In Brazil, the SARS-CoV-2 vaccination program has so far prioritized people over 75 years of age. By the end of March 2021, in Ceará State, a total of 313,328 elderly people had received at least one dose of vaccine (45% Oxford-AstraZeneca/Fiocruz and 55% CoronaVac-Sinovac/Butantan), and 159,970 had received two doses (83% CoronaVac-Sinovac/Butantan and 17% Oxford-AstraZeneca/Fiocruz). After a single dose, there was already a significant reduction in COVID 19-related deaths (protection ratio: 19.31 (95% CI: 18.20–20.48), attributable protection ratio: 94.8%); higher protection ratios were observed after the application of two doses of the vaccine (132.67; 95% CI: 109.88–160.18), with an attributable protection ratio of 99.2%. SARS-CoV-2 vaccines are highly effective in reducing the number of COVID-19-related deaths in over 75-year-olds in Brazil, one of the hardest hit countries by the current pandemic.

Rabies transmitted by sylvatic populations has become an increasing concern in Brazil. A total of 113 participants with a history of contact with sylvatic populations were interviewed in 27 municipalities of Ceará State in northeast Brazil. Questionnaires included questions on knowledge, attitudes and practices (KAP) regarding sylvatic rabies. Most of the respondents (92%) knew about rabies and confirmed at least one species that transmitted the disease (79.6%). Of these respondents, 69% mentioned monkeys, and 67.2% mentioned dogs. However, 16% of the respondents listed an incorrect species. In general, knowledge on the symptoms and signs and on prevention measures was weak. The majority raised pets (93.8%), most commonly dogs and cats, and, of all the pets, 85.7% were claimed to be vaccinated against rabies. A total of 67.3% reported the appearance of free-living wild animals around their houses, mostly marmosets and wild canids; 18.3% reported that sylvatic populations had attacked animals or humans. Seventy-three percent had raised or still were raising wild animals as pets, mostly capuchin monkeys (79.5%) and marmosets (24.1%). This is the first KAP study on sylvatic rabies in Brazil. The data indicate important knowledge gaps and risk behavior within a high-risk population. There is a need for strengthening and improving sylvatic rabies surveillance and control, combined with the intensification of education and information campaigns.

Objetivo: Relacionar as condições sociodemográficas, epidemiológicas e clínicas à ocorrência de casos graves de varicela. Métodos: Trata-se de um estudo transversal e analítico, tendo como fonte de dados prontuários de pacientes internados entre os anos de 2009 a 2018 no Hospital São José de doenças infecciosas (HSJ). Todas as variáveis selecionadas foram analisadas pelo programa Stata versão 15.1 e relacionadas com a presença de complicação, de forma a descobrir os fatores associados. Resultado: De um total de 302 prontuários, 54,3% eram do sexo masculino com idade mediana de 8 anos. A presença de complicação ocorreu em 82,4%, sendo complicações cutâneas as mais relatadas (65,4%). Das internações, 2,3% foram a óbito. A escolha da terapêutica com uso de antivirais associados a antibióticos (RP: 0,44; IC95%: 0,33 – 0,59 p=0,00) e alterações no exame de raios x de tórax (RP: 1,37; IC95%: 1,13 – 1,66; p=0,01) foram significativamente associados à gravidade do quadro de infecção por varicela. Conclusão: A varicela não deve ser considera uma doença inofensiva devido aos inúmeros tipos de complicações que podem associar-se à doença, causando internamento hospitalar e, em alguns casos, necessidade de tratamento intensivo. Os fatores associados foram a terapêutica utilizada, reduzindo a gravidade, e alteracoes no raio-x, aumentando a gravidade do caso.

Complications of herpes zoster hospitalizations in a reference hospital in Fortaleza-Ceará, 2009-2018

CoronaVac was the first COVID-19 vaccine deployed at scale in Brazil, yet evidence on its real-world impact and the durability of immune responses in small