COVID-19 outbreaks among crew members in non-cruise vessels anchoring in Salvador, Brazil, 2021

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected the maritime sector due to virus transmission onboard and traffic restrictions. However, reports of SARS-CoV-2 transmission on board have been mostly restricted to those occurring on cruise ships. OBJECTIVES To report COVID-19 outbreaks in eight non-cruise vessels and discuss measures to prevent and control the onboard transmission of SARS-CoV-2. METHODS We investigated outbreaks of COVID-19 on vessels anchoring in Baía de Todos-os-Santos, Salvador, Brazil, between February and November 2021. FINDINGS Most vessels were cargo ships that had docked several times before anchoring in Salvador (five had docked in ≥ 9 ports). The crew ranged from 22 to 63 members. The infection attack rate on each vessel ranged from 9.7 to 88.9%. The risk of symptomatic infection largely varied among the crew of each vessel (0 to 91.6%). Overall, the risk of developing COVID-19 signs and symptoms was lower among crew members vaccinated (age-adjusted risk ratio: 0.19; 95% confidence interval 0.06-0.65). SARS-CoV-2 variants not previously identified in Salvador were detected (C.14, B.1.617.2 and B.1.351). MAIN CONCLUSIONS Despite maritime guidelines to avert COVID-19 on board, outbreaks have happened. The multiple stopovers of non-cruise vessels during their routes may contribute to the spread of SARS-CoV-2 variants worldwide. Reducing the onboard transmission of SARS-CoV-2 depends on joint efforts by the crew and local health authorities and, equally important, achieving high vaccination coverage to prevent infections and illness.

Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.

A implementação do curso de graduação em saúde coletiva do Instituto de Saúde Coletiva da Universidade Federal da Bahia: da criação até a formatura da primeira turma / The implementation of the Undergraduate Course in Collective Health at the Institute of Collective Health of the Federal University of Bahia, Brazil: from its opening up to the graduation of the first class / La implementación del Curso de Graduación en Salud Colectiva del Instituto de Salud Colectiva de la Universidad Federal de Bahía: de su inauguración hasta la graduación de la primera clase

Introdução: A criação dos Cursos de Graduação em Saúde Coletiva (CGSC), com uma configuração interdisciplinar e fortemente compromissada com o Sistema Único de Saúde (SUS), inaugurou uma nova maneira de ensinar Saúde Coletiva e ampliou substancialmente a capacidade brasileira para formar sanitaristas para atuar no SUS. Objetivo: Este artigo tem como objetivo descrever e refletir sobre o processo de implementação do CGSC no ISC/UFBA, sob a perspectiva de um grupo de docentes e discentes que participou do Colegiado do Curso, desde a sua criação até a conclusão da primeira turma. Material e método: O Instituto de Saúde Coletiva da Universidade Federal da Bahia (ISC-UFBa) foi pioneiro na defesa da criação desta modalidade formativa e abriu, em 2009, o seu CGSC. Em 2013, a primeira turma de alunos do CGSC/ISC/UFBa recebeu o grau de Bacharel em Saúde Coletiva. A consolidação desta nova modalidade formativa no ISC-UFBA e em outras Universidades do Brasil traz a necessidade de refletirmos sobre a experiência obtida na implementação destes cursos. Conclusão: Espera-se que este relato seja útil como meio de troca de experiência com outros Cursos semelhantes, ao identificar desafios tanto para a consolidação desta nova modalidade formativa em Saúde Coletiva

Introduction: The creation of undergraduate courses in Collective Health (CGSC) with an interdisciplinary configuration and strongly committed to the Brazilian Health System (SUS), inaugurated a novel way of teaching collective health and substantially expanded the Brazilian capacity to train health workers to work in SUS. Objective: This article aims to describe and reflect on the implementation process of CGSC at UFBa, under the perspective of a group of teachers and students who participated in the Collegiate Comittee, from the course's beginning up to the graduation of the first class. Material an methods: The Institute of Collective Health of the Federal University of Bahia (ISC-UFBa) pioneered the defense of this training modality and opened its Course in 2009. In 2013, the first class of students received the Bachelor's degree in Collective Health. The consolidation of this new course at ISC-UFBa and at other university schools in Brazil brings the need to reflect on the experience in implementing these courses. Results: It is hoped that this article be helpful in exchanging experiences with other similar Courses, and to identify challenges for both the consolidation of this new training modality in Collective Health.

Introducción: La creación de Cursos de Pregrado em Salud Colectiva (CPSC) con un ambiente interdisciplinario y fuertemente comprometido con el Sistema Único de Salud (SUS), inauguró una nueva modalidad de enseñanza en Salud Colectiva y amplió considerablemente la capacidad brasileña para formar sanitaristas para actuar en el SUS. Objetivo: Este artículo tiene como objetivo describir y reflexionar sobre el proceso de implementación del CPSC/ISC/UFBa a partir de la perspectiva de un grupo de profesores y estudiantes que participaron de su Colegiado Gestor, desde su inicio hasta la finalización de la primera clase. Materiales y métodos: El Instituto de Salud Colectiva de la Universidad Federal de Bahia (ISC-UFBa) fue pionero en la defensa de la creación de esta modalidad de formación y inauguró su CPSC en 2009. En 2013, la primera clase de alumnos matriculados en CPSC/ISC/UFBa recibió su Licenciatura em Salud Colectiva. La consolidación de esta nueva modalidad de formación en ISC-UFBa y otras universidades de Brasil trae consigo La necesidad de reflexionar sobre la experiência adquirida en el proceso de implementación de estos cursos. conclusión: Se espera que este informe pueda ser útil como medio de intercambio de experiencias con otros Cursos similares, em la medida que identifique los desafíos para la consolidación de esta nueva modalidad formativas en Salud Colectiva.