An examination of adverse drug reaction reporting to the yellow card scheme

Chief pharmacists in 209 hospitals were surveyed about ADR reporting schemes, the priority given to ADR reporting, and attitudes towards ADR reporting. ADR reporting had a low managerial priority. Local reporting schemes were found to be operating in 37% trusts, but there were few plans to start new schemes. Few problems were discovered by the introduction of pharmacist ADR reporting. Chief pharmacists had concerns about the competence of hospital pharmacists to detect ADRs and were in favour of increased training. Lack of time on wards, and recruitment difficulties were suggested as reasons for hospital pharmacist under-reporting. Teaching hospitals appeared to have an increased interest in ADR reporting. A retrospective analysis of reporting trends within the West Midlands region from 1994, showed increasing or stable reporting rates for most sectors of reporters, except for general practitioners (GPs). The West Midlands region maintained higher ADR reporting rates than the rest of the UK. National reporting figures showed a worrying decline in ADR reports from healthcare professionals. Variation was found in the ADR reporting rates of Acute NHS Hospital Trusts and Primary Care Trusts (PCTs) in the West Midlands region, including correlations with prescribing rates and other PCT characteristics. Qualitative research into attitudes of GPs towards the Yellow Card scheme was undertaken. A series of qualitative interviews with GPs discovered barriers and positive motivators for their involvement in the Yellow Card scheme. A grounded theory of GP involvement in the Yellow Card scheme was developed to explain GP behaviour, and which could be used to inform potential solutions to halt declining rates of reporting. Under-reporting of ADRs continues to be a major concern to those who administer spontaneous reporting schemes.

Warfarin toxicity: do discharge ICD-10 codes and yellow cards accurately identify serious adverse drug reactions?

Focal points: ICD-10 codings and spontaneous yellow card reports for warfarin toxicity were compared retrospectively over a one-year period Eighteen cases of ICD-10 coded warfarin toxicity were identified from a total of 55,811 coded episodes More than three times as many ADRs to warfarin were found by screening ICD-10 codes as were reported spontaneously using the yellow card scheme Valuable information is being lost to regulatory authorities and as recognised reporters to the yellow card scheme, pharmacists are well placed to report these ADRs, enhancing their role in the safe and appropriate prescribing of warfarin

Um estudo sobre cartões amarelos e vermelhos aplicados ao mandante e não mandante do jogo pelo arbitro de futebol

Universidade Estadual de Campinas . Faculdade de Educação Física

Evaluación del rendimiento de jugadores y equipos de fútbol de nivel de élite en diferentes contextos situacionales = Evaluation on Match Performances of Professional Football Players and Teams under Different Situational Conditions = 不同情境条件下高水平足球运动员和运动队的比赛表现分析

El análisis del rendimiento en deportes juega un papel esencial en el fútbol profesional. Aunque el estudio del análisis del juego en fútbol se ha utilizado desde diferentes ámbitos y situaciones, todavía existen diferentes aspectos y componentes del juego que siguen sin estar estudiados. En este sentido existen diferentes aspectos que deben de superar los estudios previos centrados en el componente descriptivo tales como el uso de variables/ indicadores de rendimiento que no se han definido ni estudiado, la validez de los métodos observaciones que no han sido testados con los softwares específicos en fútbol, la aplicación y utilidad de los resultados, así como las limitaciones del estudio de las variables situacionales/contextuales. Con el objetivo de cubrir las citadas limitaciones se han diseñado 6 estudios independientes e inter-relacionados que tratan de estudiar los aspectos anteriormente referidos. El primer estudio evalua la fiabilidad inter-observadores de las estadísticas de juego de la empresa privada OPTA Sportsdata, estos datos son la muestra de estudio de la presente tesis doctoral. Dos grupos de observadores experimentados se requieren para analizar un partido de la liga española de manera independiente. Los resultados muestran que los eventos de equipos y porteros codificados por los inter-operadores alcanzan un acuerdo muy bueno (valores kappa entre 0.86 y 0.94). La validez inter-observadores de las acciones de juego y los datos de jugadores individuales se evaluó con elevados niveles de acuerdo (valores del coeficiente de correlación intraclase entre 0.88 hasta 1.00, el error típico estandarizado variaba entre 0.00 hasta 0.37). Los resultados sugieren que las estadísticas de juego registradas por los operadores de la empresa OPTA Sportsdata están bien entrenados y son fiables. El segundo, tercer y cuarto estudio se centran en resaltar la aplicabilidad del análisis de rendimiento en el fútbol así como para explicar en profundidad las influencias de las variables situacionales. Utilizando la técnica de los perfiles de rendimiento de jugadores y equipos de fútbol se puede evaluar y comparar de manera gráfica, fácil y visual. Así mismo, mediante esta técnica se puede controlar el efecto de las variables situacionales (localización del partido, nivel del equipo y del oponente, y el resultado final del partido). Los perfiles de rendimiento de porteros (n = 46 porteros, 744 observaciones) y jugadores de campo (n = 409 jugadores, 5288 observaciones) de la primera division professional de fútbol Española (La Liga, temporada 2012-13), los equipos (n = 496 partidos, 992 observaciones) de la UEFA Champions League (temporadas 2009-10 a 2012-13) fueron analizados registrando la media, desviación típica, mediana, cuartiles superior e inferior y el recuento de valores de cada indicador de rendimiento y evento, los cuales se presentaron en su forma tipificada y normalizada. Los valores medios de los porteros de los equipos de diferentes niveles de La Liga y de los equipos de diferente nivel de la UEFA Champions League cuando jugaban en diferentes contextos de juego y situaciones (variables situacionales) fueron comparados utilizando el ANOVA de un factor y la prueba t para muestras independientes (localización del partido, diferencias entre casa y fuera), y fueron establecidos en los perfiles de red después de unificar todos los registros en la misma escala derivada con valores estandarizados. Mientras que las diferencias de rendimiento entre los jugadores de los mejores equipos (Top3) y los peores (Bottom3) fueron comparados mediante el uso de diferencias en la magnitud del tamaño del efecto. El quinto y el sexto estudio analizaban el rendimiento del fútbol desde un punto de vista de predicción del rendimiento. El modelo linear general y el modelo lineal general mixto fue empleado para analizar la magnitud de las relaciones de los indicadores y estadísticas de juego con el resultado final del partido en función del tipo de partido (partidos ajustados o todos los partidos) en la fase de grupos de la Copa del Mundo 2014 de Brasil (n = 48 partidos, 38 partidos ajustados) y La Liga 2012-13 (n = 320 partidos ajustados). Las relaciones fueron evaluadas mediante las inferencias en la magnitud de las diferencias y se expresaron como partidos extra ganados o perdidos por cada 10 partidos mediante la variable calculada en 2 desviaciones típicas. Los resultados mostraron que, para los 48 partidos de la fase de grupos de la Copa del Mundo 2014, nueve variables tuvieron un efecto positive en la probabilidad de ganar (tiros, tiros a puerta, tiros de contraataque, tiros dentro del área, posesión de balón, pases en corto, media de secuencia de pases, duelos aéreos y entradas), cuatro tuvieron efectos negativos (tiros bloqueados, centros, regates y tarjetas amarillas), y otras 12 variables tenían efectos triviales o poco claros. Mientras que los 38 partidos ajustados, el efecto de duelos aéreos y tarjetas amarillas fueron triviales y claramente negativos respectivamente. En la La Liga, existió un efecto moderado positive para cada equipo para los tiros a puerta (3.4 victorias extras por cada 10 partidos; 99% IC ±1.0), y un efecto positivo reducido para tiros totales (1.7 victorias extrsa; ±1.0). Los efectos de la mayoría de los eventos se han relacionado con la posesión del balón, la cual obtuvo efectos negativos entre equipos (1.2 derrotas extras; ±1.0) pero un efecto positivo pequeño entra equipos (1.7 victorias extras; ±1.4). La localización del partido mostró un efecto positive reducido dentro de los equipos (1.9 victorias extras; ±0.9). Los resultados obtenidos en los perfiles y el modelado del rendimiento permiten ofrecer una información detallada y avanzada para el entrenamiento, la preparación previa a los partidos, el control de la competición y el análisis post-partido, así como la evaluación e identificación del talento de los jugadores. ABSTRACT Match performance analysis plays an important role in the modern professional football. Although the research in football match analysis is well-developed, there are still some issues and problems remaining in this field, which mainly include the lack of operational definitions of variables, reliability issues, applicability of the findings, the lack of contextual/situational variables, and focusing too much on descriptive and comparative analysis. In order to address these issues, six independent but related studies were conducted in the current thesis. The first study evaluated the inter-operator reliability of football match statistics from OPTA Sportsdata Company which is the data resourse of the thesis. Two groups of experienced operators were required to analyse a Spanish league match independently in the experiment. Results showed that team events and goalkeeper actions coded by independent operators reached a very good agreement (kappa values between 0.86 and 0.94). The inter-operator reliability of match actions and events of individual outfield players was also tested to be at a high level (intra-class correlation coefficients ranged from 0.88 to 1.00, standardised typical error varied from 0.00 to 0.37). These results suggest that the football match statistics collected by well-trained operators from OPTA Sportsdata Company are reliable. The second, third and fourth study aims to enhance the applicability of football match performance analysis and to explore deeply the influences of situational variables. By using a profiling technique, technical and tactical performances of football players and teams can be interpreted, evaluated and compared more easily and straightforwardly, meanwhile, influences and effects from situational variables (match location, strength of team and opposition, and match outcome) on the performances can be properly incorporated. Performance profiles of goalkeepers (n = 46 goalkeepers, 744 full match observations) and outfield players (n = 409 players, 5288 full match observations) from the Spanish First Division Professional Football League (La Liga, season 2012-13), teams (n = 496 matches, 992 observations) from UEFA Champions League (seasons 2009-10 to 2012-13) were set up by presenting the mean, standard deviation, median, lower and upper quartiles of the count values of each performance-related match action and event to represent their typical performances and spreads. Means of goalkeeper from different levels of team in La Liga and teams of different strength in UEFA Champions League when playing under different situational conditions were compared by using one-way ANOVA and independent sample t test (for match location, home and away differences), and were plotted into the same radar charts after unifying all the event counts by standardised score. While differences between the performances of outfield players from Top3 and from Bottom3 teams were compared by magnitude-based inferences. The fifth and sixth study aims to move from the descriptive and comparative football match analysis to a more predictive one. Generalised linear modelling and generalised mixed linear modelling were undertaken to quantify relationships of the performance-related match events, actions and variables with the match outcome in different types of games (close games and all games) in the group stage of 2014 Brazil FIFA World Cup (n = 48 games, 38 close games) and La Liga 2012-13 (n = 320 close games). Relationships were evaluated with magnitude-based inferences and were expressed as extra matches won or lost per 10 matches for an increase of two standard deviations of a variable. Results showed that, for all the 48 games in the group stage of 2014 FIFA World Cup, nine variables had clearly positive effects on the probability of winning (shot, shot on target, shot from counter attack, shot from inside area, ball possession, short pass, average pass streak, aerial advantage, and tackle), four had clearly negative effects (shot blocked, cross, dribble and red card), other 12 variabless had either trivial or unclear effects. While for the 38 close games, the effects of aerial advantage and yellow card turned to trivial and clearly negative, respectively. In the La Liga, there was a moderate positive within-team effect from shots on target (3.4 extra wins per 10 matches; 99% confidence limits ±1.0), and a small positive within-team effect from total shots (1.7 extra wins; ±1.0). Effects of most other match events were related to ball possession, which had a small negative within-team effect (1.2 extra losses; ±1.0) but a small positive between-team effect (1.7 extra wins; ±1.4). Game location showed a small positive within-team effect (1.9 extra wins; ±0.9). Results from the established performance profiles and modelling can provide detailed and straightforward information for training, pre-match preparations, in-match tactical approaches and post-match evaluations, as well as for player identification and development. 摘要 比赛表现分析在现代足球中起着举足轻重的作用。尽管如今对足球比赛表现分析的研究已经相对完善，但仍有很多不足之处。这些不足主要体现在：研究中缺乏对研究变量的清晰定义、数据信效度缺失、研究结果的实用性受限、比赛情境因素缺失以及过于集中在描述性和对比性分析等。针对这些问题，本论文通过六个独立而又相互联系的研究，进一步对足球比赛表现分析进行完善。 第一个研究对本论文的数据源--OPTA Sportsdata公司的足球比赛数据的信效度进行了实验检验。实验中，两组数据收集人员被要求对同一场西班牙足球甲级联赛的比赛进行分析。研究结果显示，两组收集人员记录下的球队比赛事件和守门员比赛行为具有高度的一致性(卡帕系数介于0.86和0.94)。收集人员输出的外场球员的比赛行为和比赛事件也具有很高的组间一致性(ICC相关系数介于0.88和1.00，标准化典型误差介于0.00和0.37)。实验结果证明了OPTA Sportsdata公司收集的足球比赛数据具有足够高的信效度。 第二、三、四个研究旨在提升足球比赛表现分析研究结果的实用性以及深度探讨比赛情境因素对足球比赛表现的影响。通过对足球运动员和运动队的比赛技战术表现进行档案创建，可以对运动员和运动队的比赛表现进行简直接而直观的呈现、评价和对比，同时，情境变量(比赛场地、球队和对手实力、比赛结果)对比赛表现的影响也可以被整合到表现档案中。本部分对2012-13赛季西班牙足球甲级联赛的参赛守门员(n = 46球员人次，744比赛场次)和外场球员(n = 409球员人次, 5288比赛场次)以及2009-10至2012-13赛季欧洲足球冠军联赛的参赛球队(n = 496比赛场次)的比赛技战术表现进行了档案创建。在表现档案中，各项比赛技战术指标的均值、标准差、中位数和大小四分位数被用来展现守门员、外场球员和球队的普遍表现和表现浮动性。方差分析(ANOVA)被用来对西甲不同水平球队的守门员、欧冠中不同水平球队在不同比赛情境下的普遍表现(各项指标的均值)进行对比，独立样本t检验被用来对比主客场比赛普遍表现的差异。数据量级推断(magnitude-based inferences)的方法则被用来对西甲前三名和最后三名球队外场球员的普遍表现进行对比分析。所有来自不同水平球队的运动员和不同水平运动队的各项比赛指标皆被转换成了标准分数，从而能把他们在各种不同比赛情境下的普遍表现(各项比赛指标的均值)投到相同的雷达图中进行直观的对比。 第五和第六个研究目的在于进行预测性足球比赛表现分析，从而跨越之前固有的描述性和对比性分析。广义线性模型和广义混合线性模型被用来对2014年巴西世界杯小组赛(n = 48 比赛场次，38小分差场次)和2012-13赛季西甲联赛(n = 320小分差场次)的比赛中各表现相关比赛事件、行为和变量与比赛结果(胜、平、负)的关系进行建模。模型中的关系通过数据量级推断(magnitude-based inferences)的方法来界定，具体表现为某个变量增加两个标准差对比赛结果的影响(每10场比赛中额外取胜或失利的场数)。研究结果显示，在2014年巴西世界杯小组赛的所有48场比赛中，9个变量(射门、射正、反击中射门、禁区内射门、控球、短传、连续传球平均次数、高空球争抢成功率和抢断)与赢球概率有清晰的正相关关系，4个变量(射门被封堵、传中、过人和红牌)与赢球概率有清晰的负相关关系，其他12个被分析的变量与赢球概率的相关关系微小或不清晰。而在38场小分差比赛中，高空球争抢成功率由正相关变为微小关系，黄牌则由微小关系变为清晰的负相关。在西甲联赛中，每一支球队增加两个标准差的“射正球门”可以给每10场比赛带来3.4场额外胜利(99%置信区间±1.0场)，而所有球队作为一个整体，每增加两个标准差的“射正球门”可以给每10场比赛带来1.7场额外胜利(99%置信区间±1.0场)。其他大多数比赛相关事件与比赛结果的相关关系与“控球”相关联。每一支球队增加两个标准差的“控球”将会给每10场比赛带来1.2场额外失利(99%置信区间±1.0场)，而所有球队作为一个整体，每增加两个标准差的“控球”可以给每10场比赛带来1.7场额外胜利(99%置信区间±1.4场)。与客场比赛相对，主场能给球队带来1.9 /10场额外胜利(99%置信区间±0.9场)。 比赛表现档案和模型中得出的研究结果可以为俱乐部、足球队、教练组、表现分析师和运动员提供详细而直接的参考信息。这些信息可用于训练指导、赛前备战、赛中技战术调整和赛后技战术表现分析，也可运用于足球运动员选材、培养和发展。

Adverse drug reaction teaching in UK undergraduate medical and pharmacy programmes

Objectives: To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy. Methods: A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK. Results: The majority of undergraduate syllabuses feature the Yellow Card Scheme. Knowledge of the Yellow Card Scheme was assessed in 79% of pharmacy programmes and 57% of medical schools. Specialist speakers on the Yellow Card Scheme were infrequently used. Fewer than half of respondents provided students with a guide to reporting ADRs (43% pharmacy and 43% medical). There is some disagreement about the value of supplying students with printed material about the Yellow Card Scheme. Half of medical Schools did not think that supplying 'Current Problems In Pharmacovigilance' would be useful. Conclusions: It was found that in both medicine and pharmacy, courses differed substantially in teaching about the Yellow Card Scheme and adverse drug reactions (ADRs). There is scope for increased involvement of the Medicines and Healthcare products Regulatory Agency in undergraduate education, in line with recommendations from the National Audit Office.

Correlates of spontaneous reporting of adverse drug reactions within primary care: the paradox of low prescribers who are high reporters

AIM(S) To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance. METHODS PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drugs (‘top drugs’). PCT data, adjusted for population size, were aggregated. Prescribing statistics and other characteristics were obtained for each PCT, and associations between these characteristics and ADR reporting rates were examined. RESULTS During 2004–06, 1175 reports were received from PCTs. Two hundred and eighty (24%) of these reports were for 14 ‘top drugs’. The mean rate of reporting for PCTs was 213 reports per million population. A total of 153 million items were prescribed during 2004–06, of which 33% were ‘top drugs’. Reports for all drugs and ‘top drugs’ were inversely correlated with the number of prescriptions issued per thousand population (rs = -0.413, 95% CI -0.673, -0.062, P < 0.05, and r = -0.420, 95% CI -0.678, -0.071, P < 0.05, respectively). Reporting was significantly negatively correlated with the percentages of male GPs within a PCT, GPs over 55 years of age, single-handed GPs within a PCT, the average list size of a GP within a PCT, the overall deprivation scores and average QOF total points. ADR reports did not correlate significantly with the proportion of the population over 65 years old. CONCLUSIONS Some PCT characteristics appear to be associated with low levels of ADR reporting. The association of low prescribing areas with high ADR reporting rates replicates previous findings.

The pharmacist's contribution towards monitoring and reporting adverse drug reactions

The activities and function of the West Midlands Adverse Drug Reaction Study Group are described. The impact of the Group on the reporting of adverse drug reactions to the CSM by the yellow card system has been evaluated in several ways including a comparison with the Trent Region. The role of the pharmacist in the Group is highlighted. A nationwide survey of the hospital pharmacist's involvement in adverse drug reaction reporting and monitoring is described, the results are reported and discussed. The available sources of information on adverse drug reactions, both primary and secondary, are critically reviewed. A checklist of necessary details for case reports is developed and examples of problems in the literature are given. The contribution of the drug information pharmacist in answering enquiries and encouraging reporting is examined. A role for the ward pharmacist in identifying, reporting, documenting and following up adverse drug reactions is proposed. Studies conducted to support this role are described and the results discussed. The ward pharmacist's role in preventing adverse drug reactions is also outlined. The reporting of adverse drug reactions in Australia is contrasted with the U.K. and particular attention is drawn to the pharmacist's contribution in the former. The problems in evaluating drug safety are discussed and examples are given where serious reactions have only been recognised after many patients have been exposed. To remedy this situation a case is made for enhancing the CSM yellow card scheme by further devolution of reporting, increasing the involvement of pharmacists and improving arrangements at the CSM. It is proposed that pharmacists should undertake the responsibility for reporting reactions to the CSM in some instances.

A patient's perspective:the impact of adverse drug reactions on patients and their views on reporting

What is known and objective: Adverse drug reactions to prescribed medication are relatively common events. However, the impact such reactions have on patients and their attitude to reporting such events have only been poorly explored. Previous studies relying on self-reporting patients indicate that altruism is an important factor. In the United Kingdom, patient reporting started in 2005; though, numbers of serious reports remain low. Method: A purposive sample of fifteen patients who had been admitted to an inner city hospital with an adverse drug reaction were interviewed using a semi-structured questionnaire. Patients were asked to relate in their own words their experience of an adverse drug reaction. Patient's reactions to the information leaflet, adherence to treatment and use of other sources of information on medication were assessed. Interviews were recorded, and a thematic analysis of patients'responses was performed. Results and discussion: Analysis of the patient interviews demonstrated the reality of being admitted to hospital is often a frightening process with a significant emotional cost. Anger, isolation, resentment and blame were common factors, particularly when medicines had been prescribed for acute conditions. For patients with chronic conditions, a more phlegmatic approach was seen especially with conditions with a strong support networks. Patients felt that communication and information should have been more readily available from the health care professional who prescribed the medication, although few had read the patient information leaflet. Only a minority of patients linked the medication they had taken to the adverse event, although some had received false reassurance that the drug was not related to their illness creating additional barriers. In contrast to previous studies, many patients felt that adverse drug reporting was not their concern, particularly as they obtained little direct benefit from it. The majority of patients were unaware of the Yellow Card Scheme in the UK for patient reporting. Even when explained, the scheme was felt too cold and impersonal and not a patient's 'job'. What is new and conclusion: Patients having a severe adverse drug reaction following an acute illness felt negative emotions towards their health care provider. Those with a chronic condition rationalized the event and coped better with its impact. Neither group felt that reporting the adverse reaction was their responsibility. Encouraging patients to report remains important but expecting patients to report solely for altruistic purposes may be unrealistic. © 2011 Blackwell Publishing Ltd.

Place Card - Girl in Blue Dress on Yellow Chest

A place card with an illustration of a girl in a blue dress sitting on a yellow chest.

Place Card - Girl in Red Dress on Yellow Chest

A place card with an illustration of a girl in a red dress sitting on a yellow chest.

Dynamic and steady: shear rheological properties of xanthan and guar gums dispersed in yellow passion fruit pulp (Passiflora edulis f. flavicarpa)

Yellow passion fruit pulp is unstable, presenting phase separation that can be avoided by the addition of hydrocolloids. For this purpose, xanthan and guar gum [0.3, 0.7 and 1.0% (w/w)] were added to yellow passion fruit pulp and the changes in the dynamic and steady - shear rheological behavior evaluated. Xanthan dispersions showed a more pronounced pseudoplasticity and the presence of yield stress, which was not observed in the guar gum dispersions. Cross model fitting to flow curves showed that the xanthan suspensions also had higher zero shear viscosity than the guar suspensions, and, for both gums, an increase in temperature led to lower values for this parameter. The gums showed different behavior as a function of temperature in the range of 5 - 35ºC. The activation energy of the apparent viscosity was dependent on the shear rate and gum concentration for guar, whereas for xanthan these values only varied with the concentration. The mechanical spectra were well described by the generalized Maxwell model and the xanthan dispersions showed a more elastic character than the guar dispersions, with higher values for the relaxation time. Xanthan was characterized as a weak gel, while guar presented a concentrated solution behavior. The simultaneous evaluation of temperature and concentration showed a stronger influence of the polysaccharide concentration on the apparent viscosity and the G' and G" moduli than the variation in temperature.

Genetic evaluation of the mating system in the blue-and-yellow macaw (Ara ararauna, Aves, Psittacidae) by DNA fingerprinting

More than 90% of birds are socially monogamous, although genetic studies indicate that many are often not sexually monogamous. In the present study, DNA fingerprinting was used to estimate the genetic relationships between nestlings belonging to the same broods to evaluate the mating system in the socially monogamous macaw, Ara ararauna. We found that in 10 of 11 broods investigated, the nestlings showed genetic similarity levels congruent with values expected among full-sibs, suggesting that they shared the same parents. However, in one brood, the low genetic similarity observed between nestlings could be a result of intraspecific brood parasitism, intraspecific nest competition or extra-pair paternity. These results, along with available behavioral and life-history data, imply that the blue-and-yellow macaw is not only socially, but also genetically monogamous. However, the occurrence of eventual cases of extra-pair paternity cannot be excluded.

Biotin-avidin sandwich elisa with specific human isotypes IgG1 and IgG4 for Culicidae mosquito blood meal identification from an epizootic yellow fever area in Brazil

With a view toward investigating the feeding behavior of Culicidae mosquitoes from an area of epizootic yellow fever transmission in the municipalities of Garruchos and Santo Antônio das Missões, Rio Grande do Sul State, Brazil, specimens were collected by aspiration from September 2005 to April 2007. The engorged females were submitted to blood meal identification by enzyme-linked immunosorbent assay (ELISA). A total of 142 blood-engorged samples were examined for human or monkey blood through species-specific IgG. Additional tests for specificity utilizing isotypes IgG1 and IgG4 of human monoclonal antibodies showed that only anti-human IgG1 was effective in recognizing blood meals of human origin. The results indicated a significant difference (p = 0.027) in detection patterns in samples of Haemagogus leucocelaenus recorded from human blood meals at Santo Antônio das Missões, which suggests some degree of exposure, since it was an area where epizootic outbreaks have been reported.

Circulation of antibodies against yellow fever virus in a simian population in the area of Porto Primavera Hydroelectric Plant, São Paulo, Brazil

Yellow fever (YF) is an acute viral infectious disease transmitted by mosquitoes which occurs in two distinct epidemiological cycles: sylvatic and urban. In the sylvatic cycle, the virus is maintained by monkey's infection and transovarian transmission in vectors. Surveillance of non-human primates is required for the detection of viral circulation during epizootics, and for the identification of unaffected or transition areas. An ELISA (enzyme-linked immunosorbent assay) was standardized for estimation of the prevalence of IgG antibodies against yellow fever virus in monkey sera (Alouatta caraya) from the reservoir area of Porto Primavera Hydroelectric Plant, in the state of São Paulo, Brazil. A total of 570 monkey sera samples were tested and none was reactive to antibodies against yellow fever virus. The results corroborate the epidemiology of yellow fever in the area. Even though it is considered a transition area, there were no reports to date of epizootics or yellow fever outbreaks in humans. Also, entomological investigations did not detect the presence of vectors of this arbovirus infection. ELISA proved to be fast, sensitive, an adequate assay, and an instrument for active search in the epidemiological surveillance of yellow fever allowing the implementation of prevention actions, even before the occurrence of epizootics.

Circulation of antibodies against yellow fever virus in a simian population in the area of Porto Primavera hydroeletric plant, São Paulo, Brazil

A febre amarela (FA) é doença infecciosa aguda de origem viral transmitida por mosquitos. No ciclo silvestre, o vírus é mantido por meio da infecção de macacos e da transmissão transovariana nos vetores. A vigilância sobre populações de primatas não humanos torna-se necessária para detectar a circulação viral, quando ainda está restrito a epizootias, e para determinar sua presença em regiões indenes ou de transição para a doença. Padronizou-se a técnica ELISA (Enzyme Linked Immunosorbent Assay) para determinar a prevalência de anticorpos da classe IgG contra o vírus da FA em soros de bugios (Alouatta caraya) da região do reservatório da Usina Hidrelétrica de Porto Primavera, SP. Foram testados soros de 570 macacos sendo que nenhuma amostra mostrou-se reativa para a presença de anticorpos contra o vírus da FA. Os resultados são coerentes com a epidemiologia da FA na região. Mesmo sendo área de transição, não se conhece, até o momento, ocorrência de epizootia ou surto de FA em humanos e investigações entomológicas não apontaram a presença de vetores para esta arbovirose. A técnica mostrou-se sensível, rápida e útil à vigilância epidemiológica como instrumento de busca ativa permitindo desencadear ações preventivas, como vacinação, antes mesmo do surgimento de epizootias