Rabies viruses circulating in Ceará, Brazil, were identified by molecular analysis to be related to variants maintained by dogs, bats, and other wildlife. Most of these viruses are associated with human rabies cases. We document the emergence of a rabies virus variant responsible for an independent epidemic cycle in the crab-eating fox (Cerdocyon thous).

No abstract

Rabies is an endemic disease in Brazil, where it is considered a serious public health problem. Although the number of human and dog-transmitted cases has declined in recent decades, rabies in wildlife has emerged considerably. Among the sylvatic animals, wild canids have been considered important hosts of the rabies virus. We performed a retrospective study of reported cases of rabies in wild canids and human victims in Ceará state (Northeast Brazil) during 2003 to 2013. Information was provided by governmental laboratories involved in rabies detection and by the Ministry of Health. From January 2003 to December 2013, a total of 11 931 animal samples were examined for rabies. Positivity were detected in 438 samples (3.67%), of which 229 (52.28%) were domestic animals, 105 (23.97%) wild canids and 104 (23.74%) other wild animals (bats, marmosets and raccoons). Approximately 33% of wild canids surveyed (n = 317) were positive for rabies. During the studied period, a total of 1923 attacks on humans by wild canids were registered. Males (n = 1405) were more affected than females (n = 520; 72.98% versus 27.01%), and the median age of all cases was 36.5 years. Injuries to individuals up to 19 years old corresponded to approximately 30% (n = 565) of all cases. Most of the victims lived in rural areas (72.46%; n = 1395), and the majority showed bites (81.13%; n = 1677) or scratches (12.23%; n = 253). Injuries were considered profound (52.1%; n = 1003), superficial (40.91; n = 788) or multiple with severe laceration (6.98%; n = 134). Only 1300 (67.53%) victims were enrolled for the complete rabies post-exposure prophylaxis scheme. Data from the present study confirm that wild canids are important hosts of rabies virus in northeastern Brazil and jeopardize rabies control in this area. Local authorities should focus their efforts in education of health professionals. In addition, strategies should be formulated to preserve wildlife.

Introduction:In the State of Ceará, a new variant of the rabies virus was identified associated with cases of human rabies transmitted by common marmosets (Callithrix jacchus), which are frequently kept as pets. This new variant does not present antigenic proximity or genetic relationship to variants of the virus isolated from bats and terrestrial mammals from the American continent. The present study aimed to evaluate the risk factors of rabies virus transmission from common marmosets (C. jacchus) maintained as pets in the metropolitan region of Fortaleza, State of Ceará, Brazil, to human beings. Methods: A questionnaire focusing on animal management and interaction between humans and primates was applied to individuals who had marmosets in the municipalities of Aquiraz and Maranguape. In order to evaluate the presence of rabies antigens by direct immunofluorescence test (DIF), samples of saliva were collected from domiciliary captive marmosets. Based on the detection of rabies antigens, biopsy samples of central nervous system (CNS) were analyzed. Results: Analysis of questionnaire data verified that a close relation exists between humans and their pet marmosets, especially during management practices. Additionally, these people showed minimal knowledge regarding rabies, which represents a greater risk of infection. Of the 29 saliva samples evaluated, one (3.4%) was positive for DIF reaction and of the 11 CNS samples, three (27.3%) were positive. Conclusions: Laboratory data are in agreement with the questionnaire findings, which confirm an increased risk of rabies virus transmission due to the close relation between humans and marmosets.

Purpose: Members of the class Arachnida are eight-legged arthropods, and include spiders (Araneae) and scorpions (Scorpiones). Spider and scorpion injury can cause pain at the site, with systemic symptoms, including neurotoxicity, hemolysis, tissue necrosis, and autonomic dysfunction, arising after severe envenomations. In such scenarios, prompt administration of antivenom may substantially reduce morbidity and mortality, however, awareness of appropriate management strategies and access to antivenom amongst clinicians is generally lacking. Additionally, clinicians may misdiagnose envenomations due to the absence of bite history and knowledge of cardinal symptoms. With increased human migration and transcontinental shipment of produce from the tropics, the incidence of arachnid envenomations may increase in non-endemic areas. We aim to synthesize existing evidence around prevention and treatment of arachnid envenomations into a clinical resource, including provision of information on access to, and indications for, antivenom.Methods & Materials: PubMed (NCBI) and MEDLINE (OVID) were searched for from inception to June 2018 using combinations of the search terms "spider", "scorpion", and "envenomation*". Iterative inclusion and exclusion of search terms was employed to maximize relevant article extraction. For the systematic review, we will include observational studies, case reports, case series, and cohort studies, as well as clinical trials reporting therapeutic outcomes, and antivenom safety, tolerability, and efficacy. Molecular epidemiology and purely mechanistic pathogenesis studies will be excluded. The GRADE approach will be used to assess quality of studies reporting therapeutic interventions. Evidence will be summarized using descriptive measures for each intervention type. Meta-analysis will be planned if sufficient efficacy measures for the same intervention are available.Results: 412 MEDLINE articles and 788 PubMed articles were retrieved for title and abstract screening; after duplicate removal, 637 remained. Data will be grouped and summarized for ease of clinician use by prevention and therapeutic strategies including antivenom, and according to geographic location and species.Conclusion: Increased transcontinental movement of people and tropical produce has facilitated importation of arachnids to non-endemic regions where clinicians lack familiarity with envenomation syndromes and appropriate therapeutics. Synthesizing the current evidence around therapeutic strategies including antivenom for medically significant arachnid envenomations can inform the development of appropriate treatment and prevention protocols.