Characterizing Human Cysticercosis In Portugal

Abstract text Introduction: Cysticercosis results from the ingestion Taenia solium eggs directly by faecal-oral route or contaminated food or water. While, still considered a leading cause of acquired epilepsy in developed countries, this zoonosis has been controlled or eradicated in industrialized countries due to significant improvements in sanitation, pig rearing and slaughterhouse control systems. Objectives: the health burden of human cysticercosis in Portugal. Material and Metodes: We developed a retrospective study on human neurocysticercosis (NCC) hospitalisations based on the national database resulting from National Health Service (NHS) hospital episodes except those of Madeira and Azores Islands. Results: Between 2006 and 2013 there were 357 hospitalized NCC cases in Portugal. Annual frequency of cases between 2006-2013 kept stable (mean 45). NCC was most frequent in those aged 25-34 years (59; 16,5%) and those >75 years (65; 18,2%). Overall, mean age was 47,3 years (median age 45, standard deviation 41,1, mode 28) and 176 cases were in males (49,3%); no significant differences were observed between age and gender (t-student, p>0,05). In Norte Region cases tended to be older than in Lisboa and Vale do Tejo Region. Conclusions: The Directorate-General of Health established the National Observatory of Cysticercosis and Teniiasis which will define criteria for NCC cases monitoring and surveillance (hospitalized and non-hospitalized cases).

A INFLUÊNCIA DAS ALTERAÇÕES CLIMÁTICAS NO APARECIMENTO DE DOENÇAS RE-EMERGENTES

Fundamentar as acompetências a adquirir pelo estudante

Caracterização da diversidade parasitária em carníveros silvestres e implicações na conservação

Recolher dados para actualizar os conhecimento da diversidade parasitária dos mesocarnívoros mais abundantes nas regiões do sul de Portugal e relacionar a dispersão parasitária, a conservação e a saúde humana constituíram os principais objetivos deste estudo. Raposas (Vulpes vulpes), sacarrabos (Herpestes ichneumon), fuinhas (Martes foina), ginetes (Genetta genetta) e texugos (Meles meles) atropelados foram os carnívoros-hospedeiros em estudo. Um grupo de raposas caçadas foi também considerado parte da amostra. A informação geo-referenciada de todos os animais serviu para executar a análise espacial. Realizaram-se necrópsias meticulosas e procedeu­ se à recolha, identificação e preservação dos parasitas encontrados. Pela primeira vez em Portugal é registada a presença do parasita da gineta Ancytostoma martinezi. A correlação entre os factores humanos e ambientais e, a riqueza de espécies foi determinada estatisticamente. Densidade populacional, disponibilidade de égua, tipo de uso de solo e distância mínima às sedes de concelho não apresentaram uma relação estatisticamente significativa com a infecção parasitária das raposas. Os resultados obtidos relativamente à presença de parasitas zoonóticos nos animais silvestres em estudo fomentam o trabalho multidisciplinar entre a Biologia da Conservação e as ciências médicas. ABSTRACT; The aim of this study was to collect data in order to update the information related to the parasitic diversity of the predominant mesocarnívores in the southern regions of Portugal and to establish relationships between the parasite dispersal, conservation and human health. Road killed foxes (Vulpes vulpes), mongoose (Herpestes ichneumon), stone marten (Martes foina), common genets (Genetta genetta) and euroasian badgers (Meles meles) were the considered carnivore-hosts. A sample of hunted foxes was also regarded.AD the animals had geo-reference information, ultimately used for spatial analysis. Thorough necropsies were performed and macroparasites collected, identified and preserved. For the first time in Portugal Ancylostoma martinezi, a common genets parasite.is recorded. Statistical species richness and correlation between human and environmental factors were determined. Human population density, water drainage, soil use, minimum distance to head council cities and the infection status of foxes proved no significant statistical relation. Results obtained on zoonotic parasites present in wild animals enhance the necessity of multidisciplinary work between Biology conservation and medical sciences.

Clínica de animais de companhia

O presente relatório diz respeito ao estágio curricular realizado no Hospital Veterinário de Portimão, sob a orientação da Prof. Doutora Josefina Coucelo e com a duração de cinco meses, entre um de janeiro de 2016 e trinta e um de maio de 2016. Este relatório foi realizado no âmbito da conclusão do Mestrado Integrado em Medicina Veterinária e consiste em duas partes. A primeira é referente aos casos acompanhados no decorrer do estágio curricular, e a segunda é uma revisão bibliográfica do tema “Leishmaniose Felina”, seguida de um caso clínico acompanhado pelo autor. A Leishmaniose é uma importante zoonose, endémica em várias regiões no mundo, como o sul da Europa, afetando variados mamíferos, debilitando-os e podendo ser fatal. Causada por protozoários do género Leishmania, considera-se como uma afeção rara em gatos. Existe um número crescente de casos nesta espécie, que não é, no entanto, reservatório da infeção para humanos; Small Animal Practice Abstract: The present report describes a training in Portimãos’s Veterinary Hospital, under Doctor Josefina Coucelo’s supervision with the duration of five months, between the 1st January 2016 and the 31st May 2016. This report was written in the context of the Veterinary Medicine Integrated Master degree’s conclusion and is made up of two parts. The first refers to the clinical cases followed during the training and the second is a monography about “Feline Leishmaniasis”, followed by a case report on the subject observed by the author. Leishmaniasis is an important zoonosis endemic in many world regions as well as in southern Europe, affecting many mammals debilitating them and sometimes fatal. It is caused by protozoan of the genus Leishmania. It’s considered a rare affection in cats, however, there’s an increasing number of cases in this host species which still isn’t considered a human infection reservoir.

Characterizing human cysticercosis in Portugal 2006-2013

Cysticercosis results from the ingestion Taenia solium eggs directly by faecal-oral route or contaminated food or water. While, still considered a leading cause of acquired epilepsy in developed countries, this zoonosis has been controlled or eradicated in industrialized countries due to significant improvements in sanitation, pig rearing and slaughterhouse control systems. We developed a retrospective study on human neurocysticercosis (NCC) hospitalisations based on the national database resulting from National Health Service (NHS) hospital episodes except those of Madeira and Azores Islands. Between 2006 and 2013 there were 357 hospitalized NCC cases in Portugal. Annual frequency of cases between 2006-2013 kept stable (mean 45). NCC was most frequent in those aged 25-34 years (59; 16,5%) and those >75 years (65; 18,2%). Overall, mean age was 47,3 years (median age 45, standard deviation 41,1, mode 28) and 176 cases were in males (49,3%); no significant differences were observed between age and gender (t-student, p>0,05). In Norte Region cases tended to be older than in Lisboa and Vale do Tejo Region. The Directorate-General of Health established the National Observatory of Cysticercosis and Teniiasis which will define criteria for NCC cases monitoring and surveillance (hospitalized and non-hospitalized cases).

1ST CYSTINET INTERNATIONAL CONFERENCE TAENIOSIS AND CYSTICERCOSIS: A ONE HEALTH CHALLENGE – Belgrade 2015

CYSTINET INTERNATIONAL CONFERENCE TAENIOSIS AND CYSTICERCOSIS: A ONE HEALTH CHALLENGE –

"Portuguese Observatory of Taeniasis and Cysticercosis": A "One Health" example for epidemiological surveillance of one neglected disease in a European country

Cysticercosis results from the ingestion Taenia solium eggs directly by faecal-oral route or contaminated food or water. Human tapeworm carriers who have become infected after ingesting pork meat contaminated with cysticerci release these eggs. Cysticercosis occurs after tapeworm eggs are ingested by an intermediate host (pig or human) and then hatch, migrate, and lodge in the host's tissues, where they develop onto larval cysticerci. When they lodged in the central nervous system of humans, results in the disease condition called Neurocysticercosis (NCC), with a heterogeneous manifestations depending of the locations of cysts, number, size and their stage of evolution (1). Consequently the prognostic ranges from asymptomatic to situations leading to death in 2% to 9.8%. of cases (7) In swine’s there are few studies, but recent works have proved that animals, for the same reasons, also have neurological abnormalities, expressed by seizures, stereotypic walk in circles, chewing motions with foamy salivation included tonic muscle contractions followed by a sudden diminution in all muscle tone leading to collapse (2). Conventional domestic wastewater treatment processes may not be totally effective in inactivating parasites eggs from Taenia solium, allowing some contamination of soils and agricultural products (11). In Portugal there are some evidence of aggregation of human cysticercosis cases in specific regions, bases in ecological design studies (6). There are few information about human tapeworm carriers and social and economic factors associated with them. Success in knowledge and consequently in lowering transmission is limited by the complex network of biological and social factors that maintain the spread. Effective control of mostly zoonosis require One Health approach, after a real knowledge and transparency in the information provided by the institutions responsible for both animal and human health, allowing sustained interventions targeted at the transmission cycle's crucial nodes. In general, the model used to control, reflects a rural reality, where pigs are raised freely, poor sanitation conditions and incipient sanitary inspection. In cysticercosis, pigs are obligate intermediate hosts and so considered as first targets for control and used as sentinels to monitor environmental T. solium contamination (3). Usually environmental contamination with Taenia spp. eggs is a key issue in most of studies with landscape factors influencing presence of Taenia spp. antigens in both pigs and humans (5). Soil-related factors as well as socio-economic and behavioural factors are associated with the emergence of significant clustering human cysticercosis (4,5). However scarce studies has been produced in urban environmental and in developed countries with the finality to characterize the spatial pattern. There are still few data available regarding its prevalence and spatial distribution; Transmission patterns are likely to exhibit correlations as housing conditions, water supply, basic sanitation, schooling and birthplace of the individual or relatives, more than pigs rearing free, soil conditions (9). As a matter of fact, tapeworm carriers from endemic zones can auto-infect or transmit infection to other people or arrive already suffering NCC (as a result of travelling to or being a citizen from an endemic cysticercosis country) to a free cysticercosis country. Transmission is fecal-oral; this includes transmission through person-to-person contact, through autoinfection, or through contaminated food This has been happening in different continents as North America (5.4–18% been autochthonous), Europe and Australia (7). Recently, case reports of NCC have also emerged from Muslim countries. (10). Actually, different papers relate an epidemic situation in Spain and Portugal (7, 8). However the kind of study done does not authorize such conclusion. There are no evidence that infections were acquired in Portugal and there are not characterized the mode of transmission. Papers with these kind of information will be allow to have economic consequences resulted from artificial trade barriers with serious consequences for pig producers and pig meat trade. We need transparency in information’s that allow provide the basis to support the development and targeting of future effective control programmes (and prove we need that). So, to have a real picture of the disease, it is necessary integrate data from human, animal and environmental factors surrounding human and pig cases to characterize the pattern of the transmission. The design needs to be able to capture unexpected, and not common outcomes (routine data). We need to think “One Health” to get a genuine image of the situation.