Síndrome cardiopulmonar por hantavírus no Triângulo Mineiro e Alto Paranaíba, Minas Gerais, 1998-2005: aspectos clínico-epidemiológicos de 23 casos

Foram analisados os achados epidemiológicos, clínicos, laboratoriais e terapêuticos de 23 casos de síndrome cardiopulmonar por hantavírus, identificados sorologicamente ou por imunohistoquímica em hospitais do município de Uberlândia, Minas Gerais. Febre (100%), dispnéia (100%) e mialgias (78%) foram os sintomas mais frequentemente observados nesta casuística. Os sinais físicos mais prevalentes foram hipotensão (65%) e taquicardia (65%). Achados laboratoriais mais comuns incluíram trombocitopenia (96%), hemoconcentração (83%) e leucocitose (74%). Valores anormais de enzimas hepáticas foram encontrados em todos os pacientes testados e alterações em radiografias de tórax foram muito (95,6%) freqüentes. Em 55,5% dos pacientes, foi necessário intubação orotraqueal e suporte hemodinâmico. O presente estudo confirmou o padrão sazonal da síndrome cardiopulmonar por hantavírus na região de Uberlândia e o envolvimento, no ciclo de transmissão da doença, de grupos profissionais considerados de baixo risco de infecção. A alta (39%) taxa de letalidade e a gravidade da doença observadas neste estudo podem estar associadas ao atendimento tardio dos pacientes.

Domiciliation of Triatoma pseudomaculata (Corrêa e Espínola 1964) in the Jequitinhonha Valley, State of Minas Gerais

Impact of the vector control program was evaluated eight years after implantation of epidemiological surveillance for Chagas’ disease in Berilo, a municipality in the Jequitinhonha Valley of the Brazilian State of Minas Gerais. In all 5,242 domiciliary units (96% of the total) were inspected and 10 found to be infested by the triatomine bug Triatoma pseudomaculata. Triatomines were found associated with bats inside one house and in the peridomiciles of the other nine. None of the 111 Triatoma pseudomaculata captured was infected with Trypanosoma cruzi. Noireau et al16 traps were installed in (n=8) and around (n=100) the infested house but no Trypanpsoma cruzi-infected triatomines were found. None bat, opossums (Didelphis albiventris) and rat captured in the peridomicile were infected with Trypanosoma cruzi although 24% of the inhabitants of the house infested by Triatoma pseudomaculata were seropositive for the parasite, based on ELISA, IHA and IIF.

Avaliação da armadilha HP iscada com diferentes taxas de liberação de octenol na captura de anofelinos (Diptera: Culicidae) em Brejo do Mutambal, Município de Varzelândia, Estado de Minas Gerais

Para avaliar o papel do octenol na coleta de anofelinos foram utilizadas armadilhas HP iscadas com diferentes taxas de evaporação. Foram capturados 285 anofelinos e não houve diferença entre o número de anofelinos coletados com as armadilhas controle e as iscadas com octenol e nem entre as taxas de evaporação.

Susceptibility of Aedes aegypti (L) to the insect growth regulators diflubenzuron and methoprene in Uberlândia, State of Minas Gerais

Aedes aegypti (L) (Diptera: Culicidae) was reared in several concentrations of diflubenzuron and methoprene under laboratory conditions in Uberlândia, State of Minas Gerais, southeastern Brazil. Characteristics such as LC50 and LC95, the susceptibility of immature stages of different ages to these insect growth regulators and their residual effects were studied. The LC50 and LC95 of diflubenzuron and methoprene were 5.19 and 12.24 ppb; 19.95 and 72.08 ppb, respectively. While diflubenzuron caused great mortality in all larval instars, methoprene was more effective when the mosquito was exposed from the start of the fourth larval instar onwards. Commercial concentrations of these two insect growth regulators close to LC95 presented greater residual activity than did their respective technical formulations. The parameters were compared with those obtained elsewhere. The characteristics investigated here indicate that these insect growth regulators are effective alternatives for controlling the dengue vector in the Uberlândia region.

Infecção em humanos por varíola bovina na microrregião de Itajubá, Estado de Minas Gerais: relato de caso

Os autores relatam três casos de varíola bovina em humanos, ordenhadores manuais em vacas infectadas, na microrregião de Itajubá, MG. As técnicas diagnósticas foram: isolamento de amostra semelhante ao vírus vaccinia de secreções das lesões cutâneas, reação em cadeia de polimerase, microscopia eletrônica e anticorpos para Orthopoxvirus no sangue dos pacientes.

Enteroparasites and commensals among children in four peripheral districts of Uberlândia, State of Minas Gerais

The aim of this study was to determine the occurrence of intestinal parasites and commensals among children in four peripheral districts located in the northern, southern, eastern and western sectors of Uberlândia, Minas Gerais, using the Baermann methods as modified by Moraes and Lutz. Out of 160 individuals studied, 93 (58.1% CI: 50.4-65.7) were infected, distributed among the sectors as follows: northern (72.5%), southern (47.5%), eastern (57.5%) and western (55%). The positive findings according to age groups were: 0-5 years (26.9%), 5-10 years (21.2%) and 10-15 years (10%). Male children presented 2.7 times higher risk of infection than females did (OR: 2.7; CI: 1052-7001). The parasites and commensals identified were: Giardia lamblia (27.5%), Entamoeba coli (20.6%), Ascaris lumbricoides (14.4%), Enterobius vermicularis (8.8%), Hymenolepis nana (7.5%), Hymenolepis diminuta (5%), hookworms (3.1%), Trichuris trichiura (2.5%), Endolimax nana (2.5%), Entamoeba hartmanni (2.5%), Strongyloides stercoralis (1.3%), Iodamoeba butschlii (1.3%) and Capillaria hepatica (0.6%). The infection rate in these children was high and showed the need to implement prophylactic education programs in the community.

Estudo das características epidemiológicas e clínicas de pacientes portadores do vírus da imunodeficiência humana em Pronto Atendimento do Hospital das Clínicas da Universidade Federal de Minas Gerais

Este trabalho objetiva a análise prospectiva das características clínicas e epidemiológicas que levam os pacientes adultos com HIV/AIDS a procurarem atendimento clínico de urgência em Pronto Atendimento do Hospital das Clínicas da Universidade Federal de Minas Gerais. Noventa e nove pacientes perfizeram 118 internações. A idade foi em média 39,4 anos. A relação homem e mulher foi de 1,35:1. O tempo desde o diagnóstico até a admissão situou-se de forma mais freqüente entre 0-5 anos em 40,4% dos casos. A terapêutica anti-retroviral era usada regularmente em 56,8% das admissões. A contagem de linfócitos T CD4+ foi inferior a 200 células/mm³ em 45,7% dos pacientes. As queixas mais freqüentes foram aumento da temperatura corpórea, diarréia, tosse e dispnéia. O aparelho respiratório foi o mais acometido. As doenças oportunistas mais freqüentes foram pneumocistose, pneumonia comunitária, síndrome diarréica, e candidiase oral. A demanda de internações de pacientes com HIV representou 2,8% das admissões, com tempo médio de permanência hospitalar de 4,6 dias. Os pacientes possuíam, em sua maioria, contagem de linfócitos TCD4+ baixa, quase metade não usava a terapia anti-retroviral altamente eficaz. Houve tendência à feminização. As doenças relacionadas à AIDS continuam sendo as mais freqüentes no nosso meio.

Entomological surveillance of Chagas disease in Berilo municipality, Jequitinhonha Valley, State of Minas Gerais, Brazil

This study aimed to evaluate the Chagas Disease Control Program which has operated since 1982 in the municipality of Berilo in the Jequitinhonha Valley, Minas Gerais, Brazil, based on evaluation of 5,242 domiciliary units (DUs) and 7,807 outbuildings over an eight-year period of epidemiological surveillance implanted in 1997. A total of 391 triatomines (280 Panstrongylus megistus and 111 Triatoma pseudomaculata) were captured, indicating the continued predominance of the former species. However, Triatoma pseudomaculata is clearly becoming more important in this region, with intradomiciliary colonies being detected in recent years. Entomological parameters, such as dispersion (17%) and intradomiciliary infestation (0.15%) indices, are compatible with the results of the epidemiological surveillance. The majority of DUs were of construction type A (plaster over bricks) or C (plaster over adobe). Twenty-five percent of the inhabitants of the DUs infested by triatomines were reactive in ELISA, IHA and IIF tests for Trypanosoma cruzi antigens.

Genetic characterization of rabies virus isolated from bovines and equines between 2007 and 2008, in the States of São Paulo and Minas Gerais

INTRODUCTION: Rabies is an acute disease of the central nervous system and is responsible for the deaths of thousands of humans, wild animals and livestock, particularly cattle, as well as causing major economic losses. This study describes the genetic characterization of rabies virus variants that circulate in Desmodus rotundus populations and are transmitted to herbivores. METHODS: Fifty rabies virus isolates from bovines and equines in the States of São Paulo and Minas Gerais, Brazil, were genetically characterized and compared with sequences retrieved from GenBank. RESULTS: Two clusters (I and II) with mean nucleotide identities of 99.1 and 97.6% were found. The first of these contained nearly all the samples analyzed. Lineages from other Brazilian states grouped in cluster II. CONCLUSIONS: Analysis of the amino acid sequences of the N proteins revealed the existence of genetic markers that may indicate possible variations between geographic regions, although the biologically active regions are conserved within the species over space and time.

Análise da fonte alimentar de Panstrongylus megistus (Hemiptera, Reduviidae, Triatominae) e sua atual importância como vetor do Trypanosoma cruzi, no Estado de Minas Gerais

INTRODUÇÃO: A pesquisa da fonte alimentar dos triatomíneos auxilia no conhecimento sobre a biologia destes insetos, inclusive para inferir-se a importância dos mesmos como transmissores do Trypanosoma cruzi ao homem. MÉTODOS: O presente estudo objetivou registrar, através da reação de precipitina, a fonte alimentar de triatomíneos provenientes de 54 municípios da região centro-oeste de Minas Gerais, assim como a infecção natural destes para flagelados semelhantes ao Trypanosoma cruzi. RESULTADOS: De julho de 2003 até março de 2007, foram avaliados 416 insetos, todos da espécie Panstrongylus megistus. Somando-se as ocorrências, as aves (70%) e os humanos (22,5%) constituíram as principais fontes sanguíneas. Encontrou-se 16 (3,8%) insetos positivos para flagelados semelhantes ao Trypanosoma cruzi sendo que oito realizaram hematofagia no homem. CONCLUSÕES: Os resultados demonstram necessidade de acentuar a vigilância entomológica na região, visto que foi detectada a possibilidade de ocorrência de novos casos da doença de Chagas através da transmissão vetorial.

Declínio da prevalência do HTLV-1/2 em doadores de sangue do Hemocentro Regional da Cidade de Uberaba, Estado de Minas Gerais, 1995 a 2008

INTRODUCÃO: Estudo retrospectivo com o objetivo de avaliar a prevalência e fatores associados à soropositividade para o HTLV-1/2, no período de 1995 a 2008, no Hemocentro Regional de Uberaba e descrever os doadores soropositivos quanto ao gênero, idade, estado civil, cor de pele e procedência. MÉTODOS: Foram realizados análise estatística descritiva, testes qui-quadrado e odds ratio para comparação de proporções e gráfico de dispersão com coeficiente de correlação linear. RESULTADOS: Dentre x doadores testados, foi encontrada a prevalência de sorologia positiva para o HTLV de 0,02% e indeterminada de 0,09%. Houve uma redução significativa da sorologia positiva para HTLV, no período de 2002 a 2008, em comparação ao período de 1995 a 2001. Dentre os soropositivos, observou predomínio significante no gênero feminino. CONCLUSÕES: Imputamos a queda gradativa de soropositividade no período à exclusão permanente dos doadores de repetição soropositivos e ao aprimoramento dos métodos de triagem clínica e dos testes sorológicos ao longo dos anos com reflexos positivos na segurança transfusional.

Decline in prevalence and asymmetric distribution of human T cell lymphotropic virus 1 and 2 in blood donors, State of Minas Gerais, Brazil, 1993 to 2007

INTRODUCTION: Human T cell lymphotropic virus types 1 and 2 (HTLV-1/2) are endemic in Brazil and are screened for in transfusion services since 1993. This study evaluated the evolution of the prevalence of HTLV-1 and 2 in blood donors of the Hemominas Foundation from 1993 to 2007, and its geographical distribution in State of Minas Gerais, Brazil. METHODS: The Hemominas Foundation is a centralized blood center in Minas Gerais, Brazil. The sources of data were the Hemominas Foundation Technical Bulletin and files from the centralized serological laboratory. Donors were tested in the period using enzyme linked immuno sorbent assays (ELISA), followed by Western blot, when repeatedly reactive. The data were analyzed by EPIINFO 6.2 and TABWIN 3.5 softwares. RESULTS: The average seroprevalence in the period 1993-2007 was 0.1%. A steady decline occurred from 0.4% in 1993 to below 0.1% in 2002 and later, with a transient peak of 0.5% in 1994. HTLV reactivity distribution was asymmetrical in the state, with regions of higher prevalence, interspersed with low prevalence areas. Comparison of positive and negative donors verified that increasing age was proportional to virus positivity. Odds ratio for age ranged from 1.43 (30 to 39 years-old) to 3.09 (50 to 65 years-old). Women had a greater chance of being positive (OR-1.64), as previously described. CONCLUSIONS: Possible explanations for HTLV-1/2 prevalence decline are the exclusion of positive donors from the donor pool, an increase in repeat donors and ELISA test improvement, with reduction in the number of false positive results.

Infecção natural de Lutzomyia (Lutzomyia) longipalpis (Diptera: Psychodidae) por Leishmania infantum chagasi em flebotomíneos capturados no município de Janaúba, Estado de Minas Gerais, Brasil

INTRODUÇÃO: A leishmaniose visceral tem sido notificada em quase todos os estados do Brasil, e principalmente no norte de Minas Gerais, onde a doença é endêmica. Este estudo visou detectar a infecção natural de Lutzomyia longipalpis e identificar através da técnica de PCR/RFLP a espécie de Leishmania encontrada nos flebotomíneos do município de Janaúba. MÉTODOS: Utilizando-se armadilhas luminosas, foram capturadas 1.550 fêmeas de L. longipalpis, que agrupadas em pool de 10 exemplares foram submetidas à extração e amplificação de DNA, através das técnicas de PCR genérico e cacofonia. RESULTADOS: Dos 155 pools, seis apresentaram-se positivos para Leishmania sp., sendo a taxa de infecção do município de 3,9%. Através da PCR/RFLP determinou-se que o padrão de digestão das amostras positivas foi semelhante ao da cepa referência Leishmania chagasi (MHOM/BR/74/PP75). CONCLUSÕES: A detecção de infecção natural associada a estudos sobre a epidemiologia da LV sugere que L. longipalpis esteja envolvida na transmissão de L. infantum chagasi em Janaúba, principalmente nas áreas de intensa transmissão de LV.

Phlebotomine sandflies (Diptera: Psychodidae) in Governador Valadares, a transmission area for American tegumentary leishmaniasis in State of Minas Gerais, Brazil

INTRODUCTION: A study on the phlebotomine sandfly fauna was carried out in an endemic area for American tegumentary leishmaniasis in the municipality of Governador Valadares, in the State of Minas Gerais, Brazil. METHODS: Captures were undertaken using HP light traps in four districts, on three nights per month, for one year (from January to December 2008). Correlations between climatic factors (temperature, relative air humidity and rainfall) and the numbers of sandflies collected was observed. RESULTS: 5,413 phlebotomine specimens were caught and were identified as belonging to 12 species. Of these specimens, 2,851 (52%) were females and 2,562 (48%) were males. CONCLUSIONS: Lutzomyia intermedia predominated (29.9% of the species caught), thus suggesting that they were responsible for transmission of American tegumentary leishmaniasis, together with L. whitmani, which was also found in the area (4.3%). The presence of L. longipalpis (11.9%), the main vector for visceral leishmaniasis in Brazil, is an important finding, which makes rigorous entomological surveillance of the area necessary.

Malacological survey of Biomphalaria snails in municipalities along the Estrada Real in the southeast of the State of Minas Gerais, Brazil

INTRODUCTION: The increasing practice of ecotourism and rural tourism in the State of Minas Gerais, Brazil, highlights the importance of studies concerning the occurrence of potential intermediate hosts of Schistosoma mansoni. This study aimed to identify species of Biomphalaria snails in municipalities along the Estrada Real, an important Brazilian tourism project. METHODS: The specimens were collected in different water collections of 36 municipalities along the Estrada Real in the southeast of the State of Minas Gerais. Biomphalaria species were characterized using both morphological and molecular approaches. The research was conducted between August 2005 and September 2009 and all the sites visited were georeferenced using GPS. RESULTS: Six Biomphalaria species were found in 30 of the 36 municipalities studied: glabrata, tenagophila, straminea, peregrina, occidentalis and schrammi. The first three species of Biomphalaria, recognized as intermediate hosts of S. mansoni, were present in 33.3%, 47.2% and 8.3% of the municipalities studied, respectively. The mollusks were found in different types of water collections and no infection by S. mansoni was detected. The highest occurrence of Biomphalaria concentration was verified in the area covered by the Caminho Novo route (Diamantina/MG to Rio de Janeiro/RJ). CONCLUSIONS: Considering the occurrence of schistosomiasis in the State of Minas Gerais and the socioeconomic repercussions involved in the Estrada Real Project, this work focuses on the vulnerability of water collections due to the presence of Biomphalaria mollusks and emphasizes the need for epidemiological surveillance and sanitary and educational measures integrated with the local community and tourism sectors.