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HUMAN enterovirus AND VIRAL MENINGITIS IN SOUTHERN BRAZIL. Luine Rosele Renaud Vidal Universidade Federal do Paraná Financial Support : Secretaria de Ciência e Tecnologia do Estado do Paraná- SETI - PR. Research Background. Notifiable Disease in the N ational Health System
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HUMAN enterovirus AND VIRAL MENINGITIS IN SOUTHERN BRAZIL LuineRosele Renaud Vidal Universidade Federal do Paraná Financial Support: Secretaria de Ciência e Tecnologia do Estado do Paraná- SETI - PR
Research Background • NotifiableDisease in theNational Health System • Around 1000 meningitis cases per year • Alletiology • Estimated 60% - viral etiology
Research Background DistributionofViral Meningitisin Curitiba City byNeighborhood
Research Background 460 CSF Samples July 2005 – December 2006 13% Positive
Research Background Vidal et al, 2011
Research Background • July 2005 – September 2008 • 1010 CSF samples (immunocompromised / immunocompetent) • 4.55% positive bynested PCR (nPCR) • 50% encephalitis • 40% meningoencephalitis • 2.5% mielitis Central NervousSystem (CNS) InfectionsbyHerpesviridaeFamily
Research Background Central Nervous System (CNS) Infections by Herpesviridae Family %
Molecular characterizationoFHuman enterovirus • July 2005 – December 2006 • 440 CSF samples – meningitispatients • 49 positive samples - 11%
MeningitisPatients InclusionCriteria ExclusionCriteria EncephalitisParenquimaEnvolvement BacterialMeningitis Inadequatesample: collection / transport / storage • Acuteonset: < 4 weeks • Fever: > 38 °C • WBC: > 4 cell/mm3 • LymphocytesPredominance • Normal Glucose (≥ 45 mG/dL) • Lactate: < 3.5 mmol/L
METHODS Casas et al, Journalof Medical Virology,1999 Obersteet al, Virus Research, 1999
Nucleotidesequencing EV Typing 12 samples
Nucleotidesequencing HumanEchovirus 30
Nucleotidesequencing ECHOVIRUS 4
Nucleotidesequencing HUMAN ECHOVIRUS
Conclusions • The molecular methodologywasefectiveandfastto define theetiologyofmeningitis. • CNS infection for EV wasobserved in thesummer (highertemperatures). • The EV typesfoundwereHumanEchovirus • It wasobserved a predominanceof EV infection in the ages of 4 to 17 years old. • It wasnotpossibletoidentifytheetiologicagent in themajorityofthesamples.
Currently • Establishing a flowchart for CSF collecting • Introduction of lactate quantification • DNA/RNA Extraction – commercial reagentes • Real Time PCR Changesand Benefits
Investigationand Molecular Epidemiology: • Adenoviruses • Flavivirus • Arenavirus • Patientswithsignsandsymptomsofencephalitisandmeningoencephalitis Future Researches
Future Researches Human Parechovirus - HPeV Project CSF samplesstoredfrom2007-2014 Objectivetoestablishtheimpactofthevirus
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