Inactive

The Virology & Emerging Infections Department of the U.S. Naval Medical and Research Unit No. 6 (NAMRU-6) conducts the study entitled "Characterization of the infectious causes of acute febrile and ex... The Virology & Emerging Infections Department of the U.S. Naval Medical and Research Unit No. 6 (NAMRU-6) conducts the study entitled "Characterization of the infectious causes of acute febrile and exanthematous illness in Latin America". Surveillance performed by the NAMRU-6 Virology & Emerging Infections Department over the past two decades has been instrumental in characterizing the burden of endemic tropical diseases throughout the region. Initial NAMRU-6 surveillance activities in Peru characterized the presence of Mayaro virus, VEE virus, and Oropouche virus. Later, Eastern equine encephalitis, encephalomyocarditis virus, Ilheus virus, and many other viruses have been described using the febrile protocol. In addition to viruses, two often overlooked causes of acute undifferentiated febrile disease, rickettsiosis and leptospirosis, have also been a focus of the protocol. Many arthropod and rodent-borne virus surveillance efforts around the world, including NAMRU-6's surveillance are fever-related; however, the Zika virus infection is changing our approach since this illness appears mainly with signs of acute rash with or without fever, or non-purulent conjunctivitis- characteristics included in PAHO's new case definitions. The epidemiology of influenza-like illness (ILI) throughout Latin America has also been a main research area of NAMRU-6's Virology laboratory. From 2006 to 2008, the most common viral agent identified in Peruvian patients with ILI was influenza A virus (25.1%) and influenza B virus (9.7%), followed by parainfluenza virus and adenoviruses. In Central America, the distribution of pathogens was distinct over a similar time period, with a lower percentage of influenza A viruses detection and a higher percentage of RSV. These data underscore the need to continue ILI surveillance in distinct regions and populations of Latin America. During the 2009 swine influenza pandemic, much of the local epidemiology of the disease was described through collaborative efforts involving NAMRU-6. Furthermore, influenza anti-viral resistance patterns throughout the region have been elucidated through molecular characterization and in vitro assays. The molecular epidemiology of adenovirus, rhinovirus, parainfluenza has also been studied. Dengue has been reported to cause neurological manifestations in about 1% of the patients admitted with suspected dengue illness in Vietnam. Neurological complications of severe dengue include encephalopathy, myelitis, Guillain-Barré syndrome, and cranial nerve palsies with some patients developing permanent sequelae. In VEE infection, a small proportion of cases progress to stupor and coma and are sometimes followed by death. An estimated 0.7% mortality rate among humans was reported in Colombia and Venezuela during the 1995 outbreak. Although some patients infected with Oropouche become severely ill to the point of prostration, no fatalities or sequelae have yet been described. Nevertheless, some patients have reported the recurrence of one or more clinical manifestations such as headache, myalgia, and asthenia from one to ten days after clinical recovery. Follow-up studies on patients with previous Chikungunya virus infection showed a trend of long-lasting, rheumatic disorders, including rare inflammatory joint destruction. Additionally, articular compromise was seen in patients with confirmed Mayaro virus infection. Recently, it was also described that Zika virus causes neurological damage in fetuses, newborns, and adults. These long-term effects could potentially have profound impact on the health and socioeconomic stability of populations living in endemic areas, in addition to the impact of the initial acute illness. Other diseases, such as Chikungunya and Zika, continue to spread across the globe at an alarming rate, and recently entered in the Americas. Our network of surveillance sites, which collects samples from febrile and/or exanthematous patients over a large region, is poised to uncover tomorrow's next threat to human health. NAMRU-6 collects samples not only in Peru but also in a variety of countries throughout Latin America with the support of collaborating institutions. For the specific purpose of sample storage at study sites, NAMRU-6 needs to purchase 06 ultra-low temperature upright freezers that will be shipped to the following study sites: Bagua, La Merced, Cartagena, Meta, Medellin, and Tegucigalpa. Samples will be stored in such freezers prior to shipment to NAMRU-6 laboratory.