RESUMO
We compared prevalence of hospitalization, endotracheal intubation, and death among case-patients with and without Down syndrome during pandemic (H1N1) 2009 in Mexico. Likelihoods of hospitalization, intubation, and death were 16-fold, 8-fold, and 335-fold greater, respectively, for patients with Down syndrome. Vaccination and early antiviral drug treatment are recommended during such epidemics.
Assuntos
Síndrome de Down/virologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/complicações , Pandemias , Adolescente , Adulto , Criança , Síndrome de Down/epidemiologia , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Adulto JovemRESUMO
The high incidence of Hepatitis A and B in institutionalized patients with Down Syndrome (DS) is not fully understood. Under poor hygienic conditions, immunological alterations might predispose individuals to these infections. Sixty three DS children between 1 and 12 years old living at home with their families were examined for anti-HAV and compared to age-matched controls (64 healthy children). This cross-sectional study was carried out from May 1999 to April 2000 at the Hospital de Clínicas of Porto Alegre, southern Brazil. Groups were compared in terms of age, sex, skin color, and family income (> R$ 500 and < R $ 500/month) by the chi-square test, with Yates' correction and for the prevalence of anti-HAV (Fisher's exact test). In the DS group (n=63), the mean age was 4.4 +/- 3.3 years, 94% of the patients were white and 51% were female. Family income was < or = R$ 500/month in 40 cases (63%). In the control group (n=64), the mean age was 4.8 +/- 2.7 years, 81% of the patients were white and 56% were female. Family income was < or = R$ 500 in 20 patients (31%). DS children's families had a significantly lower income (P<0.0005). In the DS group there were 6 positive (9.5%) anti-HAV cases, and all came from low-income families (less than R$ 500/ month). In the control group, 3 cases (4.7%) were positive for anti-HAV (two were from a low-income family and one was from a higher income family). These differences were not significant. Our data indicate that Hepatitis A is not a special risk for mentally retarded DS outpatients, even in a developing country like Brazil.
Assuntos
Síndrome de Down/imunologia , Anticorpos Anti-Hepatite A/sangue , Hepatite A/imunologia , Brasil , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Síndrome de Down/virologia , Feminino , Hepatite A/sangue , Hepatite A/complicações , Humanos , Lactente , Masculino , Estudos Soroepidemiológicos , Fatores SocioeconômicosRESUMO
This study evaluates the transmission of CMV infection in 120 children aged 1 to 15 years with Down syndrome who attended a day-care center for handicapped children in São Paulo, Brazil. A blood sample was obtained from each children at the beginning of the study for detection of IgG and IgM cytomegalovirus (CMV) antibodies by an immunofluorescence assay. Samples of saliva and urine were obtained every 3 months from the children with CMV antibodies to detect shedding of the virus by culture in human foreskin fibroblasts, by detection of pp65 CMV-antigen and by a nested PCR assay. The prevalence of anti CMV-IgG antibodies was 76.6% (92/120), and IgM anti-CMV antibodies were detected in 13% (12/92) of the seropositive children. During the first viral evaluation, CMV was detected in the urine and/or saliva in 39/90 (43.3%) of the seropositive children. In the second and third evaluations, CMV was detected in 41/89 (46%) and in 35/89 (39.3%) children, respectively. Detection of CMV was shown both in urine and saliva in 28/39 (71.8%), 19/41(46.3%) and 20/35 (57.1%) of the children excreting the virus, respectively. Additionally, in 3(3/4)9 (67.4%) of the excreters CMV could be demonstrated in urine or saliva in at least two out of the three virological evaluations carried out sequentially in a six month period. Of the 28 initially seronegative children, 26 were re-examined for anti-CMV IgG antibodies about 18 months after the negative sample; seroconversion was found in 10/26 (38.5%). Taking all 536 samples of urine or saliva examined by virus culture and pp65 antigen detection during the study into account, 159 (29.6%) were positive by virus culture and 59 (11%) gave a positive result with the pp65 assay. These data demonstrate the high prevalence of CMV shedding and the high risk of CMV infection in children with Down syndrome attending a day-care center for mentally handicapped patients. The virus culture was more sensitive than the pp65 CMV antigen assay for CMV detection in both urine and saliva samples.
Assuntos
Creches/estatística & dados numéricos , Infecções por Citomegalovirus/epidemiologia , Síndrome de Down/virologia , Adolescente , Anticorpos Antivirais/isolamento & purificação , Brasil/epidemiologia , Criança , Pré-Escolar , Citomegalovirus/imunologia , Infecções por Citomegalovirus/transmissão , Humanos , Imunoglobulina G/isolamento & purificação , Imunoglobulina M/isolamento & purificação , Lactente , Reação em Cadeia da Polimerase , Prevalência , Eliminação de Partículas ViraisRESUMO
This study evaluates the transmission of CMV infection in 120 children aged 1 to 15 years with Down syndrome who attended a day-care center for handicapped children in São Paulo, Brazil. A blood sample was obtained from each children at the beginning of the study for detection of IgG and IgM cytomegalovirus (CMV) antibodies by an immunofluorescence assay. Samples of saliva and urine were obtained every 3 months from the children with CMV antibodies to detect shedding of the virus by culture in human foreskin fibroblasts, by detection of pp65 CMV-antigen and by a nested PCR assay. The prevalence of anti CMV-IgG antibodies was 76.6 per cent (92/120), and IgM anti-CMV antibodies were detected in 13 per cent (12/92) of the seropositive children. During the first viral evaluation, CMV was detected in the urine and/or saliva in 39/90 (43.3 per cent) of the seropositive children. In the second and third evaluations, CMV was detected in 41/89 (46 per cent) and in 35/89 (39.3 per cent) children, respectively. Detection of CMV was shown both in urine and saliva in 28/39 (71.8 per cnet), 19/41(46.3 per cent) and 20/35 (57.1 per cent) of the children excreting the virus, respectively...