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.

An outbreak of chlamydiosis in captive blue-fronted Amazon parrots (Amazona aestiva) in Brazil

Fifty-eight blue-fronted Amazon parrot (Amazona aestiva) nestlings, recovered from the illegal trade, became ill at a wildlife rehabilitation center in São Paulo State, Brazil. Clinical signs observed were nonspecific, and the mortality rate was 96.5% despite initial treatment with norfloxacin. Postmortem examinations were performed on 10 birds. Liver and spleen smears showed structures suggestive of Chlamydophila psittaci in four cases. Diagnosis was confirmed by seminested polymerase chain reaction on tissue samples. Other birds from the same location showed no clinical signs of the disease, although high complement fixation titers to C. psittaci were found in 10 adult psittacines. All birds in the facility were treated with doxycycline. The two surviving nestlings did not recover after two doxycycline treatments and were euthanatized. The high mortality rate observed in this outbreak was attributed to poor conditions of husbandry and delays in the diagnosis and treatment of the disease. After diagnosis, improved control measures for chlamydiosis were instituted.

Cryptococcosis outbreak in psittacine birds in Brazil

An outbreak of cryptococcosis occurred in a breeding aviary in São Paulo, Brazil. Seven psittacine birds (of species Charmosyna papou, Lorius lory, Trichoglossus goldiei, Psittacula krameri and Psittacus erithacus) died of disseminated cryptococcosis. Incoordination, progressive paralysis and difficulty in flying were seen in five birds, whereas superficial lesions coincident with respiratory alterations were seen in two birds. Encapsulated yeasts suggestive of Cryptococcus sp. were seen in faecal smears stained with India ink in two cases. Histological examination of the birds showed cryptococcal cells in various tissues, including the beak, choana, sinus, lungs, air sacs, heart, liver, spleen, kidneys, intestines and central nervous system. High titres of cryptococcal antigen were observed in the serum of an affected bird. In this case, titres increased during treatment and the bird eventually died. Yeasts were isolated from the nasal mass, faeces and liver of one bird. Cryptococcus neoformans var. gattii serovar B was identified based on biochemical, physiological and serological tests. These strains were resistant (minimum inhibitory concentration 64 μ g/ml) to fluconazole. This is the first report of C. neoformans var. gattii occurring in psittacine birds in Brazil. © 2004 ISHAM.

An outbreak of Portuguese man-of-war (Physalia physalis - Linnaeus, 1758) envenoming in Southeastern Brazil

Introduction Portuguese man-of-war, Physalia physalis (Linnaeus, 1758), are cnidarians capable of discharging intracellular organelles filled with venom, resulting in severe envenomation in humans. Methods We report the clinical and therapeutic aspects of 331 accidents involving Portuguese man-of-war in an outbreak on the coast of the State of São Paulo, Brazil. Results The clinical manifestations of envenomation were rare and mild and mostly local, systemic reactions; there was a low rate of late complications. Conclusions The consequences of envenomation were of moderate severity, and first aid measures were effective in controlling the pain. Outbreaks of accidents involving Portuguese man-of-war occur periodically in the area without a clear explanation.

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Outbreak control and clinical, pathological, and epidemiological aspects and molecular characterization of a bovine herpesvirus type 5 on a feedlot farm in S(a)over-tildeo Paulo State

This paper describes the control, epidemiological, pathological, and molecular aspects of an outbreak of meningoencephalitis in calves due to bovine herpesvirus 5 at a feedlot with 540 animals in Sa (a) over tildeo Paulo State, Brazil. The introduction of new animals and contact between the resident animals and the introduced ones were most likely responsible for virus transmission. Bovine herpesvirus 1 vaccine was used, resulting in the efficacy of the outbreak control, although two bovine herpesvirus 1 positive animals, vaccinated and revaccinated, presented meningoencephalitis, thereby characterizing vaccinal failure.

Detection of Mayaro virus infections during a dengue outbreak in Mato Grosso, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intramammary coinfection by vaccinia virus and staphylococcus aureus in a bovine vaccinia outbreak

Introduction: Bovine vaccinia virus (VACV) is a well-known zoonotic agent related to exanthemous lesions in skin and mucous membranes of dairy cattle and humans, characterized by the formation of vesicles, pustules and ulcers. Mastitis is one of the most common infectious diseases of dairy herds. Bovine mammary infections are caused mainly by bacterial microorganisms, especially staphylococci. To the best of our knowledge, intramammary coinfection with VACV and Staphylococcus aureus in cows has not been reported previously. Case presentation: During an outbreak of exanthematic bovine VACV infection with animals showing vesicles, pustules and haemorrhagic ulcers on the teats, milk samples were collected for mastitis detection. Conclusion: The present report describes a case of intramammary coinfection by VACV and S. aureus in a bovine VACV outbreak.

Predicting epidemic outbreak from individual features of the spreaders

Knowing which individuals can be more efficient in spreading a pathogen throughout a determinate environment is a fundamental question in disease control. Indeed, over recent years the spread of epidemic diseases and its relationship with the topology of the involved system have been a recurrent topic in complex network theory, taking into account both network models and real-world data. In this paper we explore possible correlations between the heterogeneous spread of an epidemic disease governed by the susceptible-infected-recovered (SIR) model, and several attributes of the originating vertices, considering Erdos-Renyi (ER), Barabasi-Albert (BA) and random geometric graphs (RGG), as well as a real case study, the US air transportation network, which comprises the 500 busiest airports in the US along with inter-connections. Initially, the heterogeneity of the spreading is achieved by considering the RGG networks, in which we analytically derive an expression for the distribution of the spreading rates among the established contacts, by assuming that such rates decay exponentially with the distance that separates the individuals. Such a distribution is also considered for the ER and BA models, where we observe topological effects on the correlations. In the case of the airport network, the spreading rates are empirically defined, assumed to be directly proportional to the seat availability. Among both the theoretical and real networks considered, we observe a high correlation between the total epidemic prevalence and the degree, as well as the strength and the accessibility of the epidemic sources. For attributes such as the betweenness centrality and the k-shell index, however, the correlation depends on the topology considered.

The characteristics of VIM-1-producing Klebsiella pneumoniae from South Africa

A study was designed to characterize a carbapenem-resistant Klebsiella pneumoniae (KPSA01) isolated from a patient in Gauteng, South Africa without recent travel outside South Africa. Molecular characterization was done using isoelectric focusing, polymerase chain reaction and sequencing for bla(VIM), bla(IMP), bla(NDM), bla(CTX-Ms), bla(OXAs), bla(TEMs), and bla(SHV), plasmid-mediated quinolone resistance determinants, multilocus sequencing typing, plasmid replicon typing, and addiction factors. KPSA01 produced VIM-1 and belonged to the newly described sequence type ST569. The plasmid that harboured bla(VIM) typed within the narrow host range IncF replicon group, contained the aadA1 gene cassette, and tested positive for the vagCD and ccdAB addiction systems. This is the first report of VIM-1-producing K. pneumoniae outside Europe. It is important that surveillance studies be undertaken in Africa to determine if VIM-1-producing K. pneumoniae are present in significant numbers.

Low Sensitivity of NS1 Protein Tests Evidenced during a Dengue Type 2 Virus Outbreak in Santos, Brazil, in 2010

In 2010, a large outbreak of dengue occurred in Santos, Brazil. The detection of the NS1 antigen was used for diagnosis in addition to the detection of IgG, IgM, and RNA. A large number of NS1 false-negative results were obtained. A total of 379 RNA-positive samples were selected for thorough evaluation. NS1 was reactive in 37.7% of cases. Most of the cases were characterized as a secondary infection by dengue 2 virus. Sequencing of NS1 positive and negative isolates did not reveal any mutation that could justify the diagnostic failure. Use of existing NS1 tests in the Brazilian population may present a low negative predictive value, and they should be used with caution, preferentially after performing a validation with samples freshly obtained during the ongoing epidemic.

Epidemiological and clinical characteristics of nosocomial candidiasis in university hospitals in Cuiaba - Mato Grosso, Brazil

Background: Fungal infections are emerging as an important cause of human disease, especially among hospitalized patients with serious underlying disease and several risk factors. Aims: To evaluate epidemiological and clinical characteristics of patients with nosocomial candidiasis in university hospitals in Cuiaba - MT, Brazil. Methods: A descriptive study of 91 patients admitted to university hospitals in Cuiaba - MT, with clinical and laboratory diagnosis of nosocomial candidiasis, over a 20-month period. Results: A rate for nosocomial infections by Candida spp. of 5 per 1000 admissions, proportional mortality of 14.4% and lethality of 53.8% were determined. The patient age ranged from 29 days to 82 years-old, among which, 74.7% were adults and 25.3% children. The intensive care units contributed with the highest number of cases of infection by Candida spp. (69.2%). The most important underlying disease was gastrointestinal tract disease (11%). Prematurity and low birth weight were the most important risk factors among newborns. The use of antibiotics, invasive procedures, H-2 blockers, multiple blood transfusions and stay length of >= 21 days were the most frequent risk factors among adults. Candida albicans was the most common species in all cases. Conclusions: In this study, C. albicans was the most frequently detected species in candidiasis and risk factors increased the susceptibility of hospitalized patients to acquiring a nosocomial infection by Candida spp. (C) 2011 Revista Iberoamericana de Micologia. Published by Elsevier Espana, S.L. All rights reserved.

Bacillus cereus infection outbreak in captive psittacines

This study reports an uncommon epizootic outbreak of Bacillus cereus that caused the sudden death of 12 psittacines belonging to the species Anodorhynchus hyacinthinus (1 individual), Diopsittaca nobilis (1 individual), Ara severe (1 individual) and Ara ararauna (9 individuals) in a Brazilian zoo. Post-mortem examination of the animals reveled extensive areas of lung hemorrhage, hepatic congestion, hemorrhagic enteritis and cardiac congestion. Histopathological examination of the organs showed the presence of multiple foci of vegetative cells of Gram-positive bacilli associated with discrete and moderate mononuclear inflammatory cell infiltrate. Seventeen B. cereus strains isolated from blood and sterile organs of nine A. ararauna were analyzed in order to investigate the genetic diversity (assessed by Rep-PCR) and toxigenic profiles (presence of hblA, hblC and hblD; nheA, nheB and nheC as well as cytK, ces and entFM genes) of such strains. Amplification of genomic DNA by Rep-PCR of B. cereus strains generated two closely related profiles (Rep-PCR types A and B) with three bands of difference. All strains were classified as belonging to the toxigenic profile I which contained HBL and NHE gene complexes, entFM and cytK genes. Altogether, microbiological and histopathological findings and the evidence provided by the success of the antibiotic prophylaxis, corroborate that B. cereus was the causative agent of the infection that killed the birds. (C) 2012 Elsevier B.V. All rights reserved.