ESTER CERDEIRA SABINO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
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- Genomic, epidemiological and digital surveillance of Chikungunya virus in the Brazilian Amazon(2019) NAVECA, Felipe Gomes; CLARO, Ingra; GIOVANETTI, Marta; JESUS, Jaqueline Goes de; XAVIER, Joilson; IANI, Felipe Campos de Melo; NASCIMENTO, Valdinete Alves do; SOUZA, Victor Costa de; SILVEIRA, Paola Paz; LOURENCO, Jose; SANTILLANA, Mauricio; KRAEMER, Moritz U. G.; QUICK, Josh; HILL, Sarah C.; THEZE, Julien; CARVALHO, Rodrigo Dias de Oliveira; AZEVEDO, Vasco; SALLES, Flavia Cristina da Silva; NUNES, Marcio Roberto Teixeira; LEMOS, Poliana da Silva; CANDIDO, Darlan da Silva; PEREIRA, Glauco de Carvalho; OLIVEIRA, Marluce Aparecida Assuncao; MENESES, Catia Alexandra Ribeiro; MAITO, Rodrigo Melo; CUNHA, Claudeth Rocha Santa Brigida; CAMPOS, Daniela Palha de Sousa; CASTILHO, Marcia da Costa; SIQUEIRA, Thalita Caroline da Silva; TERRA, Tiza Matos; ALBUQUERQUE, Carlos F. Campelo de; CRUZ, Laura Nogueira da; ABREU, Andre Luis de; MARTINS, Divino Valerio; SIMOES, Daniele Silva de Moraes Vanlume; AGUIAR, Renato Santana de; LUZ, Sergio Luiz Bessa; LOMAN, Nicholas; PYBUS, Oliver G.; SABINO, Ester C.; OKUMOTO, Osnei; ALCANTARA, Luiz Carlos Junior; FARIA, Nuno RodriguesBackground Since its first detection in the Caribbean in late 2013, chikungunya virus (CHIKV) has affected 51 countries in the Americas. The CHIKV epidemic in the Americas was caused by the CHIKV-Asian genotype. In August 2014, local transmission of the CHIKV-Asian genotype was detected in the Brazilian Amazon region. However, a distinct lineage, the CHIKV-East-Central-South-America (ECSA)-genotype, was detected nearly simultaneously in Feira de Santana, Bahia state, northeast Brazil. The genomic diversity and the dynamics of CHIKV in the Brazilian Amazon region remains poorly understood despite its importance to better understand the epidemiological spread and public health impact of CHIKV in the country. Methodology/Principal findings We report a large CHIKV outbreak (5,928 notified cases between August 2014 and August 2018) in Boa vista municipality, capital city of Roraima's state, located in the Brazilian Amazon region. We generated 20 novel CHIKV-ECSA genomes from the Brazilian Amazon region using MinION portable genome sequencing. Phylogenetic analyses revealed that despite an early introduction of the Asian genotype in 2015 in Roraima, the large CHIKV outbreak in 2017 in Boa Vista was caused by an ECSA-lineage most likely introduced from northeastern Brazil. Epidemiological analyses suggest a basic reproductive number of R-0 of 1.66, which translates in an estimated 39 (95% CI: 36 to 45) % of Roraima's population infected with CHIKV-ECSA. Finally, we find a strong association between Google search activity and the local laboratory-confirmed CHIKV cases in Roraima. Conclusions/Significance This study highlights the potential of combining traditional surveillance with portable genome sequencing technologies and digital epidemiology to inform public health surveillance in the Amazon region. Our data reveal a large CHIKV-ECSA outbreak in Boa Vista, limited potential for future CHIKV outbreaks, and indicate a replacement of the Asian genotype by the ECSA genotype in the Amazon region.
- Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort(2023) LAZARI, Carolina dos Santos; RAMUNDO, Mariana Severo; TEN-CATEN, Felipe; BRESSAN, Clarisse S.; FILIPPIS, Ana Maria Bispo de; MANULI, Erika Regina; MORAES, Isabella de; PEREIRA, Geovana Maria; CORTES, Marina Farrel; CANDIDO, Darlan da Silva; GERBER, Alexandra L.; GUIMARAES, Ana Paula; FARIA, Nuno Rodrigues; NAKAYA, Helder I.; VASCONCELOS, Ana Tereza R.; BRASIL, Patricia; PARANHOS-BACCALA, Glaucia; SABINO, Ester CerdeiraBackgroundChikungunya-fever (CHIKF) remains a public health major issue. It is clinically divided into three phases: acute, post-acute and chronic. Chronic cases correspond to 25-40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD). We aimed to identify early clinical markers of evolution to pCHIKV-CIJD during acute and post-acute phases. Methodology/Principal findingsWe studied a prospective cohort of CHIKF-confirmed volunteers with longitudinal clinical data collection from symptoms onset up to 90 days, including a 21-day visit (D21). Of 169 patients with CHIKF, 86 (50.9%) completed the follow-up, from whom 39 met clinical criteria for pCHIKV-CIJD (45.3%). The relative risk of chronification was higher in women compared to men (RR = 1.52; 95% CI = 1.15-1.99; FDR = 0.03). None of the symptoms or signs presented at D0 behaved as an early predictor of pCHIKV-CIJD, while being symptomatic at D21 was a risk factor for chronification (RR = 1.31; 95% CI = 1.09-1.55; FDR = 0.03). Significance was also observed for joint pain (RR = 1.35; 95% CI = 1.12-1.61; FDR = 0.02), reported edema (RR = 3.61; 95% CI = 1.44-9.06; FDR = 0.03), reported hand and/or feet small joints edema (RR = 4.22; 95% CI = 1.51-11.78; FDR = 0.02), and peri-articular edema observed during physical examination (RR = 2.89; 95% CI = 1.58-5.28; FDR = 0.002). Furthermore, patients with no findings in physical examination at D21 were at lower risk of chronic evolution (RR = 0.41, 95% CI = 0.24-0.70, FDR = 0.01). Twenty-nine pCHIKV-CIJD patients had abnormal articular ultrasonography (90.6% of the examined). The most common indings were synovitis (65.5%) and joint effusion (58.6%). ConclusionThis cohort has provided important insights into the prognostic evaluation of CHIKF. Symptomatic sub-acute disease is a relevant predictor of evolution to chronic arthritis with synovitis, drawing attention to joint pain, edema, multiple articular involvement including small hand and feet joints as risk factors for chronification beyond three months, especially in women. Future studies are needed to accomplish the identification of accurate and early biomarkers of poor clinical prognosis, which would allow better understanding of the disease's evolution and improve patients' management, modifying CHIKF burden on global public health. Author summaryChikungunya fever (CHIKF) is a vector-borne viral disease first described in 1952 in Africa, which recently reached the Americas, where it then originated epidemics of unprecedented magnitude. Its acute phase is characterized by fever associated with joint pain and edema, which resolve in about seven days for most patients. However, 25-40% of these patients develop chronic musculoskeletal and arthritic symptoms, which may be incapacitating and lead to permanent joint damage. We have conducted a prospective longintudinal cohort of CHIKF confirmed individuals, in Brazil, which aimed to identify clinical early markers of evolution to post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD) after 90 days, using objective physical examination to define pCHIKV-CIJD. We have also performed joint ultrasonography to improve evaluation of chronic arthritis. We found that 45.3% of patients who completed the follow-up met criteria for pCHIKV-CIJD. Women were at higher risk of chronification, as well as individuals who remain symptomatic 21 days after the onset of symptoms. Abnormal ultrasonography results were seen in 90.6% of examined pCHIKV-CIJD patients, in whom synovitis and joint effusion were the most commom songraphic signs, affecting mostly ankles and knees. The adoption of objective criteria to define pCHIKV-CIJD is crucial to estimate accurately the proportion of patients who evolve to chronic rheumatism, and to indentify early risk factors to this outcome, which may add important information to tailor therapeutic strategies for this particular population. It may also help to understand the burden of CHIKF in developing countries, measuring either its impact in individual's quality of life, or its communitary repercussion after widespread outbreaks.
- Importation and early local transmission of COVID-19 in Brazil, 2020(2020) JESUS, Jaqueline Goes de; SACCHI, Claudio; CANDIDO, Darlan da Silva; CLARO, Ingra Morales; SALE, Flavia Cristina Silva; MANULI, Erika Regina; SILVA, Daniela Bernardes Borges da; PAIVA, Terezinha Maria de; PINHO, Margarete Aparecida Benega; SANTOS, Katia Correa de Oliveira; HILL, Sarah Catherine; AGUIAR, Renato Santana; ROMERO, Filipe; SANTOS, Fabiana Cristina Pereira dos; GONCALVES, Claudia Regina; TIMENETSKY, Maria do Carmo; QUICK, Joshua; CRODA, Julio Henrique Rosa; OLIVEIRA, Wanderson de; RAMBAUT, Andrew; PYBUS, Oliver G.; LOMAN, Nicholas J.; SABINO, Ester Cerdeira; FARIA, Nuno RodriguesWe conducted the genome sequencing and analysis of the first confirmed COVID-19 infections in Brazil. Rapid sequencing coupled with phylogenetic analyses in the context of travel history corroborate multiple independent importations from Italy and local spread during the initial stage of COVID-19 transmission in Brazil.
- SARS-CoV-2 reinfection caused by the P.1 lineage in Araraquara city, Sao Paulo State, Brazil(2021) ROMANO, Camila Malta; FELIX, Alvina Clara; PAULA, Anderson Vicente de; JESUS, Jaqueline Goes de; ANDRADE, Pamela S.; CANDIDO, Darlan; OLIVEIRA, Franciane M. de; RIBEIRO, Andreia C.; SILVA, Francini C. da; INEMAMI, Marta; COSTA, Angela Aparecida; LEAL, Cibele O. D.; FIGUEIREDO, Walter Manso; PANNUTI, Claudio Sergio; SOUZA, William M. de; FARIA, Nuno Rodrigues; SABINO, Ester CerdeiraReinfection by the severe acute respiratory syndrome coronavirus type 2 (SARS-COV-2) has been reported in many countries, suggesting that the virus may continue to circulate among humans despite the possibility of local herd immunity due to massive previous infections. The emergence of variants of concern (VOC) that are more transmissible than the previous circulating ones has raised particular concerns on the vaccines effectiveness and reinfection rates. The P.1 lineage was first identified in December 2020 in Manaus city and is now globally spread. We report the first case of reinfection of SARS-CoV-2 caused by the P.1 variant outside of Manaus. The potential of these new variants to escape naturally and vaccine-induced immunity highlights the need for a global vigilance.
- Detection of coinfection with Primate Erythroparvovirus 1 and arboviruses (DENV, CHIKV and ZIKV) in individuals with acute febrile illness in the state of Rio Grande do Norte in 2016(2023) MORAIS, Vanessa dos Santos; SANTANA, Lidia Maria Reis; BEZERRA, Joao Felipe; CRUZ, Flavia Emmanuelle; SOUZA, Themis Rocha de; TAHMASEBI, Roozbeh; RAPOSO, Rafael Augusto Alves; MARCATTI, Roberta; BARBOSA, Erick Matheus Garcia; HEFFORD, Philip Michael; BUCCHERI, Renata; SABINO, Ester Cerdeira; COSTA, Antonio Charlys daBackgroundArthropod-borne viruses, known as arboviruses, pose substantial risks to global public health. Dengue (DENV), Chikungunya (CHIKV) and Zika (ZIKV) viruses stand out as significant concerns in Brazil and worldwide. Their overlapping clinical manifestations make accurate diagnosis a challenge, underscoring the need for reliable laboratory support. This study employs a comprehensive molecular diagnostic approach to track viral infections in individuals with acute febrile illness, a period marked by widespread outbreaks of DENV, CHIKV and ZIKV.MethodsBetween January and August 2016, we received a total of 713 serum samples obtained from individuals with acute febrile illness, previously tested for DENV, CHIKV or ZIKV, with initial negative results, from LACEN-NATAL. Of the total 713 samples, 667 were from females (354 of them pregnant) and 46 from males. Molecular diagnosis was conducted using the Multiplex RT-qPCR technique for simultaneous detection of DENV, CHIKV and ZIKV. Additionally, we performed differential diagnosis by RT-qPCR for other viruses of the Flavivirus, Alphavirus Enterovirus genera and qPCR for Primate Erythroparvovirus 1 (B19V) species, in accordance with Ministry of Health guidelines.ResultsAmong the 713 cases, 78.2% tested positive for viral infections, including 48% with CHIKV viremia, 0.6% with DENV and 0.1% with ZIKV. Arboviral coinfections totaled 2.4%, including DENV-CHIKV (1.7%) and CHIKV-ZIKV (0.7%). Moreover, 8% exhibited B19V viremia. Simultaneous infections were identified in 17.5%, encompassing B19V-CHIKV (17.1%), B19V-DENV (0.1%), and B19V-ZIKV (0.3%) Triple infections were observed in 1.3% of cases with B19V-DENV-CHIKV (1%) and B19V-CHIKV-ZIKV (0.3%).ConclusionMolecular testing demonstrated high efficacy in diagnosing prevalent arboviruses and detecting multiple coinfections. This approach helps to elucidate etiologies for symptomatic cases, especially during arbovirus outbreaks, and aids comprehensive surveillance. Our findings underscore the importance of monitoring co-circulating pathogens, such as B19V, with implications for clinical management, particularly in pregnant individuals. This study enhances our understanding of arbovirus epidemiology and reinforces the critical role of molecular diagnosis in disease surveillance and control.
- Genomic detection of a virus lineage replacement event of dengue virus serotype 2 in Brazil, 2019(2020) JESUS, Jaqueline Goes de; DUTRA, Karina Rocha; SALES, Flavia Cristina da Silva; CLARO, Ingra Morales; TERZIAN, Ana Carolina; CANDIDO, Darlan da Silva; HILL, Sarah C.; THEZE, Julien; TORRES, Celeste; D'AGOSTINI, Tatiana Lang; FELIX, Alvina Clara; REIS, Andreia F. Negri; ALCANTAR, Luiz Carlos Junior; ABREU, Andre L. de; CRODA, Julio H. R.; OLIVEIRA, Wanderson K. de; FILIPIS, Ana Maria Bispo de; CAMIS, Maria do Carmo Rodrigues dos Santos; ROMANO, Camila Malta; LOMAN, Nick J.; PYBUS, Oliver G.; SABINO, Ester Cerdeira; NOGUEIRA, Mauricio L.; FARIA, Nuno RodriguesBACKGROUND Despite efforts to mitigate the impact of dengue virus (DENV) epidemics, the virus remains a public health problem in tropical and subtropical regions around the world. Most DENV cases in the Americas between January and July 2019 were reported in Brazil. Sao Paulo State in the southeast of Brazil has reported nearly half of all DENV infections in the country. OBJECTIVES To understand the origin and dynamics of the 2019 DENV outbreak. METHODS Here using portable nanopore sequencing we generated20 new DENV genome sequences from viremic patients with suspected dengue infection residing in two of the most-affected municipalities of Sao Paulo State, Araraquara and Sao Jose do Rio Preto. We conducted a comprehensive phylogenetic analysis with 1,630 global DENV strains to better understand the evolutionary history of the DENV lineages that currently circulate in the region. FINDINGS The new outbreak strains were classified as DENV2 genotype III (American/Asian genotype). Our analysis shows that the 2019 outbreak is the result of a novel DENV lineage that was recently introduced to Brazil from the Caribbean region. Dating phylogeographic analysis suggests that DENV2-III BR-4 was introduced to Brazil in or around early 2014, possibly from the Caribbean region. MAIN CONCLUSIONS Our study describes the early detection of a newly introduced and rapidly-expanding DENV2 virus lineage in Brazil.
- Shotgun metagenomic sequencing of the first case of monkeypox virus in Brazil, 2022(2022) CLARO, Ingra Morales; ROMANO, Camila Malta; CANDIDO, Darlan da Silva; LIMA, Evelyn Lepka de; LINDOSO, Jose Angelo Lauletta; RAMUNDO, Mariana Severo; MOREIRA, Filipe Romero Rebello; BARRA, Luiz Alberto Costa; BORGES, Luciana Marques Sansao; MEDEIROS, Lucas Alberto; TOMISHIGE, Marcia Y. S.; MOUTINHO, Tomas; SILVA, Anderson Jose Dias da; RODRIGUES, Camila Cristina Martini; AZEVEDO, Luiz Cesar Fernandes de; VILLAS-BOAS, Lucy Santos; SILVA, Camila Alves Maia da; COLETTI, Thais Moura; MANULI, Erika R.; O'TOOLE, Aine; QUICK, Joshua; LOMAN, Nicholas; RAMBAUT, Andrew; FARIA, Nuno R.; FIGUEIREDO-MELLO, Claudia; SABINO, Ester CerdeiraMonkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.
- Genomic Surveillance of Yellow Fever Virus Epizootic in Sao Paulo, Brazil, 2016-2018(2020) HILL, Sarah C.; SOUZA, Renato de; THEZE, Julien; CLARO, Ingra; AGUIAR, Renato S.; ABADE, Leandro; SANTOS, Fabiana C. P.; CUNHA, Mariana S.; NOGUEIRA, Juliana S.; SALLES, Flavia C. S.; ROCCO, Iray M.; MAEDA, Adriana Y.; VASAMI, Fernanda G. S.; PLESSIS, Louis du; SILVEIRA, Paola P.; JESUS, Jaqueline G. de; QUICK, Joshua; FERNANDES, Natalia C. C. A.; GUERRA, Juliana M.; RESSIO, Rodrigo A.; GIOVANETTI, Marta; ALCANTARA, Luiz C. J.; CIRQUEIRA, Cinthya S.; DIAZ-DELGADO, Josue; MACEDO, Fernando L. L.; TIMENETSKY, Maria do Carmo S. T.; PAULA, Regiane de; SPINOLA, Roberta; DEUS, Juliana Telles de; MUCCI, Luis F.; TUBAKI, Rosa Maria; MENEZES, Regiane M. T. de; RAMOS, Patricia L.; ABREU, Andre L. de; CRUZ, Laura N.; LOMAN, Nick; DELLICOUR, Simon; PYBUS, Oliver G.; SABINO, Ester C.; FARIA, Nuno R.Sao Paulo, a densely inhabited state in southeast Brazil that contains the fourth most populated city in the world, recently experienced its largest yellow fever virus (YFV) outbreak in decades. YFV does not normally circulate extensively in Sao Paulo, so most people were unvaccinated when the outbreak began. Surveillance in non-human primates (NHPs) is important for determining the magnitude and geographic extent of an epizootic, thereby helping to evaluate the risk of YFV spill over to humans. Data from infected NHPs can give more accurate insights into YFV spread than when using data from human cases alone. To contextualise human cases, identify epizootic foci and uncover the rate and direction of YFV spread in Sao Paulo, we generated and analysed virus genomic data and epizootic case data from NHP in Sao Paulo. We report the occurrence of three spatiotemporally distinct phases of the outbreak in Sao Paulo prior to February 2018. We generated 51 new virus genomes from YFV positive cases identified in 23 different municipalities in Sao Paulo, mostly sampled from NHPs between October 2016 and January 2018. Although we observe substantial heterogeneity in lineage dispersal velocities between phylogenetic branches, continuous phylogeographic analyses of generated YFV genomes suggest that YFV lineages spread in Sao Paulo at a mean rate of approximately 1km per day during all phases of the outbreak. Viral lineages from the first epizootic phase in northern Sao Paulo subsequently dispersed towards the south of the state to cause the second and third epizootic phases there. This alters our understanding of how YFV was introduced into the densely populated south of Sao Paulo state. Our results shed light on the sylvatic transmission of YFV in highly fragmented forested regions in Sao Paulo state and highlight the importance of continued surveillance of zoonotic pathogens in sentinel species.
- Genomic evidence of yellow fever virus in Aedes scapularis, southeastern Brazil, 2016(2020) CUNHA, Mariana Sequetin; FARIA, Nuno Rodrigues; CALEIRO, Giovana Santos; CANDIDO, Darlan Silva; HILL, Sarah C.; CLARO, Ingra Morales; COSTA, Antonio Charlys da; NOGUEIRA, Juliana Silva; MAEDA, Adriana Yurika; SILVA, Fernanda Gisele da; SOUZA, Renato Pereira de; SPINOLA, Roberta; TUBAKI, Rosa Maria; MENEZES, Regiane Maria Tironi de; ABADE, Leandro; MUCCI, Luis Filipe; TIMENETSKY, Maria do Carmo Sampaio Tavares; SABINO, EstherThe southeastern region of Brazil has recently experienced the largest yellow fever disease outbreak in decades. Since July 2016 epizootic events were reported in Sao Paulo state's north region, where 787 Culicidae were captured as part of public health surveillance efforts and tested using real-time quantitative PCR. One Aedes scapularis pool collected in November 2016 in an agriculture area in Urupes city tested positive for YFV-RNA. Using a validated multiplex PCR approach we were able to recover a complete virus genome sequence from this pool. Phylogenetic analysis of the novel strain and publicly available data indicates that the belongs to the South American genotype 1 clade circulating in Sao Paulo state and is basal to the recent outbreak clade in southeast Brazil. Our findings highlight the need of additional studies, including vector competence studies, to disentangle the role of Aedes scapularis in yellow fever transmission in the Americas.