Publications by authors named "Cassia Fernanda Estofolete"

Background: Brazil is considered an epicenter for emerging and re-emerging arboviruses that significantly impact public health. The mid-sized city of São José do Rio Preto (SJdRP) in northwestern São Paulo state is considered hyperendemic for arboviral diseases, with case numbers climbing each year. Only 45 cases of chikungunya (CHIKV) were reported in the city from 2015 to 2022, indicating cryptic circulation of this virus, but cases in the state increased notably in 2023.

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Dengue is of growing global public health concern. Diabetes is a significant risk factor for severe dengue and dengue-related mortality. Countries with the highest number of reported dengue cases are projected to experience a substantial increase in diabetes by 2050.

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Article Synopsis
  • Chikungunya virus (CHIKV) has been spreading variably across Brazil, and its impact in São José do Rio Preto (SJdRP) is studied to understand the low incidence of reported cases, despite the potential for underdiagnosis due to overlapping symptoms with other viruses like dengue.
  • A study involving 341 asymptomatic individuals over four years showed an increase in anti-CHIKV IgG seroconversion from 0.35% to 2.3%, and 4.4% of dengue-suspected individuals tested positive for anti-CHIKV IgM during a 2019 outbreak.
  • Genomic analysis confirmed the presence of the ECSA genotype of CHIKV in SJd
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Retinal lesions, including cotton-wool exudates, microbleeds, vascular occlusions and vasculitis, occur in a minority of Coronavirus Disease-19 (COVID-19) patients. Retinal assessments using retinography can help document these lesions. The objective of this work was to identify retinal changes in patients admitted to the ward with a positive Real Time Quantitative Polymerase Chain Reaction (RT-qPCR) exam for COVID-19.

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The precise pathogenesis of COVID-19-related multisystem inflammatory syndrome remains largely elusive, despite its rarity. The syndrome symptoms often overlap with those of other infections, posing challenges for prompt diagnosis. A male patient, 34 years old, was admitted with suspicion of severe dengue, rapidly progressing to multiple organ dysfunction.

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Acute respiratory infections are a constant public health problem causing childhood morbidity and mortality worldwide. Reported cases of major respiratory infections decreased in 2020 after restrictive measures were adopted to contain the COVID-19 pandemic, but there is little data on the impact after these measures were relaxed in the subsequent years. This study conducted molecular analysis to identify rhinovirus, respiratory syncytial virus, influenza A virus, and adenovirus in SARS-CoV-2-negative samples taken from symptomatic pediatric patients during 2021 and 2022 to ascertain the impact of pandemic response measures within the broader epidemiological scenario.

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The genetic diversity of the dengue virus is characterized by four circulating serotypes, several genotypes, and an increasing number of existing lineages that may have differences in the potential to cause epidemics and disease severity. Accurate identification of the genetic variability of the virus is essential to identify lineages responsible for an epidemic and understanding the processes of virus spread and virulence. Here, we characterize, using portable nanopore genomic sequencing, different lineages of dengue virus 2 (DENV-2) detected in 22 serum samples from patients with and without dengue warning signs attended at Hospital de Base of São José do Rio Preto (SJRP) in 2019, during a DENV-2 outbreak.

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The disease burden of yellow fever virus infection (YFV) is quite high in the tropics where vaccination coverage is low. To date, vaccination is the most effective control strategy to mitigate and eliminate the burden of YF disease. The licensed YF vaccines are safe and effective and serious adverse events are rare.

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Measles is a highly contagious acute febrile disease responsible for sporadic but explosive outbreaks worldwide. Although it was considered eliminated from the Americas, the disease reemerged in 2017. This reemergence was linked to reduced immunization rates.

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Background: The emergence of the Brazilian variant of concern, Gamma lineage (P.1), impacted the epidemiological profile of COVID-19 cases due to its higher transmissibility rate and immune evasion ability.

Methods: We sequenced 305 SARS-CoV-2 whole-genomes and performed phylogenetic analyses to identify introduction events and the circulating lineages.

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Despite great advances in our knowledge of the consequences of Zika virus to human health, many questions remain unanswered, and results are often inconsistent. The small sample size of individual studies has limited inference about the spectrum of congenital Zika manifestations and the prognosis of affected children. The Brazilian Zika Cohorts Consortium addresses these limitations by bringing together and harmonizing epidemiological data from a series of prospective cohort studies of pregnant women with rash and of children with microcephaly and/or other manifestations of congenital Zika.

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Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including rotavirus (RVA), human astrovirus (HAstV), and norovirus (NoV), have also been associated with CNS neurological disorders. The aim of the present study was to investigate the presence of EV, RVA, HAst, and NoV associated to CNS infections with undiagnosed etiology in Northwest region of São Paulo State, Brazil, and to conduct the molecular characterization of the positive samples detected.

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Background: We evaluated the validity of clinical diagnosis compared with laboratory diagnosis of dengue in a retrospective sample of patients in São José do Rio Preto, Brazil.

Methods: Our sample included 148 299 clinically (56.3%) or laboratory-diagnosed (43.

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Measles is an acute and highly contagious but vaccine-preventable infectious disease. Despite years of being considered eliminated, decreased vaccination rates have produced virus reemergence in several countries, including Brazil. Measles can be controlled through immunization programs, through which aim to achieve 95% coverage with two doses of the vaccine.

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Dengue infection (DI) is the most important arboviral infection in the world. The majority of immunocompetent patients will have asymptomatic or mild infections, but the degree of dengue severity in kidney transplant recipients (KTx) is unknown. In this study, we report the clinical profile and outcomes of 39 dengue cases in KTx.

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The disease caused by each of the four serotypes of dengue virus (DENV) have plagued humans since last century. Symptoms of dengue virus (DENV) infection range from asymptomatic to dengue fever (DF) to severe dengue disease (SDD). One third of the world's population lives in regions with active urban DENV transmission, and thousands of serologically naïve travelers visit these areas annually, making a significant portion of the human population at risk of being infected.

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Article Synopsis
  • Enterobacter hormaechei is a significant cause of severe infections in critically ill patients, and its resistance to aminoglycosides, major antibiotics for treatment, is on the rise due to the rmtG gene.
  • This study aimed to analyze the genetic context of plasmids containing the rmtG gene in two resistant E. hormaechei isolates from Brazil, utilizing advanced sequencing and bioinformatics tools.
  • The findings revealed both isolates carried the rmtG gene on large plasmids associated with transposable elements, which could promote the spread of resistance to other pathogens, complicating treatment options further.
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Background: São José do Rio Preto is one of the cities of the state of São Paulo, Brazil, that is hyperendemic for dengue, with the presence of the four dengue serotypes.

Objectives: to calculate dengue seroprevalence in a neighbourhood of São José do Rio Preto and identify if socioeconomic and demographic covariates are associated with dengue seropositivity.

Methods: A cohort study to evaluate dengue seroprevalence and incidence and associated factors on people aged 10 years or older, was assembled in Vila Toninho neighbourhood, São José do Rio Preto.

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  • The study focused on pregnant women in Brazil during the 2016 Zika virus outbreak, where Zika virus RNA was found in urine samples.
  • The women exhibited both positive and negative periods of the virus in their urine, and three newborns from those mothers experienced negative health outcomes.
  • Additional research is necessary to better understand how the presence of the virus in urine may affect newborn health outcomes.
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  • The study investigates the impact of prior dengue virus (DENV) exposure on the severity and viral load in patients later infected with Zika virus (ZIKV) or another dengue strain.
  • Researchers analyzed viral loads and cytokine levels during acute infections to identify any differences between individuals with and without previous DENV exposure.
  • The results showed no increase in viremia related to prior DENV exposure, and only one cytokine (IL-1β) showed a significant difference, suggesting no evidence of antibody-dependent enhancement (ADE) in those concurrently infected with ZIKV.
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In Brazil, the incidence of hospitalization due to dengue, as an indicator of severity, has drastically increased since 1998. The objective of our study was to identify risk factors associated with subsequent hospitalization related to dengue. We analyzed 7613 dengue confirmed via serology (ELISA), non-structural protein 1, or polymerase chain reaction amplification.

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