Brechla Moreno

The Gorgas Memorial Institute for Health Studies (GMI) | ICGES · Department of Virology and Biotechnology

Human Parechoviruses, officially known as Parechovirus A (PeV-A), is associated with mild gastrointestinal and respiratory illness in young children, however, they may also give rise to Central Nervous System (CNS) infections and neonatal sepsis. While studies have delved into the detection of PeV-A in different populations, the detection of PeV-A...

Human parechoviruses, officially known as Parechovirus A (PeV-A), from the family Picornaviri-dae, genus Parechovirus, are non-enveloped, icosahedral, positive-sense RNA viruses associated with mild gastrointestinal and respiratory illness in young children, however, they may also give rise to Central Nervous System (CNS) infections and neonatal se...

We report a case of reinfection by SARS-CoV-2 with the second virus harboring amino acid changes in the Spike protein (141-143del, D215A, ins215AGY, L452R, D614 G), orf1a, helicase, orf3a, and Nucleocapside. The virus associated with the reinfection, from an endemic lineage containing the S:L452R immune escape mutation, was circulating in Panama at...

Identifying the specific epitopes targeted by antibodies elicited in response to infectious diseases is important for developing vaccines and diagnostics. However, techniques for broadly exploring the specificity of antibodies in a rapid manner are lacking, limiting our ability to quickly respond to emerging viruses. We previously reported a techno...

We describe the epidemiological characteristics, pattern of circulation, and geographical distribution of influenza B viruses and its lineages using data from the Global Influenza B Study. We included over 1.8 million influenza cases occurred in thirty-one countries during 2000-2018. We calculated the proportion of cases caused by influenza B and i...

Dengue virus (DENV) is the most prevalent arbovirus in terms of human public health importance globally. In addition to DENV epidemiological surveillance, genomic surveillance may help investigators understand the epidemiological dynamics, geographic distribution, and temporal patterns of DENV circulation. Herein, we aimed to reconstruct the molecu...

Zika virus (ZIKV) was first detected in the Americas in Brazil in 2015, with a rapid spread to surrounding countries. In Panama, the outbreak began in November 2015 in an indigenous community located on the Caribbean side of the country. Zika virus is typically associated with a diffuse rash, fever, and conjunctivitis. It can rarely cause neurologi...

Until 2011 there were 29 dengue-associated deaths, 17 of which occurred in 2011, the most severe outbreak with a case fatality rate (CFR) of 44% (17 deaths out of 38 severe dengue cases). During this outbreak DENV-2 was reintroduced into the country, whereas over the prior five years DENV-1 and −3 were predominant. Herein, we describe the 2011 Pana...

Background: Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases). Methods: For each virus, we calculated a Relative Ill...

The clinical and pathologic characterisation of two fatal cases of tick-borne rickettsiosis in rural (El Valle) and urban (City of Panama) Panama are described. Clinical and autopsy findings were non-specific, but the molecular analysis was used to identify Rickettsia rickettsii in both cases. No ticks were collected in El Valle, while in the urban...

The circulation of the South-east Asian/American (AS/AM) dengue 2 virus (DENV-2) genotype in the Americas has been associated with a high rate of severe disease. From 1993, the year DENV was reintroduced in Panama, until 2011 there were 29 dengue-associated deaths, 17 of which occurred in 2011, the most severe outbreak with a case fatality rate (CF...

Human metapneumovirus (HMPV) is a common causative agent of severe respiratory tract infections in children under 5 years old, the elderly and immunocompromised patients, being responsible for 5-15% of all viral respiratory infections requiring hospitalization. Though HMPV was included in the surveillance program for respiratory viruses in 2010, it...

An investigation in Panama found that Punta Toro virus species complex (PTVs) may contribute to febrile illnesses with symptoms mirroring those of dengue fever. However, further studies are needed to determine if PTV infection causes only a mild disease or if it can have more serious manifestations in some patients.

In Panama, human respiratory syncytial virus (HRSV) is responsible of 20 to 40 percent of acute respiratory infections in children under five years old. Currently, little is known about the genetic variability of HRSV in Central America and the Caribbean. Recently, we reported the genetic variability of HRSV-A, however; no studies on HRSV-B in Pana...

Phylogenetic tree of Punta Toro species complex (PTVs), location and number of dengue-negatives samples in Panama analyzed for PTVs in 2009, and demographic characteristics and symptoms of persons with PTV infection versus those with dengue.

Introduction The increased availability of influenza surveillance data in recent years justifies an actual and more complete overview of influenza epidemiology in Latin America. We compared the influenza surveillance systems and assessed the epidemiology of influenza A and B, including the spatio-temporal patterns of influenza epidemics, in ten cou...

Laboratory-confirmed influenza cases reported to the local influenza surveillance system in each year and country or sub-national region, by virus type, subtype and lineage. The Global Influenza B Study, Latin-American countries, 2004–2014. (DOC)

Contact information of data owners. (DOC)

Background Chikungunya virus (CHIKV) typically causes explosive epidemics of fever, rash and polyarthralgia after its introduction into naïve populations. Since its introduction in Panama in May of 2014, few autochthonous cases have been reported; most of them were found within limited outbreaks in Panama City in 2014 and Puerto Obaldia town, near...

Flow chart for the notification of chikungunya or dengue cases of the Ministry of Health for Panama. (TIF)

Dengue and chikungunya detection in samples received by National Dengue Surveillance Program during 2014 until July 2015 (Epidemiological week 26). (DOCX)

Flow chart of National Dengue Surveillance Laboratory Program. (TIF)

Flow chart of National Chikungunya Surveillance Laboratory Program. (TIF)

Epidemic curve of chikungunya and dengue cases and vector infestation rates reported in Rio Abajo and Juan Diaz counties from 2014 to July 2015. A. Rio Abajo County B. Juan Diaz County. Red bar represents chikungunya imported cases and green bar autochthonous cases. Grey bar represent dengue cases and line blue represent the infestation index mosqu...

Identifying the targets of antibody responses during infection is important for designing vaccines, developing diagnostic and prognostic tools, and understanding pathogenesis. We developed a novel deep sequence-coupled biopanning approach capable of identifying the protein epitopes of antibodies present in human polyclonal serum. Here, we report th...

E-associated peptides identified for each DENV secondary infection patients. Deep sequence-coupled biopanning results are plotted showing peptides (black lines) that were enriched 10-fold or more for each patient. Shading indicates the associated domain of E. (PDF)

Annual trivalent influenza vaccines (TIV) containing 2 A strains and one B lineage have been recommended for the prevention of influenza in most of Latin American countries. However, the circulation of 2 B lineages (Victoria and Yamagata) and difficulties in predicting the predominating lineage have led to the development of quadrivalent influenza...

Distribution of symptoms by patients with Zika, dengue, and chikungunya virus infections in the Guna Yala region of Panama, November 27, 2015–January 22, 2016; epidemiologic curve for the outbreak of Zika virus infection in this region; and maximum-likelihood tree of the Zika virus isolated during the outbreak.

[This corrects the article DOI: 10.1371/journal.pone.0152310.].

Table S1. Strain information for the most prevalent circulating influenza strains in our study, per country, per year.

Este comunicado tiene como propósito informar al equipo médico panameño y de la región de América Latina y el Caribe de la situación actual por la amenaza del virus Zika (ZIKV), y condensar el conocimiento clínico y molecular sobre esta amenaza emergente. Este esfuerzo interinstitucional de la República de Panamá tiene como objetivo fortalecer las...

p>Resumen El propósito de esta revisión es presentar al equipo de salud latinoamericano y de la región del caribe un panorama de la situación actual con el virus Zika (ZIKAV), y al mismo tiempo, proveer conocimiento clínica y molecular relevante para enfrentar este problema emergente. Esperamos que esta revisión tenga un impacto positivo en el diag...

Background Neurotropic arboviral infections are an important cause of encephalitis. A zoonotic, vector-borne alphavirus, Madariaga virus (MADV; formerly known as South American eastern equine encephalitis virus), caused its first documented human outbreak in 2010 in Darien, Panama, where the genetically similar Venezuelan equine encephalitis virus...

MADV and VEEV plaque reduction neutralization test titers for human subjects. (XLS)

Marginal effects of MADV antibodies by community. (DOCX)

MADV and VEEV plaque reduction neutralization test titers for animal samples. (XLS)

Marginal effects of VEEV antibodies by community. (DOCX)

Human serosurveillance variables and interaction terms. (DOCX)

The purpose of this review is to provide Latin America's and the region's healthcare professionals with an overview of the current situation related to Zika virus (ZIKAV), and at the same time, to provide relevant clinical and molecular knowledge against this emerging problem. We expect to have a positive impact in diagnostic, surveillance and trea...

Introduction: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. Methods: This was a retrospective analysis of surv...

Contact information of data owners. (DOC)

Background Influenza-associated illness results in increased morbidity and mortality in the Americas. These effects can be mitigated with an appropriately chosen and timed influenza vaccination campaign. To provide guidance in choosing the most suitable vaccine formulation and timing of administration, it is necessary to understand the timing of in...

The Human Bocavirus (HBoV) was added as a new member of the Parvoviridae family in 2005 upon its discovery in nasopharyngeal aspirates from children with respiratory infection. Recently, there has been increasing evidence of worldwide circulation of HBoV; however, in Latin America few studies have been conducted. In order to detect the circulation...

Chikungunya virus (CHIKV) is a mosquito-borne pathogen that was only endemic in Africa and south Asia until 2005 and 2006, when the virus spread into the Indian Ocean islands, Europe, and Asia. Autochthonous CHIKV transmission in the Caribbean islands was reported in December of 2013. In Panama, two febrile cases were detected in May of 2014: one t...

Palabras clave: dengue, diagnóstico, NS1 (proteína no estructural 1), ELISA de captura de NS1, IgM, genoma viral, RT-PCR, aislamiento viral, sensibilidad. Resumen Introducción. El dengue es una enfermedad infecciosa endémica en Panamá, por lo cual debemos tener un algoritmo de diagnóstico sensible y rápido para realizar un diagnóstico temprano, tom...

A one-step RT-PCR and one-enzyme RFLP was used to detect and distinguish among flaviviruses, including the four serotypes of dengue and the St. Louis Encephalitis, West Nile and Yellow Fever viruses in cultured virus samples or acute-phase human serum. Using a previously described RT-PCR, but novel RFLP procedure, results are obtained in 24 h with...