Aspectos epidemiológicos das infecções por arbovírus em pacientes do Hospital Escola Dr. Hélvio Auto (HEHA) – Maceió/AL

Abstract

The arboviruses are transmitted by arthropod vectors, generating concern in public health by causing epidemics in many parts of the world. In the acute phase of their infection, these viruses cause asymptomatic infections or indistinguishable fever, hindering the clinical diagnosis, and consequently, appropriate treatment. In Brazil, there are several circulating arboviruses, with reports of outbreaks caused by Ilheus (ILHV), Saint Louis (SLEV), Rocio (ROCV) and Oropouche (OROV), besides dengue epidemic. However, in the state of Alagoas there is a deficit in the epidemiological and scientific data about these viruses. Thus, the aim of this study is to evaluate the epidemiology of circulating arboviruses in Alagoas, through the molecular detection of viral genomes and characterization of the epidemiologic profile of affected individuals. Therefore, we analyzed 230 samples (205 serum and 25 liquor) of patients attending at the Hospital Escola Hélvio Auto (HEHA), acquired between October 2013 and June 2014. After assay of PCR we detected 85 patients with viral RNA that had their epidemiologic profile analyzed in addition to the quantification of proinflammatory cytokines. Among the viruses screened, the serotype 4 dengue virus (DENV-4) was detected as circulating in Alagoas, which was introduced in the state in 2012, after the re-emergence in 2010 of the DENV-4 in Brazil. Furthermore, the symptoms commonly associated with infections caused by dengue virus were predominant in our patients. However, only 37.65% of the patients developed thrombocytopenia and 17.65% of them had a decrease in hematocrit level. They presented increased levels of AST and / or ALT. In addition, we identified correlation between the complaint of abdominal pain and thrombocytopenia. We also observed high levels of IL-10 in severe cases, in addition to high levels of IL -8 and IL -6 in the other samples. In view of this, the results are of great importance for the epidemiological surveillance department of Alagoas, due to the knowledge about the current serotype of dengue in the region and to the epidemiologic information that will help elaborate clinical management protocols to DENV-infected individuals. However, more studies are needed including individuals with viral genome not detected in order to find epidemiological differences over those DENV-infected and thus aid in clinical diagnosis.