In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barré syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April–July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9–47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications.
the findings reinforce a possible relationship between GBS and Zika infection, given the absence of increased GBS occurrence in previous dengue epidemic years, absence of chikungunya transmission records, presence of clinical manifestations compatible with infection and a laboratory confirmation.
Regulations for the vaccination of pregnant women in Brazil occurred in March 2021. Despite the absence of robust data in the literature on the coronavirus disease 2019 (COVID-19) vaccinations in pregnant women, it is understood that the benefit-risk ratio tends to be favorable when considering the pandemic and the high burden of the disease. However, it is still important to monitor for Events Supposedly Attributable to Vaccination or Immunization (ESAVI) and to draw safety profiles of the different platforms used in pregnant and postpartum women. The present study aims to describe the main characteristics of ESAVIs related to COVID-19 vaccines occurring in pregnant women in the first months of the vaccination campaign in Brazil. During the evaluation period, 1,674 notifications of ESAVIs in pregnant women were recorded, and 582 notifications were included for the analysis. Of the 582 ESAVIs identified, 481 (82%) were classified as non-serious adverse events and 101 (17%) as serious adverse events. Ten deaths were identified, including one death which was considered to be causally related to the vaccine. The other nine maternal deaths had causality C, that is, without causal relationship with the vaccine, and most were due to complications inherent to pregnancy, such as pregnancy-specific hypertensive disorder (PSHD) in 4 cases and 3 due to COVID-19. Despite some limitations in our study, we believe it brings new insights into COVID-19 vaccines in this group and will add to the available evidence.
Introdução: A hantavirose é uma zoonose aguda, transmitida pela inalação de aerossóis formados a partir de excretas de roedores silvestres. A Síndrome Cardiopulmonar por Hantavírus (SCPH) é a forma clínica identificada no Brasil e apresenta elevada letalidade. Objetivo: Descrever a investigação epidemiológica de hantavirose no Estado do Rio de Janeiro (RJ), município de Rio Claro. Métodos: Foi realizado um estudo descritivo no período de fevereiro a maio de 2015. As informações obtidas foram provenientes do sistema de vigilância epidemiológica municipal e dos prontuários da assistência médica hospitalar. Resultados: Foi confirmado um óbito por hantavirose, indivíduo do sexo masculino, 34 anos, trabalhador rural que apresentou febre, cefaleia e mialgia, progredindo com sintomas respiratórios, digestivos, hipotensão além de gradual hemoconcentração e plaquetopenia, vindo a óbito seis dias após o início dos sintomas. Na investigação de 9.898 prontuários, foram identificados 46 indivíduos como casos suspeitos; destes, 31 foram submetidos à entrevista e à coleta de amostras clínicas. A análise sorológica detectou quatro indivíduos IgG reagentes, com exposições similares ao do óbito relatado. Conclusão. É registrado o primeiro caso de hantavirose no Estado do RJ, município de Rio Claro, bem como a detecção de indivíduos soro-reagentes, com clínica compatível e expostos a fatores de risco para a doença. Estes achados corroboram para a afirmativa da circulação prévia de hantavirose nessa região.
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