In Brazil, epizootics among New World monkey species may indicate circulation of yellow fever (YF) virus and provide early warning of risk to humans. Between 1999 and 2001, the southern Brazilian state of Rio Grande do Sul initiated surveillance for epizootics of YF in non-human primates to inform vaccination of human populations. Following a YF outbreak, we analyzed epizootic surveillance data and assessed YF vaccine coverage, timeliness of implementation of vaccination in unvaccinated human populations. From October 2008 through June 2009, circulation of YF virus was confirmed in 67 municipalities in Rio Grande do Sul State; vaccination was recommended in 23 (34%) prior to the outbreak and in 16 (24%) within two weeks of first epizootic report. In 28 (42%) municipalities, vaccination began more than two weeks after first epizootic report. Eleven (52%) of 21 laboratory-confirmed human YF cases occurred in two municipalities with delayed vaccination. By 2010, municipalities with confirmed YF epizootics reported higher vaccine coverage than other municipalities that began vaccination. In unvaccinated human populations timely response to epizootic events is critical to prevent human yellow fever cases.

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Vaccination with the L-Z strain of mumps vaccine as part of a mass campaign was associated with a significantly increased risk of aseptic meningitis. Decisions about type of mumps vaccine and mumps vaccination strategies must consider vaccine safety issues in addition to other criteria.

Objective. To compare the incidence of adverse events following the administration of three commercially available measles-mumps-rubella (MMR) combination vaccines. Methods. A randomized double-blind clinical trial was performed in (RR = 3.11;

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RESUMO -Introdução: O objetivo deste estudo foi identificar e analisar fatores relacionados à meningite n e o n a t a l . Método: Em estudo de caso-controle, foram examinados neonatos com meningite no período de agosto/2002 a dezembro/2003 na Unidade de Tratamento Intensivo Neonatal (UTIN) e alocados re c é mnascidos hígidos como grupo controle (GC). Foram relatados dados re f e rentes à gestação, ao parto e ao neonato. Os resultados foram considerados significativos quando p (alfa)< 0,05. Resultados: F o r a m examinados 42 neonatos com meningite e 42 controles. A média numérica de consultas durante o pré-natal foi menor no grupo meningite (GM). As interc o rrências mais comuns detectadas nas gestações, em ambos os grupos, foram o uso de substâncias de abuso, infecções, pré-eclâmpsia, diabetes melitus gestacional e infecções do trato urinário. O sofrimento fetal e a utilização de cuidados respiratórios foram associados à meningite. O GM apresentou médias menores de peso e de índice de APGAR em relação ao GC. A p revalência de prematuridade e de neonatos pequenos para a idade gestacional foi significativamente maior no GM. O exame neurológico foi alterado em apenas 35,7% dos casos de meningite. C o n c l u s ã o : Em nosso meio, a associação de fatores de risco relacionados à gestação, ao parto e próprios do neonato com o desfecho de meningite neonatal não diferiu da literatura. PALAVRAS-CHAVE: meningite neonatal, fatores de risco.Neonatal meningitis: related features ABSTRACT -Objective: The goal of this study was to identify and to analyze the features related to the o c c u rrence of neonatal meningitis. Method: In a case-control study we examined all newborns pre s e n t i n g meningitis between August/2002 and December/2003 in the neonatal Intensive Care Unit. Healthy newborn s w e re enrolled as a Control Group (CG). Data related to pre g n a n c y, labor and the neonate itself were collected. The results with p<0,05 were considered significant. Results: 42 newborns with meningitis were c o m p a red to 42 controls. The meningitis group (MG) presented a lower number of medical visits during the prenatal care. The most common abnormalities detected in both groups were: drug addiction, congenital infections, preeclampsia, eclampsia, gestational diabetes mellitus and urinary tract infections. Fetal re s p i r a t o ry d i s t ress and the use of re s p i r a t o ry support were related to the occurrence of meningitis. The average weight and the APGAR scores were lower in the MG. The prevalence of premature and small for the gestational age infants was significantly higher in the MG. The neurological examination detected abnormalities in 35.7% of the meningitis cases. Conclusion: The association of risk factors related to pre g n a n c y, labor and the newborn itself to the neonatal meningitis outcome in our setting is similar to the described in the literature.

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