Identificação da presença do vírus da dengue e do vírus Zika em amostras de soro e urina no município de Mirassol, São Paulo
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Data
2021-04-07
Autores
Conceição, Pâmela Jóyce Previdelli da
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Universidade Estadual Paulista (Unesp)
Resumo
As doenças transmitidas por vetores, tal como o Aedes aegypti causam um grande impacto na saúde pública. As arboviroses fazem parte desse grupo de doenças, afetando milhares de pessoas ao redor do mundo todos os anos. O vírus da dengue (DENV), um arbovírus do gênero Flavivirus, família Flaviviridae, é responsável por diversas epidemias e também por trazer complicações graves aos pacientes, que vão de quadros hemorrágicos a complicações orgânicas irreversíveis. Outro arbovírus do gênero Flavivirus de importância clínica é o Zika vírus (ZIKV), responsável pela epidemia no ano de 2015 no Brasil, trazendo consigo a Síndrome Congênita do Zika, que implicou no nascimento de centenas de crianças com microcefalia. Este estudo tem por objetivo avaliar a circulação de DENV e ZIKV no município de Mirassol-SP. Para este fim, foram coletadas amostras de voluntários presentes na Unidade de Pronto Atendimento de Mirassol (UPA-Mirassol) entre fevereiro de 2018 a abril de 2019. Os voluntários foram divididos em 2 grupos. Do primeiro grupo, composto por pacientes com suspeita clínica de arbovirose, foram coletadas amostras de soro e urina. O segundo grupo incluiu pacientes sem diagnóstico clínico de arboviroses e acompanhantes de pacientes da UPA, sendo coletadas apenas amostras de urina. Todos os voluntários preencheram questionários sobre a sintomatologia apresentada no momento da coleta. Após a extração do RNA, a investigação da presença dos vírus foi realizada por RT-qPCR. Ambas as amostras do grupo suspeito para arbovirose foram testadas para DENV e ZIKV enquanto as amostras de voluntários sem diagnóstico clinico para arbovirose e acompanhantes foram testadas apenas para ZIKV. Foram coletadas 697 amostras de urina dos indivíduos sem diagnóstico clínico de arboviroses e acompanhantes, dessas, 11,3% (79) foram positivas para ZIKV. Dentre os indivíduos positivos, 16,5% (13) eram acompanhantes e 83,5% (66) indivíduos sem diagnóstico clínico de arbovirose, sendo 59,5% (47) do gênero feminino. Do grupo de sintomáticos, foram coletadas 285 amostras de soro e 272 amostras de urina de 308 pacientes e desses 42,5% (131) foram positivos para DENV2, 0,3% (1) foi positivo para DENV1, 36% (111) foram positivos para ZIKV e 12,7% (39) estavam coinfectados com ZIKV/DENV2. Se apenas as amostras de soro tivessem sido usadas, a detecção de ZIKV teria caído para 24,7% (76/308). De todos os pacientes incluídos no estudo, apenas um tinha suspeita de infecção pelo ZIKV e os demais eram suspeitos de DENV de acordo com o diagnóstico clínico. Com isso, através do nosso estudo foi possível ver a importância da realização de um diagnóstico diferencial, utilizando amostras de soro e urina, diminuindo assim o número de casos positivos subnotificados.
Diseases transmitted by vectors, such as Aedes aegypti, have an impact on public health. Arboviruses are part of this group of diseases, affecting thousands of people around the world every year. The dengue virus (DENV), an arbovirus of the genus Flavivirus, family Flaviviridae, is responsible for several epidemics and for bringing complications to patients, ranging from hemorrhagic conditions to irreversible organic complications. Another arbovirus from the genus Flavivirus of clinical importance is the Zika virus (ZIKV), responsible for the 2015 epidemic in Brazil, bringing with it the Zika Congenital Syndrome, which caused the birth of a hundreds of children with microcephaly. This study aims to evaluate the circulation of DENV and ZIKV in the municipality of Mirassol-SP. For this purpose, samples were collected from volunteers in the Mirassol Emergency Care Unit (UPA-Mirassol) from February 2018 to April 2019. The volunteers were divided into two groups. From the first group, composed of patients with clinical hypothesis of arbovirusis, serum, and urine samples were collected. The second group included patients without a clinical diagnosis of arbovirusis and companions from patients attended at the UPA, with only urine samples collected. The volunteers completed questionnaires about the symptoms presented at the time of collection. After RNA extraction, the investigation of the presence of viruses was performed by RT-qPCR. Both samples from the group suspected for arbovirus infection were tested for DENV and, ZIKV while samples from volunteers without a clinical diagnosis for arbovirus and companions were tested only for ZIKV. Six hundred and ninety-seven urine samples were collected from individuals without a clinical diagnosis of arbovirosis and companions, of which 11.3% (79) were positive for ZIKV. Among positive individuals, 16.5% (13) are companions and, 83.5% (66) are individuals without a clinical diagnosis of arbovirosis, 59.5% (47) of whom are female. From the symptomatic group, 285 serum samples and 272 urine samples were collected from 308 patients, and from those, 42.5% (131) were positive for DENV2, 0.3% (1) was positive for DENV1, 36.4% ( 111) were positive for ZIKV and 12.5% (38) were co-infected with ZIKV / DENV2. If only serum samples had been used, ZIKV detection would have dropped to 24.7% (76/308). From all the patients included in the study only one was suspected of ZIKV infection and the remaining were suspected of DENV according to the clinical diagnosis. Thus, through our study, it was possible to see the importance of making a differential diagnosis using serum and urine samples so that there is a decrease in the number of underreported positive cases.
Diseases transmitted by vectors, such as Aedes aegypti, have an impact on public health. Arboviruses are part of this group of diseases, affecting thousands of people around the world every year. The dengue virus (DENV), an arbovirus of the genus Flavivirus, family Flaviviridae, is responsible for several epidemics and for bringing complications to patients, ranging from hemorrhagic conditions to irreversible organic complications. Another arbovirus from the genus Flavivirus of clinical importance is the Zika virus (ZIKV), responsible for the 2015 epidemic in Brazil, bringing with it the Zika Congenital Syndrome, which caused the birth of a hundreds of children with microcephaly. This study aims to evaluate the circulation of DENV and ZIKV in the municipality of Mirassol-SP. For this purpose, samples were collected from volunteers in the Mirassol Emergency Care Unit (UPA-Mirassol) from February 2018 to April 2019. The volunteers were divided into two groups. From the first group, composed of patients with clinical hypothesis of arbovirusis, serum, and urine samples were collected. The second group included patients without a clinical diagnosis of arbovirusis and companions from patients attended at the UPA, with only urine samples collected. The volunteers completed questionnaires about the symptoms presented at the time of collection. After RNA extraction, the investigation of the presence of viruses was performed by RT-qPCR. Both samples from the group suspected for arbovirus infection were tested for DENV and, ZIKV while samples from volunteers without a clinical diagnosis for arbovirus and companions were tested only for ZIKV. Six hundred and ninety-seven urine samples were collected from individuals without a clinical diagnosis of arbovirosis and companions, of which 11.3% (79) were positive for ZIKV. Among positive individuals, 16.5% (13) are companions and, 83.5% (66) are individuals without a clinical diagnosis of arbovirosis, 59.5% (47) of whom are female. From the symptomatic group, 285 serum samples and 272 urine samples were collected from 308 patients, and from those, 42.5% (131) were positive for DENV2, 0.3% (1) was positive for DENV1, 36.4% ( 111) were positive for ZIKV and 12.5% (38) were co-infected with ZIKV / DENV2. If only serum samples had been used, ZIKV detection would have dropped to 24.7% (76/308). From all the patients included in the study only one was suspected of ZIKV infection and the remaining were suspected of DENV according to the clinical diagnosis. Thus, through our study, it was possible to see the importance of making a differential diagnosis using serum and urine samples so that there is a decrease in the number of underreported positive cases.
Descrição
Palavras-chave
Zika vírus, ZIKV assintomático, Urina, Sem sintomas clínicos de arbovirose, ZIKV asymptomatic, Urine, No clinical symptoms of arboviruses