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PubMed2001

Epidemic of jungle yellow fever in Brazil, 2000: implications of climatic alterations in disease spread.

Seventy-seven human cases of sylvatic yellow fever were reported in Brazil during the period January-June 2000. The first cases were reported 1 week after New Year's day and originated at Chapada dos Veadeiros, a tourist canyon site in Goiás state, near Brasília, the Brazilian capital. The laboratory procedures used for diagnoses included serology with an IgM capture assay and plaque reduction neutralization test, virus isolation in suckling mice and C6/36 cells, and immunohistochemistry. All cases were diagnosed by at least two different laboratory procedures, with the exception of the first three fatal cases, which were diagnosed on the basis of clinical and epidemiological information. The cases were reported in eight Brazilian states as follows: Goiás with 64.9% (50 cases); Amazonas (1); Bahia (10); Distrito Federal (1); Mato Grosso (4); Minas Gerais (2); Pará (1); São Paulo (2); and Tocantins (6). Patient ages were within the following ranges: 13-74 years old (mean 34.3), 64 (84.4%) were male, especially agricultural workers (n = 30), but tourists (n = 11), carpenters (n = 4), fishermen (n = 4), students (n = 3), truck drivers (n = 3), and other people (n = 22) were also sickened. The case fatality rate was 50.6% (39/77). In Bahia state, a serologic survey that was carried out has suggested a symptomatic/asymptomatic coefficient of 1:4. Field studies developed in Distrito Federal, Goiás, and São Paulo states showed that Haemagogus janthinomys was the mosquito species associated with the transmission. A single strain was also obtained from Aedes scapularis in Bahia. Epizootic occurrence (monkey mortality) was observed in 49 municipalities mainly in Goiás state, where 40 municipalities made reports, 21 of which also diagnosed human cases. Data obtained by the National Institute of Meteorology in Brazil showed an increase in temperature and rain in December 1999 and the first 3 months of 2000 in Goiás and surrounding states, which perhaps has contributed to the intense and widespread transmission of the yellow fever virus. The relatively small number of cases probably reflects the extensive use of yellow fever 17D-vaccine during the last 3 years, in which about 45 million doses were used. During the last months of 1999, 16 and 11 yellow fever cases were reported in Tocantins and Goiás states, respectively. It is noteworthy that the last reported autochthonous cases of sylvatic yellow fever in São Paulo and Bahia, both states outside the endemic/enzootic area, had occurred in 1953 and 1948, respectively.

Adolescent↗
PubMedDate not supplied

[Pharmaceutical patents and the accessibility of drugs in Brazil].

Passage of Patent Law 9279/96, in effect since April 1997, has made relations between pharmaceutical patents and accessibility to medicine in Brazil complex. Under the new law, patents may extend to chemical inventions (products and process) and transgenic microorganisms. The issue is analyzed from two specific yet inter-related approaches: science and technology policy and health-care policy. The conclusion draws attention to the main future consequences of current international trends, both legal and regulatory. Brazil should ready its legal framework to respond to the negative consequences that genome patenting can be expected to have on the flow of scientific information and on access to pharmaceutical drugs.

Brazil↗
PubMed1975

Genetics of acheiropodia (the handless and footless families of Brazil). VII. Population dynamics.

Since carriers of the acheiropodia gene cannot be distinguished from noncarriers, parents and normal sibs of affected individuals have been used to estimate the fitness of heterozygotes. No significant difference in biologic fitness (viability and fertility) between normal sibs and the general population could be detected. A comparison between acheiropods and their normal sibs showed the following: (1) a nonsignificant difference in stillbirth rate; (2) a higher mortality rate of acheiropods in the first 5 years of life; (3) a relative viability not larger than .7; (4) a relative fertility no greater than .14, due to "cosmetic effects"; and (5) a fitness of .10 or lower. The total number of acheiropodia genes in Brazil has been calculated as 25,000 in the 1970s. The data are compatible with an extremely low mutation rate and a very stable locus. It is suggested that all Brazilian acheiropods can be traced to a single mutation. A conservative estimate of the number of acheiropods to appear in the future in Brazil is 14,000 with an extinction time of no less than 2,300 generations or almost 70,000 years. A variety of other parameters have been calculated.

Abnormalities, Multiple↗
PubMed1998

[Pavie: one of the pioneers of modern medicine in Brazil].

This is a brief biography and analysis of Pavie's medical work, who at the beginning of our century, practiced medicine in the broad area of Minas Gerais (Brazil). As a consequence of his great professional activity and correspondence with European medical centres, he developed a highly sophisticated practice of medicine for the time, in a poor region far from any brazilian urban centres resources. The success of Pavie's innovative work became one of the first accounts of true modern medical pioneering in Brazil.

Brazil↗
PubMed2001

[Yellow fever epidemiology in Brazil].

We have carried out a meticulous time-space-analysis of the incidence of yellow fever in humans in Brazil from 1954 to 1972 and especially from 1973 to 1999. This study has added to our knowledge of the epidemiology of yellow fever and enabled us to redefine epidemiological zones and determine their geographical limits. The endemic area is located within the Amazon basin; here cases are scattered and generally limited in number. However, there are also "foci of endemic emergence" within this area, where cases are less rare, although occurrence remains irregular. The epidemic area is for the most part situated outside the Amazon basin, to the north east and particularly to the south. It has been divided into two parts according to whether the occurrence of yellow fever is cyclic or sporadic. The epidemics, which are all sylvatic, follow either a circular path (in the forest area) or a linear path (in forest-galleries of the savannah area). The study of the development of the 3 main epidemics (1972-74; 1979-82; 1986-92) in the cyclic emergence area showed that, on each occasion, the yellow fever virus appeared at a particularly active outbreak site located in the "serra dos Carajás", and from there, it followed the courses of the Tocantins and Araguaia rivers upstream, moving southwards during the "pre-epidemic phase" which may be visible due to the occurrence of a few cases, or may remain invisible. Subsequently the virus reached the emergence area, where it appeared in the form of epidemics. In this zone, it also followed privileged south-western pathways, moving from one hydraulic basin to another along the upstream courses of the rivers. Almost exactly the same pathways have been identified for each of the 3 epidemics studied. The distances travelled by the virus over a period of one year--when it goes rapidly--can reach several hundred kilometers. On the other hand, it may be stationary for a period of one or two consecutive years, occasionally three, remaining present in the area but infecting humans only rarely if at all. The virus occasionally leaves the cyclic emergence area and appears in the sporadic emergence area to the east, in the states of Bahia, Minas Gerais and São Paulo, and, as a consequence, moving onto other hydraulic basins. The small river basins in Maranhão and NorthWest states, as well as in the northern part of the state of Roraima also form part of the sporadic emergence area. The epidemics that occur here are directly linked to the endemic area and are only preceded by sometimes indiscernible epizootics and can consequently not be foreseen. Again the virus appears to use privileged pathways to reach the sporadic emergence areas where human and monkey populations are generally only partially immunised against yellow fever and where contact with mosquitoes is intense despite the fact it is limited in space and time, being restricted to the often narrow strip of trees along the water courses. Other routes used by the virus may be the Madeira, Xingu and Tapajós rivers, the scene of outbreaks observed in the state of Rondônia and in the north of Mato Grosso, where ongoing environmental changes are likely to result in an increasing number of outbreaks in the coming years. Since the discovery of the sylvatic cycle of yellow fever in 1933, not only the extent of the epidemiological areas has changed, but also their limits. Ecological modifications that are currently taking place in the Amazon basin, which is an endemic reservoir of the virus, will inevitably facilitate an increase the contact between humans and vectors. While more and more urban areas harbour populations of Aedes aegypti, the domestic and urban vector of yellow fever, it is particularly important to try to protect human populations living in emergence zones and epidemic areas and thus to prevent the arrival of the virus in towns via humans with viremia--in other words the much feared urbanisation of yellow fever in Brazil.

Aedes↗
PubMedDate not supplied

[Rural work-related accidents in Pelotas, Rio Grande do Sul State, Brazil: a population-based cross-sectional study].

Epidemiological literature on occupational accidents among rural workers is scarce in Brazil. This population-based cross-sectional study was designed to investigate the characteristics of farming accidents occurring in the rural area of Pelotas, Southern Brazil. A multi-stage sampling scheme was used to select a representative sample of farms. From January to April 1996, a total of 258 rural families were visited, and all 580 rural workers identified in these families answered a standardized questionnaire. Sixty-three rural workers (11%) reported at least one work-related accident in the previous twelve months. There were 82 accidents during the study period, mainly related to the use of hand farm tools (29%) and handling farm animals (27%). The main types of injuries were cuts (50%), bruises (13%), and burns (9%). The body areas most frequently involved were hands (34%), feet (29%), and legs (18%). Among the injured rural workers, only 32% used health services to treat the resulting lesions (46% went to primary health care facilities and 36% to emergency services).

Accidents, Occupational↗
PubMed2002

Human responses to the threat of or exposure to ionizing radiation at Three Mile Island, Pennsylvania, and Goiania, Brazil.

The psychological stressors and their aftereffects associated with the Three Mile Island accident, the Goiania, Brazil, cesium-137 accident, and the Abadia, Brazil, storage location are summarized and compared. Cross-cultural comparisons of human responses to ionizing radiation are rare. A multidisciplinary methodological approach to examining the psychological responses to ionizing radiation is even more rare. The psychological, behavioral, neuroendocrine, and cardiovascular results are summarized for Three Mile Island, Goiania, and Abadia.

Brazil↗
PubMed2002

Association of severe noncerebral Plasmodium falciparum malaria in Brazil with expressed PfEMP1 DBL1 alpha sequences lacking cysteine residues.

BACKGROUND: Cytoadherence and rosetting contribute to the development of severe Plasmodium falciparum malaria. In Brazil,severe falciparum malaria is mostly associated with renal or pulmonary complications and very rarely with cerebral malaria. The most N-terminal DBL1 alpha domain of PfEMP1, a protein encoded by the var multigene family mediates rosetting. We analyzed parasites of Brazilian patients with severe malaria to determine whether there were particular DBL1 alpha var sequences predominantly expressed in such patients. MATERIALS AND METHODS: DBL1 alpha var sequences were obtained from parasites of Brazilian patients with severe and mild malaria and were analyzed by standard bioinformatic programs. Three hundred twenty var DBL1 alpha sequences obtained from 80 Brazilian patients with mild malaria were spotted in high-density filters and hybridized to probes representing predominantly expressed sequences in parasites from patients with severe malaria. A DBL1 alpha domain was expressed in bacteria and used to demonstrate its binding capacity to erythrocytes by immunofluorescence. RESULTS: Forty-three different and unreported DBL1 alpha amino acid sequences were obtained. Sequences predominantly expressed in patients with severe malaria could be subgrouped due to deletions of 1-2-cysteine residues. These sequences were commonly found in the var gene repertoire of parasites from patients with mild malaria, yet they were rarely expressed in these patients. A recombinant protein representing the most abundantly expressed sequence detected in one patient with severe malaria bound directly to uninfected erythrocytes. CONCLUSIONS: This is the first report showing an association of severe noncerebral malaria from Brazil with particular DBL1 alpha sequences.

Adolescent↗
PubMed2002

Cholera in Brazil during 1991-1998: socioeconomic characterization of affected areas.

The paper describes the trends in, and spatial patterns of, the incidence of cholera in Brazil from 1991 to 1998. During this period, 161,432 cases and 1,296 deaths from cholera were reported. The poorest (North and Northeast) regions of the country had the highest morbidity and mortality rates. The remaining regions had self-limited outbreaks. Seventy-eight percent of affected municipalities had populations of fewer than 30,000, and about 65% of them lived in rural areas. The affected municipalities of the North and Northeast regions had consistent indications of deprivation: average Human Development Index was 0.41, infant mortality rate 90.3%, average life expectancy 59.4 years, and adult illiteracy rate 46.5%. The epidemiological profile of the disease in Brazil highlights intra- and inter-regional socioeconomic differentials in the country and indicates the importance of planning and implementing public-health interventions and specific policies aimed at reducing health inequalities.

Brazil↗
PubMedDate not supplied

Involvement and fragmentation: a study of parental care of hospitalized children in Brazil.

Parental involvement in the care of children who are hospitalized has been encouraged by the government in Brazil, as it has in the United Kingdom (UK). In this paper, key aspects of the UK, North American, and Latin American literature concerning parental participation are discussed, and implications for hospital care of children in Brazil are considered. A study of the division of work between nurses and the mothers (or other relatives) of 10 children hospitalized with chronic illnesses is reported. Data were collected by participant observation of child care in a Brazilian hospital. The results highlight some of the difficulties that arise in the integration of the work of mothers and nurses in hospital care of children and the fragmentation of care into "manual" and "intellectual" work. The results are considered within the theoretical framework of the model of technologic organization of work (Gonçalves, 1979, 1994). Implications for the organization of child care in the hospital are discussed.

Attitude of Health Personnel↗
PubMedDate not supplied

Occupational health in Brazil.

In a positive approach, the authors propose that occupational safety and health in Brazil is an example of how crises and opportunities can come together to produce excellent results. The history provided here as well as the overview of occupational health problems in Brazil together offer a detailed picture of conditions in this country. Also included is a lengthy table covering OSH steps, strategies, and approaches; national needs; and suggestions for international assistance.

Agriculture↗
PubMed2001

Upward trend in the rate of detection of new cases of leprosy in the State of Bahia, Brazil.

BACKGROUND: The worldwide fall in the rate of detection of new cases of leprosy has been partly attributed to the introduction of multidrug therapy and other improvements in control programs. However, the rate of detection of new cases has not decreased in Brazil. METHODS: An analysis was made of the temporal distribution of 18,872 newly reported leprosy cases in Bahia, Brazil, from 1974 to 1997. Population denominators for the annual detection rate were obtained from population estimates based on the national census. Trends were presented by sex, date of birth, date of diagnosis, date of release, clinical form and by residence in areas which had notified cases in the 5 years prior to the rise in detection rate. RESULTS: There was a marked increase in the new case detection rate (NCDR) in the State of Bahia, from 0.19 to 1.43 cases per 10,000 inhabitants during the study period, an increment of nearly 7% to 8% per year. This increase was also observed in people aged 14 years and younger. During this period tuberculoid and indeterminate forms have become predominant among women and younger people. The average age of male cases has shifted toward younger ages. CONCLUSIONS: We interpret this pattern to mean that the increase in NCDR reflects a real increase in incidence of leprosy, whether or not accompanied by improved detection.

Adolescent↗
PubMed2002

Dengue virus infection of the central nervous system (CNS): a case report from Brazil.

Dengue infection that is accompanied by unusual complications has been described in Brazil. We report on the presence of dengue virus in the central nervous system (CNS) of a patient who died in 1998 in Rio Grande do Norte, northeast Brazil. DEN-2 viruses were isolated from the brain liver, and lymphnode tissue of a 67-year-old man whose signs and symptoms were those of dengue infection and a secondary immune response. A postmortem revealed nose bleeds a liver that was brownish with yellow areas, and pulmonary and cerebrae congestion. Immunoperoxidase staining showed a dengue antigen-specific positive reaction in the gray matter cells of the cerebrall cortex; a granular citoplasmatic reaction was seen in the neurons. Dengue infection should always be considered as a cause encephalitis in tropical countries, especially in those where the disease is endemic.

Aged↗
PubMed2002

Acquired immunodeficiency syndrome in Brazil.

AIM: To describe the acquired immunodeficiency syndrome (AIDS) epidemic in Brazil and analyze the impact of federal government measures addressing the problem since its onset. METHOD: Retrospective review of AIDS epidemic data from its onset in 1980 up to the last published data in June 2001. RESULTS: AIDS was first reported in Brazil in 1980. By 1988, all 27 Brazilian states had diagnosed cases, and until June 2000 more than half of Brazilian municipalities had recorded at least one case of the disease. The AIDS incidence reached its peak between 1996 and 1997 (14.7 per 100,000 population), and then declined between 1998 and 2000 to 9 per 100,000 population. In the last two decades, the proportion of deaths has been also significantly reduced. These were not random events, but reflected the efficiency of the program implemented by the Brazilian Health Ministry's Coordination on Sexually Transmitted Diseases and AIDS. The program includes an epidemiological surveillance modeling system, which records cases from several regular epidemiological bulletins; national network of diagnosis and monitoring of HIV-infected individuals (ill or not); highly active antiretroviral therapy available free to all patients; mother-infant protection program; educational programs on condom use; the introduction of the female condom; development of AIDS studies in different areas to provide practical solutions; constant preoccupation about drug costs accounting for the patent breaking; and national production of many drugs currently in use. CONCLUSION: Well-planned and implemented national program against AIDS can significantly reduce the burden of this disease to the population.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Lepidoptera pests collected in Eucalyptus urophylla (Myrtaceae) plantations during five years in Três Marias, State of Minas Gerais, Brazil.

Lepidoptera pest species from eucalyptus were collected in Eucalyptus urophylla plantations in the region of Três Marias, State of Minas Gerais, Brazil, every 15 days from June 1989 to June 1994 with five light traps. Twelve primary and 15 secondary pest species were collected in the period with an average of 13,387 and 812 individuals per light trap, respectively. Most collected primary pest species were Stenalcidia grosica (Geometridae), Iridopsis subferaria (Geometridae), Eupseudosoma aberrans (Arctiidae) and Psorocampa denticulata (Notodontidae), totalizing for the study period an average of 5,450, 2,162, 2,436 and 1,458 individuals per light trap, respectively. Idalus admirabilis (Arctiidae) was the most collected secondary pest species, averaging 652 individuals/trap. Most primary pest species were collected during the dry season, from April to July, whereas most secondary pest species were collected during the rainy season, from January to March. These differences on seasonal occurrence between the two groups could be due to the fact that many secondary pest species of Eucalyptus in Brazil pupate in the soil, and they need humidity to complete its pupal stage.

Animals↗
PubMed2002

Detection and genotyping of astroviruses from children with acute gastroenteritis from Goiânia, Goiás, Brazil.

BACKGROUND: The astroviruses constitute important agents of childhood diarrhea. The purpose of our research was to detect and genotype astroviruses in fecal samples from children with acute gastroenteritis from Goiânia- Goiás, Brazil. MATERIAL/METHODS: The samples were collected from children up to five years of age with acute gastroenteritis, hospitalized in two public hospitals in Goiânia- Goiás, a city located in the West Central region of Brazil. A total of 516 fecal samples were collected from March 1998 to March 2000. These samples were first screened for rotavirus and adenovirus by an enzyme immunoassay (EIARA) and by PAGE for the detection of rotaviruses. In all samples negative for both viruses (n=351) the presence of astrovirus was investigated by reverse-transcription-polymerase chain reaction (RT-PCR). RESULTS: 2.8% of the samples obtained from children up to two years of age were positive for astrovirus by RT-PCR, with an expected amplicon size of 449 bp. All positive samples, except one, were collected between October and December of 1998, which corresponds to the rainy season in the region (spring/early summer). Nested-PCR genotyping showed that all samples were genotyped and belonged to astrovirus genotype 1, presenting an amplicon band pattern of 212 bp. CONCLUSIONS: This study supports data from the literature about the occurrence of astrovirus in children with acute gastroenteritis. It also helps provide a better understanding of viral etiology in diarrhea.

Age Factors↗
PubMedDate not supplied

[The statistical system, planning, and society in Brazil (notes for discussion)].

"The main purpose of this article is to study the relationship between the Statistical System and Society in Brazil. The analysis of demographic data and information systems [is included].... In general, the question is seen in [a] historical and prospective approach....[The author also discusses] the information demand created by the New Constitution of 1988 in Brazil." (SUMMARY IN ENG)

Americas↗
PubMed2002

A new species of Scaris from southeastern Brazil, with notes on S. nessimiani and S. bahiensis (Homoptera: Cicadellidae).

A new leafhopper species, Scaris angrensis sp.nov., is described and illustrated based on an adult male from Angra dos Reis, State of Rio de Janeiro, southeastern Brazil. The holotype is deposited in the entomological collection of Museu Nacional, Universidade Federal do Rio de Janeiro, Brazil. The new species seems to be more closely related to S. bahiensis because of its single ventral process on the aedeagal base, being distinguished from that by the apical shape of the stylus. A problem related to the illustrations in the original description of S. nessimiani and S. bahiensis is herein corrected.

Animals↗