Giuseppe
Emeritus
UNDIAGNOSED RESPIRATORY DISEASE, FATAL - BRAZIL: (SAO PAULO), REQUEST FOR INFORMATION
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A ProMED-mail post http://www.promedmail.org
Date: Wed 9 Apr 2008
Source: Ministry of Health, Secretariat for Health Surveillance [in Portuguese, trans. & summ. Mod.JW, edited]
http://portal.saude.gov.br/portal/arquivos/pdf/nota_doenca_respiratoria0904.pdf
On 2 Apr 2008, the Secretariat for Health Surveillance (SVS)/Ministry of Health (MS), through the Center for Epidemiological Surveillance (CVE)/Coordination Control of Diseases of Sao Paulo, was notified of the occurrence of cases of respiratory disease in the municipality of Santos, state of Sao Paulo.
Epidemiological surveillance is being carried out jointly by city, state, and federal health authorities.
The 4 cases initially reported belonged to the same family, with signs and symptoms of low fever, coryza, throat pain, cough, earache (3 cases), and otorrhea with purulent exudate from the ears (2 cases); 2 cases had severe clinical evolution and died for reasons that are being investigated.
Dengue virus and hantaviruses were excluded in all 4 cases and seasonal influenza and avian influenza viruses, respiratory syncytial
virus, adenovirus, and parainfluenza virus excluded in samples processed from 3 cases.
In 2 cases secretion from the nasopharynx showed suggestive electron microscopy images of a picornavirus, agents, which are normally associated with the common cold.
Analyses for other viral agents using the techniques of molecular biology and virus isolation are being carried out at the Institute Adolfo Lutz.
Besides the family cases, a symptomatic case with an epidemiological connection to the family was found, who recovered with negative immunofluorescence tests for respiratory viruses.
A municipal surveillance team is carrying out an active search for new cases among household and close contacts, as well as a retrospective review of ospitalizations and deaths from atypical pneumonia of acute evolution.
The guidelines for precautionary measures directed against contact, droplets, and aerosols, washing hands, and organizing the flow of care for possible cases, were strengthened.
The system of municipal surveillance is on alert for the identification of new cases through the monitoring of contacts already identified.
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Communicated by:
Mirian M. de Moura mirianmoura@uol.com.br
via ProMED-PORT promed@promedmail.org
[It may be just a coincidence, but the presence of otitis and intra-family transmission recalls infection with _Mycoplasma_ or _Moraxella_. - Mod.LJS
The etiology of this illness in which it appears that 2 of 4 members of the family died is not clear. As suggested above, _Mycoplasma pneumoniae_ can be associated with ear disease, generally bullous myringitis, which does not usually cause a purulent otorrhea.
Fatalities from mycoplasmosis can occur but 2 in one family seems extraordinary. As well, _Moraxella catarrhalis_ can cause otitis media and pneumonia, but not usually in the same patient and again, fatalities in otherwise well individuals are uncommon.
It would be of interest to know more about the epidemiology including the ages of those afflicted, pets at home, travel, visitors from elsewhere, and the living conditions.
The port city of Santos is partially located on the island of Sao Vicente -- which harbors both the city of Santos and the city of Sao Vicente -- and partially on the mainland. It is the main city in the metropolitan region of the Baixada Santista and can be found on a map at http://en.wikipedia.org/wiki/Santos_(S%C3%A3o_Paulo). - Mod.LL]
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http://apex.oracle.com/pls/otn/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,72306
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A ProMED-mail post http://www.promedmail.org
Date: Wed 9 Apr 2008
Source: Ministry of Health, Secretariat for Health Surveillance [in Portuguese, trans. & summ. Mod.JW, edited]
http://portal.saude.gov.br/portal/arquivos/pdf/nota_doenca_respiratoria0904.pdf
On 2 Apr 2008, the Secretariat for Health Surveillance (SVS)/Ministry of Health (MS), through the Center for Epidemiological Surveillance (CVE)/Coordination Control of Diseases of Sao Paulo, was notified of the occurrence of cases of respiratory disease in the municipality of Santos, state of Sao Paulo.
Epidemiological surveillance is being carried out jointly by city, state, and federal health authorities.
The 4 cases initially reported belonged to the same family, with signs and symptoms of low fever, coryza, throat pain, cough, earache (3 cases), and otorrhea with purulent exudate from the ears (2 cases); 2 cases had severe clinical evolution and died for reasons that are being investigated.
Dengue virus and hantaviruses were excluded in all 4 cases and seasonal influenza and avian influenza viruses, respiratory syncytial
virus, adenovirus, and parainfluenza virus excluded in samples processed from 3 cases.
In 2 cases secretion from the nasopharynx showed suggestive electron microscopy images of a picornavirus, agents, which are normally associated with the common cold.
Analyses for other viral agents using the techniques of molecular biology and virus isolation are being carried out at the Institute Adolfo Lutz.
Besides the family cases, a symptomatic case with an epidemiological connection to the family was found, who recovered with negative immunofluorescence tests for respiratory viruses.
A municipal surveillance team is carrying out an active search for new cases among household and close contacts, as well as a retrospective review of ospitalizations and deaths from atypical pneumonia of acute evolution.
The guidelines for precautionary measures directed against contact, droplets, and aerosols, washing hands, and organizing the flow of care for possible cases, were strengthened.
The system of municipal surveillance is on alert for the identification of new cases through the monitoring of contacts already identified.
--
Communicated by:
Mirian M. de Moura mirianmoura@uol.com.br
via ProMED-PORT promed@promedmail.org
[It may be just a coincidence, but the presence of otitis and intra-family transmission recalls infection with _Mycoplasma_ or _Moraxella_. - Mod.LJS
The etiology of this illness in which it appears that 2 of 4 members of the family died is not clear. As suggested above, _Mycoplasma pneumoniae_ can be associated with ear disease, generally bullous myringitis, which does not usually cause a purulent otorrhea.
Fatalities from mycoplasmosis can occur but 2 in one family seems extraordinary. As well, _Moraxella catarrhalis_ can cause otitis media and pneumonia, but not usually in the same patient and again, fatalities in otherwise well individuals are uncommon.
It would be of interest to know more about the epidemiology including the ages of those afflicted, pets at home, travel, visitors from elsewhere, and the living conditions.
The port city of Santos is partially located on the island of Sao Vicente -- which harbors both the city of Santos and the city of Sao Vicente -- and partially on the mainland. It is the main city in the metropolitan region of the Baixada Santista and can be found on a map at http://en.wikipedia.org/wiki/Santos_(S%C3%A3o_Paulo). - Mod.LL]
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http://apex.oracle.com/pls/otn/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,72306
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