INTRODUCTION: The Amazon region has extensive forested areas and natural ecosystems, providing favorable conditions for the existence of innumerous arboviruses. Over 200 arboviruses have been isolated in Brazil and about 40 are associated with human disease. Four out of 40 are considered to be of public health importance in Brazil: Dengue viruses (1-4), Oropouche, Mayaro and Yellow Fever. Along with these viruses, about 98% of the malaria cases are restricted to the Legal Amazon region. METHODS: This study aimed to investigate the presence of arboviruses in 111 clinical serum samples from patients living in Novo Repartimento (Pará), Plácido de Castro (Acre), Porto Velho (Rondônia) and Oiapoque (Amapá). The viral RNA was extracted and RT-PCR was performed followed by a Multiplex-Nested-PCR, using Flavivirus, Alphavirus and Orthobunyavirus generic and species-specific primers. RESULTS: Dengue virus serotype 2 was detected in two patients living in Novo Repartimento (Pará) that also presented active Plasmodium vivax infection. CONCLUSIONS: Despite scant data, this situation is likely to occur more frequently than detected in the Amazon region. Finally, it is important to remember that both diseases have similar clinical findings, thus the diagnosis could be made concomitantly for dengue and malaria in patients living or returning from areas where both diseases are endemic or during dengue outbreaks.
LETTER TO THE EDITORArboviruses in blood donors: a study in the Amazon region and in a small city with a dengue outbreak Dear Sir, Arboviruses are an ecological group of viruses which represent a very important public health problem worldwide. Very often, arboviruses have been responsible for large epidemics with serious impacts on human and veterinary health (Vasconcelos, 1992). Dengue virus (DENV) is considered the most important arbovirus which infects humans. DENV, serotypes 1-4, is responsible for large urban outbreaks, especially when the cocirculation of different serotypes is observed or when a new serotype is introduced (Figueiredo, 2000).A high number of asymptomatic cases, the asymptomatic viraemia in the early stage of infection and a high viral transmission during outbreaks are the main factors that may contribute towards a substantial number of blood donors to be viraemic at the time of donation (Mohammed et al., 2008). Therefore, the aim of this study was to evaluate the potential for transmission of arboviruses in serum samples of blood donors from the Amazon region and from a small city in the São Paulo State (Tupã) with DENV outbreak.A total of 205 clinical samples (aliquots from collected blood) from blood donors were obtained during January 2006 in Belém, Pará (50 samples), Rio Branco, Acre (50 samples) and Tupã, São Paulo (105 samples) in Brazil. All samples were collected according to Brazilian regulations for blood donation and were concluded to be suitable for donation. None of the blood donors had fever or any other clinical sign of infection. All samples were initially tested for the presence of Flavivirus and Alphavirus using the procedure described by Bronzoni et al. (2005). Briefly, firstly Flavivirus and Alphavirus genus-specific primers were used simultaneously in a duplex reverse transcription-polymerase chain reaction (RT-PCR) assay. Secondly, three multiplex nested-PCRs with species-specific primers were used to identify DENV 1-3, yellow fever virus and Saint Louis encephalitis virus; to identify DENV-4, Rocio
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