|146-1||ACUTE HEMORRHAGIC CONJUNCTIVITIS OUTBREAK BY COXSACKIEVIRUS A24 IN SÃO PAULO STATE, BRAZIL – 2011
|Autores:||Denise Hage Russo (IAL - Instituto Adolfo Lutz) ; Bráulio Caetano Machado (IAL - Instituto Adolfo Lutz) ; Cleusa Aparecida de Sousa (IAL - Instituto Adolfo Lutz) ; Bethânia Costa Vilanova (IAL - Instituto Adolfo Lutz) ; Norma Medina (CVE - Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac) ; Maria do Carmo Sampaio Tavares Timenetsky (IAL - Instituto Adolfo Lutz) ; Rita de Cássia Compagnoli Carmona (IAL - Instituto Adolfo Lutz) |
Acute hemorrhagic conjunctivitis (AHC) is a highly contagious viral disease, characterized by sudden onset, conjunctive hemorrhages, excessive lacrimation and red eyes. In a period of February to April 2011 the Epidemiological Surveillance Center (CVE) received 155.730 notifications of AHC cases in São Paulo State, Brazil. In order to identify the etiology of this outbreak, 93 eye discharges were sent to Enteric Diseases Laboratory of Adolfo Lutz Institute to viral isolation. These specimens were inoculated in RD and MRC5 cell lines and analyzed daily for cytophatic effect (CPE) characteristic of Enterovirus, and identified as Coxsackievirus A-24 (CV-A24) by RT-PCR on the 5' NTR and VP1 regions. Twenty four paired of acute and convalescent serum were analyzed by neutralizing antibody titers. The development of CPE was observed in 60.2% (56/93) samples. Our study identified CV-A24 as the aetiological agent responsible for the AHC epidemic. RT-PCR showed a fragment of 171 base pairs in all samples and the sequencing of the partial fragment of the VP1 region, confirmed the Enterovirus as CV-A24. In the neutralizing antibody assay 29,6% (8/27) of serum showed a 4 fold or higher titer against CV-A24. The low positivity of the isolation and seroconverting rates could be due of the samples collection. It is known that the collection of samples in AHC cases should be performed within 48 hours after onset of symptoms, and in our study 30.10% (28/93) and 31.10% (20/93) of cases did not report the dates of onset of symptoms and collection, respectively. The first case notified to CVE was from Prison Facilities in Florida city of São Paulo State, and person-to-person transmission in among prisoners, employees and their family probably played an important role in causing this outbreak.
Palavras-chave: ACUTE HEMORRHAGIC CONJUNCTIVITIS, enterovirus, coxsackievirus A24