Zika virus cases in Brazil have diminished since emergence in 2015. We report Guillain Barré Syndrome caused by Zika and possible Chikungunya co-infection during an expected low arboviral season. This case highlights the importance of clinical vigilance for Zika in those with neurological syndromes outside typical arboviral season.
The World Health Organization (WHO) Clean Care is Safer Care global programme is based around a change model. It fosters partnerships and coordinates activities as set out in its programme plan. By May 2016, more than 140 of the 194 United Nations' member states had pledged their support to implement actions to reduce healthcare-associated infections, corresponding to 95% coverage of the world population.The finalized WHO Guideline on Hand Hygiene in Healthcare was launched in 2009 alongside a field-tested and validated multimodal improvement strategy. The strategy comprises five critical components: 1) system change; 2) healthcare workers' training and education; 3) evaluation and performance feedback; 4) reminders in the workplace; and 5) promotion of an institutional safety climate.WHO has over this time coordinated more than 50 national campaigns and importantly launched the global annual healthcare worker call to action; the SAVE LIVES: Clean Your Hands campaign to maintain a profile on hand hygiene action at the point of care.Reasons for the success of Clean Care is Safer Care will be reviewed, including those possibly associated with a positive influence on infection rates and patient safety.
Dengue fever is among the most significant public health concerns in Brazil. To date, the highest number of Dengue notifications in the Americas has been reported in Brazil, with cases accounting for a total number of 3,418,796 reported cases as of mid-December 2022. Furthermore, the northeastern region of Brazil registered the second-highest incidence of Dengue fever in 2022. Due to the alarming epidemiological scenario, in this study, we used a combination of portable whole-genome sequencing, phylodynamic, and epidemiological analyses to reveal a novel DENV-1 genotype V clade and the persistence of DENV-2 genotype III in the region. We further report the presence of non-synonymous mutations associated with non-structural domains, especially the NS2A (non-structural protein 2A), as well as describe synonymous mutations in envelope and membrane proteins, distributed differently between clades. However, the absence of clinical data at the time of collection and notification, as well as the impossibility of monitoring patients in order to observe worsening or death, restricts our possibility of correlating mutational findings with possible clinical prognoses. Together, these results reinforce the crucial role of genomic surveillance to follow the evolution of circulating DENV strains and understand their spread across the region through inter-regional importation events, likely mediated by human mobility, and also the possible impacts on public health and outbreak management.
Background
Salvador was one of the Brazilian cities most affected during the 2015 Zika virus (ZIKV) outbreak.
Methods
A cross-sectional study was performed with enrolment of parturients and their newborns.
Results
Positive IgM antibodies for ZIKV, dengue (DENV) and Chikungunya (CHIKV) were present in 6.9, 11.9 and 22.8% of the parturients, and IgG antibodies were detected in 72.3, 92.3 and 38.6%, respectively. No cases of DENV congenital infection were identified. ZIKV and CHIKV congenital infections were observed in 16.5 and 13% of newborns, respectively.
Conclusions
High exposure rates to the three arboviruses and the identification of newborns with ZIKV and CHIKV congenital infections reinforces the necessity of ZIKV and CHIKV prenatal and neonatal screening in endemic regions.
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