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Influenza causes a substantial number of respiratory illnesses among young children in Kenya (1). The best time to vaccinate against seasonal influenza is before influenza viruses circulate, but because there [...]

Meningococcal disease has a case-fatality rate of 50% for patients not given treatment and 10%-20% for those given treatment (1,2). The causative agent is Neisseria meningitidis, for which 14 serogroups [...]

Objective. Develop a risk matrix to evaluate the ongoing risk of measles and rubella outbreaks associated with imported cases in Chile. Methods. The risk assessment tools were developed in the following stages: preparation and approval of biological, programmatic, and demographic variables; weighting of the selected variables by a panel of experts; calculation of the risk index; specialization; and knowledge transfer. Results. Of the 346 Chilean communes analyzed, 34% were in the high-risk interval for experiencing a measles and rubella outbreak with the introduction of the virus, 59%, in the average-risk interval, and 3%, in the low-risk interval. The remaining percentage corresponded to communes lacking data in at least one of the 13 variables required for calculating the risk index. Conclusion. Use of this tool will enable subnational teams to use their own data to evaluate the risk of outbreaks in their area and take corrective action for a rapid response to any importation of these viruses in the post-elimination phase. [ABSTRACT FROM AUTHOR]

Background: Vaccine effectiveness (VE) is essential to monitor the performance of vaccines and generate strategic information to guide decision making. We pooled data from six Latin American countries to estimate the effectiveness of COVID-19 vaccines in preventing laboratory-confirmed SARS-CoV-2 hospitalisation during three different pandemic waves from February 2021 to September 2022., Methods: We used a test-negative case-control design in hospitalised adults in Chile, Costa Rica, Ecuador, Guatemala, Paraguay, and Uruguay. We estimated adjusted VE by age group (18-64 and ≥65 years), vaccine type and product for primary series vaccination and booster vaccination and by time since last dose during the Omicron variant dominant period. We used mixed effects logistic regression models adjusting for sex, age, week of onset of symptom onset and pre-existing conditions with country fit as a random effect term., Findings: We included 15,241 severe acute respiratory infection (SARI) patients in the analysis. Among adults 18-64 years, VE estimates for primary series vaccination during pre-Delta and Delta periods ranged by product from 66.5% to 95.1% and from 33.5% to 88.2% for older adults. During the Omicron period, VE estimates for primary series were lower and decreased by time since last vaccination, but VE increased to between 26.4% and 57.4% when a booster was administered., Interpretation: mRNA and viral vector vaccines presented higher VE for both primary series and booster. While VE decreased over time, protection against severe COVID-19-associated hospitalisation increased when booster doses were administered. Vaccination with additional doses should be recommended, particularly for persons at increased risk of developing severe COVID-19., Funding: This work was supported by a grant from the U.S. Centers for Disease Control and Prevention (CDC) through cooperative agreements with the Pan American Health Organization/World Health Organization., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Background: Infectious diarrhea is still a major problem in public health, especially in children under 5 years of age. The identification of the etiologic agent is important for the clinical management of the diarrhea episode and, from the epidemiological point of view, to implement control measures., Aim: To determine the presence of gastrointestinal pathogens in children under five years of age with diarrhea in a Chilean rotavirus surveillance center., Methods: Observational study in children under five years of age who were hospitalized for diarrhea at the Dr. Luis Calvo Mackenna Hospital from December 2015 to December 2019. Molecular detection was performed using the FilmArray gastrointestinal (FilmArray GI®) panel., Results: We analyzed 493 diarrheal stool samples of children, 427 samples (87%) were positive and 66 samples (13%) were negative. Of positive samples, 174 samples (41%) and 253 samples (59%) were positive for one or more pathogen, respectively. In children under one year and the group between one and four years there was a predominance of infections caused by enteric virus. Rotavirus and norovirus were the most common virus in both age groups. The most frequent bacteria were EPEC (27%), C. difficile (17%), EAEC (14%) and Campylobacter (9%). In parasites, Giardia lamblia and Cryptosporidium were identified, in 3% and 1% of the total samples, respectively., Conclusions: The molecular detection system used allowed an increase in the detection of enteropathogens in children under five years of age. The information generated by this type of surveillance could help to characterize the episodes of diarrhea in the population and might be a tool to technically advise the authorities in the decision-making process for the implementation of control measures.

Objective: Develop a risk matrix to evaluate the ongoing risk of measles and rubella outbreaks associated with imported cases in Chile., Methods: The risk assessment tools were developed in the following stages: preparation and approval of biological, programmatic, and demographic variables; weighting of the selected variables by a panel of experts; calculation of the risk index; specialization; and knowledge transfer., Results: Of the 346 Chilean communes analyzed, 34% were in the high-risk interval for experiencing a measles and rubella outbreak with the introduction of the virus, 59%, in the average-risk interval, and 3%, in the low-risk interval. The remaining percentage corresponded to communes lacking data in at least one of the 13 variables required for calculating the risk index., Conclusion: Use of this tool will enable subnational teams to use their own data to evaluate the risk of outbreaks in their area and take corrective action for a rapid response to any importation of these viruses in the post-elimination phase., Competing Interests: Conflictos de interés Los autores declaran no tener conflictos de interés.

Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences., Objective: To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile., Material and Methods: Case series considering 149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihood of dying., Results: 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score., Discussion: The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.

Background: During 2012 in Chile, there were 60 cases of serogroup W135 meningococcal disease, which accounts for 57.7% of identified serogroup cases., Aim: To describe main clinical features of patients with serogroup W135 meningococcal disease confirmed in 2012., Material and Methods: Descriptive study of case series based on retrospective review of medical records., Results: Male patients represented 61.7% and 46.7% were children under 5 years. At first clinical attention, 3.4% of patients were suspected of meningococcal disease, while 83.3% had meningococcemia as final diagnosis. Also at first attention, the most common symptoms or clinical signs were fever ≥ 38.0° C (60.3%), cold symptoms (52.5%), and nausea or vomiting (46.7%). Meningeal signs had a low frequency (8.7%). Diarrhea was the second most common symptom found among deceased patients (55.6%) and statistically higher than survivors (26.8%; p = 0.034). Six cases reported with sequelae: limb amputation, hearing loss or neurological damage, and mortality was 31.7%., Discussion: In 2012, serogroup W135 meningococcal disease reported high mortality, atypical clinical presentation, low initial meningococcal disease diagnosis, and a high number of cases with poor clinical course.