ESTUDO MOLECULAR DE PATÓGENOS EMERGENTES E REEMERGENTES NO DIAGNÓSTICO DIFERENCIAL COM ARBOVIROSES NO ESTADO DE MATO GROSSO DO SUL

Abstract

The emergence of arboviruses in vulnerable locations (regions with favorable conditions for the maintenance of the vector, with social and economic vulnerability and with populations susceptible to arboviruses) represents a potential challenge for Public Health in Brazil. In addition to arboviruses, other diseases with similar symptoms that circulate simultaneously are underdiagnosed due to, among other factors, the lack of implementation of specific diagnostic tests in routine laboratory procedures. This work sought to analyze the occurrence of pathogens, until then, little studied in the state, in samples sent to the Central Public Health Laboratory of Mato Grosso do Sul (LACEN-MS). This is a two-way epidemiological study based on molecular analysis of Mayaro, Oropouche, Erythrovirus B19 and West Nile viruses in biological samples suspected of dengue, zika, and chikungunya but that tested negative by PCR and serology from 2017 to 2022. A total of 773 samples were subjected to PCR amplification using protocols previously validated by Fiocruz Amazonia. Erythrovirus B19 (B19V) DNA was detected in 10.6% of the samples examined, including 10 from pregnant women. The B19V-positive samples were sequenced, and phylogenetic reconstruction showed that all samples belonged to genotype 1a (G1a). These results demonstrate the importance of including B19V in differential laboratory diagnosis, not only for epidemiological purposes but also for appropriate patient management. Despite the absence of molecular evidence of MAYV, OROV, and WNV in the examined samples, we reiterate the importance of integrated surveillance to detect the circulation of neglected and emerging arboviruses in Brazil and to develop different actions to address the challenges at the animal- human-ecosystem interface (One Health). Many cases have symptoms that lead to clinical suspicion of arboviruses, but laboratory results are negative, making diagnosis in health services difficult. Therefore, our results reinforce the need to strengthen and integrate epidemiological, vector, and laboratory surveillance to expand investigations of circulating pathogens and to direct methods of control and prevention against these diseases in the state of Mato Grosso do Sul and throughout the country, as the population is susceptible to these pathogens.

Keywords: Arboviruses, Erythrovirus B19, Surveillance, Differential diagnosis.