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Introduction: Hepatitis B surveillance is crucial. We proposed to describe the seroprevalence of Hepatitis B infection and the associated factors among Ecuadorian Amazonia communities. Outline: A serologic cross-sectional study was carried out in subjects over two years old. We classified seropositivity according to the Centers of Diseases Control criteria and recorded sex, age, temporary migration, sometime Hepatitis B in their life, and previous vaccination. Results: Out of 215 participants, 50.0%, 8.8%, 1.9%, and 1.4% were susceptible, immune due to natural infection, chronic infection, and early acute HBV infection, respectively. Of the 8 people who reported having ever been diagnosed with Hepatitis B, none showed chronic or acute infection and one was positive for immunity due to the vaccine. HBsAg was found in 3.3% (95% IC 0.9-7.0) and was higher among those who migrate 7.7% (p-value 0.04). 16.3% (95% CI 11.6-21.4) was immune due to HBV vaccination. Among the 58 participants who declared having received the vaccine, 20.7% presented post-vaccine immunity. Implications: Participants who should have benefited from the vaccination campaign (susceptible) are those with the lowest immune response due to vaccination. To assessing the burden of viral hepatitis in people living in marginalized areas and guide preventive measures is mandatory.

We report an asplenic patient who was infected with Babesia divergens–like/MO-1. The clinical course was complicated by multiorgan failure that required intubation and dialysis. The patient recovered after an exchange transfusion and antimicrobial drug therapy. Physicians should be alert for additional cases, particularly in asplenic persons.

Objective: The objective of this study was to review the impact of an automatic email notification to infectious disease consultants. Design: Cases were identified from a community hospital system microbiology database by at least one positive blood culture. Records were reviewed both before (2013 and 2014) and after (2015 and 2016) the implementation of the automated email system (intervention). Prior to this policy, consultation with the infectious disease (ID) specialist was at the discretion of the primary team. Results: There were no significant differences in 30-day mortality between the two groups (18 vs 20%, p = 0.10). However, a trend of shorter hospital stays (12.2 vs 9.5 days, p = 0.03) and reduced 30 day readmissions (40% vs 19%, p = 0.03) was observed and antibiotics prescribed for complicated cases was more appropriate (57% vs 85%, p = 0.004). Conclusions: In this study population, the implementation of an automatic email generator to ID specialists was associated with a shorter hospital length of stay, less 30-day readmissions and more appropriate length of antibiotics prescribed in complicated cases of SAB. The authors recommend future studies replicating the methodology employed here with larger sample sizes before consideration of employing a similar automatic email ID consult generation at other health systems.

Background Recent influenza antiviral resistance studies reveal an alarming increase in both adamantanes and neuraminidase inhibitors (NAIs) resistant viral strains worldwide, particularly in Asia, Europe and the United States. Objectives In this study, we have evaluated influenza virus resistance in Central and South America. Methods Influenza viruses, isolated from symptomatic patients throughout Central and South America in 2005–2008 were analyzed for inhibitor resistance. The M2 and NA genes of influenza viruses were sequenced and resistance was inferred by comparison with published sequences and known resistant mutations. Results Our results indicate that: (i) resistance to adamantanes was seen in the majority (95·5%) of the influenza A/H3N2 isolates but only in one isolate of the influenza A/H1N1 viruses; (ii) resistance to NAIs began to be detected in A/H1N1 isolates from Central America in 2008; and (iii) none of the influenza B viruses analyzed were resistant to NAIs. Conclusions These findings suggest a limited effectiveness of influenza inhibitors due to the detection of resistance among A/H1 and A/H3 viruses.