Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects.
BACKGROUND:In 2015, Brazil was faced with the cocirculation of three arboviruses of major public health importance. The emergence of Zika virus (ZIKV) presents new challenges to both clinicians and public health authorities. Overlapping clinical features between diseases caused by ZIKV, Dengue (DENV...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-04-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC4829157?pdf=render |
| _version_ | 1819092091161018368 |
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| author | Patrícia Brasil Guilherme Amaral Calvet André Machado Siqueira Mayumi Wakimoto Patrícia Carvalho de Sequeira Aline Nobre Marcel de Souza Borges Quintana Marco Cesar Lima de Mendonça Otilia Lupi Rogerio Valls de Souza Carolina Romero Heruza Zogbi Clarisse da Silveira Bressan Simone Sampaio Alves Ricardo Lourenço-de-Oliveira Rita Maria Ribeiro Nogueira Marilia Sá Carvalho Ana Maria Bispo de Filippis Thomas Jaenisch |
| author_facet | Patrícia Brasil Guilherme Amaral Calvet André Machado Siqueira Mayumi Wakimoto Patrícia Carvalho de Sequeira Aline Nobre Marcel de Souza Borges Quintana Marco Cesar Lima de Mendonça Otilia Lupi Rogerio Valls de Souza Carolina Romero Heruza Zogbi Clarisse da Silveira Bressan Simone Sampaio Alves Ricardo Lourenço-de-Oliveira Rita Maria Ribeiro Nogueira Marilia Sá Carvalho Ana Maria Bispo de Filippis Thomas Jaenisch |
| author_sort | Patrícia Brasil |
| collection | DOAJ |
| description | BACKGROUND:In 2015, Brazil was faced with the cocirculation of three arboviruses of major public health importance. The emergence of Zika virus (ZIKV) presents new challenges to both clinicians and public health authorities. Overlapping clinical features between diseases caused by ZIKV, Dengue (DENV) and Chikungunya (CHIKV) and the lack of validated serological assays for ZIKV make accurate diagnosis difficult. METHODOLOGY / PRINCIPAL FINDINGS:The outpatient service for acute febrile illnesses in Fiocruz initiated a syndromic clinical observational study in 2007 to capture unusual presentations of DENV infections. In January 2015, an increase of cases with exanthematic disease was observed. Trained physicians evaluated the patients using a detailed case report form that included clinical assessment and laboratory investigations. The laboratory diagnostic algorithm included assays for detection of ZIKV, CHIKV and DENV. 364 suspected cases of Zika virus disease were identified based on clinical criteria between January and July 2015. Of these, 262 (71.9%) were tested and 119 (45.4%) were confirmed by the detection of ZIKV RNA. All of the samples with sequence information available clustered within the Asian genotype. CONCLUSIONS / SIGNIFICANCE:This is the first report of a ZIKV outbreak in the state of Rio de Janeiro, based on a large number of suspected (n = 364) and laboratory confirmed cases (n = 119). We were able to demonstrate that ZIKV was circulating in Rio de Janeiro as early as January 2015. The peak of the outbreak was documented in May/June 2015. More than half of the patients reported headache, arthralgia, myalgia, non-purulent conjunctivitis, and lower back pain, consistent with the case definition of suspected ZIKV disease issued by the Pan American Health Organization (PAHO). However, fever, when present, was low-intensity and short-termed. In our opinion, pruritus, the second most common clinical sign presented by the confirmed cases, should be added to the PAHO case definition, while fever could be given less emphasis. The emergence of ZIKV as a new pathogen for Brazil in 2015 underscores the need for clinical vigilance and strong epidemiological and laboratory surveillance. |
| first_indexed | 2024-12-21T22:50:06Z |
| format | Article |
| id | doaj.art-0558a0fea3fe4428a1199984dad24389 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-21T22:50:06Z |
| publishDate | 2016-04-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-0558a0fea3fe4428a1199984dad243892022-12-21T18:47:36ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-04-01104e000463610.1371/journal.pntd.0004636Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects.Patrícia BrasilGuilherme Amaral CalvetAndré Machado SiqueiraMayumi WakimotoPatrícia Carvalho de SequeiraAline NobreMarcel de Souza Borges QuintanaMarco Cesar Lima de MendonçaOtilia LupiRogerio Valls de SouzaCarolina RomeroHeruza ZogbiClarisse da Silveira BressanSimone Sampaio AlvesRicardo Lourenço-de-OliveiraRita Maria Ribeiro NogueiraMarilia Sá CarvalhoAna Maria Bispo de FilippisThomas JaenischBACKGROUND:In 2015, Brazil was faced with the cocirculation of three arboviruses of major public health importance. The emergence of Zika virus (ZIKV) presents new challenges to both clinicians and public health authorities. Overlapping clinical features between diseases caused by ZIKV, Dengue (DENV) and Chikungunya (CHIKV) and the lack of validated serological assays for ZIKV make accurate diagnosis difficult. METHODOLOGY / PRINCIPAL FINDINGS:The outpatient service for acute febrile illnesses in Fiocruz initiated a syndromic clinical observational study in 2007 to capture unusual presentations of DENV infections. In January 2015, an increase of cases with exanthematic disease was observed. Trained physicians evaluated the patients using a detailed case report form that included clinical assessment and laboratory investigations. The laboratory diagnostic algorithm included assays for detection of ZIKV, CHIKV and DENV. 364 suspected cases of Zika virus disease were identified based on clinical criteria between January and July 2015. Of these, 262 (71.9%) were tested and 119 (45.4%) were confirmed by the detection of ZIKV RNA. All of the samples with sequence information available clustered within the Asian genotype. CONCLUSIONS / SIGNIFICANCE:This is the first report of a ZIKV outbreak in the state of Rio de Janeiro, based on a large number of suspected (n = 364) and laboratory confirmed cases (n = 119). We were able to demonstrate that ZIKV was circulating in Rio de Janeiro as early as January 2015. The peak of the outbreak was documented in May/June 2015. More than half of the patients reported headache, arthralgia, myalgia, non-purulent conjunctivitis, and lower back pain, consistent with the case definition of suspected ZIKV disease issued by the Pan American Health Organization (PAHO). However, fever, when present, was low-intensity and short-termed. In our opinion, pruritus, the second most common clinical sign presented by the confirmed cases, should be added to the PAHO case definition, while fever could be given less emphasis. The emergence of ZIKV as a new pathogen for Brazil in 2015 underscores the need for clinical vigilance and strong epidemiological and laboratory surveillance.http://europepmc.org/articles/PMC4829157?pdf=render |
| spellingShingle | Patrícia Brasil Guilherme Amaral Calvet André Machado Siqueira Mayumi Wakimoto Patrícia Carvalho de Sequeira Aline Nobre Marcel de Souza Borges Quintana Marco Cesar Lima de Mendonça Otilia Lupi Rogerio Valls de Souza Carolina Romero Heruza Zogbi Clarisse da Silveira Bressan Simone Sampaio Alves Ricardo Lourenço-de-Oliveira Rita Maria Ribeiro Nogueira Marilia Sá Carvalho Ana Maria Bispo de Filippis Thomas Jaenisch Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. PLoS Neglected Tropical Diseases |
| title | Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. |
| title_full | Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. |
| title_fullStr | Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. |
| title_full_unstemmed | Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. |
| title_short | Zika Virus Outbreak in Rio de Janeiro, Brazil: Clinical Characterization, Epidemiological and Virological Aspects. |
| title_sort | zika virus outbreak in rio de janeiro brazil clinical characterization epidemiological and virological aspects |
| url | http://europepmc.org/articles/PMC4829157?pdf=render |
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