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In Brazil, Leishmania (Leishmania) infantum causes canine visceral leishmaniasis; the primary vector is the Lutzomyia longipalpis sand fly. We describe a case of canine visceral leishmaniasis caused by Leishmania (Viannia) lainsoni in a dog from Barra Mansa municipality, Rio de Janeiro state. Better specificity of serologic diagnostic techniques is needed for diagnoses.

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, whose 2020 outbreak was characterized as a pandemic by the World Health Organization. Restriction measures changed healthcare delivery, with telehealth providing a viable alternative throughout the pandemic. This study analyzed a telemedicine platform database with the goal of developing a diagnostic prediction model for COVID-19 patients. This is a longitudinal study of patients seen on the Conexa Saude telemedicine platform in 2022. A multiple binary logistic regression model of controls (negative confirmation for COVID-19 or confirmation of other influenza-like illness) versus COVID-19 was developed to obtain an odds ratio (OR) and a 95% confidence interval (CI). In the final binary logistic regression model, six factors were considered significant: presence of rhinorrhea, ocular symptoms, abdominal pain, rhinosinusopathy, and wheezing/asthma and bronchospasm were more frequent in controls, thus indicating a greater chance of flu-like illnesses than COVID-19. The presence of tiredness and fatigue was three times more prevalent in COVID-19 cases (OR = 3.631; CI = 1.138–11.581; p-value = 0.029). Our findings suggest potential predictors associated with influenza-like illness and COVID-19 that may distinguish between these infections.

The One Health approach highlights the interconnectedness between human, animal, and environmental health, reinforcing the importance of public awareness in preventing zoonoses, which remain major sources of emerging infectious diseases. Given the increasing popularity of pet ownership and the widespread use of mobile phones for accessing information, understanding how pet owners engage with digital health content is essential for guiding effective educational strategies. This study assessed the profile of dog and cat owners in Rio de Janeiro, Brazil; their knowledge about zoonoses; patterns of internet and mobile app use; and their interest in a health education app. A cross-sectional study was conducted with 166 pet owners recruited from a public veterinary clinic and a private service. Data were collected using a REDCap-based questionnaire administered through face-to-face interviews and online surveys. Descriptive statistics and association tests were performed to explore relationships between demographic variables, digital engagement, and knowledge of zoonoses. Most respondents were women (78.3%), aged 18-34 years (51.2%) and had higher education degrees (54.2%). Mobile phones were the primary means of internet access. A total of 85.5% had heard of zoonoses, with rabies (86.7%) and sporotrichosis (35.5%) being the most frequently cited. Although 62.6% reported visiting veterinarians twice or more per year, 18.7% did not seek veterinary care. Only 19.9% used pet-care apps, while 74.7% searched online for animal health information. No significant associations were found between demographic characteristics and zoonosis knowledge, predominant mobile phone use, or app use. Significant associations were observed only between mobile phone users and social media access, information-seeking behaviors, knowledge of zoonoses, and pet-care app use. Mobile phones are the main gateway to health information, indicating strong potential for digital tools to enhance health education and support responsible pet ownership, while respecting veterinarians' exclusive role in diagnosis and treatment.

Treatment of cutaneous leishmaniasis (CL) remains challenging since the drugs currently used are quite toxic, thus contributing to lethality unrelated to the disease itself but to adverse events (AE). The main objective was to evaluate different treatment regimens with meglumine antimoniate (MA), in a reference center in Rio de Janeiro, Brazil. A historical cohort of 592 patients that underwent physical and laboratory examination were enrolled between 2000 and 2017. The outcome measures of effectiveness were epithelialization and complete healing of cutaneous lesions. AE were graded using a standardized scale. Three groups were evaluated: Standard regimen (SR): intramuscular (IM) MA 10-20 mg Sb5+/kg/day during 20 days (n = 46); Alternative regimen (AR): IM MA 5 mg Sb5+/kg/day during 30 days (n = 456); Intralesional route (IL): MA infiltration in the lesion(s) through subcutaneous injections (n = 90). Statistical analysis was performed through Fisher exact and Pearson Chi-square tests, Kruskal-Wallis, Kaplan-Meier and log-rank tests. SR, AR and IL showed efficacy of 95.3%, 84.3% and 75.9%, with abandonment rate of 6.5%, 2.4% and 3.4%, respectively. IL patients had more comorbidities (58.9%; p = 0.001), were mostly over 50 years of age (55.6%), and had an evolution time longer than 2 months (65.6%; p = 0.02). Time for epithelialization and complete healing were similar in IL and IM MA groups (p = 0.9 and p = 0.5; respectively). Total AE and moderate to severe AE that frequently led to treatment interruption were more common in SR group, while AR and IL showed less toxicity. AR and IL showed less toxicity and may be good options especially in CL cases with comorbidities, although SR treatment was more effective. IL treatment was an effective and safe strategy, and it may be used as first therapy option as well as a rescue scheme in patients initially treated with other drugs.

ABSTRACT Cutaneous leishmaniasis (CL) has substantial epidemiological and clinical differences depending on host characteristics, Leishmania species and geographic areas. CL in Rio de Janeiro State was evaluated. Mandatory notifications of confirmed cases from 2001–2020 were analyzed considering sociodemographic and clinical variables, temporal trends, the Cutaneous Leishmaniasis Composite Indicator (CLCI) for each affected city in relation to the total of affected cities in the state, and each triennium from the beginning to the end of the time series (2001–2003, 2002–2004 until 2018–2020, sequentially). The number of cases decreased over time. High average incidence rates occurred in contiguous cities from the Southernmost to the Northernmost regions of Rio de Janeiro State, following areas where the Atlantic Forest persists. The CLCI showed temporal variations in the intensity of the risk of CL in the affected cities. Rio de Janeiro city was the only one with intense or very intense risk of CL throughout the studied period. The disease predominantly affected people residing in urban areas and in the middle age groups (20–59 years). CL also predominated in males, regardless of age. The mucosal clinical form was also significantly associated with men, with an 80% chance of them being more affected than women. Regarding diagnostic tests, the Leishmanin Skin Test showed higher positivity than the direct parasitological exam and the histopathological exam. No differences regarding cure between sexes were found. This study may guide control actions in areas where they are most needed in Rio de Janeiro State.

ABSTRACT Cat-transmitted sporotrichosis is one of the fastest spreading zoonosis in Rio de Janeiro State, Brazil. A retrospective study was conducted with analysis of incidence of human sporotrichosis complemented with spatial methodologies. Data from case reported to the Notifiable Diseases Information System (SINAN) from 2007 to 2023 were studied. Incidence, demographic variables, temporal, and spatial dynamics of this endemic disease were investigated. During 2007–2023, 15,401 cases of sporotrichosis were reported. Most cases (64.4%) occurred with women. The annual incidence from 2007 to 2023 was 5.6 cases per 100,000 inhabitants. The incidence in 2016–2023 was 2.3 times higher than in 2007–2015. No significant differences were found regarding age between the two periods, but there were differences regarding gender: with a higher proportion of women in 2007–2015. The endemic is heterogenous with variations in time and space. Spatial analysis showed statistically significant clusters spread throughout Rio de Janeiro, in the periods of low incidence (2007–2015) and high incidence (2016–2023). In the period of high incidence, clusters were more numerous and had a greater range. In conclusion, the incidence levels and the proportion of affected territories increased over time. This study may contribute to understanding the dynamics of the endemic disease in the Rio de Janeiro State and guide control actions in places where they are most needed.

Background Skin ulcers in American cutaneous leishmaniasis (ACL) may heal spontaneously after months/years. However, few cases may present quick heal even during diagnosis procedure (early spontaneous healing- ESH). The main objective of this study was to compare ESH patients with cases requiring specific treatment [non-ESH (NESH)]. Methods A historical cohort study of ACL patients ( n  = 445) were divided into 2 groups: ESH – spontaneously healed patients ( n  = 13; 2.90%), and NESH- treated patients ( n  = 432; 97.10%). We compared clinical and laboratorial findings at diagnosis, including the lesion healing process. Results ESH patients had a higher percentage of single lesions ( p  = 0.027), epithelialized lesion on initial examination ( p  = 0.001), lesions located in the dorsal trunk ( p  = 0.017), besides earlier healing ( p  < 0.001). NESH presents higher frequency of ulcerated lesions ( p  = 0.002), amastigotes identified in histopathology exams ( p  = 0.005), positive cultures ( p  = 0.001), and higher positivity in ≥3 parasitological exams ( p  = 0.030). All ESH cases were positive in only a single exam, especially in PCR. Conclusions ESH group apparently presented a lower parasitic load evidenced by the difficulty of parasitological confirmation and its positivity only by PCR method. The absence or deficiency of specific treatment is commonly identified as predisposing factors for recurrence and metastasis in ACL. However, due to the drugs toxicity, the treatment of cases which progress to early spontaneous healing is controversial. ESH patients were followed for up to 5 years after cure, with no evidence of recrudescence, therefore suggesting that not treating these patients is justifiable, but periodic dermatological and otorhinolaryngological examinations are advisable to detect a possible relapse.

Favorable responses in American tegumentary leishmaniasis (ATL) patients to treatment with 5 mg Sbv/kg/day meglumine antimoniate (MA) has been reported in Rio de Janeiro, but little is known regarding the therapeutic response to low doses in patients from other locations. A retrospective review of medical records was conducted to compare the therapeutic response to 5 mg Sbv/kg/day MA treatment among 36 patients who acquired ATL in Brazilian states other than Rio de Janeiro (OS group) and 72 patients from Rio de Janeiro (RJ group). One course of 5 mg Sbv/kg/day MA cured 72.8% of 81 cutaneous (CL) and 66.6% of 27 mucosal (ML) leishmaniasis-infected patients: 70% in the CL/RJ group, 81% in the CL/OS group, 50% in the ML/RJ group, and 80% in the ML/OS group. After up to two additional treatment courses at the same dose, 88.9% and 85.2% of the CL and ML patients were cured, respectively. Adverse events were observed in 40% of patients in the CL/RJ group, 57% of the CL/OS group, 58% of the ML/RJ group, and 80% of the ML/OS group. No significant differences were observed in the cure rates or adverse effects between the RJ and OS groups. No patients required permanent discontinuation of treatment due to adverse events. Patients with ATL acquired in both RJ and OS may respond to low-dose MA. While high-dose MA should remain the standard treatment for ATL, low-dose MA might be preferred when toxicity is a primary concern.

Atypical presentations of cutaneous leishmaniasis include sporotrichoid leishmaniasis (SL), which is clinically described as a primary ulcer combined with lymphangitis and nodules and/or ulcerated lesions along its pathway. To assess the differences between patients with sporotrichoid leishmaniasis and typical cutaneous leishmaniasis (CL). From January 2004 to December 2010, 23 cases of SL (4.7%) were detected among 494 CL patients diagnosed at a reference center for the disease in Rio de Janeiro State, Brazil. These 23 cases were compared with the remaining 471 patients presenting CL. SL predominated in female patients (60.9%, p = 0.024), with older age (p = 0.032) and with lesions in upper limbs (52.2%, p = 0.028). CL affected more men (64.5%), at younger age, and with a higher number of lesions exclusively in lower limbs (34.8%). Differences in clinical and epidemiological presentation were found between SL patients as compared to CL ones, in a region with a known predominance of Leishmania (Viannia) braziliensis. The results are similar to the features of most of the sporotrichosis patients as described in literature, making the differential diagnosis between ATL and sporotrichosis more important in overlapping areas for both diseases, like in Rio de Janeiro State.