Evaluation of Zika rapid tests as aids for clinical diagnosis and epidemic preparedness.

Background: Development and evaluation of diagnostics for diseases of epidemic potential are often funded during epidemics, but not afterwards, leaving countries unprepared for the next epidemic. United Nations Children's Emergency Fund (UNICEF) partnered with the United States Agency for International Development (USAID) to address this important gap by investing in an advance purchase commitment (APC) mechanism to accelerate the development and evaluation of Zika rapid diagnostic tests (RDTs) for case detection and surveillance. This paper describes the performance evaluation of five Zika RDTs eligible for procurement.

Evaluation of commercially available diagnostic tests for the detection of dengue virus NS1 antigen and anti-dengue virus IgM antibody.

Commercially available diagnostic test kits for detection of dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO), the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Pediatric Dengue Vaccine Initiative (PDVI). Each network laboratory contributed characterized serum specimens for the panels used in the evaluation. Microplate enzyme-linked immunosorbent assay (ELISA) and rapid diagnostic test (RDT formats) were represented by the kits.

Dengue: a continuing global threat.

Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ∼50 million dengue infections and ∼500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes.

Evaluation of commercially available anti-dengue virus immunoglobulin M tests.

Anti-dengue virus immunoglobulin M kits were evaluated. Test sensitivities were 21%-99% and specificities were 77%-98% compared with reference ELISAs. False-positive results were found for patients with malaria or past dengue infections.

[Society, economy, inequities and dengue].

Dengue and dengue hemorrhagic fever in the Americas have been on the rise throughout the 1990s, with the highest number -over one million cases- reported in 2002. This paper analyzed the situation of dengue in the region and discussed the determining factors that account for the rise of the disease, making emphasis on socioeconomic factors, such as poverty, inequality, migrations and the lack of access to basic services, which are the most influential in perpetuating this disease in most countries. Considering that a safe and accessible vaccine is now unavailable, basic principles of vector control combined with political willingness, inter-sectoral involvement, active community participation and the tightening of health legislation were also examined as the only viable solution at present.

Morphometric studies of specific brain regions of rats chronically intoxicated with the organophosphate methamidophos.

Subtle neurological disturbances have been described in organophosphorus intoxication. Experimental studies have reported neuronal necrosis, particularly in animals experiencing seizures. The objective of the present work was to investigate if in rats (without seizures) exposed to an organophosphate agent, morphological changes occur in specific regions of the brain.

Dengue 3 epidemic, Havana, 2001.

In June 2001, dengue transmission was detected in Havana, Cuba; 12,889 cases were reported. Dengue 3, the etiologic agent of the epidemic, caused the dengue hemorrhagic fever only in adults, with 78 cases and 3 deaths. After intensive vector control efforts, no new cases have been detected.

[Quality control of the serological diagnosis of dengue in laboratories throughout the Americas, 1996-2001].

Objective: To report the results from participating laboratories for four external quality control proficiency tests of dengue serological diagnosis that were carried out in the Region of the Americas in the period of 1996-2001.

Methods: External quality control proficiency tests of dengue serological diagnosis were carried out in 1996-1997, 1998-1999, 1999-2000, and 2000-2001. Panels made up of 20 serum samples (12 of them positive for dengue IgM antibodies) were sent to participating laboratories in the Region.

MAC-ELISA and ELISA inhibition methods for detection of antibodies after yellow fever vaccination.

The IgM antibody capture ELISA (MAC-ELISA) and ELISA inhibition methods for the detection of antibodies against dengue virus were modified to detect antibodies against yellow fever virus. Tests were carried out in 21 persons vaccinated with 17D and compared with the Plaque reduction neutralizing test. Of 17 naive subjects vaccinated, 16 (94%) seroconverted using the MAC-ELISA test and 14 (82%) seroconverted (or >/=fourfold titer increase) in the ELISA inhibition method.

Protective effect of early and late administration of pralidoxime against organophosphate muscle necrosis.

The objective of the present investigation was to study the protection afforded by a single administration of pralidoxime against the muscle necrosis induced by the organophosphate compound metamidophos at different times after intoxication. The fiber necrosis of the diaphragm muscle was quantified by a morphometric technique, comparing the area fraction occupied by necrotic muscle fibers in animals that received pralidoxime at different times after intoxication, i.e.

[Emerging viral diseases].

In the last few years an increasing rise of new infectious diseases or of other diseases considered to be under control has been observed. The so called emerging and reemerging diseases are those new infections that have come up in a population or those existing diseases which incidence and geographic extension are on a rapid increase. Factors such as social and economic situations, medical assistance, food production, changes in human behaviours, environmental changes, health systems deterioration, and adaptation and changes of microorganisms are related with the emergence or reemergence of a number of entities.

Detection and genetic relationship of dengue virus sequences in seventeen-year-old paraffin-embedded samples from Cuba.

This study describes the use of the reverse transcriptase-polymerase chain reaction (RT-PCR) to generate dengue 2 amplicons from paraffin-embedded autopsy tissues collected in Cuba 17 years ago. The presumptive diagnoses had been made only by clinical evolution without serologic confirmation. This study confirms once again that dengue 2 virus was directly associated with the fatal cases in children and illustrates the potential of the RT-PCR for retrospective diagnosis of dengue cases 17 years after death.

Urbanisation of yellow fever in Santa Cruz, Bolivia.

Background: Reinvasion by Aedes aegypti of cities in the Americas poses a threat of urbanisation of yellow fever. After detection of yellow-fever infection in a resident of the city of Santa Cruz, Bolivia, in December, 1997, we investigated all subsequent suspected cases.

Methods: We introduced active surveillance of yellow fever in the Santa Cruz area.

[Epidemic outbreak of dengue virus 2/Jamaica genotype in Bolivia].

Objective: To confirm an epidemic outbreak of Dengue virus in the city of Santa Cruz, Bolivia, and to determine the serotype of the virus, to estimate the rate of attack and the proportion of symptomatic infections.

Material And Methods: In March 1997, a seroepidemiological survey was conducted with random sampling in a central district of the city of Santa Cruz, Bolivia. Information on recent acute illness and febrile episodes was gathered, and venous blood samples were obtained.

Protective effect of pralidoxime on muscle fiber necrosis induced by organophosphate compounds.

Objective: To determine the protective effect of pralidoxime on muscle fiber necrosis induced by organophosphate acute intoxication in rats.

Design: Adult male Wistar rats were given oral organophosphate compounds dissolved in glycerol formal: dichlorvos, isofenphos, metamidophos, and diazinon. Half of the animals also received pralidoxime mesylate (20 mg/kg, intraperitoneal).

Viral isolation from cases of epidemic neuropathy in Cuba.

Objective: To investigate the possibility of a viral agent in the central nervous system of patients with epidemic neuropathy.

Design: Virus isolation attempts, in cell cultures and suckling mice, from cerebrospinal fluid (CSF) of neuropathy patients and controls undergoing lumbar puncture for unrelated reasons. Serologic studies in patients, contacts, and controls.

[Standardization of immunohistochemical techniques for detecting dengue virus antigens in paraffin-embedded tissues].

The immunohistochemical techniques may be very useful for the detection of antigens of the dengue virus in infected tissues. The results obtained with the use of 2 IHC methods: one direct and another indirect amplified with a biotin universal antibody and a streptavidin peroxidase system (LSAB) (the peroxidase enzyme is used in both) are shown in this paper. These methods were applied on paraffin-embedded tissues from mice that were inoculated with the dengue virus intracerebrally.

[Dengue in Panama, 1993].

Up to 1993, Panama was the only country in Central America where the autochthonous transmission of dengue virus had been detected without experimenting an explosive epidemic despite being reinfected with the Aedes aegypti mosquito since 1985. The characteristics of this first outbreak reported on November 19, 1993, are described in this paper. It is shown that even when there is a Program for the Surveillance and Control of Dengue, which considers low levels of Aedes aegypti infection and a system for the early detection of the virus, the epidemics appear if the community does not take an active part as it happened in 1994, 1995, and 1996.

[Surveillance of St. Louis encephalitis, Eastern equine and Western equine in the province of Ciego de Avila].

Serological studies were carried out using the haemagglutination inhibition and neutralization tests so as to know the circulation dynamics of some arboviruses with the use of Western and Eastern equine encephalitis antigens and St Louis encephalitis antigens in human serum from sound and symptomatic individuals, as well as from sentinel birds, between 1987 and 1991, and during 1994. 1.7% of the asymptomatic subjects tested presented neutralizing antibodies to to Eastern equine and 4.

[Direct sequencing of an amplified product from a serum sample].

It is reported the nucleotide and amino acidic sequence of a great variability region in the dengue 2 virus genome, starting from the RNA of the original virus with no passage in the isolation systems. It is compared with the first strain of dengue 2 isolated during the 1981 epidemic with 4 passages in lactating mouse. Results show that the nucleotide sequence of serum and of strain A15 are the same.

Partial nucleotide and amino acid sequences of the envelope and the envelope/nonstructural protein-1 gene junction of four dengue-2 virus strains isolated during the 1981 Cuban epidemic.

In 1981, an epidemic of dengue hemorrhagic fever (DHF) caused by dengue-2 virus occurred in Cuba. This was the first DHF epidemic reported in the Western Hemisphere. In this study, we have analyzed four dengue-2 Cuban strains for two short genomic fragments: one on the envelope (E) glycoprotein and one at the E/nonstructural protein-1 (NS1) gene junction.

[An immunoenzyme assay for the detection of monoclonal antibodies against the E and NS1 proteins of the dengue virus].

The ELISA was standardized to detect monoclonal antibodies of dengue virus proteins E and NS1. One indirect ELISA was applied, using C6-36 cells inoculated with the A-15 strain, isolated during the dengue 2 epidemic in 1981 as an antigen source. These cells were fixed in ELISA plates at a 200,000 cell/well concentration.

[Cuban epidemic neuropathy. I. Viral isolation].

From the end of 1991 to June, 1993, an epidemic neuropathy affecting 50,963 persons occurred in Cuba. Two clinical forms of the disease were observed: the optic form (with or without peripheral manifestations, 52% of the cases) and the peripheral form (48%). The epidemiological studies revealed nutritional disorders, mainly a vitamin B complex deficiency due to economic difficulties faced by the country in the "special period".