ABSTRACT
Background: Laboratory surveillance of Invasive Meningococcal Disease (IMD) is performed by the Institute of Public Health of Chile. It confirms identification, classifies in serogroups and analyzes the genetic profiles of Neisseria meningitidis isolates from laboratories throughout the country. Aim: To show the results of this surveillance from 2006 to 2012. Methods: A descriptive data analysis of the confirmed cases of IMD and serological characterization, susceptibility and genetic profiles of the isolates. The analysis was disaggregated by serogroup, age and region. Results: From 2006 to 2012, 486 isolates of N. meningitidis were confirmed. In 2011 a rise in IMD rates was observed due to an increase in W serogroup cases, mainly affecting children aged 5 years or less. Serogroup W became the most prevalent during 2012 (58.3%), replacing the historically prevalent serogroup B. Predominating strains belonged to ST-32 complex/ET-5 complex (40, 4% of strains) and ST-41/44 complex/ Lineage 3 (45, 9% of strains). Conclusions: Laboratory surveillance has allowed the early detection of increasing IMD caused by serogroup W, which is emergent in Chile. This information has reinforced the daily monitoring of new cases, in collaboration with all the clinical laboratories of the country.
Introducción: La vigilancia de laboratorio de enfermedad meningocócica invasora (EMI) que realiza el Instituto de Salud Pública de Chile, confirma, seroagrupa y estudia el perfil genético de las cepas de Neisseria meningitidis provenientes de los laboratorios del país. Objetivo: En este artículo se muestra los resultados de esta vigilancia entre los años 2006 a 2012. Materiales y Métodos: Se realizó un análisis descriptivo de los casos confirmados de EMI, caracterización serológica, el análisis de susceptibilidad antimicrobiana y el estudio de subtipo genético de la cepa. El análisis se desagregó por serogrupo, edad y región. Resultados: En el período 2006-2012 fue confirmado un total de 486 cepas de N. meningitidis. A partir del año 2011 se observó un alza en la tasa de EMI dado por el número de casos del serogrupo W, afectando principalmente a niños bajo 5 años de edad. El W se transformó en el serogrupo prevalente el año 2012 (58,3%), desplazando al serogrupo B, el cual históricamente había sido prevalente. Predominaron principalmente las cepas pertenecientes al complejo clonal ST-32 complex/ET-5 complex (40,4% de las muestras) y el ST-41/44 complex/Lineage 3 (45,9% de las muestras). Conclusiones: El sistema de vigilancia de laboratorio ha permitido la identificación del serogrupo W, emergente en Chile. Esta información nos ha obligado a estar en permanente alerta y monitoreo de casos diarios, mediante la participación activa de todos los laboratorios clínicos del país.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Middle Aged , Young Adult , Meningococcal Infections/epidemiology , Neisseria meningitidis , Population Surveillance , Anti-Bacterial Agents/pharmacology , Bacterial Typing Techniques , Chile/epidemiology , Epidemiological Monitoring , Genotype , Incidence , Microbial Sensitivity Tests , Meningococcal Infections/microbiology , Neisseria meningitidis/drug effects , Neisseria meningitidis/geneticsSubject(s)
Female , Humans , Male , Middle Aged , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/microbiology , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiology , Streptococcus suis/isolation & purification , Chile/epidemiology , Meningitis, Bacterial/epidemiology , Streptococcal Infections/epidemiology , Streptococcus suis/geneticsABSTRACT
The epidemiologic behavior of the Invasive Meningococcal Disease (IMD) in Chile has changed. At the end of 2011, the W135 serogroup belonging to the hypervirulent clone ST-11 emerged. It affected diverse countries of the world, after the Mecca pilgrimage in 2000. In Chile, there have been 133 IMD cases during 2012. These figures represent an incidence of 0.7 per 100,000 inhabitants, which is 30% higher than expected. Eighty eight percent of cases were confirmed by the National Reference Laboratory at the Chilean Public Health Institute. The serogroup was determined in 103 strains and 58% belonged to the W135 serogroup, surpassing for the first time the B serogroup (37%). The Metropolitan Region concentrated 80% of these cases, and the remaining 20% affected other seven regions of the country. Forty seven percent of cases corresponded to children less than 5 years of age. The predominant clinical presentation of the W135 serogroup was a sepsis in 67% of cases. The fatality ratio of IDM during 2012 was 27%, the highest in the past 20 years. With this information, the Chilean Ministry of Health decreed a sanitary alert and implemented an integrated approach to control and prevent W-135 IDM, denominated "W-135 Action Plan".
Subject(s)
Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Meningitis, Meningococcal/epidemiology , /classification , Chile/epidemiology , Electrophoresis, Gel, Pulsed-Field , Epidemiological Monitoring , Incidence , Meningitis, Meningococcal/diagnosis , Meningitis, Meningococcal/microbiology , Multilocus Sequence Typing , /genetics , SerotypingABSTRACT
Background: Foodborne disease outbreaks are one of the main health problems globally, having an extensive impact on human welfare. The World Health Organization considers them as the main cause of morbidity and mortality in developing countries, and responsible for high levels of loss of productivity in developed countries. Aim: To describe the epidemiology of foodborne disease outbreaks according to data contained in an automated surveillance system. Method: Descriptive observational study of notified outbreaks from the surveillance system, between 2005 and 2010 in Chile. The information was based on etiology, temporal and spatial distribution, and epidemiologic description of outbreaks during this period. Results: There were 5,689 notified outbreaks. Most of them occurred during 2006 (1,106 outbreaks, rate 6.7 per 100,000 inhabitants) and 2008 (1,316 outbreaks, rate 7.9 per 100, 000 inhabitants) with an increase during summer. Fifty four percent occurred in the Metropolitan region. The group aged 15 to 44 years old, was the most affected one. Sixty four percent of the outbreaks had the food involved registered, of which fish and fishery products reached 42%. An 81% of the outbreaks did not have a precise etiologic diagnosis. Of all patients involved, 97% were outpatients, 3,2% were hospitalized patients, and 0,1% died. Only 49% of the outbreaks had information about the lack of food safety, with a 34,1% related to food handling procedures. Conclusions: Through the information on the epidemiology of foodborne diseases obtained by the Chilean surveillance system, appropriate control measures could be taken.
Antecedentes: Las enfermedades transmitidas por alimentos (ETA) son una importante carga de enfermedad en el mundo. La OMS las señala como la principal causa de enfermedad y muerte en países en desarrollo, mientras que en países desarrollados son responsables de altos niveles de pérdida de productividad. Objetivo: Describir epidemiológicamente los brotes de ETA chilenos de acuerdo a la información contenida en un sistema automatizado de vigilancia. Método: Estudio observacional descriptivo de los brotes notificados en el sistema de vigilancia, entre los años 2005 y 2010 en Chile. La descripción se basó en el aspecto etiológico, distribución temporal y espacial, y descripción epidemiológica de los brotes durante dicho período. Resultados: Se notificaron 5.689 brotes. La mayoría se presentó durante el 2006 (1.106 brotes, tasa 6,7 por 100.000 hab) y 2008 (1.316 brotes, tasa 7,9 por 100.000 hab) con un aumento en los meses de verano. El 54% ocurrió en la Región Metropolitana. El grupo de 15 a 44 años fue el más afectado. Del 64% que registró el alimento involucrado, pescados y productos de la pesca alcanzaron el 42%. Un 81% del total de brotes no tuvo un diagnóstico etiológico preciso. Del total de pacientes, 97% fueron ambulatorios, 3,2% se hospitalizaron, y 0,1% fallecieron. Sólo 49% de los brotes registró pérdida de inocuidad del alimento, siendo el mayor porcentaje (34,1%) atribuible al proceso de manipulación del alimento. Conclusiones: El sistema de vigilancia chileno permitió conocer el comportamiento epidemiológico de las ETA, y facilitó la adopción de medidas de control oportunas.