Piranha Attacks on Humans in Southeast Brazil: Epidemiology, Natural History, and Clinical Treatment, with Description of a Bite Outbreak

There are many tales describing ferocious schools of piranha attacking humans, but there are few scientific data supporting such behavior. The very few documented instances of humans attacked and eaten by piranha schools include 3 that occurred after death by other causes (eg, heart failure and drowning). These predaceous fishes, however, do occasionally injure bathers and swimmers in lakes and rivers. The characteristic profile of most injuries is a single bite per victim, generally related to the fish defending its brood. This paper describes an outbreak of piranha bites in a dammed river portion in southeast Brazil. The outbreak was caused by the speckled piranha, Serrasalmus spilopleura, a widespread species which benefits from the growing tendency of damming rivers all over Brazil. This article focuses on the epidemiological and clinical aspects of the injuries, as well as on piranha biology, to gain a better understanding of the natural history of bite outbreaks.

Antimycobacterial activity of some Brazilian indigenous medicinal drinks

Tuberculosis (TB) is a very serious problem worldwide and the increasing number of multiple drugs resistant TB cases makes the search for new anti-TB drugs an urgent need. Indigenous knowledge about the use of native plants to treat illnesses has contributed to the discovery of new medicines. In this study, the antimycobacterial activity of seven medicinal drinks was assessed: Ananas sativus (hydroalcoholic fruit extract), Aristolochia triangularis (aqueous and hydroalcoholic leaf, root and stem extracts), Bromelia antiacantha (hydroalcoholic fruit extract), Stryphnodendron adstringens (hydroalcoholic bark extract), Tabebuia ovellanedae (hydroalcoholic bark extract), Vernonia polyanthes (hydroalcoholic root extract), all used by the Vanuíre indigenous community in the treatment of respiratory diseases. The activity was evaluated by using a time-to-kill assay, in which Mycobacterium tuberculosis H37Rv was cultured on Löwenstein-Jensen medium, after thirty minutes, one, three, six, twelve and twenty-four hours contact of the bacteria with each drink. Within half to one hour contact, the hydroalcoholic drinks of A. triangularis, S. adstringens, T. ovellanedae and V. polyanthes reduced the bacterial growth by 2 orders of magnitude in CFU/mL, and all bacterial growth was absent after three hours contact. In contrast, no mycobactericidal effect was detected in the aqueous extract of A. triangularis or in the hydroalcoholic beverages of A. sativus and B. antiacantha, even after twenty-four hours contact.

Importance of xenarthrans in the eco-epidemiology of Paracoccidioides brasiliensis

Background. Several pathogens that cause important zoonotic diseases have been frequently associated with armadillos and other xenarthrans. This mammal group typically has evolved on the South American continent and many of its extant species are seriously threatened with extinction. Natural infection of armadillos with Paracoccidioides brasiliensis in hyperendemic areas has provided a valuable opportunity for understanding the role of this mammal in the eco-epidemiology of Paracoccidioidomycosis (PCM), one of the most important systemic mycoses in Latin America. Findings. This study aimed to detect P. brasiliensis in different xenarthran species (Dasypus novemcinctus, Cabassous spp., Euphractus sexcinctus, Tamandua tetradactyla and Myrmecophaga tridactyla), by molecular and mycological approaches, in samples obtained by one of the following strategies: i) from road-killed animals (n = 6); ii) from naturally dead animals (n = 8); iii) from animals that died in captivity (n = 9); and iv) from living animals captured from the wild (n = 2). Specific P. brasiliensis DNA was detected in several organs among 7/20 nine-banded armadillos (D. novemcinctus) and in 2/2 anteaters (M. tridactyla). The fungus was also cultured in tissue samples from one of two armadillos captured from the wild. Conclusion. Members of the Xenarthra Order, especially armadillos, have some characteristics, including a weak cellular immune response and low body temperature, which make them suitable models for studying host-pathogen interaction. P. brasiliensis infection in wild animals, from PCM endemic areas, may be more common than initially postulated and reinforces the use of these animals as sentinels for the pathogen in the environment. © 2009 Bagagli et al; licensee BioMed Central Ltd.

Late-onset sepsis: Epidemiology, evaluation, and outcome

Late-onset neonatal sepsis is a common serious problem in preterm infants in neonatal intensive care units. Diagnosis can be difficult because clinical manifestations are not specific and none of the available laboratory tests can be considered an ideal marker. For this reason, a combination of markers has been proposed. Complete blood count and acute-phase reactants evaluated together help in diagnosis. C-reactive protein is a specific but late marker, and procalcitonin has proven accurate, although it is little studied in newborns. Blood, cerebrospinal fluid, and urine cultures always should be obtained when late-onset sepsis is suspected. Blood culture, the gold standard in diagnosis, is highly sensitive but needs up to 48 hours to detect microbial growth. Various cytokines have been investigated as early markers of infection, but results are not uniform. Other diagnostic tests that offer promise include: neutrophil surface markers, granulocyte colony-stimulating factor, toll-like receptors, and nuclear factor kappa B. The greatest hope for quick and accurate diagnosis lies in molecular biology, using real time polymerase chain reaction combined withDNAmicroarray. Sepsis and meningitis may affect both the short- and long-term prognosis for newborns. Mortality in neonatal meningitis has been reduced in recent years, but short-term complications and later neurocognitive sequelae remain. Late-onset sepsis significantly increases preterm infant mortality and the risk of cerebral lesions and neurosensory sequelae, including developmental difficulties and cerebral palsy. Early diagnosis of late-onset sepsis contributes to improved neonatal prognosis, but the outcome remains far from satisfactory. © 2010 by the American Academy of Pediatrics.

Epidemiology of vampire bat-transmitted rabies virus in Goiaαs, central Brazil: Re-evaluation based on G-L intergenic region

Background. Vampire bat related rabies harms both livestock industry and public health sector in central Brazil. The geographical distributions of vampire bat-transmitted rabies virus variants are delimited by mountain chains. These findings were elucidated by analyzing a high conserved nucleoprotein gene. This study aims to elucidate the detailed epidemiological characters of vampire bat-transmitted rabies virus by phylogenetic methods based on 619-nt sequence including unconserved G-L intergenic region. Findings. The vampire bat-transmitted rabies virus isolates divided into 8 phylogenetic lineages in the previous nucleoprotein gene analysis were divided into 10 phylogenetic lineages with significant bootstrap values. The distributions of most variants were reconfirmed to be delimited by mountain chains. Furthermore, variants in undulating areas have narrow distributions and are apparently separated by mountain ridges. Conclusions. This study demonstrates that the 619-nt sequence including G-L intergenic region is more useful for a state-level phylogenetic analysis of rabies virus than the partial nucleoprotein gene, and simultaneously that the distribution of vampire bat-transmitted RABV variants tends to be separated not only by mountain chains but also by mountain ridges, thus suggesting that the diversity of vampire bat-transmitted RABV variants was delimited by geographical undulations. © 2010 Itou et al; licensee BioMed Central Ltd.

Relevance of Chinese goose (Anser cygnoides) in experimental epidemiology of Newcastle disease

This study aimed to characterize the true epidemiological role played by the Chinese goose (Anser cygnoides) as a potential source of infection by the Newcastle disease virus (NDV). For this, Specific-Pathogen-Free chicks (SPF) were used and were housed with Chinese geese that had been inoculated with a pathogenic strain (velogenic viscerotropic, strain São João do Meriti) of NDV (DIE50=108.15/0.1 mL) pathogenic to chickens, by the ocular-nasal route. Each group was composed of 6 SPF Leghorn chicks and 3 geese. At 6 days (Group I) and 14 days (Group II) after inoculation of the Chinese geese with NDV, SPF chicks were put into direct contact with each goose group. Cloacal swabs were collected from both species (Chinese geese and SPF chicks) 6, 10 and 20 days after challenge to genome viral excretion by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Chinese geese did not demonstrate any clinical signs of Newcastle disease (ND). They were refractory to the clinical disease with the NDV. However, NDV genome was detected 20 days after challenge. Therefore, NDV carrier status was demonstrated by Chinese geese. Moreover, 100% of SPF chicks housed with the infected Chinese geese had died by 6 (Group I) and 14 days (Group II) after challenge. Thus, the transmission of the pathogenic virus from the Chinese geese to cohabiting SPF chicks was evident within 20 days of the experimental infection. This reveals the epidemiological importance of Chinese geese as a potential transmitter of NDV infection to other commercial birds that could be raised in close proximity.

Relevance of lovebirds (Agapornis roseicollis Selby, 1836) in experimental epidemiology of Newcastle disease

Studies were made to clarify the role that was played by the lovebirds (Agapornis roseicollis) in the epidemiological plan, under the perspective of its being a potential source of infection of Newcastle Disease Virus (NDV). The study used Specific-Pathogen-Free chicks (SPF) that were housed with lovebirds inoculated with a pathogenic strain (velogenic viscerotropic) of NDV pathogenic to chickens, by the ocular-nasal via. Each group was composed of six SPF chicks and four lovebirds. After five days of the inoculation of the lovebirds with NDV, SPF chicks were put together with each group of lovebirds. Cloacae swabs were collected after 9, 14 and 21 days post-challenge in both species (lovebirds and SPF chicks) for genome viral excretion by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Lovebirds did not demonstrate any clinical signs of NDV. They were refractory to the clinical disease with the NDV. However, NDV genome was detected 9 and 21 days after challenge. This study shows that lovebirds can be carriers NDV. Moreover, 100% of SPF chicks allocated with the infected lovebirds demonstrated clinical signs and lesions suggestive of NDV. In these birds, NDV genome was detected 9, 14 and 21 days after challenge. Thus, the transmission of the pathogenic virus from the lovebirds to SPF chicks that were housed together was evident until 21 days of the experimental infection. This study reveals the importance of lovebirds from the epidemiological point of view as potential source of infection of the NDV to other avian species that could be raised near this species. © Asian Network for Scientific Information, 2012.

Candida species: Current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options

The incidence of fungal infections has increased significantly, so contributing to morbidity and mortality. This is caused by an increase in antimicrobial resistance and the restricted number of antifungal drugs, which retain many side effects. Candida species are major human fungal pathogens that cause both mucosal and deep tissue infections. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth. Biofilms are biological communities with a high degree of organization, in which micro-organisms form structured, coordinated and functional communities. These biological communities are embedded in a self-created extracellular matrix. Biofilm production is also associated with a high level of antimicrobial resistance of the associated organisms. The ability of Candida species to form drugresistant biofilms is an important factor in their contribution to human disease. The study of plants as an alternative to other forms of drug discovery has attracted great attention because, according to the World Health Organization, these would be the best sources for obtaining a wide variety of drugs and could benefit a large population. Furthermore, silver nanoparticles, antibodies and photodynamic inactivation have also been used with good results. This article presents a brief review of the literature regarding the epidemiology of Candida species, as well as their pathogenicity and ability to form biofilms, the antifungal activity of natural products and other therapeutic options. © 2013 SGM.

At least two indigenous species of the Bemisia tabaci complex are present in Brazil

Bemisia tabaci is one of the most important global agricultural insect pests, being a vector of emerging plant viruses such as begomoviruses and criniviruses that cause serious problems in many countries. Although knowledge of the genetic diversity of B. tabaci populations is important for controlling this pest and understanding viral epidemics, limited information is available on this pest in Brazil. A survey was conducted in different locations of São Paulo and Mato Grosso states, and the phylogenetic relationships of B. tabaci individuals from 43 populations sampled from different hosts were analysed based on partial mitochondrial cytochrome oxidase 1 gene (mtCOI) sequences. According to the recently proposed classification of the B. tabaci complex, which employs the 3.5% mtCOI sequence divergence threshold for species demarcation, most of the specimens collected were found to belong to the Middle East-Asia Minor 1 species, which includes the invasive populations of the commonly known B biotype, within the Africa/Middle East/Asia Minor high-level group. Three specimens collected from Solanun gilo and Ipomoea sp. were grouped together and could be classified in the New World species that includes the commonly known A biotype. However, six specimens collected from Euphorbia heterophylla, Xanthium cavanillesii and Glycine maxima could not be classified into any of the 28 previously proposed species, although according to the 11% mtCOI sequence divergence threshold, they belong to the New World high-level group. These specimens were classified into a new recently proposed species named New World 2 that includes populations from Argentina. Middle East-Asia Minor 1, New World and New World 2 were differentiated by RFLP analysis of the mtCOI gene using TaqI enzyme. Taq I analysis in silico also differentiates these from Mediterranean species, thus making this method a convenient tool to determine population dynamics, especially critical for monitoring the presence of this exotic pest in Brazil. © 2012 Blackwell Verlag, GmbH.

The pernicious cycle of vlus in brazil: Epidemiology, pathogeny and auxiliary healing methods

Venous leg ulcers (VLUs) represent the most advanced stage of chronic venous insufficiency. Despite the large body of knowledge available regarding the risk factors and aetiopathogeny of the condition, patients referred to public health care systems in developing countries often do not receive adequate diagnosis or early treatment, leading to clinical evolution and disease recurrence. This review collates updated information about the epidemiology, risk factors, aetiopathogeny, diagnosis, ulcer healing methods and determinant factors of the pernicious cycle of VLUs in developing countries, with a focus on the Brazilian setting.

Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment

Cryptococcosis is an important systemic mycosis and the third most prevalent disease in human immunodeficiency virus (HIV)-positive individuals. The incidence of cryptococcosis is high among the 25 million people with HIV/acquired immunodeficiency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. In Cryptococcus neoformans, resistance to azoles may be associated with alterations in the target enzyme encoded by the gene ERG11, lanosterol 14α-demethylase. These alterations are obtained through mutations, or by overexpressing the gene encoding. In addition, C. gattii and C. neoformans present a heteroresistance phenotype, which may be related to increased virulence. Other species beyond C. neoformans and C. gattii, such as C. laurentii, have been diagnosed mainly in patients with immunosuppression. Infections of C. albidus have been isolated in cats and marine mammals. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth, which is also related with increased resistance to antifungal agents. Therefore, there is a great need to search for alternative antifungal agents for these fungi. The search for new molecules is currently occurring from nanoparticle drugs of plant peptide origin. This article presents a brief review of the literature regarding the epidemiology of cryptococcosis, as well as fungal resistance and new alternatives for treatment. © 2013 Springer-Verlag Berlin Heidelberg.

Epidemiology of human immunodeficiency virus-visceral leishmaniasis-co-infection

In Brazil, the rates of mother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) decreased from 20% to 1-2% in some regions. However, the country contains 90% of individuals infected with visceral leishmaniasis (VL) in Latin America, and the west region of São Paulo state faces an alarming expansion of the disease. We describe the epidemiological aspects of the expanding infection of VL and a case report of an HIV-VL-co-infected child from the west region of São Paulo state. The patient was an AIDS-C3 with low levels of CD4, high viral load, severe diarrhea, oral and perineal candidiasis, severe thrombocytopenia, and protein-caloric malnourishment. She evolved with sepsis, renal and cardiac failure. An rK rapid diagnosis test, indirect fluorescent antibody test (IFAT), and bone marrow aspirate were performed for VL. Her symptoms improved significantly after liposomal amphotericin B administration. From the 45 municipalities that compose the Regional Health Department of Presidente Prudente, Lutzomyia longipalpis vectors were found in 58% of them. VL infected dogs were found in 33% of those municipalities, infected dogs and humans were found in 29%, 20% are starting and 33% of the municipalities are preparing VL investigation. It is likely, in this patient, that VL advanced the clinical progression of the HIV disease and the development of AIDS severity. Supported by favorable conditions, the region becomes a new frontier of VL in Brazil. © 2013.