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Objetivo: Avaliar as condições microbiológicas das maçanetas internas e externas das portas da unidade de clí­nica médica de um Hospital Público no interior da Amazônia, Municí­pio de Santarém, Oeste do Pará, Brasil. Método: Pesquisa exploratório-descritiva, quantitativa, realizado através de amostras da superfí­cie de maçanetas das portas da clí­nica médica de um Hospital em Santarém-Pará. A análise microbiológica, foi realizada no agitador para dessorção das bactérias e a suspensão foi semeada por esgotamento. Resultados: Das 84 maçanetas, 26,2% apresentaram resultado microbiológico positivo, sendo encontrada em todos os casos a bactéria Staphylococcus sp. Quanto o material de cobertura, 25% das maçanetas estavam comprometido, sendo que, dentre os casos positivos na análise microbiológica, 18,2% das maçanetas estavam com a superfí­cie prejudicada. Conclusão: Apesar do número de amostras positivas serem relativamente pequenos, é importante destacar ações voltada para a higienização dos fômites hospitalares, dado que estes podem funcionar como reservatórios de microrganismos patogênicos.

Introdução: A candidemia é uma das infecções nasocomiais mais frequentes a nível mundial e apresenta diferentes espécies de Candida envolvidas com o desenvolvimento dessa patologia. Objetivo: Este estudo analisou os aspectos epidemiológicos e as diferentes espécies de Candida associadas à candidemia. Material e Métodos: Uma revisão de literatura foi realizada, através da leitura de artigos científicos publicados nas bases de dados Pubmed e Scielo nos últimos cinco anos. Utilizou-se as seguintes combinações de descritores: Candidemia, Candidemia e Prevalência, Candidemia e Incidência, Candidemia e Candida. Resultados: A candidemia é a infecção fúngica mais hostil atualmente encontrada e prevalente nas populações estudadas. A população mais afetada são os recém-nascidos. Apresenta altas taxas de mortalidade e disseminação em várias partes do mundo. A nutrição parenteral, a administração de antibióticos de amplo espectro, hospitalização prolongada, cirurgia prévia e colonização por Candida sp são os principais fatores de risco relatados na literatura. Múltiplas espécies fúngicas estão associadas a essa condição, porém C. albicans é a mais predominante, seguida por C. parapsilosis e C. tropicalis. Conclusões: A Candidemia é uma patologia prevalente e apresenta alta incidência e morbimortalidade nas populações estudadas das diferentes partes do mundo. C. albicans é a espécie mais associada, seguida por C. parapsilosis e C. tropicalis. Descritores: Candidemia; Prevalência; Incidência; Candida. Referências Treviño-Rangel RJ, Peña-López CD, Hernández-Rodríguez PA, Beltrán-Santiago D, González GM. Association between Candida biofilm-forming bloodstream isolates and the clinical evolution in patients with candidemia: An observational nine-year single center study in Mexico. Rev Iberoam Micol. 2018;35(1):11-16. Kaur H, Chakrabarti A. Strategies to Reduce Mortality in Adult and Neonatal Candidemia in Developing Countries. J Fungi (Basel). 2017;3(3):41. Wu PF, Liu WL, Hsieh MH, Hii IM, Lee YL, Lin YT et al. Epidemiology and antifungal susceptibility of candidemia isolates of non-albicans Candida species from cancer patients. Emerg Microbes Infect. 2017;6(10):e87. Vasilyeva NV, Raush ER, Rudneva MV, Bogomolova TS, Taraskina AE, Fang Y et al. Etiology of invasive candidosis agents in Russia: a multicenter epidemiological survey. Front Med. 2018;12(1):84-91. Barchiesi F, Orsetti E, Osimani P, Catassi C, Santelli F, Manso E. Factors related to outcome of bloodstream infections due to Candida parapsilosis complex. BMC Infect Dis. 2016;16:387. Barchiesi F, Orsetti E, Mazzanti S, Trave F, Salvi A, Nitti C, Manso E. Candidemia in the elderly: What does it change? PLoS One. 2017;12(5):e0176576. Benedict K, Roy M, Kabbani S, Anderson EJ, Farley MM, Harb S et al. Neonatal and pediatric candidemia: results from population-based active laboratory surveillance in four US locations, 2009-2015. J Pediatric Infect Dis Soc. 2018;7(3):e78-e85. Bhattacharjee P. Epidemiology and antifungal susceptibility of Candida species in a tertiary care hospital, Kolkata, India. Curr Med Mycol. 2016;2(2):20-7. Breda GL, Tuon FF, Meis JF, Herkert PF, Hagen F, de Oliveira LZ, Dias VC, da Cunha CA, Queiroz-Telles F. Breakthrough candidemia after the introduction of broad spectrum antifungal agents: A 5-year retrospective study. Med Mycol. 2018;56(4):406-15 Caggiano G, Lovero G, De Giglio O, Barbuti G, Montagna O, Laforgia N et al. Candidemia in the Neonatal Intensive Care Unit: a retrospective, observational survey and analysis of literature Data. Biomed Res Int. 2017;2017:7901763. Fu J, Ding Y, Wei B, Wang L, Xu S, Qin P, Wei L, Jiang L. Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China. BMC Infect Dis. 2017;17(1):329. Guzzetti LB, Vescina CM, Gil MF, Gatti BM. Candidemias en pediatría: distribución de especies y sensibilidad a los antifúngicos [Candidemia in Pediatrics: Species distribution and antifungal susceptibility]. Rev Argent Microbiol. 2017;49(4):320-22. Kofteridis DP, Valachis A, Dimopoulou D, Andrianaki AM, Christidou A, Maraki S, Spernovasilis NA, Samonis G. Factors Influencing Non-albicans Candidemia: A Case-Case-Control Study. 2017; 182(7-8):665-72. Kubiak DW, Farmakiotis D, Arons V, Hollins RM, Rostas SE, Weiser LM et al. Utility of in-house fluconazole disk diffusion susceptibility testing in the treatment of candidemia. Diagn Microbiol Infect Dis. 2016;84(3):223-26. Li D, Zhang W, Zheng S, Ma Z, Zhang P, Liu Z. Surveillance study of candidemia in cancer patients in North China. Med Mycol. 2013;51(4):378-84. Li D, Xia R, Zhang Q, Bai C, Li Z, Zhang P. Evaluation of candidemia in epidemiology and risk factors among cancer patients in a cancer center of China: an 8-year case-control study. BMC Infect Dis. 2017;17(1):536. Lortholary O, Renaudat C, Sitbon K, Desnos-Ollivier M, Bretagne S, Dromer F; French Mycoses Study Group. The risk and clinical outcome of candidemia depending on underlying Intensive Care Med. 2017; 43(5):652-62. Lovero G, De Giglio O, Montagna O, Diella G, Divenuto F, Lopuzzo M, Rutigliano S, Laforgia N, Caggiano G, Montagna MT. Epidemiology of candidemia in neonatal intensive care units: a persistent public health problem. Ann Ig. 2016;28(4):282-87. Márquez F, Iturrieta I, Calvo M, Urrutia M, Godoy-Martínez P. Epidemiología y susceptibilidad antifúngica de especies causantes de candidemia en la ciudad de Valdivia, Chile [Epidemiology and antifungal susceptibility of species producing candidemia in Valdivia, Chile]. Rev Chilena Infectol. 2017;34(5):441-46. Pinhati HM, Casulari LA, Souza AC, Siqueira RA, Damasceno CM, Colombo AL. Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit. BMC Infect Dis. 2016;16(1):433. Siri L, Legarraga P, García P, González T, Rabagliati R. Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013. Rev Chilena Infectol. 2017;34(1):19-26. Spiers R, Smyth B, Lamagni T, Rooney P, Dorgan E, Wyatt T et al. The epidemiology and management of candidemia in Northern Ireland during 2002-2011, including a 12-month enhanced case review. Med Mycol. 2019;57(1):23-9. Tiraboschi IN, Pozzi NC, Farías L, García S, Fernández NB. Epidemiología, especies, resistencia antifúngica y evolución de las candidemias en un hospital universitario de Buenos Aires, Argentina, durante 16 años [Epidemiology, species, antifungal resistance and outcome of candidemia in a university hospital in Buenos Aires, Argentina for 16 years]. Rev Chilena Infectol. 2017;34(5):431-40. Vena A, Bouza E, Valerio M, Padilla B, Paño-Pardo JR, Fernández-Ruiz M et al. Candidemia in non-ICU surgical wards: comparison with medical wards. PLoS One. 2017;12(10):e0185339. Kelly MS, Benjamin DK Jr, Smith PB. The epidemiology and diagnosis of invasive candidiasis among premature infants. Clin Perinatol. 2015;42(1):105-17, viii-ix. Wu JQ, Zhu LP, Ou XT, Xu B, Hu XP, Wang X et al. Epidemiology and risk factors for non-Candida albicans candidemia in non-neutropenic patients at a Chinese teaching hospital. Med Mycol. 2011;49(5):552-55. Navalkele BD, Revankar S, Chandrasekar P. Candida auris: a worrisome, globally emerging pathogen. Expert Rev Anti Infect Ther. 2017;15(9):819-27. Spivak ES, Hanson KE. Candida auris: an Emerging Fungal Pathogen. J Clin Microbiol. 2018;56(2):e01588-17. Colombo AL, Guimarães T, Sukienik T, Pasqualotto AC, Andreotti R, Queiroz-Telles F et al. Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of five multicenter studies sequentially conducted over a 9-year period Intensive Care Med. 2014;40(10):1489-98. Gehring GM, Carrilho CMM, Pelisson M, Perugini M, Tano ZN. Candidemia: Revisão Bibliográfica. J Infect Control. 2015;4(4):1-19. Lepak A, Andes D. Fungal sepsis: optimizing antifungal therapy in the critical care setting. Crit Care Clin. 2011;27(1):123-47. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-50. Wisplinghoff H, Ebbers J, Geurtz L, Stefanik D, Major Y, Edmond MB et al. Nosocomial bloodstream infections due to Candida spp. in the USA: species distribution, clinical features and antifungal susceptibilities. Int J Antimicrob Agents. 2014;43(1):78-81.

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Objetivo: Analisar a associação entre o nível de estresse ocupacional e uso de psicotrópicos por docentes da área de saúde. Métodos: Estudo transversal, analítico e quantitativo, realizado entre novembro e dezembro de 2018, em uma instituição privada do estado de Goiás, onde 48 docentes universitários da área de saúde responderam a questionários sociodemográfico e profissional, Escala de Estresse no Trabalho e questionário sobre o uso de psicotrópicos. Analisaram-se os dados por meio de medidas descritivas e teste de qui-quadrado. Resultados: Foi detectado alto nível de estresse ocupacional em 39,6% da amostra. Houve associação significativa entre estresse ocupacional e as seguintes variáveis: uso atual ou prévio de medicação psicotrópica (0,037), percepção de melhora da qualidade de vida após terapia medicamentosa (p=0,041) e realização de atividades de risco no ambiente de trabalho (p=0,036). Conclusão: O uso de psicotrópicos pelos docentes universitários está significativamente associado ao estresse ocupacional na amostra em questão.

Fluoroquinolones (FQs) are broad-spectrum antibiotics largely used in the clinical practice against Gram-negative and some Gram-positive bacteria. Nevertheless, bacteria have developed several antimicrobial resistance mechanisms against such class of antibiotics. Ternary complexes of FQs, copper(II) and phenanthroline, known as metalloantibiotics, arise in an attempt to counteract an antibiotic resistance mechanism related to low membrane permeability. These metalloantibiotics seem to use an alternative influx route, independent of porins. The translocation pathways of five FQs and its metalloantibiotics were studied through biophysical experiments, allowing us to infer about the role of OmpF porin in the influx. The FQ-OmpF interaction was assessed in mimetic membrane systems differing on the lipidic composition, disclosing no interference of the lipidic composition. The drug-porin interaction revealed similar values for the association constants of FQs and metalloantibiotics with native OmpF. Therefore, OmpF mutants and specific quenchers were used to study the location-association relationship, comparing a free FQ and its metalloantibiotic. The free FQ revealed a specific association, with preference for residues on the centre of OmpF, while the metalloantibiotic showed a random interaction. Thereby, metalloantibiotics may be an alternative to pure FQs, being able to overcome some antimicrobial resistance mechanism of Gram-negative bacteria related to decreased membrane permeability.

A 24-year-old man with known bicuspid aortic valve presented with constitutional symptoms starting one month before, after an episode of fever. He had no history of recent dental procedures.Transth...

Introducao As metastases no coracao e pericardio sao muito mais comuns que os tumores cardiacos primarios e geralmente estao associadas a mau prognostico. , Embora sejam mais frequentemente assintomaticas, as metastases cardiacas podem simular doencas cardiacas primarias, como sindromes coronarias agudas, insuficiencia cardiaca congestiva e pericardite. , O câncer de pulmao e a fonte mais frequente de doenca cardiaca metastatica, seja por extensao direta ou por uma combinacao de disseminacao linfatica, hematogenica e transvenosa. , […] Um Caso de Doenca [...]

Background Zika virus (ZIKV) infection during pregnancy may cause major congenital defects, including microcephaly, ocular, articular and muscle abnormalities, which are collectively defined as Congenital Zika Syndrome. Here, we performed an in-depth characterization of the effects of congenital ZIKV infection (CZI) in immunocompetent mice. Methods Pregnant dams were inoculated with ZIKV on embryonic day 5.5 in the presence or absence of a sub-neutralizing dose of a pan-flavivirus monoclonal antibody (4G2) to evaluate the potential role of antibody-dependent enhancement phenomenon (ADE) during short and long outcomes of CZI. Findings ZIKV infection induced maternal immune activation (MIA), which was associated with occurrence of foetal abnormalities and death. Therapeutic administration of AH-D antiviral peptide during the early stages of pregnancy prevented ZIKV replication and death of offspring. In the post-natal period, CZI was associated with a decrease in whole brain volume, ophthalmologic abnormalities, changes in testicular morphology, and disruption in bone microarchitecture. Some alterations were enhanced in the presence of 4G2 antibody. Interpretation Our results reveal that early maternal ZIKV infection causes several birth defects in immunocompetent mice, which can be potentiated by ADE phenomenon and are associated with MIA. Additionally, antiviral treatment with AH-D peptide may be beneficial during early maternal ZIKV infection. Fund This work was supported by the Brazilian National Science Council (CNPq, Brazil), Minas Gerais Foundation for Science (FAPEMIG), Funding Authority for Studies and Projects (FINEP), Coordination of Superior Level Staff Improvement (CAPES), National Research Foundation of Singapore and Centre for Precision Biology at Nanyang Technological University.

Introduction: Takotsubo syndrome (TTS) is characterized by transient left ventricular (LV) dysfunction, typically mimicking an anterior wall myocardial infarction (MI), without obstructive coronary artery disease. In the few published reports assessing myocardial deformation in TTS and MI, no consistent differences have been described between the two entities. We sought to characterize global and regional function in TTS and to compare it with a population with MI. Methods: Clinical data, including echocardiography, were gathered from 17 TTS patients and 20 anterior wall ST-segment elevation myocardial infarction (STEMI) controls. Peak systolic longitudinal strain was determined for each LV segment using speckle tracking imaging, and global and mean apical, midventricular and basal longitudinal strain were calculated from these. Results: Both TTS and STEMI patients presented significant LV systolic dysfunction, and there were no significant differences in ejection fraction or global longitudinal strain. Regional longitudinal strain was more severely impaired in basal inferolateral and mid anterolateral segments in the TTS group and in apical anteroseptal segments in the STEMI group. Mean longitudinal strain was worse in the basal segments of TTS patients (-9.8±2.9 vs. -12.4±4.1%, p=0.010), with no significant differences in mid and apical segments. The basal/apical ratio was significantly lower in this group as well (1.51±0.86 vs. 2.94±1.88, p=0.006). Conclusions: While both TTS and STEMI feature significantly impaired global systolic function, we found a regional pattern of worse basal longitudinal strain and a lower basal/apical ratio in the former. These suggest generalized myocardial impairment in TTS, providing new clues about its pathophysiology and possible specific echocardiographic changes. Resumo: Introdução: A síndrome de Takotsubo (TTS) é caracterizada por disfunção ventricular esquerda transitória, habitualmente simulando um enfarte agudo do miocárdio (STEMI) anterior, sem doença coronária obstrutiva. Nos poucos trabalhos publicados avaliando deformação miocárdica não estão descritas diferenças consistentes entre as duas entidades. Procurámos caracterizar a função global e regional na TTS e compará-la com uma população com STEMI. Métodos: Reunimos dados clínicos, incluindo ecocardiográficos, de 17 doentes com TTS e 20 controlos com STEMI anterior. O pico sistólico de strain longitudinal foi determinado para cada segmento ventricular usando speckle tracking; a partir destes calculou-se o strain longitudinal global e a média dos segmentos apicais, médios e basais. Resultados: Tanto os doentes com TTS como STEMI apresentaram disfunção sistólica ventricular esquerda importante, sem diferença significativa da fração de ejeção e strain longitudinal global. O strain regional foi pior nos segmentos basal inferolateral e médio anterolateral do grupo com TTS e no apical anteroseptal dos doentes com STEMI. O strain longitudinal médio dos segmentos basais foi pior nos doentes com TTS (-9,8 ± 2,9 versus -12,4 ± 4,1%, p=0,010), sem diferença significativa nos médios ou apicais. A razão basal/apical também foi mais baixa neste grupo (1,51±0,86 versus 2,94±1,88, p=0,006). Conclusões: Apesar de tanto a TTS como o STEMI apresentarem disfunção sistólica global importante, encontrámos um padrão de pior strain longitudinal basal e uma razão basal/apical mais baixa nos primeiros. Isto sugere uma disfunção miocárdica generalizada na TTS e fornece novas pistas relativamente à sua fisiopatologia e possíveis alterações ecocardiográficas específicas. Keywords: Takotsubo cardiomyopathy, Echocardiography, Myocardial deformation, Palavras-chave: Miocardiopatia de Takotsubo, Ecocardiografia, Deformação miocárdica

Made available in DSpace on 2019-10-04T12:35:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-19 FEDER - COMPETE Program Fundacao para a Ciencia e Tecnologia Project CMDT: Past and present population genetics of the vector Aedes aegypti: a tool for dengue control policies FCT Historically known as the yellow fever mosquito, Aedes aegypti invaded Madeira Island in 2005 and was the vector of the island's first dengue outbreak in 2012. We have studied genetic variation at 16 microsatellites and two mitochondrial DNA genes in temporal samples of Madeira Island, in order to assess the origin of the invasion and the population structure of this mosquito vector. Our results indicated at least two independent colonization events occurred on the island, both having a South American source population. In both scenarios, Venezuela was the most probable origin of these introductions, a result that is in accordance with the socioeconomic relations between this country and Madeira Island. Once introduced, Ae. aegypti has rapidly expanded along the southern coast of the island and reached a maximum effective population size (N-e) in 2012, coincident with the dengue epidemic. After the outbreak, there was a 10-fold reduction in N-e estimates, possibly reflecting the impact of community-based vector control measures implemented during the outbreak. These findings have implications for mosquito surveillance not only for Madeira Island, but also for other European regions where Aedes mosquitoes are expanding. Univ Nova Lisboa, Inst Higiene & Med Trop, Global Hlth & Trop Med, Lisbon, Portugal Univ Estadual Paulista, Inst Biociencias, Dept Parasitol, Botucatu, SP, Brazil Museum Nat Hist Funchal, RAM, Madeira, Portugal Univ Cent Venezuela, Inst Med Trop, Secc Entomol Med, Caracas, Venezuela IP RAM, Dept Saude Planeamento & Adm Geral, Inst Adm Saude & Assuntos Sociais, Funchal, Madeira, Portugal Madeira Reg Govt, Funchal, Madeira, Portugal Hlth & Social Affairs, Funchal, Madeira, Portugal Univ Estadual Paulista, Inst Biociencias, Dept Parasitol, Botucatu, SP, Brazil FEDER - COMPETE Program: PTDC/SAU-EPI/115853/2009 Fundacao para a Ciencia e Tecnologia: PTDC/SAU-EPI/115853/2009 Project CMDT: Past and present population genetics of the vector Aedes aegypti: a tool for dengue control policies: Pest-OE/SAU/LA0018/2011 FCT: SFRH/BD/98873/2013 FCT: SFRH/BPD/72532/2010 : GHTM-UID/Multi/04413/2013

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We report a case of temporary pacemaker lead malposition in the left ventricle crossing the interventricular septum (IVS). The majority of described cases occur due to a patent foramen ovale and are frequently incidental findings. A course across the IVS is rarely found and this complication with temporary leads is not even reported in the literature. This very rare location entails a risk of dangerous complications associated with left-to-right flow after lead removal. Echocardiography was an essential tool to diagnose the lead's course inside the heart and enabled secure removal of the lead with cardiac surgery backup. Resumo: Reportamos um caso de mau posicionamento de sonda de pacemaker temporário no ventrículo esquerdo com trajeto através do septo interventricular. A maioria dos casos descritos ocorre devido à existência de um foramen ovale patente e são frequentemente achados incidentais. O trajeto através do septo interventricular é raramente encontrado e esta complicação com sondas temporárias não está sequer descrita na literatura. Esta localização muito rara comporta um risco de complicações graves associadas a um fluxo esquerdo-direito após a remoção da sonda. A ecocardiografia foi uma ferramenta essencial para o diagnóstico do trajeto da sonda dentro do coração e permitiu a sua remoção de forma segura com backup de cirurgia cardíaca.

Fluoroquinolones (FQs) are antibiotics commonly used in clinical practice, although nowadays they are becoming ineffective due to the emergence of several mechanisms of resistance in most bacteria. The complexation of FQs with divalent metal ions and phenanthroline (phen) is a possible approach to circumvent antimicrobial resistance, since it forms very stable complexes known as metalloantibiotics. This work is aimed at determining the antimicrobial activity of metalloantibiotics of Cu(II)FQphen against a panel of multidrug‑resistant (MDR) clinical isolates and to clarify their mechanism of action. Minimum inhibitory concentrations (MICs) were determined against MDR isolates of Escherichia coli, Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). Metalloantibiotics showed improved antimicrobial activity against several clinical isolates, especially MRSA. Synergistic activity was evaluated in combination with ciprofloxacin and ampicillin by the disk diffusion and checkerboard methods. Synergistic and additive effects were shown against MRSA isolates. The mechanism of action was studied though enzymatic assays and atomic force microscopy (AFM) experiments. The results indicate a similar mechanism of action for FQs and metalloantibiotics. In summary, metalloantibiotics seem to be an effective alternative to pure FQs against MRSA. The results obtained in this work open the way to the screening of metalloantibiotics against other Gram‑positive bacteria.

Aedes albopictus, also known as the “Asian Tiger Mosquito”, is an invasive mosquito species to Europe causing high concern in public health due to its severe nuisance and its vectorial capacity for pathogens such as dengue, chikungunya, yellow fever and Zika. Consequently, the responsible authorities implement management activities to reduce its population density, possibly to below noxious and epidemiological thresholds. In urban areas, these aims are difficult to achieve because of the species’ ability to develop in a wide range of artificial breeding sites, mainly private properties. This document (Management Plan) has been structured to serve as a comprehensive practical and technical guide for stakeholders in organizing the vector control activities in the best possible way. The current plan includes coordinated actions such as standardized control measures and quality control activities, monitoring protocols, activities for stakeholders and local communities, and an emergency vector control plan to reduce the risk of an epidemic.

The geographical spread of dengue is a global public health concern. This is largely mediated by the importation of dengue from endemic to non-endemic areas via the increasing connectivity of the global air transport network. The dynamic nature and intrinsic heterogeneity of the air transport network make it challenging to predict dengue importation.Here, we explore the capabilities of state-of-the-art machine learning algorithms to predict dengue importation. We trained four machine learning classifiers algorithms, using a 6-year historical dengue importation data for 21 countries in Europe and connectivity indices mediating importation and air transport network centrality measures. Predictive performance for the classifiers was evaluated using the area under the receiving operating characteristic curve, sensitivity, and specificity measures. Finally, we applied practical model-agnostic methods, to provide an in-depth explanation of our optimal model’s predictions on a global and local scale.Our best performing model achieved high predictive accuracy, with an area under the receiver operating characteristic score of 0.94 and a maximized sensitivity score of 0.88. The predictor variables identified as most important were the source country’s dengue incidence rate, population size, and volume of air passengers. Network centrality measures, describing the positioning of European countries within the air travel network, were also influential to the predictions.We demonstrated the high predictive performance of a machine learning model in predicting dengue importation and the utility of the model-agnostic methods to offer a comprehensive understanding of the reasons behind the predictions. Similar approaches can be utilized in the development of an operational early warning surveillance system for dengue importation.

Since its emergence in Yap Island in 2007, Zika virus (ZIKV) has affected all continents except Europe. Despite the hundreds of cases imported to European countries from ZIKV-infested regions, no local cases have been reported in localities where the ZIKV-competent mosquito Aedes albopictus is well established. Here we analysed the vector competence of European Aedes (aegypti and albopictus) mosquitoes to different genotypes of ZIKV. We demonstrate that Ae. albopictus from France was less susceptible to the Asian ZIKV than to the African ZIKV. Critically we show that effective crossing of anatomical barriers (midgut and salivary glands) after an infectious blood meal depends on a viral load threshold to trigger: (i) viral dissemination from the midgut to infect mosquito internal organs and (ii) viral transmission from the saliva to infect a vertebrate host. A viral load in body ≥4800 viral copies triggered dissemination and ≥12,000 viral copies set out transmission. Only 27.3% and 18.2% of Ae. albopictus Montpellier mosquitoes meet respectively these two criteria. Collectively, these compelling results stress the poor ability of Ae. albopictus to sustain a local transmission of ZIKV in Europe and provide a promising tool to evaluate the risk of ZIKV transmission in future outbreaks. publishersversion published

Sensitive techniques for the detection of Plasmodium (Aconoidasida: Plasmodiidae) sporozoites in field-collected malaria vectors are essential for the correct assessment of risk for malaria transmission. A real-time polymerase chain reaction (RT-PCR) protocol targeting Plasmodium mtDNA proved to be much more sensitive in detecting sporozoites in mosquitoes than the widely used enzyme-linked immunosorbent assay targeting Plasmodium circumsporozoite protein (CSP-ELISA). However, because of the relatively high costs associated with equipment and reagents, RT-PCRs are mostly used to assess the outcomes of experimental infections in the frame of research experiments, rather than in routine monitoring of mosquito infection in the field. The present authors developed a novel mtDNA-based nested PCR protocol, modified from a loop-mediated isothermal amplification (LAMP) assay for Plasmodium recognition in human blood samples, and compared its performance with that of routinely used CSP-ELISAs in field-collected Anopheles coluzzii (Diptera: Culicidae) samples. The nested PCR showed 1.4-fold higher sensitivity than the CSP-ELISA. However, nested PCR results obtained in two laboratories and in different replicates within the same laboratory were not 100% consistent, probably because the copy number of amplifiable Plasmodium mtDNA was close in some specimens to the threshold of nested PCR sensitivity. This implies that Plasmodium-positive specimens should be confirmed by a second nested PCR to avoid false positives. Overall, the results emphasize the need to use molecular approaches to obtain accurate estimates of the actual level of Plasmodium circulation within malaria vector populations.