1. Epidemiological, prevention and control updates of yellow fever outbreak in Brazil
Marli DO CARMO CUPERTINO ; Rodrigo SIQUEIRA-BATISTA ; Marli DO CARMO CUPERTINO ; Rebeca GARCIA ; Andréia Patrícia GOMES ; Nicholas MAYERS ; Rodrigo SIQUEIRA-BATISTA ; Sérgio Oliveira DE PAULA ; Nicholas MAYERS
Asian Pacific Journal of Tropical Medicine 2019;12(2):49-59
Yellow fever is an acute viral disease endemic to tropical countries, like Brazil, where, since the 1940s, has no significant documented outbreaks similar to that observed between 2016/2018 (2 045 confirmed cases and 677 deaths; caused by the sylvatic form). The principal manipulating factors inciting this change were absence of appropriate vaccination campaigns and increased urbanization & population growth in forest areas, with prevalence of the virus in the species inhabiting of these areas. The 2016/2018 outbreaks exhibited incidence in areas with historically low or no yellow fever virus activity, triggering a surge in recorded deaths - mainly in the Southeastern states of Brazil. The Brazilian government aggressively responded, reforming the countries' prophylactic measures, including vaccine implementation - as of March, 2018, switching from the former double dose regimen of the vaccine, to a single dose protocol, deemed as adequate. Moreover, some states appropriated the fractionated dosage (1/5 of the standard dose), in foresight of potential vaccine shortages. To prevent the uprising of new sylvatic yellow fever cases in Brazil, it's obligatory the development of effective combative plans, including adaptation of prophylactic measures individually (use of repellents, protective clothing etc.), applicable vaccination campaigns in every endemic region, to raise awareness to locals and visitors alike. Notwithstanding these preventative strategies, the persistence of cases and the recent outbreaks in Brazil, highlight the possible ineffectiveness of combative measures. Based on these considerations, the objective of this review was to raise more awareness of the epidemiological impact of the disease in Brazil.
2. Meningococcal disease, a clinical and epidemiological review
Rodrigo Siqueira BATISTA ; Andréia Patrícia GOMES ; Paulo Sérgio BALBINO MIGUEL ; Luiz Alberto SANTANA ; Rodrigo Siqueira BATISTA ; Jorge Luiz DUTRA GAZINEO ; Lisa OLIVEIRA ; Mauro GELLER ; Mauro GELLER
Asian Pacific Journal of Tropical Medicine 2017;10(11):1019-1029
Meningococcal disease is the acute infection caused by Neisseria meningitidis, which has humans as the only natural host. The disease is widespread around the globe and is known for its epidemical potential and high rates of lethality and morbidity. The highest number of cases of the disease is registered in the semi-arid regions of sub-Saharan Africa. In Brazil, it is endemic with occasional outbreaks, epidemics and sporadic cases occurring throughout the year, especially in the winter. The major epidemics of the disease occurred in Brazil in the 70's caused by serogroups A and C. Serogroups B, C and Y represent the majority of cases in Europe, the Americas and Australia. However, there has been a growing increase in serogroup W in some areas. The pathogen transmission happens for respiratory route (droplets) and clinically can lead to meningitis and sepsis (meningococcemia). The treatment is made with antimicrobial and supportive care. For successful prevention, we have some measures like vaccination, chemoprophylaxis and droplets’ precautions. In this review, we have described and clarify clinical features of the disease caused by N. meningitidis regarding its relevance for healthcare professionals.