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Asymptomatic carriers are a likely source of transmission of Neisseria meningitidis to close contacts who are placed at a higher risk for invasive meningococcal disease (IMD). Although N. meningitidis ciprofloxacin-resistance is rare, there have been an increase in the reports of resistant isolates mainly in patients diagnosed with IMD, and little is known about the N. meningitidis ciprofloxacin-resistance in the carrier populations. We performed a pharyngeal carriage study during a 2017 military setting outbreak in Peru, caused by a ciprofloxacin-resistant N. meningitidis B. The isolates analysed came from two hospitalized cases and six asymptomatic carriers. Whole-genome sequence-based analysis was performed and showed that strains carrying the Thr 91 Ile mutation, in the gene encoding for subunit A of DNA gyrase ( gyr A), were responsible for the fluoroquinolone resistance (MICs ≥0.256 µg ml -1 ) and were closely related to highly virulent strains from France, Norway and the UK. Phylogenetic analysis of the gyr A gene revealed that likely these Peruvian isolates acquired resistance through horizontal gene transfer from Neisseria lactamica . Our study provides evidence for the emergence and propagation of ciprofloxacin-resistant N. meningitidis B from asymptomatic carriers, and recommends the introduction of serogroup B vaccines for high-risk populations.

Objectives: To estimate the prevalence of antibodies against measles, rubella and hepatitis B in children aged between 1 and 4 years in Peru., Materials and Methods: A national survey was conducted based on a questionnaire and capillary blood sample taken on filter paper in order to study antibodies against measles, rubella and hepatitis B in children from 1 to 4 years of age. A stratified, multistage, probability sampling design was used to be representative at the national level and at level of seven ambits, including the Metropolitan Lima Area, the rest of the urban coast, the rural coast, the urban highlands, the rural highlands, the urban jungle and the rural jungle. The capillary blood samples were processed according to the standardized protocols for detection of antibodies using the ELISA technique and commercial reagents., Results: The survey showed a national prevalence of antibodies against measles, rubella and hepatitis B of 91.6% (CI 95%: 90.6%; 92.7%), 91.3% (CI 95%: 90.3%; 92.4%) and 95.9% (CI 95%: 95.0%; 96.8%) respectively. There was no evidence of significant differences in the prevalence among the ambits of study or among the socioeconomic strata of the conglomerates for any of the three types of antibodies., Conclusions: In children from 1 to 4 years of age, the national prevalence of antibodies against measles and Rubella was between 90-93%, while the prevalence of antibodies against Hepatitis B (anti-HBsAg) was between 95-97%.

We conducted a clinical description of confirmed dengue cases admitted to the Hospital " César Garayar García" in Iquitos from January 25 to February 5, 2011. According to current WHO classification, major warning signs leading to hospitalization were: abdominal pain (28/28) and persistent vomiting (15/28), the causes of severity were: hypotension (9 / 13), severe bleeding (6 / 13) and plasma extravasation with respiratory distress (4 / 13). The median patient age was 22 years, however, 8 / 13 patients classified as severe dengue were under 16 years. In conclusion, unlike previous epidemics, we found a high involvement of young people and severity in the clinical presentation predominating a high frequency of shock (hypotension) and vascular leakage, which could be related to the circulation of an emerging variant DENV-2 which is more virulent.