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Dengue fever is a common infectious disease transmitted by mosquitoes and is a major burden in Brazil. In 2013, there were over 950,000 clinical cases and 201 deaths reported in Brazil. The state of São Paulo, which includes the city of São Paulo, has the highest number of cases in the country. The authors of the article are concerned that the co-circulation of multiple dengue serotypes in this densely populated area may lead to hyperendemicity, which could increase the risk of severe disease, particularly in children. The presence of all four serotypes in the same outbreak in São Paulo is a concerning finding that has also been seen in other countries, such as India. The authors emphasize the importance of long-term prevention and control measures to address this issue. [Extracted from the article]

The article presents the author's views on the detection of various dengue serotypes which are increasing in the hyperendemicity in urban areas of Brazil. Brief information on terms including dengue fever and hyperendemicity are presented. Four serotypes of the fever that are discussed includes DENV-1, DENV-2, DENV-3 and DENV-4.

Introduction: The Coronavirus Disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. Data on the mobility level of patients with COVID-19 in the intensive care unit (ICU) are needed. Objective: To describe the mobility level of patients with COVID-19 admitted to the ICU and to address factors associated with mobility level at the time of ICU discharge. Methods: Single center, retrospective cohort study. Consecutive patients admitted to the ICU with confirmed COVID-19 infection were analyzed. The mobility status was assessed by the Perme Score at admission and discharge from ICU with higher scores indicating higher mobility level. The Perme Mobility Index (PMI) was calculated [PMI = ΔPerme Score (ICU discharge–ICU admission)/ICU length of stay]. Based on the PMI, patients were divided into two groups: "Improved" (PMI > 0) and "Not improved" (PMI ≤ 0). Results: A total of 136 patients were included in this analysis. The hospital mortality rate was 16.2%. The Perme Score improved significantly when comparing ICU discharge with ICU admission [20.0 (7–28) points versus 7.0 (0–16) points; P < 0.001]. A total of 88 patients (64.7%) improved their mobility level during ICU stay, and the median PMI of these patients was 1.5 (0.6–3.4). Patients in the improved group had a lower duration of mechanical ventilation [10 (5–14) days versus 15 (8–24) days; P = 0.021], lower hospital length of stay [25 (12–37) days versus 30 (11–48) days; P < 0.001], and lower ICU and hospital mortality rate. Independent predictors for mobility level were lower age, lower Charlson Comorbidity Index, and not having received renal replacement therapy. Conclusion: Patients' mobility level was low at ICU admission; however, most patients improved their mobility level during ICU stay. Risk factors associated with the mobility level were age, comorbidities, and use of renal replacement therapy. [ABSTRACT FROM AUTHOR]

AbstractLongitudinal mosquito surveys were carried out in southern Portugal from 2004 to 2007, in a wetland area (Comporta, District of Setúbal) and around the perimeter of a dam irrigation plant that created the largest artificial lake in Europe, 250 km2(Alqueva, Districts of Évora and Beja). Our aim was to study the diversity, abundance, and seasonal dynamics of mosquitoes, comparing these two different areas, to screen mosquitoes for West Nile Virus (WNV), an arboviral agent already detected in Portugal, because these areas are populated with abundant avian fauna. Monthly collections of adult mosquitoes were carried out by Centers for Disease Control light-traps with CO2and by indoor resting collections. Mosquitoes were identified and screened for arboviruses by reverse transcriptase (RT)-polymerase chain reaction directed toward amplification of a 217-bp fragment of the NS5 gene. Mosquito peak densities were observed in July–August in Comporta and May–June, with a plateau in July–October, in Alqueva. However, densities were far higher in Comporta area (220,821 specimens) than in Alqueva area (9442 specimens), with a clear difference in species distribution, as in Comporta the predominant species was Culex theileri(85%), followed by Aedes caspius(6%), Anopheles atroparvus(4%), and Culex pipiens sensu latu(s.l.) (3%), whereas in Alqueva the predominant species was Cx. pipienss.l. (56%), followed by An. atroparvus(18%), Cx. theileri(14%), and Culiseta longiareolata(9%). Female mosquitoes (8842 in 175 pools) of the species Ae. caspius, An. atroparvus, Culex mimeticus, Cx. pipiensSensu latu(s.l.), Cx. theileri, and Culex univittatuswere screened and found to be negative for WNV genomic RNA. Although there was no detection of WNV sequences in mosquitoes, vigilance should continue as the circulation of virus has been previously detected more than once in Portugal, in humans, animals, and mosquitoes, and in other surrounding Mediterranean countries. [ABSTRACT FROM AUTHOR]