Análise da presença do Zika vírus em pacientes sintomáticos e sem sintomas clínicos para arboviroses
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Data
2019-02-25
Autores
Carvalho, Lucas Rodrigues de
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Universidade Estadual Paulista (Unesp)
Resumo
O Zika vírus (ZIKV), pertencente à família Flaviviridae, gênero Flavivirus, é um dos arbovírus transmitidos por mosquitos hematófagos do gênero Aedes. Durante a epidemia de Zika no Brasil foi observado um aumento de quase 20 vezes nos casos reportados de microcefalia em fetos, levando a OMS a declarar estado de emergência global. A expansão do Zika vírus (ZIKV) pelas Américas ressalta a importância da vigilância e monitoramento de doenças emergentes. Uma vez reportado que cerca de 80% das pessoas infectadas pelo vírus não apresentam sintomas, o presente estudo coletou amostras de soro e urina de pacientes sintomáticos e de urina de pacientes sem sintomas clínicos para arboviroses na Unidade de Pronto Atendimento do municipio de Mirassol/SP. As amostras de sangue e urina foram processadas no Laboratório de Estudos Genômicos (IBILCE/UNESP). Após a extração do RNA viral, elas foram testadas para presença de ZIKV por meio da técnica de RT-qPCR. As amostras positivas para ZIKV em soro foram avaliadas para coinfecção por DENV. Por meio de questionários, foram avaliados os sintomas apresentados pelos pacientes e construídos mapas georreferenciados para avaliar a distribuição do vírus. Dos 141 pacientes sintomáticos e dos 447 sem sintomas clínicos, 9,9% e 6,6% foram positivos para ZIKV, respectivamente. No total, a presença de ZIKV foi vista em 7,5% dos pacientes coletados, compreendidas em 32% no grupo de pacientes sintomáticos e 68% no grupo de sem sintomas clínicos. Dos pacientes avaliados para possível coinfecção, 8,7% apresentaram coinfecção por ZIKV/DENV-2. Os sintomas mais relatados pelos pacientes sintomáticos positivos para ZIKV foram dores musculares, dor nos olhos e febre. Os mapas georreferenciados revelaram que duas regiões compreenderam 46% dos casos positivos no município de Mirassol. O uso concomitante de amostras de soro e urina para diagnósticos de arboviroses são importantes para revelar casos positivos subnotificados em pacientes. Destaca-se a importância de um diagnóstico específico e laboratorial mais efetivo por meio da utilização de amostras de soro e urina de pacientes para revelar casos positivos sub-notificados em pacientes. Ademais, nossos dados são importantes para articulação e desenvolvimento de campanhas de vigilância, controle de vetores e de possíveis doenças associadas com o objetivo de prever novas emergências epidemiológicas no mesmo município e em municípios vizinhos.
Zika virus (ZIKV), family Flaviviridae, genus Flavivirus, is one of the arboviruses transmitted by hematophagous mosquitoes of the genus Aedes. During the Zika epidemic in Brazil an almost 20-fold increase was observed in reported cases of microcephaly in fetuses, leading to WHO declaring a state of global emergency. The expansion of the Zika virus (ZIKV) across the Americas underscores the importance of surveillance and monitoring of emerging diseases. Recent studies reported that about 80% of people infected with the virus do not present symptoms, thus the present study collected serum and urine samples from symptomatic and urine patients from patients with no clinical symptoms for arboviruses at the Emergency Care Unit in the municipality of Mirassol/SP. Blood and urine samples were processed in the Laboratory of Genomic Studies (IBILCE/UNESP). After extraction of viral RNA, they were tested for the presence of ZIKV by RT-qPCR reaction. ZIKV positive serum samples were also evaluated for DENV coinfection. Through questionnaires, the symptoms presented by the patients were evaluated and georeferenced maps were constructed to evaluate the distribution of the virus. Of the 141 symptomatic patients and 447 without clinical symptoms, 9.9% and 6.6% were positive for ZIKV, respectively. In total, the presence of ZIKV was seen in 7.5% of the patients collected, comprised in 32% of symptomatic patients and 68% of those without clinical symptoms. Of the patients evaluated for possible coinfection, 8,7% were coinfected with ZIKV/DENV-2. The most reported symptoms by symptomatic patients positive for ZIKV were muscle pain, eye pain and fever. The georeferenced maps revealed that two regions comprised 46% of the positive cases in the municipality of Mirassol. The concomitant use of serum and urine samples for arbovirus diagnoses are important to reveal underreported positive cases in patients. The importance of a more specific and laboratory diagnosis through the use of serum and urine samples from patients to reveal sub-notified positive cases in patients is emphasized. In addition, our data are important for articulation and development of surveillance campaigns, vector control and possible diseases associated with the objective of predicting new epidemiological emergencies in the same municipality and in neighboring municipalities.
Zika virus (ZIKV), family Flaviviridae, genus Flavivirus, is one of the arboviruses transmitted by hematophagous mosquitoes of the genus Aedes. During the Zika epidemic in Brazil an almost 20-fold increase was observed in reported cases of microcephaly in fetuses, leading to WHO declaring a state of global emergency. The expansion of the Zika virus (ZIKV) across the Americas underscores the importance of surveillance and monitoring of emerging diseases. Recent studies reported that about 80% of people infected with the virus do not present symptoms, thus the present study collected serum and urine samples from symptomatic and urine patients from patients with no clinical symptoms for arboviruses at the Emergency Care Unit in the municipality of Mirassol/SP. Blood and urine samples were processed in the Laboratory of Genomic Studies (IBILCE/UNESP). After extraction of viral RNA, they were tested for the presence of ZIKV by RT-qPCR reaction. ZIKV positive serum samples were also evaluated for DENV coinfection. Through questionnaires, the symptoms presented by the patients were evaluated and georeferenced maps were constructed to evaluate the distribution of the virus. Of the 141 symptomatic patients and 447 without clinical symptoms, 9.9% and 6.6% were positive for ZIKV, respectively. In total, the presence of ZIKV was seen in 7.5% of the patients collected, comprised in 32% of symptomatic patients and 68% of those without clinical symptoms. Of the patients evaluated for possible coinfection, 8,7% were coinfected with ZIKV/DENV-2. The most reported symptoms by symptomatic patients positive for ZIKV were muscle pain, eye pain and fever. The georeferenced maps revealed that two regions comprised 46% of the positive cases in the municipality of Mirassol. The concomitant use of serum and urine samples for arbovirus diagnoses are important to reveal underreported positive cases in patients. The importance of a more specific and laboratory diagnosis through the use of serum and urine samples from patients to reveal sub-notified positive cases in patients is emphasized. In addition, our data are important for articulation and development of surveillance campaigns, vector control and possible diseases associated with the objective of predicting new epidemiological emergencies in the same municipality and in neighboring municipalities.
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Zika vírus, ZIKV, sintomáticos, sem sintomas clínicos, sangue, urina, diagnóstico, coinfecção, symptomatic, without clinical symptoms, blood, serum, urine, diagnosis, coinfection, Zika virus, soro