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Funda??o de Amparo ? Pesquisa do Estado do Rio de Janeiro (Faperj) under the grant no. E-26/202.930/2016, European Union?s Horizon 2020 grant agreement ZIKACTION no. 734857 and Coordena??o de Vigil?ncia em Sa?de e Laborat?rios de Refer?ncia da Funda??o Oswaldo Cruz/Minist?rio de Sa?de. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Ag?ncia de Defesa Agropecu?ria do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Minist?rio da Agricultura Pecu?ria e Abastecimento. Departamento de Servi?os T?cnicos. Secretaria de Defesa Agropecu?ria. Bras?lia, DF, Brazil. Funda??o BioBrasil. Ituber?, BA, Brazil. Minist?rio do Meio Ambiente. Instituto Chico Mendes de Conserva??o da Biodiversidade. Centro Nacional de Pesquisa para Conserva??o das Aves Silvestres. Cabedelo, PB, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Funda??o Oswaldo Cruz. Laborat?rio de Mosquitos Transmissores de Hematozo?rios. Rio de Janeiro, RJ, Brazil. Autonomous Veterinarian. Boa Viagem, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Laborat?rio Central do Estado do Cear? . Fortaleza, CE, Brazil. Ag?ncia de Defesa Agropecu?ria do Estado do Cear?. Fortaleza, CE, Brazil. Laborat?rio Central do Estado do Cear? . Fortaleza, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Funda??o Oswaldo Cruz. Laborat?rio de Mosquitos Transmissores de Hematozo?rios. Rio de Janeiro, RJ, Brazil. Coordena??o Geral de Laborat?rios de Sa?de P?blica. Bras?lia, DF, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil / Secretaria de Estado da Sa?de do Piau?. Coordena??o de Epidemiologia. Teresina, PI, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Ag?ncia de Defesa Agropecu?ria do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria Municipal de Sa?de de Boa Viagem. Boa Viagem, CE, Brazil. Secretaria Estadual de Sa?de do Estado do Cear?. Fortaleza, CE, Brazil. Laborat?rio Central do Estado do Cear?. Fortaleza, CE, Brazil. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil. Secretaria de Vigil?ncia em Sa?de. Coordena??o-Geral de Vigil?ncia das Arboviroses. Departamento de Imuniza??o e Doen?as Transmiss?veis. Bras?lia, DF, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Funda??o Oswlado Cruz. Laborat?rio de Mosquitos Transmissores de Hematozo?rios. Rio de Janeiro, RJ, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil. Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Laborat?rio de Flaviv?rus. Rio de Janeiro, RJ, Brazil / Texas A&M University. College Station. Department of Veterinary Integrative Biosciences. TX, USA. Abstract: In June 2019, a horse with neurological disorder was diagnosed with West Nile virus (WNV) in Boa Viagem, a municipality in the state of Cear?, northeast Brazil. A multi-institutional task force coordinated by the Brazilian Ministry of Health was deployed to the area for case investigation. A total of 513 biological samples from 78 humans, 157 domestic animals and 278 free-ranging wild birds, as well as 853 adult mosquitoes of 22 species were tested for WNV by highly specific serological and/or molecular tests. No active circulation of WNV was detected in vertebrates or mosquitoes by molecular methods. Previous exposure to WNV was confirmed by seroconversion in domestic birds and by the detection of specific neutralizing antibodies in 44% (11/25) of equids, 20.9% (14/67) of domestic birds, 4.7% (13/278) of free-ranging wild birds, 2.6% (2/78) of humans, and 1.5% (1/65) of small ruminants. Results indicate that not only equines but also humans and different species of domestic animals and wild birds were locally exposed to WNV. The detection of neutralizing antibodies for WNV in free-ranging individuals of abundant passerine species suggests that birds commonly found in the region may have been involved as amplifying hosts in local transmission cycles of WNV.

Visceral leishmaniasis (VL) is considered as an important tropical disease because it rapidly spreads across a wide geographical area. This study aimed to analyse the temporal and spatial patterns of incidence, mortality and case fatality rates due to human VL in Ceara, Brazil, from 2007 to 2018. This is an ecological study involving time series and spatial analyses, and data were obtained from human VL notifications. Temporal trend analysis was carried out using the Joinpoint Regression Program. SaTScan 9.6 was used for conducting spatial analyses, and ArcMap 9.2 was used for building maps. There were 6,066 incident cases and 516 deaths due to human VL. There was an increasing trend in the incidence rate from 2007 to 2014 (annual per cent change [APC] = 3.8; 95% confidence interval [CI]:0.5 to 7.3; p = .031). Mortality (APC = -0.3; 95%CI: -2.5 to 1.9; p = .765) and VL case fatality rates (APC = -3.0; 95%CI: -4.3 to -1,7; p = .188) showed non-significant decline. The incidence rates were higher in the northwest and south regions of the state, with 11 high incidence rate clusters from 2007 to 2010, seven clusters in 44 municipalities from 2011 to 2014, and six clusters in 49 municipalities from 2015 to 2018. During 2007-2010, only one significant mortality rate cluster was identified in the southern region (relative risk [RR] = 7.6); during 2011-2014, two clusters in the northwest region were identified (RR=3.9 and RR=4.6). In the last period, a cluster of 11 municipalities in the southern region was identified (RR = 4.2). Mortality rate clusters were identified in the centre-south (2007-2010), northwest and south (both from 2011 to 2018). VL has a heterogeneous distribution, with maintenance of clusters with high incidence and mortality rates, as well as case fatality rates in municipalities in the northwest and south regions. These clusters present areas with the greatest risk of transmission of human VL.

Resumo Objetivo: Analisar a tendência temporal e descrever a distribuição espacial da leishmaniose visceral (LV) em Fortaleza, 2007-2017. Métodos: Estudo ecológico, mediante regressão temporal segmentada e mapeamento temático. Resultados: No período 2007-2017, foram confirmados 1.660 casos novos e 97 óbitos. No período 2007-2010, a incidência foi ascendente (variação percentual anual [Annual Percent Change], APC=8,7% - IC95% -3,3;34,1), enquanto a mortalidade (APC=-25,9 - IC95% -48,5; -10,6) e a letalidade (APC=-33,0 - IC95% -53,7;-17,6), descendentes. No período 2010-2015, a incidência reduziu (APC=-15,8 - IC95% -25,1;-4,0), mas a mortalidade (APC=18,7 - IC95% 9,4;50,6) e a letalidade (APC=40,1 - IC95% 22,5;72,0) apresentaram tendência de crescimento. Em 2015-2017, decresceram a incidência (APC=-24,6 - IC95% -36,2;-10,3) e a mortalidade (APC= -44,6 - IC95% -58,8;-17,6); a letalidade se manteve estável (APC=-13,5 - IC95% -38,7;3,8). Houve concentração de bairros com incidência elevada na região oeste da cidade; porém, a mortalidade e a letalidade não apresentaram padrões espaciais definidos. Conclusão: A LV é endêmica em Fortaleza, embora tenha havido declínio no último triênio estudado. Resumen Objetivo: Analizar la tendencia temporal y describir la distribución espacial de la leishmaniasis visceral (LV) en Fortaleza de 2007 a 2017. Métodos: Estudio ecológico utilizando regresión temporal segmentada y mapas temáticos. Resultados: Entre 2007-2017, se confirmaron 1,660 casos nuevos y 97 muertes. La incidencia fue ascendente (cambio porcentual anual [Annual Percent Change], APC=8,7% - IC95% -3,3;34,1), y mortalidad y letalidad descendentes: APC=-25,9 (IC95% -48,5;-10,6) y APC=-33,0 (IC95% -53,7;-17,6), respectivamente. Desde 2010-2015, la incidencia disminuyó (APC=-15,8 - IC95% -25,1;-4,0), pero la mortalidad (APC=18,7 - IC95% 9,4; 50,6) y la letalidad (APC=40,1 - IC95% 22,5; 72,0) tuvieron una tendencia al alza. En 2015-2017, disminuyeron incidencia (APC=-24,6 - IC95% -36,2;-10,3), y mortalidad (APC=-44,6 - IC95% -58,8;-17,6) la letalidad se mantuvo estable (APC=-13,5 - IC95% -38,7; 3,8). Los barrios con alta incidencia se agruparon en la región oeste de la ciudad, pero, la mortalidad y la letalidad no fueron definidos espacialmente. Conclusión: La LV es endémica en Fortaleza, aunque ha habido una disminución en el último trienio estudiado. Abstract Objective: To analyze the temporal trend and describe the spatial distribution of Visceral Leishmaniasis (VL) in Fortaleza from 2007 to 2017. Methods: This was an ecological study using segmented temporal regression and thematic mapping. Results: Between 2007-2017, 1,660 new cases and 97 deaths were confirmed. The overall incidence rate showed a rising trend (Annual Percent Change - APC=8.7% - 95%CI -3.3;34.1), while the mortality rate (APC=-25.9 - 95%CI -48.5;-10.6) and lethality (APC=-33.0 - 95%CI -53.7;-17.6) showed a falling trend. From 2010-2015 the incidence rate fell (APC=-15.8 - 95%CI -25.1;-4.0), but mortality (APC=18.7 - 95%CI 9.4;50.6) and lethality (APC=40.1 - 95%CI 22.5;72.0) had an upward trend. In 2015-2017, incidence (APC=-24.6 - 95%CI -36.2;-10.3), and mortality (APC=-44.6 - 95%CI -58.8;-17,6) fell, while lethality remained stable (APC=-13.5 - 95%CI -38.7;3.8). High incidence neighborhoods were clustered in the western region of the city, however, mortality and lethality did not present defined spatial patterns. Conclusion: VL is endemic in Fortaleza, although there was a reduction in the last three years studied.

INTRODUCTION: This study analyzed the magnitude and temporal trends of leprosy relapse in Ceará in 2001-2018. METHODS: Descriptive cross-sectional and ecological-time trend studies were performed. RESULTS: We diagnosed 1,777 leprosy relapse cases. Higher prevalence of relapse was observed in men, illiterates, mixed race, multibacillary leprosy, lepromatous leprosy, and persons with visible disabilities. The proportion of relapse increased throughout the study period. CONCLUSIONS: Leprosy relapse is prevalent in certain groups.

INTRODUCTION: This study investigated the spatial distribution of inappropriate post-exposure human rabies procedures in Ceará, Brazil, between 2007 and 2015. METHODS: The ecological study population was based on the records of post-exposure human rabies procedures from the Notification Disease Information System. We analyzed the data using the Moran Index (I) and the Moran Local Index. RESULTS: There were 222,036 (95.8%) records with inappropriate post-exposure human rabies procedures. There was heterogeneity in their spatial distribution, with two significant clusters in the northeast and northwest regions. CONCLUSIONS: These findings help elaborate differentiated strategies to reduce unnecessary post-exposure human rabies procedures.

To analyze the temporal trend and describe the spatial distribution of Visceral Leishmaniasis (VL) in Fortaleza from 2007 to 2017.This was an ecological study using segmented temporal regression and thematic mapping.Between 2007-2017, 1,660 new cases and 97 deaths were confirmed. The overall incidence rate showed a rising trend (Annual Percent Change - APC=8.7% - 95%CI -3.3;34.1), while the mortality rate (APC=-25.9 - 95%CI -48.5;-10.6) and lethality (APC=-33.0 - 95%CI -53.7;-17.6) showed a falling trend. From 2010-2015 the incidence rate fell (APC=-15.8 - 95%CI -25.1;-4.0), but mortality (APC=18.7 - 95%CI 9.4;50.6) and lethality (APC=40.1 - 95%CI 22.5;72.0) had an upward trend. In 2015-2017, incidence (APC=-24.6 - 95%CI -36.2;-10.3), and mortality (APC=-44.6 - 95%CI -58.8;-17,6) fell, while lethality remained stable (APC=-13.5 - 95%CI -38.7;3.8). High incidence neighborhoods were clustered in the western region of the city, however, mortality and lethality did not present defined spatial patterns.VL is endemic in Fortaleza, although there was a reduction in the last three years studied.Analisar a tendência temporal e descrever a distribuição espacial da leishmaniose visceral (LV) em Fortaleza, 2007-2017.Estudo ecológico, mediante regressão temporal segmentada e mapeamento temático.No período 2007-2017, foram confirmados 1.660 casos novos e 97 óbitos. No período 2007-2010, a incidência foi ascendente (variação percentual anual [Annual Percent Change], APC=8,7% - IC95% -3,3;34,1), enquanto a mortalidade (APC=-25,9 - IC95% -48,5; -10,6) e a letalidade (APC=-33,0 - IC95% -53,7;-17,6), descendentes. No período 2010-2015, a incidência reduziu (APC=-15,8 - IC95% -25,1;-4,0), mas a mortalidade (APC=18,7 - IC95% 9,4;50,6) e a letalidade (APC=40,1 - IC95% 22,5;72,0) apresentaram tendência de crescimento. Em 2015-2017, decresceram a incidência (APC=-24,6 - IC95% -36,2;-10,3) e a mortalidade (APC= -44,6 - IC95% -58,8;-17,6); a letalidade se manteve estável (APC=-13,5 - IC95% -38,7;3,8). Houve concentração de bairros com incidência elevada na região oeste da cidade; porém, a mortalidade e a letalidade não apresentaram padrões espaciais definidos.A LV é endêmica em Fortaleza, embora tenha havido declínio no último triênio estudado.Analizar la tendencia temporal y describir la distribución espacial de la leishmaniasis visceral (LV) en Fortaleza de 2007 a 2017.Estudio ecológico utilizando regresión temporal segmentada y mapas temáticos.Entre 2007-2017, se confirmaron 1,660 casos nuevos y 97 muertes. La incidencia fue ascendente (cambio porcentual anual [Annual Percent Change], APC=8,7% - IC95% -3,3;34,1), y mortalidad y letalidad descendentes: APC=-25,9 (IC95% -48,5;-10,6) y APC=-33,0 (IC95% -53,7;-17,6), respectivamente. Desde 2010-2015, la incidencia disminuyó (APC=-15,8 - IC95% -25,1;-4,0), pero la mortalidad (APC=18,7 - IC95% 9,4; 50,6) y la letalidad (APC=40,1 - IC95% 22,5; 72,0) tuvieron una tendencia al alza. En 2015-2017, disminuyeron incidencia (APC=-24,6 - IC95% -36,2;-10,3), y mortalidad (APC=-44,6 - IC95% -58,8;-17,6) la letalidad se mantuvo estable (APC=-13,5 - IC95% -38,7; 3,8). Los barrios con alta incidencia se agruparon en la región oeste de la ciudad, pero, la mortalidad y la letalidad no fueron definidos espacialmente.La LV es endémica en Fortaleza, aunque ha habido una disminución en el último trienio estudiado.

Para estudar o efeito da substituição do milho pelo sorgo, com ou sem a adição do pigmento natural, páprica, na ração de poedeiras comerciais, 160 poedeiras Hy-Line W36, (47 semanas de idade), distribuídas ao acaso, em duas aves por gaiola de 25 cm, divididas em cinco tratamentos com quatro repetições de oito aves cada, foram utilizadas. A ração controle foi à base de milho e farelo de soja e as demais substituíram o milho pelo sorgo, de baixo tanino, na proporção de 50 ou 100%. A páprica, quando adicionada, foi em 500 g t-1 e 1.000 g t-1 para os níveis de sorgo de 50 e 100%, respectivamente. A substituição do milho por sorgo não afetou o desempenho na postura, mas reduziu a pigmentação da gema. A coloração da gema, com a adição do pigmento natural, em ambas dosagens, foi superior ao controle, porém a dosagem de 1.000 g t-1 reduziu a postura.This study aimed to investigate the effect of the substitution of the corn for sorghum, with or without supplementation of paprika, as natural pigment, in the diets of laying hens. The experiment was conducted with 160 Hy- Line W36 layer hens (47 weeks of age), kept in cages of 25 cm, distributed in a completely randomized design, with eight birds and four replications. The control diet was on a corn and soybean meal base and the other diets had 50 or 100% of substitution of corn by sorghum, low tannin. The paprika, when supplemented, was added in 500 g t-1 or 1,000 g t-1. to the ration of low or high sorghum levels, respectively. The substitution of the corn by sorghum did not affect the performance of laying hens, but decreased the yolk pigmentation. When the natural pigment was added, in both dosages, the yolk pigmentation was higher than that obtained from the control diet, but the level of 1,000 g t-1. reduced the performance of layers.

This study aimed to investigate the effect of the substitution of the corn for sorghum, with or without supplementation of paprika, as natural pigment, in the diets of laying hens. The experiment was conducted with 160 Hy- Line W36 layer hens (47 weeks of age), kept in cages of 25 cm, distributed in a completely randomized design, with eight birds and four replications. The control diet was on a corn and soybean meal base and the other diets had 50 or 100% of substitution of corn by sorghum, low tannin. The paprika, when supplemented, was added in 500 g t-1 or 1,000 g t-1 . to the ration of low or high sorghum levels, respectively. The substitution of the corn by sorghum did not affect the performance of laying hens, but decreased the yolk pigmentation. When the natural pigment was added, in both dosages, the yolk pigmentation was higher than that obtained from the control diet, but the level of 1,000 g t-1 . reduced the performance of layers.