BACKGROUND In Brazil, the Yellow Fever virus (YFV) is endemic in the Amazon, from where it eventually expands into epidemic waves. Coastal south-eastern (SE) Brazil, which has been a YFV-free region for eight decades, has reported a severe sylvatic outbreak since 2016. The virus spread from the north toward the south of the Rio de Janeiro (RJ) state, causing 307 human cases with 105 deaths during the 2016-2017 and 2017-2018 transmission seasons. It is unclear, however, whether the YFV would persist in the coastal Atlantic Forest of RJ during subsequent transmission seasons. OBJECTIVES To conduct a real-time surveillance and assess the potential persistence of YFV in the coastal Atlantic Forest of RJ during the 2018-2019 transmission season. METHODS We combined epizootic surveillance with fast diagnostic and molecular, phylogenetic, and evolutionary analyses. FINDINGS Using this integrative strategy, we detected the first evidence of YFV re-emergence in the third transmission season (2018-2019) in a dying howler monkey from the central region of the RJ state. The YFV detected in 2019 has the molecular signature associated with the current SE YFV outbreak and exhibited a close phylogenetic relationship with the YFV lineage that circulated in the same Atlantic Forest fragment during the past seasons. This lineage circulated along the coastal side of the Serra do Mar mountain chain, and its evolution seems to be mainly driven by genetic drift. The potential bridge vector Aedes albopictus was found probing on the recently dead howler monkey in the forest edge, very close to urban areas. MAIN CONCLUSIONS Collectively, our data revealed that YFV transmission persisted at the same Atlantic Forest area for at least three consecutive transmission seasons without the need of new introductions. Our real-time surveillance strategy permitted health authorities to take preventive actions within 48 h after the detection of the sick non-human primate. The local virus persistence and the proximity of the epizootic forest to urban areas reinforces the concern with regards to the risk of re-urbanisation and seasonal re-emergence of YFV, stressing the need for continuous effective surveillance and high vaccination coverage in the SE region, particularly in RJ, an important tourist location.

O grau de urbanização de cada estado interfere no prognóstico do câncer, já que, quanto mais urbanizado o espaço, maior o acesso à saúde. O objetivo deste estudo é analisar a tendência de mortalidade por câncer de mama, próstata e colo de útero por locais selecionados, de acordo com o grau de urbanização, no período de 1980 e 2009. Para tanto, foram calculadas as taxas de mortalidade, padronizadas para a população mundial, por câncer de mama, próstata e colo de útero para os estados brasileiros selecionados por meio do grau de urbanização e suas respectivas capitais nos anos estudados. Não houve diferença quanto à evolução da taxa de mortalidade para câncer de mama e próstata entre os estados e capitais mais urbanizados e os menos urbanizados, pois em ambos foi crescente. Nos estados mais urbanizados a taxa média foi maior do que nos menos urbanizados, indicando maior número de óbitos nestas regiões, e relação inversa foi observada para o câncer do colo de útero. Observa-se que o aumento gradativo dessa taxa reforça a necessidade de ações específicas, como as previstas no Pacto pela Vida, e agrega informações peculiaridades acerca da organização da dinâmica de diagnóstico e tratamento do câncer no país.

The degree of urbanization in each state interferes in cancer prognosis, since the more urbanized space, greater access to health care. The objective of this study is to analyze trends in mortality from breast cancer, prostate and cervix for selected locations, according to the degree of urbanization between 1980 and 2009. Therefore, we calculated mortality rates, standardized to the world population, breast cancer, prostate and cervix for the Brazilian states selected by the degree of urbanization and their respective capitals in the years studied. There was no difference in the evolution of mortality rates for breast cancer and prostate cancer among the states and capitals more urbanized and less urbanized, because in both cases was increasing. In the more urbanized, the average rate was higher than in less urbanized, indicating greater number of deaths in these regions, and an inverse relationship was observed for cancer of the cervix. It is observed that the gradual increase in this rate increases the need for specific actions such as those contained in the Pact for Life, and adds information about the peculiarities of the dynamics of organizational diagnosis and treatment of cancer in the country.