMO), National Cancer Institute (INCa), Rio de Janeiro, RJ, Brazil
| | - Marilda M. Siqueira
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Thiago Moreno L. Souza
- Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
- * E-mail:
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Pereira MJ, Resende P, Azeiteiro UM, Oliveira J, de Figueiredo DR. Differences in the effects of metals on growth of two freshwater green algae (Pseudokirchneriella subcapitata (Korshikov) Hindak and Gonium pectorale Müller). Bull Environ Contam Toxicol 2005; 75:515-22. [PMID: 16385957 DOI: 10.1007/s00128-005-0782-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- M J Pereira
- Biology Department, University of Aveiro, 3810-193 Aveiro, Portugal
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Lecour H, Ferreira O, Cordeiro J, Pereira F, Nogueira A, Sarmento A, Gomes H, Seara A, Resende P. Ofloxacin in the treatment of boutonneuse fever. A preliminary report. J Chemother 1989; 1:919-20. [PMID: 16312704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- H Lecour
- Department of Infectious Diseases, School of Medicine, Hospital S. João, Porto, Portugal
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