Understanding Sabiá virus infections (Brazilian mammarenavirus).
Nastri AC., Duarte-Neto AN., Boas Casadio LV., Marciel de Souza W., Claro IM., Manuli ER., Selegatto G., Salomão MC., Fialkovitz G., Taborda M., Leal de Almeida B., Magri MC., Guedes AR., Perdigão Neto LV., Sataki FM., Guimarães T., Mendes-Correa MC., Tozetto-Mendoza TR., Fumagalli MJ., Ho Y-L., Maia da Silva CA., Coletti TM., Goes de Jesus J., Romano CM., Hill SC., Pybus O., Rebello Pinho JR., Ledesma FL., Casal YR., Kanamura CT., Tadeu de Araújo LJ., Santos da Silva Ferreira C., Guerra JM., Moraes Figueiredo LT., Dolhnikoff M., Faria NR., Sabino EC., Ferreira Alves VA., Levin AS.
BackgroundOnly two naturally occurring human Sabiá virus (SABV) infections have been reported, and those occurred over 20 years ago.MethodsWe diagnosed two new cases of SABV infection using metagenomics in patients thought to have severe yellow fever and described new features of histopathological findings.ResultsWe characterized clinical manifestations, histopathology and analyzed possible nosocomial transmission. Patients presented with hepatitis, bleeding, neurological alterations and died. We traced twenty-nine hospital contacts and evaluated them clinically and by RT-PCR and neutralizing antibodies. Autopsies uncovered unique features on electron microscopy, such as hepatocyte "pinewood knot" lesions. Although previous reports with similar New-World arenavirus had nosocomial transmission, our data did not find any case in contact tracing.ConclusionsAlthough an apparent by rare, Brazilian mammarenavirus infection is an etiology for acute hemorrhagic fever syndrome. The two fatal cases had peculiar histopathological findings not previously described. The virological diagnosis was possible only by contemporary techniques such as metagenomic assays. We found no subsequent infections when we used serological and molecular tests to evaluate close contacts.