Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil

INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG). Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF) and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene). RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6%) were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.

Risk factors associated with the transmissionof Brazilian spotted fever in the Piracicaba river basin, State of São Paulo, Brazil

INTRODUCTION : Brazilian spotted fever (BSF) is a disease transmitted by ticks for which the etiological agent is Rickettsia rickettsii. The present essay evaluates the risk factors associated with the transmission of cases of BSF in the time period between 2003 and 2013 in the Piracicaba river basin, state of São Paulo. METHODS : This essay presents a retrospective study to identify the factors associated with the transmission of cases of BSF among all suspected cases identified by the System for Epidemiological Surveillance of São Paulo (CVE). After the description of temporal distribution (onset of symptoms) and the environmental and demographic variations of the confirmed and discarded cases, a multiple logistic regression model was applied. RESULTS : We searched 569 probable locations of infection (PLI) with 210 (37%) confirmed cases of BSF and 359 (63%) discarded cases. The associated variables for the confirmation of BSF in the multiple logistic model using a confidence interval (CI) of 95% were age (OR = 1.025 CI: 1.015-1.035), the presence of Amblyomma sculptum in the environment (OR = 1.629 CI: 1.097-2.439), the collection of ticks from horses (OR = 1.939 CI: 0.999-3.764), the presence of capybaras (OR = 1.467 CI: 1.009-2.138), an urban environment (OR = 1.515 CI: 1.036-2.231), and the existence of a dirty pasture (OR = 1.759 CI: 1.028-3.003). CONCLUSIONS : The factors associated with the confirmation of BSF cases included an urban environment, age, presence of the A. sculptum vector, the collection of ticks from horses, the presence of a capybara population, and a dirty pasture environment.

Ectoparasitos de pequenos mamíferos da Ilha de Maracá, Roraima, Brasil. I. Ectoparasitofauna, registros geográficos e de hospedeiros.

Um levantamento de ectoparasitos de pequenos mamiferos foi realizado na ilha de Ma-racá, Roraima, Bnasil, durante três distintos periodos entre novembro de 1987 a fevereiro de 1989, tendo sido colecionados 1. 774 exemplares retirados de 51 roedores e 3 marsupiais. Os números e a distribuição por sexo das espécies de ectoparasitos encontrados são apresentados. Novos registros de hospedeiros são dados pana Androlaelaps fahrenhol zi, Gigantolaelaps goyanensis, Laelaps flexa, Laelaps paulistanensise Tur aymara.Todas as espécies de ectoparasiZos são registradas pela primeira vez no Estado de Rorai ma. Excetuando-se Amblyomma.sp., Cummingsiasp., Hoplopleura splendida, Polygenis kla-gesi klagesi, Polygenis klagesi samuelise Rhopalopsyllus australisssp. as demais espé-cies são assinaladas pela primeira vez na Amazônia brasileira. L. flexa, Tur amazonicus, Turapicalis, Τ. aymanae Gliricola venezuelanustambém constituem novos negistros pora o Bnasil. Duas novas espécies de. ectoparasitos - uma de ácaro, outra de malófogo-foram, também, encontradas.

Clinical impact of transesophageal echocardiography in patients with stroke without clinical evidence of cardiovascular sources of emboli

OBJECTIVE: The purpose of this study is to evaluate the impact of transeophageal echocardiography on management of patients at low-risk for cardiogenic embolism to prevent new potential cardiovascular sources of emboli. METHODS: We studied 69 patients with ischemic stroke at low-risk for cardiogenic embolism. Transeophageal echocardiography was performed to access: left atrium enlargement; communication or aneurysm of the interatrial septum; patent foramen ovale; spontaneous echo contrast or intracavitary thrombi; the presence of intraaortic atherosclerotic plaques or thrombi; significant valvar morphologic alteration or dysfunction; left ventricle enlargement, hypertrophy, or contractile abnormality. Transesophageal echocardiography altered clinical management, and we adopted anticoagulant therapy or another procedure apart from the use of acetylsalicylic acid. RESULTS: Transeophageal echocardiography detected at least one abnormality in 40 cases (58%). Clinical conduct was adjusted after the performance of transesophageal echocardiography in 11 patients (15.9%); anticoagulation was added in 10 cases and surgical correction in one patient. CONCLUSION: Transeophageal echocardiography was a very useful tool in the secondary prevention for stroke in patients at low risk for cardiogenic embolism.

Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

Ixodidas brasileiros e de alguns paizes limitrophes

The knowledge of the Ixodidae becomes every day, more and more important owing to the fact of the increasing number of diseases of man and animals they can transmit. In Brasil besides transmitting treponemosis, piroplasmosis and anaplasmosis to several domestic animals, the ticks are also responsible fo the transmission of the brazilian rocky mountain spotted fever (A. cajennense and Amblyomma striatum) and they can also harbour the virus of the yellow fever and even to transmit it in laboratory experiments (A. cajennense, O. rostratus). The Brazilian fauna of ticks is a small one and has no more than 45 well-established species belonging to the genus Argas, Ornithodoros, Ixodes, Haemaphysalis, Rhipicephalus, Boophilus, Amblyomma and Spaelaeorhynchus. The genus Amblyomma is the best represented one, with 67% of all species of ticks known in Brazil. One of the most important species in the Amblyomma cajennense owing to its abundance and its wide parasitism in many vertebrates: reptiles, birds and mammals, incluing man, who is much attacked by the larva, the nymph and the adult of this species. The other ticks who attack the man are the Amblyomma brasiliense (the pecari tick), in the forests, and the Ornithodoros, especially the species. O. rostratus and brasiliensis. Other species can bite the man, but only occasionally, like Amblyomma fossum, striatum, oblongogutatum etc. Argas persicus, Rhipicephalus sanguineus and Boophilus are very important species not only as parasites but specially because they transmit several diseases to animals. Some of the ticks of the brazilian wild animals are now also parasites of the domestic ones and vice-versa. Arga persicus var. dissimilis is very common among the poultry and transmits the Treponema anserinum (gallinarum). Boophilus microplus is very abundant on our domestic and wild ruminants (Bos, Cervus, Mazama etc.) and can also ben found on horse, dogs, Felis onca, Felis concolor etc., and it transmits to cattle piroplasmosis and anaplasmosis. Rhipicephalus sanguineus (an introduced species) is now very common on the dog, over all the country. The author recommend to give popular names to some brazilian ticks in order to make them more acquainted with the non scientific people. The author gives a classification of the superfamilia Ixoidoidea and keys to the determination of the different species of brazilian ticks. He creates a new family of Nuttallielidae to the so interesting tick, described by Bedford with the name of Nuttaliella namaqua in South Africa, a new variety of Argas persicus, the Argas persicus var. dissimilis nov. var. owing to the differences on the segment and on the size and morphology of the peritrema. He describes also the female of Amblyomma fuscum Nn. A great part of the author's work deals with the biology, life conditions and parasitism of many of the brazilian ticks in accordance with his personal and from other author's researches, especially in reference to Argas persicus, Ornithodoros rostratus, O. brasiliensis, Boophilus microplus, Rhipicephalus sanguineus, Amblyomma cajennense, A. pseudoconcolor, A. auriculare, A. rotundatum (= A. agamum) etc. The author gives a detailed report upon the parthenogenesis of A. rotundatum (A. agamum) that he first described in 1912 and gives also many references to other species of brazilian ticks, to teratological forms etc. He also gives a detailed report of the geographical distribution of brazilian ticks and of the peculiar conditions of its parasitism. The last part of this article deals with references to the species of ticks of some of the South American Republics namely Argentina, Bolivia, Colombia, Paraguay and Venezuela. Amblyomma testudinis Conil, A. neumanni Ribaga 1902 (= A. furcula Dõnitz 1909) and A. parvitarsum Nn. 1899 (= A. altiplanum Dios 1917), are found only in Argentina. It is given a special bibliography dealing with the brazilian ticks and four text figures and one plate.

Nota sobre os Ixodideos da Republica Argentina

A study of and addicional collection of Argentine ixodidae is made on material send to the Author by Professor Salvador Mazza of Departamento de pathologia do Norte - Jujuy and Professor Doello Jurado of the Museu Rivadavia. There was examined 37 lots of Ixodidae. Among them there were found the nymph of Ixodes auritulus Nn. and 3 other species already known on the South American fauna and from which there was til yet no record in Argentine; they are Ixodes ricinus, Amblyomma parvum and Amblyomma pseudo-concolor.

Verificação, em condiçoes naturais, da infecção de mais três hematófagos (Anophelineos, Flebótomos e Simulídeos) em leprosos

The A. went last August to the State of Minas Gerais to continue his studies on transmission of leprosy by insects. He selected ten lepers (all L3 cases) for his experiments. It happened in the middle of August, a few day after freezing temperature. Practically there were no day mosquitoes, even near a river where in March there were very many. Bringing the patients to a wood, near the Peixe River (Fish River), at the dawn they were attacked by very many Anopheles, some flebotomus, a few Simulium and very rare Culex scapularis. All these insects became infected, in different degrees, by biting such patients. CONCLUSIONS. 1. Two species of Anopheles (A. albitarsis and A. tarsimaculatus) became strongly infected by Hansen bacilli. 2. By dissection done by Dr. Oliveira Castro were found lepra bacilli in various points of the proboscis of two Flebotomus (F. intermedius) and in their stomachs. 3. By smearing were found lepra bacilli in two specimens of Simulium sp. (probably pertinax). 4. It was confirmed also the verification done last March, at the same Leper Colony, that Phthirius pubis can be also a carrier of lepra bacillus. 5. There was confirmed also natural infection of nymphs of Amblyomma cajennense in lepers. Dr. Oliveira Castro is dissecting the Anopheles to locate the bacilli in their organisms and he started, with the cooperation of the Director of Colonia Santa Fé, Dr. José Mariano, attenpts to re-infect a group of negative-nerve cases of leprosy with infected mosquitoes.

Culturas de bacilos ácido-álcool resistentes isolados de hematófagos infectados em leprosos: evidências de se tratar do bacilo de Hansen

The A. summarises the history of his first culture of acidfast bacillus isolated directly from leprosy lesions (Sample José) and refers about two samples recovered from guinea pig and white rat inoculated with said culture. Then the A. completes his previous descriptions of four cultures of acidfast bacilli isolated by him from ticks (Amblyomma cajaennense and Boophilus microplus, two cultures from each species) infected experimentally in lepers. The A. having found specimens of two species of Triatomidae (Triatoma infestans and Panstrongylus megistus) naturally infected with HANSEN bacillus in huts habited by lepers in the State of Minas Gerais (Dec. 1942), started a series of experiments, using larvae and nymphs of T. infestans bred in laboratory at the Instituto Oswaldo Cruz, to infect in active cases of leprosy, in the city of Rio de Janeiro, could obtain two new samples of cultures of acid-fast bacilli (Ns. 6 and 7 of his set). In this papaer the A. studies the biological properties of said cultures, proving that Penicilin has not effect upon them, like other substances. The sulphuric and acetic acids were used to purify some of the cultures, with good results, the cultures becoming more rich and growing faster. Potassium hydroxide Sodium (10% solution) was also used with success to isolate and to purify the cultures, but it seems that it affects the bacilli in some way. In flud glycerinated media the majority of such cultures produce velum suitable for the preparation of antigens for skin tests and for therapeutical use. At last the A. says that he is becoming convinced that the HANSEN bacillus is in cause, especially after thee evidences of culturing the bacillus from one patient, in different opportunities.

Profilaxia do tifo exantemático neotrópico no Brasil

A profilaxia racional de um doença decorre do melhor e mais profundo conhecimento dela. A do tifo exantematico neotrópico, apesar do que se sabe da doença, não e fácil no Brasil. Uma das maiores dificuldade encontramos nas distancias do nosso "hinterland" e na falta de cultura dos nossos agricultores. O homem se infecta certamente com as raças VB, VA e VA do virus brasileiro: 1.°) no campo, nas matas e nas macegas; 2.°) dentro dos domicílios ou nos arredores dêstes. Os primeiros constitúem de regra, os casos insulados do mal. Os segundos fazem parte, não raro, dos focos domiciliares macicos, com 2, 5, 7 e até 12 casos na mesma casa. São responsáveis, pelos primeiros, os carrapatos, principalmente o Amblyomma cayennense e o Amblyomma brasiliense, mormente quando no estado de ninfas, dada a herança habitual das infecções nesses artrópodos, que se infestam em animais silvestres, depositários do virus. São responsáveis pelos segundos, os "Cimex lectularius", percevejos dos leitos e as ninfas e larvas dos carrapatos, deixadas cair junto aos domicílios ou mesmo dentro deles. A profilaxia racional e completa da doença entre nós compreende: 1.°) Descarrapatização das zonas infestadas, por meio de leis apropriadas, coercitivas e aplicadas sem excepção; 2.°) Combate aos cães vadios, cabritos e outros animais portadores do virus; 3.°) Queima dos pastes, campos e macegas de fraco valor econômico, principalmente os que confinam com residências; 4.°) A propaganda racional contra esta grave doença exantemática: a) com palestras locais, acompanhadas de fotografias e gráficos expressivos e ao alcance de todos; b) pelo cinema; c) com artigos simples, claros e precisos sôbre a matéria; d) com folhetos apropriados; 5.°) Combater toda a vermina dentro e nas proximidades dos domicílios, 6.°) Demonstrar que é possível, com toda a certeza, evitar a doença, retirando os carrapatos que se prenderem ao corpo, dentro de 12 ou 14 horas após a fixação; 7.°) Aconselhar o emprego do DDT, “Gammexame" e “Toxafeno" para o expurgo das casas e animais, a fim de combater os carrapatos; 8.°) Vacinação preventiva contra a doença, quando possível, em zonas delimitadas e já civilizadas, feitas principalmente com raças de virus colhidas no Brasil e, se possível, com uma só dose. O autor trabalhou durante algum tempo com a vacina tipo Spencer-Parker. Hoje aconselha o trabalho com a vacina tipo Cox, original ou modificada.

Interrelação entre acari Ixodidae e hospedeiros Edentata da Serra da Canastra, Minas Gerais, Brasil

Recebemos para exame uma pequena coleção de carrapatos no Parque Nacional da Serra da Canastra (MG), entre 1979 e 1980. Os autores demosntraram a existência de uma larga co-acomodação de Amblyomma pseudoconcolor em edentados da familia Dasypodidae, sendo Dasypodini a tribo mais ajustada a sta infestação. De acordo com as Figs. 1 e 2, Dasypodini são, provavelmente, os hospedeiros reais de A. pseudoconcolor e também os hospedeiros mais antigos. Pela primeira vez, A. pseudoconcolor é também registrado e, Cabassous tatouay, C. unicinctus, priododntes maximus e Euphractus sexcinctus. Também, pela primeira vez, A. pseudoconcolor e A. calcaratum foram registrados no Estado de Minas Gerais. os ectoparasitos estão depositados no Departamento de Parasitologia da Universidade Federal de Minas Gerais, Brasil.

Study of the Weight of Eggs from Six Ixodid Species from Brazil

Eggs from engorged females of six ixodidae species (Ixodes loricatus, Amblyomma rotundatum, A. cajennense, Haemaphysalis leporis-palustris, Boophilus microplus, Dermacentor nitens) maintained in laboratory were counted to calculate the number and mean weight in 1g of eggs from each species. Phylogenetic considerations are discussed based on the results

A review of the ticks (Acari, Ixodida) of Brazil, their hosts and geographic distribution - 1. The State of Rio Grande do Sul, Southern Brazil

A review of the ticks (Acari, Ixodida) of the State of Rio Grande do Sul, southern Brazil, was completed as a step towards a definitive list (currently indicated as 12) of such species, their hosts and distribution. The ticks: Argas miniatus (poultry), Ixodes loricatus (opossums), Amblyomma aureolatum (dogs), A. calcaratum (anteaters), A. cooperi (capybaras), A. nodosum (anteaters), A. tigrinum (dogs) (Neotropical) and Rhipicephalus sanguineus (dogs) (introduced, cosmopolitan, Afrotropical) were confirmed as present, in addition to the predominant, Boophilus microplus (cattle) (introduced, pan-tropical, Oriental). Of the further 18 species thus far reported in the literature as present in the state, but unavailable for examination: only Ornithodoros brasiliensis (humans and their habitations) (Neotropical), Ixodes affinis (deer) (Nearctic/Neotropical) and I. auritulus (birds) (Nearctic/Neotropical/Afrotropical/ Australasian) are considered likely; 13 species would benefit from corroborative local data but the majority appear unlikely; reports of A. maculatum (Nearctic/Neotropical, but circum-Caribbean) are considered erroneous; the validity of A. fuscum is in doubt. The very recent, first known report of the tropical Anocentor nitens (horses)(Nearctic/Neotropical), but still apparent absence of the tropical A. cajennense (catholic) (Nearctic/Neotropical) and the sub-tropical/temperate Ixodes pararicinus (cattle) (Neotropical) in Rio Grande do Sul are important for considerations on their current biogeographical distribution and its dynamics in South America. The state has relatively long established, introduced ("exotic"), Old World tick species (B. microplus, R. sanguineus) that continue to represent significant pests and disease vectors to their traditional, introduced domestic animal hosts, cattle and urban dogs. There are also indigenous, New World ticks (A. miniatus, O. brasiliensis, A. aureolatum, A. nitens), as both long established and possibly newly locally introduced species in the state, that should be considered as potential and emergent pests and pathogen vectors to humans and their more recently acquired, introduced domestic animal hosts; rural poultry, dogs and horses.

Variants of the Plasmodium vivax circumsporozoite protein (VK210 and VK247) in Colombian isolates

Phenotypic diversity has been described in the central repeated region of the circumsporozoite protein (CSP) from Plasmodium vivax. Two sequences VK210 (common) and VK247 (variant) have been found widely distributed in P. vivax isolates from several malaria endemic areas around the world. A third protein variant called P. vivax-like showing a sequence similar to the simian parasite P. simio-ovale has also been described. Here, using an immunofluorescent test and specific monoclonal antibodies, we assessed the presence of two of these protein variants (VK210 and VK247) in laboratory produced sporozoite. Both sequences were found in parasite isolates coming from different geographic regions of Colombia. Interestingly, sporozoites carrying the VK247 sequence were more frequently produced in Anopheles albimanus than sporozoites with the VK210 sequence. This difference in sporozoites production was statistically significant (p <0.05, Kruskal-Wallis); not correlation was found with parameters as the total number of parasites or gametocytes in blood from human donors used to feed mosquitoes. Previous studies in the same region have shown a higher prevalence of anti-VK210 antibodies which in theory may suggest their role in blocking the development of sporozoites carrying the CSP VK210 sequence.