Browsing by Author "Mesquita, J.R."
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- Country-wide surveillance of norovirus outbreaks in the Portuguese Army, 2015-2017Publication . Lopes-João, A.; Mesquita, J.R.; de Sousa, R.; Oleastro, M.; Silva, C.; Penha-Gonçalves, C.; Nascimento, M.S.J.INTRODUCTION: Gastrointestinal infections are among the most common foodborne and waterborne diseases in military populations, with direct implications in operational efficiency and force readiness. Through the surveillance system of reportable acute gastrointestinal illness in the Portuguese Army, four norovirus outbreaks were identified between October 2015 and October 2017 in mainland Portugal and the Azores archipelago. The present study documents the epidemiological, clinical and laboratory investigations of these norovirus outbreaks. METHODS: Cases were investigated and epidemiological questionnaires were distributed to all soldiers in each military setting where the outbreaks occurred. Stool samples from soldiers with acute gastroenteritis illness were collected and screened for common enteropathogenic agents. Food and water samples served on the settings were also collected for microbiological investigation. Norovirus-positive samples were further characterised by sequence analysis using a public automated genotyping tool. RESULTS: The four outbreaks affected a total of 99 soldiers among the 618 stationed on base units and in a military exercise. A total of 27 soldiers provided a stool sample, of which 20 were positive for norovirus by real-time PCR. Phylogenetic analysis showed that the noroviruses involved were all genogroup II, namely GII.17, GII.Pe-GII.4 Sydney 2012, GII.P2-GII.2 and GII.P16-GII.2. Of note, 30 soldiers had to receive treatment at the military hospital due to severity of symptoms. CONCLUSION: In this short, two-year surveillance period, a total of four norovirus gastroenteritis outbreaks were detected in the Portuguese Army which caused a considerable morbidity, showing once again the impact of norovirus on Army effectiveness and force readiness.
- First report of a norovirus outbreak associated with the variant Sydney 2012 in PortugalPublication . Mesquita, J.R.; Costa, I.; Oleastro, M.; Conceição-Neto, N.; Nascimento, M.S.Introduction: This study describes the investigation of a gastroenteritis outbreak in a group of students, associated with a dinner reunion in February 2013 in Porto, Portugal. Methodology: An anonymous structured questionnaire was developed and sent to 34 students who attended the dinner reunion. Eighteen students completed the questionnaire and thirteen met the case definition (attack rate of 72%). Stools from two students were screened for norovirus by RT-PCR using primer pairs that target the highly conserved polymerase gene and the capsid gene. Results: Norovirus genotyping confirmed the variant Sydney 2012 as the probable cause of the outbreak. Conclusion: This is the first report of an outbreak associated with the new variant Sydney 2012 in Portugal.
- Multiple enteropathogenic viruses in a gastroenteritis outbreak in a military exercise of the Portuguese ArmyPublication . Lopes-João, A.; Costa, Inês; Mesquita, J.R.; Oleastro, Mónica; Penha-Gonçalves, C.; Nascimento, M.S.Background: Gastroenteritis is one of the most common infectious diseases in the military populations and can diminish operational effectiveness and impede force readiness. Objectives: The present study investigates the cause and the source of an acute gastroenteritis outbreak that occurred during a military exercise of the Portuguese Army, in February 2013. Study Design: A retrospective investigation was performed and stool samples, food items and water were screened for common foodborne bacteria and viruses, namely Norovirus GI, Norovirus GII, Astrovirus, Rotavirus, Adenovirus and Sapovirus. Results: From the total of 160 soldiers that participated in the military exercise 20 developed gastroenteritis (attack rate of 12.5%). Symptoms were predominantly vomiting (n = 17, 85%) and diarrhoea (n = 9, 45%). The first cases occurred 24–48 h after drinking water from the creek, the plausible origin of the outbreak. The epidemic peak was registered 2 days after and the last cases 6 days after, upon returning to base. No pathogenic bacteria were found in stools however virological analysis revealed the presence of multiple enteropathogenic viruses, namely Norovirus GI (GI.3), Norovirus GII (GII.4 New Orleans 2009), Astrovirus and Sapovirus, as single or co-infections. Food and water samples were not tested for the presence of viruses due to exhaustion of samples on bacteriological analysis. Conclusions: To the best of our knowledge this is the first report of a viral gastroenteritis outbreak among military personnel in the Portuguese Army.
- Pathogenic Rickettsia in ticks of spur-thighed tortoise (Testudo Graeca) sold in a Qatar live animal marketPublication . Barradas, P.F.; Mesquita, J.R.; Lima, C.; Cardoso, L.; Alho, A.M.; Ferreira, P.; Amorim, I.; De Sousa, R.; Gärtner, F.The dissemination of vector arthropods harbouring zoonotic pathogens through the uncontrolled transboundary trade of exotic and pet animals poses an important threat to Public Health. In the present report, we describe the introduction of pathogenic Rickettsia africae and R. aeschlimanni in ticks removed from imported tortoises in Qatar. A total of 21 ticks were collected from pet spur‐thighed tortoises (Testudo graeca) from Doha, May 2018, and studied for species identification and characterization of Rickettsia spp. Morphological and molecular analysis of ticks allowed their identification as Hyalomma aegyptium. Molecular analysis of partial ompA and gltA genes showed that Rickettsia sequences found on these ticks clustered with sequences classified as R. aeschilimanii and R. africae. Since pre‐adult stages of H. aegyptium also feed on humans, this tick species may play a role in the transmission of R. aeschilimanii and R. africae. We alert for the introduction of non‐native pets as vehicles for tick importation, known vectors for animal and human pathogenic agents. Importation of exotic species into non‐autochthonous countries deserves strict control to enforce robust surveillance and mitigate potential exotic diseases epidemics.
- Serological and molecular evidence of Bartonella henselae in cats from Luanda city, AngolaPublication . Barradas, P.F.; De Sousa, R.; Vilhena, H.; Oliveira, A.C.; Luz, M.F.; Granada, S.; Cardoso, L.; Lopes, A.P.; Gonçalves, H.; Mesquita, J.R.; Ferreira, P.; Amorim, I.; Gärtner, F.A total of 100 domestic cats from Luanda (Angola) were tested for the presence of antibodies against Bartonella henselae and spotted fever group of Rickettsia (SFGR) using indirect immunofluorescence assay (IFA). Molecular screening targeting the riboflavin synthase (ribC) gene for Bartonella and outer membrane protein B (ompB) gene for Rickettsia, using conventional PCR and sequencing was also performed in cat´s blood samples. Sixty-six percent of the cats from Luanda had IgG antibodies against Bartonella species but none of them had antibodies against SFGR. Of the total seroreactive cats for Bartonella henselae, 4.5% had an IgG titre of 64 (cut-off), 60.6% a titre of 128, 28.8% a titre of 256 and 6.1% a titre of 512. A statistically significant association was observed between seropositivity for Bartonella henselae and the lack of access to prophylaxis against ectoparasites (p = 0.018). Molecular detection and further sequence analysis of the positive amplicons allowed identification of Bartonella henselae in a 2-year old male cat. To the best of our knowledge this study confirms for the first time, the presence of Bartonela henselae circulating in domestic cats from Luanda. This fact call the attention for the possible cases of cat-scratch disease in humans.
- Simultaneous norovirus outbreak in three Portuguese army bases in the Lisbon region, December 2017Publication . Lopes-João, A.; Mesquita, J.R.; de Sousa, R.; Oleastro, M.; Penha-Gonçalves, C.; Nascimento, M.S.J.Introduction Norovirus outbreaks frequently occur in communities and institutional settings acquiring a particular significance in armed forces where prompt reporting is critical. Here we describe the epidemiological, clinical and laboratorial investigation of a multicentre gastroenteritis outbreak that was detected simultaneously in three Portuguese army units with a common food supplier, Lisbon region, between 5 and 6 December 2017. Methods Questionnaires were distributed to all soldiers stationed in the three affected army units, and stool specimens were collected from soldiers with acute gastrointestinal illness. Stool specimens were tested for common enteropathogenic bacteria by standard methods and screened for a panel of enteric viruses using a multiplex real-time PCR assay. Food samples were also collected for microbiological analysis. Positive stool specimens for norovirus were further genotyped. Results The three simultaneous acute gastroenteritis outbreaks affected a 31 (3.5%) soldiers from a total of 874 stationed at the three units and lasted for 2 days. No secondary cases were reported. Stool specimens (N=11) were negative for all studied enteropathogenic agents but tested positive for norovirus. The recombinant norovirus GII.P16-GII.4 Sydney was identified in all positive samples with 100% identity. Conclusions The results are suggestive of a common source of infection plausibly related to the food supplying chain. Although centralisation of food supplying in the army has economic advantages, it may contribute to the multifocal occurrence of outbreaks. A rapid intervention is key in the mitigation of outbreak consequences and in reducing secondary transmission.
- Surveillance of norovirus in Portugal and the emergence of the Sydney variant, 2011-2013Publication . Costa, Inês; Mesquita, J.R.; Veiga, E.; Oleastro, Mónica; Nascimento, M.J.This report presents the results of the national surveillance system of diarrhea etiology of the National Institute of Health of Portugal concerning norovirus (NoV) during a two-year period, May 2011-2013. Of the total 580 stool samples collected from patients hospitalized for acute diarrhea in 13 Hospitals of Portugal, 67 (11.6%) tested positive for NoV. From May 2011 to March 2012 the GII.4 variant New Orleans 2009 was the most predominant strain having been replaced by the new GII.4 variant Sydney 2012 since then till the end of the survey. To our knowledge this is the first study showing the circulation of GII.4 as the norovirus strain most commonly associated to gastroenteritis and the first to report the replacement of GII.4 New Orleans by GII.4 Sydney 2012 variant in Portugal.