OROPOUCHE FEVER OUTBREAK

MANAUS, BRAZIL 2007-2008

Shakyra Goffney & Charlotte Kinsey

 Background
 Oropouche fever is a tropical
viral infection, a zoonotic
like dengue fever
 Transmitted by sloths,
marsupials, primates and birds
mosquitoes from the blood one
to humans.
 First discovered in 1955, in
Oropouche, Trinidad (hence the
name of the virus).
 It primarily occurs in the Virus Laboratory Field Assistant
Caribbean, Panama and the Nariva Swamp, Trinidad 1959
Amazonic regions.
 Background
 OROV was first described in Brazil in 1960 when
isolated from the blood of a sloth
(Bradypustridactylus) was caught in the rain forest
during the construction of the Bel`em- Brasilia
Highway.
 The mosquito was later found to be the vector,

because the blood was found on it as well.

 OROV is the second most frequent arboviral

disease in disease.
 It causes large outbreaks in both urban centers and

rural villages in the Amazon.

 About half million cases of OROV have occurred in

 Brazil over the past 50 years.

Background
 Introduction
 Oropouche Fever comes from the
Orthobunyavirus
 Study was conducted from January 2007
through November 2008 in Manaus,
Brazil
 631 Patients were included in the study
 Midges have become the main vector in
the transmission of the virus to man
Introduction

Midges on a Car

Biting Midge
 Orthobunyavirus
 Comes from the
family
Bunyaviridae
 Reservoir is
rodents and the
main vectors are
Mosquitoes &
Ticks
 Infects the Central
Nervous System
and various organs Bunyaviridae Virion
 No vaccine or
antiviral drugs
 Materials

 Blood samples from 631 patients

 96 Well Microplates
 7% Formalin buffered at pH 7.0
 5% Skim Milk
 Peroxidase-Conjugated Goat Anti-Human IgM
 ABTS Substrate
 Spectrophotometer
 Methods
 Blood samples were obtained from 631 patients who had acute febrile
illness for ≥5 days but who had negative results for Malaria and
Dengue
 Blood samples were tested for OROV IgM
 A.Albopictus cells were grown in 96 well microplates and then infected
with OROV
 After 4 days the wells were fixed with 7% Formalin buffered at pH 7.0
 The microplate was blocked with 5% skim milk and the wells were
then washed and diluted serum was added to all those infected and
uninfected
 Wells were incubated and washed and a Peroxidase-Conjugated Goat
Anti-Human IgM was added along with the ABTS substrate and cells
were incubated once more
 The results were read on a spectrophotometer at 405nm
 Results
From 631 Patients:
 128 IgM Antibodies to OROV
 Age range 2 – 81 77 were female
 All experienced fever
 93 Headaches
 90 Myalgia
 74 Arthralgia
 54 Rash
 20 experienced hemorrhagic phenomena such as gingival
bleeding
 All patients recovered without recurrence and no
hospitalization
 Discussion
 Most cases occurred November through March during the rainy season
 Cases are usually mild and unthreatening and go undiagnosed
 Patients usually mistake their ailment with a fever and often do recover
within a few days
 Severe cases remain undiagnosed because of circumstances such as,
lack of modern healthcare, lack of healthcare facilities, and lack of
transportation to the few that are available
 OROV is most often confused with the prevalent Malaria and Dengue,
hence the reason testing is initially done to rule out the two
 Outbreak was discovered because of the surveillance for acute febrile
illness and the laboratory testing
 There were probably many more cases that went undiagnosed and this
only represents a small portion of the outbreak
 Changes in the environment will bring more midges and more outbreaks
in larger cities and the Western Hemisphere
 Critique
 The patient sampling was good (~630 patients), especially
considering the fact that there have been approximately 500,ooo
cases of OROV over ~50 years.
 However, there is nothing in the article that suggests that the
sampling was random, blind or double blind consequently leading to
its potential for bias.
 The researchers intentionally chose patients who had acute
febrile Illness for >5 days with negative results for malaria and
dengue. Hence, there were no comparative groups.
 There was also an apparent change in some of the symptoms
from previous outbreaks of OROV. However, researchers never gave
a reason for the obvious change.
 However, the author did hypothesize that the changes to the
geography of the Amazon region was playing a significant part in
the public health crisis in Brazil and spread of OROV virus in the
Americas.
THANK YOU