Epidemiologia das encefalites por arbovírus na Amazônia Brasileira

Abstract

Os autores revêem os aspectos ecoepidemiológicos apresentados pelos vírus da encefalite de St. Louis (SLE), encefalites equinas Leste (EEE), Oeste (WEE) e Venezuelana [subtipos III, Mucambo (MUC) e IV, Pixuna (PIX)], decorrentes dos estudos realizados em diversas áreas da Região Amazônica brasileira, especialmente ao longo das rodovias e projetos de desenvolvimento. Esses vírus são amplamente distribuídos na Amazónia e pelo menos quatro deles, EEE, WEE, MUC e SLE já demonstraram ser patógenos do homem. O diagnóstico da doença humana foi feito por sorologia, sendo que de MUC e SLE obteve-se também isolamento virai. O vírus PIX, parece ser o menos prevalente e foi isolado em poucas oportunidades. Virtualmente se desconhecem os vetores do PIX e WEE. As aves silvestres constituem os hospedeiros principais de todos esses vírus, exceto do MUC, para o qual constituem os roedores. O quadro clínico apresentado pelos pacientes infectados na Amazónia é discutido, comparando-o ao apresentado em outras áreas, especialmente nos EUA, onde periodicamente SLE, EEE e WEE causam surtos de doença humana. Nenhuma epidemia foi até o presente detectada, embora em 1960 uma epizootia em eqiiinos causada peio EEE tenha sido registrada em Bragança, Pará, onde em um rebanho de 500 animais ocorreu uma letalidade de 5%. Quatro outras pequenas epizootias determinadas pelo SLE ocorreram nas florestas adjacentes a Belém, envolvendo aves silvestres e animais sentinelas.

An overview of ecological, epidemiological and clinicai findings of potendal arthropod-bome encephalitis viruses circulating in the Amazon Region of Brazil are discussed. These viruses are the Eastem Equine Encephalitis (EEE), Western Equine Encephalitis (WEE), St. Louis Encephalitis (SLE), Mucambo (MUC) and Pixuna (PIX). These last two are subtypes (III and IV) of Venezuelan Equine Encephalitis virus. The áreas of study were the highways and projects of development, as well as places where outbreaks of human diseases caused by arboviruses had been detected. These viruses are widespread in aU Amazónia, and at least four of them, EEE, WEE, SLE and MUC are pathogenic to man. EEE and WEE infections were detected by serology, while SLE and MUC by either serology and virus isolation. The PIX virus has the lowest prevalence and, it was isolated in only a few cases, one being from a laboratory infection. Wild birds are the main hosts for ali these viruses, except MUC, whose major hosts are rodents. The symptoms presented by infected people were generally a mild febrile illness. Although, jaundice was observed in two individuais from whom SLE was isolated. A comparison of the clinicai symptoms presented by the patients in the Amazon Region and other áreas of America, especially in the USA is made. In Brazilian Amazon region epidemics have not been detected although, at least, one EEE epizootic was recorded in Bragança, Para State, in 1960. At that time, of 500 horses that were examined 61% were positive to EE1-: by Hl and of them 8.2% died. On the other hand. SLE has caused four epizootics in a forest near Belém. Wild birds and sentinel monkeys were infected, but no human cases were reported.