Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.

<h4>Background</h4>Yellow fever (YF) is endemic in the Brazilian Amazon Basin, and sporadic outbreaks take place outside the endemic area in Brazil. Since 2016, YF epidemics have been occurring in Southeast Brazil, with more than 1,900 human cases and more than 1,600 epizooties of non-hu...

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Main Authors: Izabela Maurício de Rezende, Lívia Sacchetto, Érica Munhoz de Mello, Pedro Augusto Alves, Felipe Campos de Melo Iani, Talita Émile Ribeiro Adelino, Myrian Morato Duarte, Ana Luísa Furtado Cury, André Felipe Leal Bernardes, Tayrine Araújo Santos, Leonardo Soares Pereira, Maria Rita Teixeira Dutra, Dario Brock Ramalho, Benoit de Thoisy, Erna Geessien Kroon, Giliane de Souza Trindade, Betânia Paiva Drumond
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-06-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pntd.0006538/2/pntd.0006538.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210223%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210223T094226Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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author Izabela Maurício de Rezende
Lívia Sacchetto
Érica Munhoz de Mello
Pedro Augusto Alves
Felipe Campos de Melo Iani
Talita Émile Ribeiro Adelino
Myrian Morato Duarte
Ana Luísa Furtado Cury
André Felipe Leal Bernardes
Tayrine Araújo Santos
Leonardo Soares Pereira
Maria Rita Teixeira Dutra
Dario Brock Ramalho
Benoit de Thoisy
Erna Geessien Kroon
Giliane de Souza Trindade
Betânia Paiva Drumond
author_facet Izabela Maurício de Rezende
Lívia Sacchetto
Érica Munhoz de Mello
Pedro Augusto Alves
Felipe Campos de Melo Iani
Talita Émile Ribeiro Adelino
Myrian Morato Duarte
Ana Luísa Furtado Cury
André Felipe Leal Bernardes
Tayrine Araújo Santos
Leonardo Soares Pereira
Maria Rita Teixeira Dutra
Dario Brock Ramalho
Benoit de Thoisy
Erna Geessien Kroon
Giliane de Souza Trindade
Betânia Paiva Drumond
author_sort Izabela Maurício de Rezende
collection DOAJ
description <h4>Background</h4>Yellow fever (YF) is endemic in the Brazilian Amazon Basin, and sporadic outbreaks take place outside the endemic area in Brazil. Since 2016, YF epidemics have been occurring in Southeast Brazil, with more than 1,900 human cases and more than 1,600 epizooties of non-human primates (NHPs) reported until April 2018. Previous studies have demonstrated that Yellow fever virus (YFV) causing outbreaks in 2017 formed a monophyletic group.<h4>Methodology/principal findings</h4>Aiming to decipher the origin of the YFV responsible for the recent epidemics, we obtained nucleotide sequences of YFV detected in humans (n = 6) and NHPs (n = 10) from Minas Gerais state during 2017-2018. Next, we performed evolutionary analyses and discussed the results in the light of epidemiological records (official numbers of YFV cases at each Brazilian Federative unit, reported by the Brazilian Ministry of Health). Nucleotide sequences of YFV from Southeast Brazil from 2016 to 2018 were highly conserved and formed a monophyletic lineage (BR-YFV_2016/18) within the genotype South America I. Different clusters were observed within lineage BR-YFV_2016/18, one containing the majority of isolates (from humans and NHPs), indicating the sylvatic transmission of YFV. We also detected a cluster characterized by two synapomorphies (amino acid substitutions) that contained YFV only associated with NHP what should be further investigated. The topology of lineage BR-YFV_2016/18 was congruent with epidemiological and temporal patterns of the ongoing epidemic. YFV isolates detected in 2016, in São Paulo state were located in the most basal position of the lineage, followed by the isolates from Minas Gerais and Espírito Santo obtained in 2017 and 2018. The most recent common ancestor of the lineage BR-YFV_2016/18 dated to 2015 (95% credible intervals = 2014-2016), in a period that was coincident with the reemergence of YFV in the Midwest region of Brazil.<h4>Conclusions</h4>The results demonstrated a single introduction of YFV in the Southeast region and the silent viral circulation before the onset of the outbreaks in 2016. Evolutionary analyses combined with epidemiological records supported the idea that BR-YFV_2016/18 was probably introduced from the Midwest into the Southeast region, possibly in São Paulo state. The persistence of YFV in the Southeast region, causing epidemics from 2016 to 2018, suggests that this region presents suitable ecological and climatic conditions for YFV maintenance during the epidemic and interepidemic seasons. This fact poses risks for the establishing of YF enzootic cycles and epidemics, outside the Amazon Basin in Brazil. YF surveillance and studies of viral dynamics deserve particular attention, especially in Midwest, Southeast and neighbor regions which are the main areas historically associated with YF outbreaks outside the Amazon Basin. YFV persistence in Southeast Brazil should be carefully considered in the context of public health, especially for public health decision-makers and researchers.
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spelling doaj-art-a1bb76fbbd324f8aae960fb9c5a005a82025-08-20T02:03:39ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352018-06-01126e000653810.1371/journal.pntd.0006538Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.Izabela Maurício de RezendeLívia SacchettoÉrica Munhoz de MelloPedro Augusto AlvesFelipe Campos de Melo IaniTalita Émile Ribeiro AdelinoMyrian Morato DuarteAna Luísa Furtado CuryAndré Felipe Leal BernardesTayrine Araújo SantosLeonardo Soares PereiraMaria Rita Teixeira DutraDario Brock RamalhoBenoit de ThoisyErna Geessien KroonGiliane de Souza TrindadeBetânia Paiva Drumond<h4>Background</h4>Yellow fever (YF) is endemic in the Brazilian Amazon Basin, and sporadic outbreaks take place outside the endemic area in Brazil. Since 2016, YF epidemics have been occurring in Southeast Brazil, with more than 1,900 human cases and more than 1,600 epizooties of non-human primates (NHPs) reported until April 2018. Previous studies have demonstrated that Yellow fever virus (YFV) causing outbreaks in 2017 formed a monophyletic group.<h4>Methodology/principal findings</h4>Aiming to decipher the origin of the YFV responsible for the recent epidemics, we obtained nucleotide sequences of YFV detected in humans (n = 6) and NHPs (n = 10) from Minas Gerais state during 2017-2018. Next, we performed evolutionary analyses and discussed the results in the light of epidemiological records (official numbers of YFV cases at each Brazilian Federative unit, reported by the Brazilian Ministry of Health). Nucleotide sequences of YFV from Southeast Brazil from 2016 to 2018 were highly conserved and formed a monophyletic lineage (BR-YFV_2016/18) within the genotype South America I. Different clusters were observed within lineage BR-YFV_2016/18, one containing the majority of isolates (from humans and NHPs), indicating the sylvatic transmission of YFV. We also detected a cluster characterized by two synapomorphies (amino acid substitutions) that contained YFV only associated with NHP what should be further investigated. The topology of lineage BR-YFV_2016/18 was congruent with epidemiological and temporal patterns of the ongoing epidemic. YFV isolates detected in 2016, in São Paulo state were located in the most basal position of the lineage, followed by the isolates from Minas Gerais and Espírito Santo obtained in 2017 and 2018. The most recent common ancestor of the lineage BR-YFV_2016/18 dated to 2015 (95% credible intervals = 2014-2016), in a period that was coincident with the reemergence of YFV in the Midwest region of Brazil.<h4>Conclusions</h4>The results demonstrated a single introduction of YFV in the Southeast region and the silent viral circulation before the onset of the outbreaks in 2016. Evolutionary analyses combined with epidemiological records supported the idea that BR-YFV_2016/18 was probably introduced from the Midwest into the Southeast region, possibly in São Paulo state. The persistence of YFV in the Southeast region, causing epidemics from 2016 to 2018, suggests that this region presents suitable ecological and climatic conditions for YFV maintenance during the epidemic and interepidemic seasons. This fact poses risks for the establishing of YF enzootic cycles and epidemics, outside the Amazon Basin in Brazil. YF surveillance and studies of viral dynamics deserve particular attention, especially in Midwest, Southeast and neighbor regions which are the main areas historically associated with YF outbreaks outside the Amazon Basin. YFV persistence in Southeast Brazil should be carefully considered in the context of public health, especially for public health decision-makers and researchers.https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pntd.0006538/2/pntd.0006538.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210223%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210223T094226Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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
spellingShingle Izabela Maurício de Rezende
Lívia Sacchetto
Érica Munhoz de Mello
Pedro Augusto Alves
Felipe Campos de Melo Iani
Talita Émile Ribeiro Adelino
Myrian Morato Duarte
Ana Luísa Furtado Cury
André Felipe Leal Bernardes
Tayrine Araújo Santos
Leonardo Soares Pereira
Maria Rita Teixeira Dutra
Dario Brock Ramalho
Benoit de Thoisy
Erna Geessien Kroon
Giliane de Souza Trindade
Betânia Paiva Drumond
Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
PLoS Neglected Tropical Diseases
title Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
title_full Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
title_fullStr Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
title_full_unstemmed Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
title_short Persistence of Yellow fever virus outside the Amazon Basin, causing epidemics in Southeast Brazil, from 2016 to 2018.
title_sort persistence of yellow fever virus outside the amazon basin causing epidemics in southeast brazil from 2016 to 2018
url https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pntd.0006538/2/pntd.0006538.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210223%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210223T094226Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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