Acute viral infections of the central nervous system (CNS) such as acute flaccid paralysis, meningitis, and encephalitis, are responsible for a high morbidity, particularly in children. Non‐Polio enteroviruses (NPEV) are known to be responsible for over 80% of viral meningitis in which the etiologic agent is identified. In the present study, we show the frequency of enterovirus meningitis in Brazil from December 1998 to December 2003. Enterovirus were isolated from 162 (15.8%), of a total of 1,022 cerebrospinal fluid (CSF) specimens analyzed. Echovirus 30 was identified in 139 of these isolates (139/162–85.2%). Other identified enteroviruses were: Coxsackievirus B5 (3.7%), Echovirus 13 (3.7%), Echovirus 18 (3%), Echovirus 6 (1.2%), Echovirus 25 (1.2%), Echovirus 1 (0.6%), and Echovirus 4 (0.6%). Patients's age ranged from 28 days to 68 years old. The most frequent symptoms were fever (77%), headache (69.5%), vomiting (71.3%), neck stiffness (41.3%), convulsion (7.1%), and diarrhea (3.7%). Although, the majority of the patients recovered without any complication or permanent squeal, five deaths occurred. Throughout the surveillance period, five viral meningitis outbreaks were confirmed: four in the Southern Brazil and one in the Northeast Brazil. Echovirus 30 was responsible for four out of the five outbreaks while Echovirus 13 caused the fifth one. Besides the outbreaks, 734 sporadic cases were also identified during the study period and 59 of these were positive for virus isolation (8%). Echovirus 30 accounted for 70% of the isolates. Our results showed that Echovirus 30 was the most prevalent etiological agent of viral meningitis in Brazil, causing both outbreaks and sporadic cases. J. Med. Virol. 78:98–104, 2006. © 2005 Wiley‐Liss, inc.
RESUMO ABSTRACTThis paper shows data regarding dengue and hemorrhagic fever of the dengue epidemic in Recife in 2002 and the clinical, laboratorial and necropsy results from the 14 patients who died that year. The sorotype Den-3 was detected in 76.3% of cases. The majority of deaths occurred among men, over 20 years old, on the 11 th day of disease, attended in the private hospitals. The average values of the hematocryt and platelets were 40.7% and 56,313p/mm 3 , respectively. Hepatitis, with high levels of transaminases, occurred in the majority of patients, who generally were anicteric. Of the fourteen deaths, 13 received laboratorial confirmation of the infection. In eight cases death occurred due to hemorrhagic phenomena, however, in the other 6 cases significant bleeding was not identified. Vascular collapse (chock) was present in 12 (85.7%) cases, with or without the association of major bleeding, and was the most important cause of death.
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