Search

En Chile, se realiza la vigilancia de gastroenteritis causadas por rotavirus en niños bajo 5 años a través de centros centinelas ambulatorios y hospitalarios. Objetivo: Conocer la epidemiología de las diarreas por rotavirus y evaluar la carga de morbi-mortalidad. Método: La vigilancia ambulatoria se desarrolla en 14 centros de 8 regiones y la vigilancia hospitalaria se lleva a cabo en 8 hospitales pediátricos de las regiones Vª, VIIIªy RM. Resultados: En 2007, 9,3% de las consultas por diarrea fue estudiada (339), detectándose rotavirus en 15% de ellas. Se hospitalizaron por diarrea, 2.074 casos, 9% del total de las hospitalizaciones en este grupo etario. De estas, 13,6% fueron por rotavirus. Conclusiones: Dada la situación epidemiológica actual, es importante mantener la vigilancia, ampliar la pesquisa de los casos, aplicar el protocolo de vigilancia establecido y determinar el serotipo/genotipo circulante en el país. A sentinel-based outpatient and inpatient surveillance for rotavirus infection has been implemented in Chile. Aim: Update the impact of rotavirus infections in Chile. Methods: Ambulatory surveillance is performed in 14 centers from 8 Regions and hospital-based surveillance in 8 hospitals from three Regions (V, VIII and Metropolitan). Results: In 2007, 339 stool samples that represented 9.3% of all outpatient cases were studied of which 15% were rotavirus positive. A total of 2.074 children younger than 5 years of age were hospitalized representing 9% of all hospitalizations for this age group. Rotavirus was detected in 13.6% of these cases. Conclusions: In the current epidemiological situation, rotavirus surveillance needs to be sustained with increased efforts to detect cases in order to avoid underreporting. Serotype/genotype surveillance of rotavirus strains needs to be included in the near future.

Background: The diagnosis of acute respiratory illness caused by Hantavirus is based in the rapid and progressive clinical course, epidemiological background and the serological confirmation of the virus. When the presence of the virus is not confirmed a differential diagnosis must be made with other infections. Between 1999 and 2001, the Chilean Public Health Institute received 1063 blood samples from patients with a suspicious clinical picture, to study the presence of Andes strain of Hantavirus. In 134 of these samples, the presence of the virus was confirmed. Aim: To study the presence of other infections in sera from patients with suspected Hantavirus acute respiratory illness but serologically negative for Hantavirus. Material and methods: A retrospective study of 98 serum samples, received at the National Public Health Institute, of patients with negative serology for Hantavirus. The presence of antibodies against influenza virus, Mycoplasma pneumoniae, Leptospira and Streptococcus pneumoniae was determined using Latex techniques. Results: Leptospira was detected in 23 patients, influenza virus in 13, Streptococcus pneumoniae in six and Mycoplasma pneumoniae in one case. Leptospira infections were confirmed in four cases by ELISA determination of IgM antibodies. Influenza virus infection was confirmed in three cases by Hemmaglutation Inhibition Assay. Conclusions: In suspected cases of Hantavirus acute respiratory infection, but with negative serology, other infectious agents such as Leptospira, influenza virus and Streptococcus pneumoniae, must be sought

El síndrome pulmonar por hantavirus (SPH) ha estado presente en Chile desde 1993 y ha sido detectado desde 1997 en la IX Región. Es una grave zoonosis con alta mortalidad, que afecta a gente joven incluyendo niños. Se ha estimado oportuno dar a conocer nuestra experiencia en la atención de 6 pacientes pediátricos, atendidos en las unidades de Cuidados Intensivos y Aislamiento en el Hospital Regional de Temuco, entre enero de 1998 y enero de 2000 mediante un estudio descriptivo de la experiencia del equipo de salud en la atención de estos pacientes. La información clínico-epidemioló-gica se extrajo de las fichas clínicas y visitas a terreno. Se efectuó la confirmación etiológica por detección de anticuerpos específicos -IgM e IgG- mediante tests de ELISA y la pesquisa de genoma viral por reacción de polimerasa en cadena (TR RPC). Edad promedio 6 años 5 meses (rango: 2-10 años). relación varón/mujer: 4/2. Procedencia: de área rural cordillerana (n: 4), costera (n:2). Todos tuvieron exposición en casas deshabitadas o galpones. Período de incubación promedio: 14 días (rango: 7-21). Todos los pacientes tuvieron fiebre elevada, dolor abdominal intenso, vómitos, mialgias, compromiso respiratorio clínico y radiológico. Hallazgos hematológicos constantes: trombocito-penia, leucocitosis, inmunoblastos o linfocitosis con formas atípicas. La confirmación etiológica (IgM e IgG positivas) se alcanzó en todos. En dos pacientes se detectó en sangre la secuencia genética viral de hantavirus cepa Andes. Dos pacientes en los cuales se requirió ventilación mecánica y manejo del shock, finalmente fallecieron; los otros enfermos tuvieron una recuperación rápida. No existe una terapia específica conocida para el SPH, la prevención, una sospecha y diagnóstico oportunos y el tratamiento agresivo son las estrategias actuales para luchar contra esta enfermedad Hantavirus Pulmonary Syndrome (HPS) has been present in Chile since 1993 and it was first detected during 1997 in our region. It is a particularly serious zoonosis with a high mortality rate that affects young people including children. We refer our experience with 6 pediatric patients admitted into the Intensive Care and Pediatric Isolation units at Hospital Regional de Temuco (January 1998 to January 2000) including a description of our experience assisting these patients based on information obtained from clinical files and epidemiological visits. The hantavirus infection was confirmed by positive specific IgM and IgG ELISA tests. Search of viral genome was done by RT-PCR. The average age was 6 yrs - 5 ms (range: 2-10 yrs). The ratio of male/females was 4/2. The origin of the patients was: rural areas near the Andes Mountains (n: 4) and rural coast (n: 2). The exposure to infection was in uninhabited houses or barns. The average incubation period was: 14 days (range: 7-21). The symptoms were: high fever, intense abdominal pain, vomiting, myalgias, clinical and Rx respiratory distress in all. The main hematological findings were: thrombocytopenia, high leukocytes count, immunoblasts and atypical lymphocytic cells. All cases were confirmed by IgM and IgG positive tests. The Andes virus genomic sequence was found in blood of one pediatric patient and in his uncle. Two patients who required mechanical ventilation and shock management finally died, the other patients recovered rapidly. Hantavirus Pulmonary Syndrome has no specific treatment. Prevention, an opportune diagnostic suspicion and aggressive treatment are the current strategies to control this disease