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Department of Health | Rubella

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Alternatively, severe forms of dengue could be related to virus mutants that emerge as part of a natural selection process [6]. Molecular epidemiology studies have shown that DENV genome suffers mutations and may lead each virus serotype to differentiate into multiple genotypes [7].

This study describes the clinical epidemiology of dengue in a city where all the four DENV serotypes are co-circulated simultaneously and also provides the opportunity to compare clinical severity to DENV serotypes. Simultaneous circulations of the four DENV serotypes and different clades were observed. Dengue co-infection seems to lead to more severe manifestations. Materials and Methods Study design This is a clinical and virological descriptive study to correlate clinical data with DENV serotypes during the outbreak of dengue in the Amazonas, Brazil.

Patients with dengue were recruited from January through May The FMT-HVD, located in the Manaus city with almost a population of 2 million inhabitants, is the referral centre for acute febrile illness and tropical infectious diseases. Study sample Patients with acute febrile illness but negative for malaria by thick blood smear test and presenting any two of the following symptoms in the first visit: All of the patients participating in the study signed a written informed consent form.

Parents or responsible party of children less than 18 years were required to sign a written inform consent form. Inclusion criteria Patients with acute febrile illness presenting fever less than 7 days were selected and classified according to the World Health Organization guidelines for dengue cases http: The clinical classification of the patients with dengue was performed by the clinicians according to the WHO guidelines for dengue on the day of enrollment.

All of the severe dengue patients were hospitalized and followed-up until discharge. Furthermore, patients were seen in outpatient clinics 48 hours and 6—7 days after hospital discharge for hospitalized patients.

Non-hospitalized patients were seen twice, between 48 hours and 6 days after first clinical assessment. The same cycling parameters were used as in the first reaction.

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Precautions to avoid contamination were followed. Positive and negative controls were used in all reactions. Several functional traits such as synthesis of hydrolytic enzymes and indole acetic acid are related to the protection against phytopathogens, plant growth promotion and resistance to environmental stress, which are relevant for their multiple applications in agriculture [ 42 — 44 ].

The same is true for natural products synthesized by endophytes, which have important applications in human health [ 45 — 50 ].

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There is a strong demand for new and more effective antibiotics and anticancer drugs, which can be synthesized by endophytes [ 51 — 54 ]. Considering that different factors can influence the structure of endophytic communities, the present study aims to identify cultivable endophytic fungal species in P. In addition, we have isolated and identified the major special metabolites from two endophytic fungal species Trichoderma asperellum and Diaporthe phaseolorum and examined their antibacterial, antitumor and genotoxic activity in vitro.

Materials and methods Isolation and molecular identification of endophytic fungi from P. The seeds and roots of five adult healthy plants of P.

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The plant material was collected at the end of the dry season, when the accumulated rainfall and average temperature were respectively The plant material was stored and transported under refrigeration until processing. Roots and seeds were washed in tap water and neutral detergent.

The efficacy of surface disinfection was verified by inoculating the last rinse water on tryptone soy agar TSA plates.

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The fungal strains were grouped morphologically [ 59 ], and the grouping was confirmed by analyzing microscopic traits in microculture slides [ 60 ] and comparing the obtained results with taxonomic keys [ 6162 ]. The isolates were stored under refrigeration in PDA medium and in tubes with sterilized rice.

Community structure analysis The endophytic colonization rate [ 65 ] and the relative frequency of fungal species [ 28 ] were evaluated. The species diversity, richness and dominance were estimated using the non-parametric Shannon-Weaver index [ 66 ], Chao 1 index [ 67 ] and Simpson index [ 68 ], respectively. The degree of similarity among different communities was determined using the Jaccard index [ 69 ], while the UPGMA Unweighted Pair Group Method with Arithmetic Mean cluster analysis grouped the endophytes into distinct clusters.

To examine whether a given endophytic community plays predominant roles, we analyzed their ecological roles. The species were classified into the categories phytopathogen, saprophyte, mycotroph, entomopathogen and coprophilous, according to the criteria established by literature reports and the Agricultural Research Service of the United States Department of Agriculture USDA-ARS database [ 70 ]. Non-metric multidimensional scaling NMDS based on Jaccard's coefficient was used to visually detect the preference of the species in relation to each host plant geographic location, genotype and organ.

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The distinctiveness of fungal assemblages was tested with one-way analysis of similarity ANOSIM considering the incorporation of permutations.

The indicator value method IndVal [ 71 ] was used to identify the most characteristic species of each community, and the ones more prevalent in a single community. A network was built to analyze the existence of interspecific interactions. The rate of connectivity between nodes was determined by analyzing betweenness centrality, while the Louvain algorithm was used to detect modularity [ 72 ]. Root associations, endophytic potential and functional traits P.

Fifteen root fragments from each individual were analyzed in the Nikon Eclipse E microscope coupled with a camera Bel Photonicsin order to identify the presence of dark septate endophytic fungi DSE and endomycorrhizal structures, such as arbuscles and vesicles. The identity of the structures was confirmed by comparison with literature reports [ 74 ]. Endophytic fungi with dark mycelium and septate hyphae isolated from P.

After 5 days, the rootlets of seedlings were inoculated with mycelium fragments.

Clinical and Virological Descriptive Study in the 2011 Outbreak of Dengue in the Amazonas, Brazil

For the 2 years from July to Junechildren aged 0—4 years continued to have the highest hospitalisation rate average annual rate 0. While there were twice as many males in this age group, the overall male: Victoria notified 13 cases during the review period, including a cluster of 3 cases in one family in No rubella notifications were recorded in Tasmania or the Northern Territory in either or Appendix 6.

The geographical distribution of rubella hospitalisations reflected that of the notifications see Appendix 6. However, there were too few hospitalisations in each jurisdiction to identify any trends. Top of page Vaccination status Vaccination status is required in the NNDSS for all notifications of rubella in women of child-bearing age i.

Two of the five reported as fully vaccinated had valid written records.

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The vaccination status of the partially vaccinated woman was also validated. Of those 6 cases aged 1—3 years, 2 had been vaccinated with 1 dose of rubella-containing vaccine validatedand 2 were reported to be unvaccinated. Of the 3 cases aged 4—7 years, 1 had received 2 vaccine doses validated1 was reported to be unvaccinated, and the vaccination status of the remaining case was unknown.

Top of page Comment The successful control of rubella in Australia over the last decade through mass school-based MMR vaccination has been sustained, and rubella notification and hospitalisation rates continue to remain at very low levels. Young men no longer appear to be at greater risk for rubella infection as previous surveillance and serology data have indicated. However, despite these achievements, some challenges still remain.

Evidence suggests that Indigenous women in the Northern Territory have inadequate immunity to rubella. The epidemiology of CRS in Australia from to has been described and discussed by Sullivan et al Details on the vaccination status of the mothers of these cases were not available.

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Endemic transmission of rubella in the USA was declared to be eliminated in Octoberon the basis of evidence showing high levels of vaccine coverage and population immunity, and low disease incidence over a number of years. The potential for global rubella control continues to improve on the back of intensive measles elimination efforts and the opportunity to increase coverage of combined vaccines.

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Individual countries must evaluate the burden of disease caused by rubella through appropriate surveillance mechanisms and assess the cost-effectiveness of introducing rubella vaccine into national immunisation programs, either targeted at adolescent and adult females or universal vaccination of all children. In addition, the high level of immunity to rubella and sustained low disease incidence indicates that Australia is moving towards rubella elimination.

In order for Australia to eliminate endogenous rubella transmission, a strong regional approach must be taken, similar to the Pan American approach that resulted in the elimination of rubella in the USA.

Semin Fetal Neonatal Med ;12 7: Communicable Diseases Network Australia.