Resultados. Se obtuvieron productos de amplificación del tamaño esperado, (424 pb) en cuatro de las muestras analizadas; estas muestras mostraron, además, una reacción inmunohistoquímica positiva, lo que confirma la presencia del virus. Conclusión. El hallazgo del virus de la fiebre amarilla en monos silvestres representa una evidencia de su actividad enzoótica en nuestro territorio, que incrementa el riesgo de transmisión a humanos y de urbanización por procesos de migración de la población. La detección por técnicas moleculares rápidas y específicas del virus en monos silvestres representa una herramienta de vigilancia epidemiológica que permite activar de manera precoz los sistemas de control necesarios para impedir brotes y epidemias.Palabras clave: fiebre amarilla/virología, reacción en cadena de la polimerasa de transcriptasa inversa, Alouatta, primates, vigilancia epidemiológica. Detection of yellow fever virus by reverse transcriptase polymerase chain reaction in wild monkeys: a sensitive tool for epidemiologic surveillanceIntroduction. Yellow fever is a zoonotic infection maintained in nature by non-human primates. Appropriate surveillance with sensitive laboratory techniques is necessary to evidence viral activity in the tropical forest habitats of these primates. Objective. Yellow fever virus was detected in hepatic tissue samples from non-human primates by reverse transcriptase polymerase chain reaction (RT-PCR) technique using specific primers for diagnosis. Materials and methods. Hepatic tissue samples were processed from five monkeys belonging genus Alouatta spp found dead in sylvatic areas of Cesar and Magdalena Provinces, Colombia, between December 2003 and June 2004. Samples were treated with lysis buffer prior to the isolation of viral RNA, which was then subjected to reverse transcriptase polymerase chain reaction (RT-PCR) using yellow fever-specific primers. Simultaneously, viral proteins were identified by immunohistochemistry on parafin-embedded hepatic tissue. Results. The PCR method amplified fragments of the expected size (424 bp) in four of the tested samples. In addition, these samples showed a positive reaction by immunohistochemistry, supporting the evidence that the virus was present. Conclusion. The detection of yellow fever virus in wild monkeys was clear evidence of enzootic activity in northern Colombia. Increased probability of yellow fever transmission among human populations is indicated due to urbanization processes as a consequence of forced migration and displacement of the human populations. Molecular tests for rapid and specific detection of yellow fever in tissue samples of non-human primates is an important tool for epidemiologic surveillance. Rapid virus identification will permit the timely activation of control systems for prevention of further cases and epidemic situations.
El panorama epidemiológico del dengue ha empeorado durante la última década. Las dificultades para prevenir su transmisión, así como la ausencia de una vacuna o tratamiento específico, lo convierten en un riesgo que desafía las medidas de salud pública y desborda la capacidad de los centros de salud y los sistemas de investigación a muchos niveles. Actualmente, la mayoría de los estudios sobre la patogenia de la infección centran su atención en la respuesta inmunitaria de las células T casi exclusivamente en infecciones secundarias y están dirigidos a identificar los mecanismos implicados en el desarrollo de la permeabilidad vascular y de los eventos hemorrágicos que lo acompañan. En este reporte se describe el caso de una menor de 45 días de edad con signos clínicos de dengue grave, cuyo diagnóstico se confirmó por reacción en cadena de la polimerasa de transcripción inversa en muestras de tejido post mórtem y por herramientas de apoyo diagnóstico de inmunohistoquímica, las cuales detectaron antígenos virales en todos los órganos obtenidos en la necropsia. Este caso subraya la importancia del estudio de las infecciones primarias asociadas a dengue grave, particularmente en niños, en quienes es más probable el desarrollo de la forma grave de la enfermedad sin una infección previa, y, además, pone de relieve la importancia de un diagnóstico que no se limite a las muestras de tejido hepático en el estudio de la patogenia de la infección viral.Palabras clave: dengue, antígenos, inmunohistoquímica. doi: http://dx.doi.org/10.7705/biomedica.v34i4.2169 Detection of dengue virus antigen in post-mortem tissuesThe epidemiological situation of dengue has worsened over the last decade. The difficulties in preventing its transmission and the absence of a vaccine or specific treatment have made dengue a serious risk to public health, health centers and research systems at different levels. Currently, most studies on the pathogenesis of dengue infection focus on the T-cell immune response almost exclusively in secondary infections and are aimed at identifying the mechanisms involved in the development of vascular permeability and bleeding events that accompany the infection. This report describes the case of a baby girl less than 45 days of age with clinical signs of severe dengue, whose diagnosis was confirmed by reverse transcription polymerase chain reaction in postmortem tissue samples and by the ancillary diagnostic use of immunohistochemistry, which detected viral antigens in all organs obtained at autopsy. This case highlights the importance of studying primary infections associated with severe dengue, particularly in children, who are more likely to develop the severe form of the disease without previous infection, and it further stresses the importance of a diagnosis that should not be based solely on the examination of liver tissue samples when studying the pathogenesis of the viral infection.
Figura 1. Corte coronal de cerebro con congestión leptomeníngea y leve edema.Figura 2. Corte transversal del tercio distal del tallo cerebral y sección medular C1, en el cual se observa congestión leptomeníngea y leve edema.Figura 3. Imagen del cuerno anterior del segmento cervical C1; en pequeño aumento, se observa proceso inflamatorio mononuclear, HE, 2,5X. Figura 4.Imagen del cuerno anterior de C1, en mayor aumento se observa un importante infiltrado inflamatorio linfomonocitario con daño neuronal. Mielitis importante de predominio motor, HE, 40X.
739"La víctima en el sistema de justicia penal. Una perspectiva jurídica y criminológica" 1 Mg. Mauricio Duce J.
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