An Outbreak of Acute Schistosoma mansoni Schistosomiasis in a Nonendemic Area of Brazil: A Report on 50 Cases, Including 5 With Severe Clinical Manifestations

Lambertucci, José Roberto; Drummond, Sandra; Voieta, Izabela; Queiroz, Leonardo Campos de; Pereira, Pedro Paulo; Chaves, Bruna Assis; Botelho, Patrícia Passos; Prata, Pedro Henrique; Otoni, Alba; Vilela, José Fagundes; Antunes, Carlos

doi:10.1093/cid/cit157

Cited by 19 publications

(29 citation statements)

References 22 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In schistosomiasis, immature worms during the acute phase or in recently reinfected cases may produce worm antigens (e.g., CCA) before eggs are excreted in the stool. This process may result in a positive result using the POC-CCA assay and a negative result using the Kato-Katz technique [30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of the circulating cathodic antigen rapid urine test in the diagnosis of Schistosomiasis mansoni infection and evaluation of morbidity in a low- endemic area in Brazil

Ferreira

Fidelis

Pereira

et al. 2017

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of the circulating cathodic antigen rapid urine test in the diagnosis of Schistosomiasis mansoni infection and evaluation of morbidity in a low- endemic area in Brazil

Ferreira

Fidelis

Pereira

et al. 2017

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Abdominal ultrasound in acute schistosomiasis is characterized by the fi ndings of hepatomegaly and splenomegaly and the presence of several lymph nodes in the portal system and mesenteric area [33][34][35] .…”

Section: Ultrasound In Hepatosplenic Schistosomiasismentioning

confidence: 99%

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Lambertucci

2014

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fi brosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fi brosis was made by abdominal palpation and the fi nding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US) has become the best imaging technique to evaluate liver fi brosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) fi ndings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count), biomarkers for liver fi brosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

show abstract

“…Fifty tourists (19 women/31 men, 4-75 years old) bathed in a swimming pool supplied by a brook on a country house in the outskirts of São João del Rei, a historical city in the state of Minas Gerais, Brazil from December 2009 to March 2010 as previously described [40]. Two months later, a patient was diagnosed with schistosomal myeloradiculopathy and he reported that other tourists had symptoms consistent with acute schistosomiasis.…”

Section: Methodsmentioning

confidence: 99%

“…Since antibodies to the parasite develop during the first weeks after infection, they can be detected before eggs in the feces to yield higher sensitivities. In clinical practice, positive serology in K-K negative people from non-endemic countries is usually sufficient to prescribe treatment with PZQ [40-42].…”

Section: Introductionmentioning

confidence: 99%

Serological proteomic screening and evaluation of a recombinant egg antigen for the diagnosis of low-intensity infections in endemic area in Brazil Antigen target in schistosomiasis diagnosis

Moraes¹,

Shollenberger

Castro-Borges

et al. 2018

Preprint

View full text Add to dashboard Cite

52Background: Despite decades of employment of control programs, schistosomiasis 53 remains a global public health problem. To further reduce prevalence and intensity of 54 infection, or to achieve the goal of elimination in low-endemic areas, there need to be 55 better diagnostic tools to detect low intensity infections in low-endemic areas as Brazil. 56The rationale for development of new diagnostic tools is because in low-endemic 57 settings, the standard Kato-Katz diagnostic method loses its sensitivity and misses low 58 intensity infections. To develop new diagnostic tools, we employed a proteomics 59 approach search for biomarkers associated with schistosome-specific immune responses 60 to develop sensitive and specific new methods for immunodiagnosis. 61 62 Methods and findings: Immunoproteomic analysis was performed on an egg extract of 63 Schistosoma mansoni using pooled sera from infected or non-infected individuals from 64 a low-endemic area of Brazil. Cross reactivity with other helminth parasites was 65 determined using pooled sera from individuals infected with different parasitic 66helminths. Using this approach we identified 23 spots recognized by schistosome acute 67 and chronic sera samples. To identify immunoreactive spots that are likely glycan 68 epitopes, we compared immunoreactivity of spots treated by sodium metaperiodate 69 oxidation of egg extract. This treatment yielded 12/23 spots maintaining 70 immunoreactivity, suggesting they are protein epitopes. From these 12 spots, 11 spots 71 cross-reacted with sera from infection with other helminths and 10 spots cross-reacted 72 with the negative control group. Spot number 5 was exclusively immunoreactive with 73 sera from schistosome-infected groups in native and deglycosylated conditions and 74 corresponds to a Major Egg Antigen. We expressed the Major egg antigen as a 75 recombinant protein and showed by western blot a similar recognition pattern of that of 4 76 the native protein. IgG-ELISA gave a sensitivity of 87.10% and specificity of 89.09% 77 represented by area under ROC curve of 0.95. IgG-ELISA performed better than the 78 conventional K-K (2 slides) identifying 56/64 cases harboring 1-10 egg per gram of 79 feces that were undiagnosed by K-K parasitological technique.80 81 Conclusions: The serological proteome approach was able to identify a new diagnostic 82 candidate. The recombinant egg antigen provided good performance in IgG-ELISA to 83 detect individuals with extreme low-intensity infections (1 egg per gram of feces). 84 Therefore, the IgG-ELISA using this newly identified recombinant major egg antigen 85 can be a useful tool to be combined with other techniques in low-endemic areas to 86 determine the true prevalence of schistosome infection that is underestimated by Kato-87 Katz method. Further, to overcome the complexity of ELISA in the field, a second-88 generation of antibody-based rapid diagnostic tests (RDT) can be developed. 89 90 Recombinant Protein, Endemic Areas. 92 93 94 95 96 97 98 99 5 100 Author Summary 101 102 ...

show abstract

An Outbreak of Acute Schistosoma mansoni Schistosomiasis in a Nonendemic Area of Brazil: A Report on 50 Cases, Including 5 With Severe Clinical Manifestations

Cited by 19 publications

References 22 publications

Sensitivity and specificity of the circulating cathodic antigen rapid urine test in the diagnosis of Schistosomiasis mansoni infection and evaluation of morbidity in a low- endemic area in Brazil

Sensitivity and specificity of the circulating cathodic antigen rapid urine test in the diagnosis of Schistosomiasis mansoni infection and evaluation of morbidity in a low- endemic area in Brazil

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Serological proteomic screening and evaluation of a recombinant egg antigen for the diagnosis of low-intensity infections in endemic area in Brazil Antigen target in schistosomiasis diagnosis

Contact Info

Product

Resources

About