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Resumen Se ofrece una perspectiva de las epidemias y pandemias en México en tres periodos: fines del siglo XVIII y siglos XX y XXI, con el fin de analizar cómo las autoridades sanitarias y gubernamentales abordaron estos problemas, así como los desafíos que han representado. Se consultaron fuentes históricas documentales y, en los casos actuales, la participación en ellos. Se combinó metodología epidemiológica e histórica social. La presencia de las epidemias en México es una constante, lo cual evidencia la necesidad de actualizar el sistema de vigilancia epidemiológica, de estar preparados para enfrentar una epidemia y de elaborar un plan de contingencia.
Abstract A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18th century, the 20th century, and the 21st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.
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Objective To find the changes of haemagglutination inhibition ( HI ) antibody level against A/California/07/2009 (H1N1) within one month after pandemic A/H1N1 influenza vaccine (A/H1N1InfV) vaccination, and to provide data for drawing up immunization protocols against novel influenza . Methods The HI antibodies against A/California/07/2009 (H1N1) in sera from the inoculated subjects were tested by HI test .The geometric mean titer ( GMT) , geometric mean increase ( GMI) , seroconversion (SC) rate, seroprotection (SP) rate of HI antibodies were compared among the sera collected on day 3, 7, 14, 30 post vaccination .Results 961 participants were injected with A/H1N1InfV.In subjects aged 3 to 11 years, the antibody level peaked on day 14 post vaccination, but neither on day 14 nor on day 30, the lower bound of the two -sided 95%CI for the SP rate could fulfill the criteria of the FDA for influenza vac-cine.In subjects aged 12 to 60 years, the antibody level peaked on day 14 post vaccination and the SC rate , SP rate and GMI fulfilled the criteria of the European Medicines Agency ( EMEA) and the FDA for influenza vaccine. In subjects aged more than 60 years, the antibody level peaked on day 30 post vaccination , and the SC rate, SP rate and GMI on day 30 fulfilled the criteria of the EMEA and the FDA .Conclusion One dose A/H1N1InfV vaccination was able to induce enough protection on day 14 for subjects aged 12 to 60 years, on day 30 for subjects aged more than 60 years;however , for subjects aged 3 to 11 years who were antibody-negative at baseline , the lower bound of the two-sided 95%CI for the SP rate on day 14 and day 30 couldn′t fulfill the criteria of the FDA for influenza vaccine .
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In the last few years, bibliometric studies have proliferated, seeking to provide data on world research. This study analyzes the profile of the Brazilian scientific production in the A (H1N1) influenza field between 2009 and 2011. The research was conducted in MEDLINE, SciELO and LILACS databases, selecting papers in which the term "H1N1" and "Brazil" were defined as the main topics. The data were analyzed taking into consideration the Brazilian state and institution in which the articles were produced, the impact factor of the journal and the language. The research revealed 40 documents (27 from MEDLINE, 16 from SciELO and 24 from LILACS). The journal impact factor ranged from 0.0977 to 8.1230. A similar amount of articles were written in English and Portuguese and São Paulo was the most productive state in the country, with 95% of the Brazilian production originating from the Southern and Southeastern regions. Linguistic data indicate that previous efforts made in order to improve the scientific production of Brazilian researchers making their observations attain a broader scientific audience produced results. It is necessary to assess the scientific studies, especially those conducted with public funds, in order to ensure that the results will benefit society.
Nos últimos anos, estudos bibliométricos proliferaram, procurando prover dados sobre a pesquisa mundial. O presente estudo analisou o perfil da produção científica brasileira no campo da influenza A (H1N1) durante o período de 2009 a 2011. A pesquisa foi conduzida através das bases de dados Medline, SciELO e Lilacs, selecionando artigos onde os termos "H1N1" e "Brazil" foram definidos como tópicos principais. Os dados foram analisados considerando-se: o estado brasileiro e a institutição onde o trabalho foi produzido, o fator de impacto de periódico e a língua. A pesquisa revelou 40 documentos (27 provenientes do Medline, 16 do SciELO e 24 do Lilacs). O fator de impacto do periódico variou de 0.0977 a 8.1230. Uma quantidade similar de artigos foi escrita em inglês e em português. São Paulo foi o estado mais produtivo no país e 95% da produção eram provenientes das regiões Sul e Sudeste. Os dados linguísticos indicam que esforços anteriores para melhorar a produção científica dos pesquisadores brasileiros, fazendo com que suas observações atingissem um público científico mais amplo, foram alcançados. É necessário avaliar os estudos científicos, especialmente os realizados com fundos públicos, a fim de assegurar que os resultados beneficiem a sociedade.
Subject(s)
Humans , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Publishing/statistics & numerical data , Bibliometrics , Brazil , PandemicsABSTRACT
Se realizó un estudio observacional analítico, de corte transversal, en el Hospital General Docente Enrique Cabrera, con el objetivo de caracterizar la morbilidad materna por enfermedad tipo influenza A H1N1 en las pacientes obstétricas ingresadas en la unidad de cuidados intensivos respiratorios, en el marco de la pandemia 2009 de influenza. Se compararon los ingresos en gestantes y puérperas que se produjeron entre el 1 de septiembre y el 31 de diciembre de 2009, en cuanto a variables sociodemográficas, obstétricas, epidemiológicas y clínicas, utilizando el sistema SPSS 11.5 para Windows como procesador estadístico. Durante el periodo de estudio ingresaron 103 pacientes en cuidados intensivos, 86 (83,5 por ciento) gestantes y 17 (16,5 por ciento) puérperas; el 87, por ciento de las gestantes estaban en el 2do y 3er trimestre del embarazo. El 55,8 por ciento de las gestantes y 47,1 por ciento de las puérperas tenían un antecedente patológico, el asma bronquial fue el más frecuente. El 69,9 por ciento de las pacientes iniciaron el tratamiento antiviral con más de 48 h de síntomas. La tos fue el síntoma más frecuente presente, significativamente, en mayor número de gestantes, 79 (91,9 por ciento) que de puérperas, 11 (61,7 por ciento), le siguieron en orden la disnea (69,9 por ciento) y la fiebre (50,5 por ciento). Los principales diagnósticos de ingreso fueron neumonía (36 por ciento gestantes y 58,8 por ciento puérperas) y bronconeumonía (33,7 por ciento gestantes y 23,5 por ciento puérperas). Las complicaciones fueron más frecuentes en las puérperas, 9 (52,9 por ciento). Concluimos que el trabajo multidisciplinario y en equipo contribuyó a los resultados obtenidos
A cross-sectional, analytical and observational study was conducted in the Enrique Cabrera Teaching Hospital to characterize the maternal morbidity due to A H1Ni influenza in the pregnant patients admitted in the respiratory intensive care unit during the influenza pandemic in 2009. The admissions of pregnants and puerperants from September 1, 2009 to December 31, 2009 as regards the sociodemographic, obstetric, epidemiological and clinical variables, using the SPSS 11.5 system for Windows as the statistic processor. During the study period 103 patients were admitted in intensive care unit, 86 (83.5 percent) pregnants and 17 (16.5 percent) puerperants; the 87 percent of pregnants were in the second and the third trimester of pregnancy. The 55.8 percent of pregnants and the 47.1 percent of puerperants had a pathologic background, the bronchial asthma was the more frequent one. The 69.9 percent of patients started the antiviral treatment with more than 48 hours from the symptoms. Cough was the more prevalent symptom, in a significant way in the greater number of pregnants, 79 (91.9 percent) than puerperants, 11 (61.7 percent), followed in order the dyspnea (69.9 percent) and fever (50.5 percent). The major diagnoses for admission were pneumonia (36 percent of pregnants and the 58.8 percent or puerperants) and bronchopneumonia (33.7 percent of pregnants and the 23.5 percent of puerperants). The complications were more frequent in the puerperants, 9 (52.9 percent). We conclude the multidisciplinary work and by teams contributed to the results obtained
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Humans , Female , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Influenza A Virus, H1N1 Subtype/physiology , Cross-Sectional Studies , Observational Studies as TopicABSTRACT
Se analizaron las principales reacciones adversas de la vacuna Pandemrix contra la influenza A (H1N1) en el municipio de II Frente Oriental, provincia de Santiago de Cuba, en el bimestre abril-mayo de 2010, dadas fundamentalmente por: cefalea, fiebre, trastornos gastrointestinales y dolor en el sitio de la inyección, en consonancia con lo descrito en otros documentos al respecto.
The main side effects of Pandemrix vaccine against A (H1N1) influenza in II Frente Oriental municipality from Santiago de Cuba province were analyzed during the two-month period April-May, 2010. Cephalea, fever, gastrointestinal disorders, and pain on the injection site were more frequent, with respect to what was described in other documents.
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Humans , Influenza, Human/prevention & control , Influenza A Virus, H1N1 Subtype , Primary Health Care , Risk Groups , Influenza Vaccines/adverse effectsABSTRACT
Objective To evaluate the epidemiological effects of vaccine immunization program related to A(H1N1)influenza in the middle school students.Methods Non-randomized clinical trial was designed to assess the A(H1N1)influenza vaccine on its efficacy.14883 students from 8 middle schools in Zhejiang province were recruited and classified into vaccinated or control groups,based on the status of immunization with A(H1N1)influenza vaccine.All subjects were followed up through one epidemic period(6 months)and the incidence rates of influenza-like illnesses,A(H1N1)influenza,and seasonal influenza in these two groups were compared to evaluate the efficacy of the vaccine.Results There were 6334 subjects in the vaccinated group and 8549 in the control group.7441.75 person-years were followed from these two groups.The incidence rate of A (H1N1)influenza in vaccinated group was 1.64‰ per person-year,lower than that of the control group.The rate difference(RD)was-1.64‰ per person-year(95% confidence interval value from-3.04‰ to-0.23‰ per person-year),and the difference was significant(P=0.010).The incidence rate of influenza-like illnesses in vaccinated group was 21.47‰ per person-year,lower than that of the control group(22.69‰ per person-year)and the diffefence was not significant(P>0.05).The incidence rate of B influenza in vaccinated group was 6.63‰ per person-year,higher than that of control group(7.02‰ per person-year)but the difference was not significant(P>0.05).Conclusion This vaccine demonstrated a good epidemiological effect against the A(H1N1)influenza virus infection,observed through a student-immunization program.The cross-protection effect against the influenza-like illnesses and other seasonal influenzas was not noticed in this study.
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Se presenta el primer caso clínico de un adolescente de 11 años de edad, ingresado en la Unidad de Cuidados Progresivos del Hospital Infantil Norte Dr Juan de la Cruz Martínez Maceira de Santiago de Cuba por presentar, desde hacía 4 días, malestar general, fiebre, tos, dolor en la garganta y falta de aire. Se diagnosticó una neumonía adquirida en la comunidad, causada por el virus de la influenza A H1N1, lo cual fue confirmado con los resultados de los exámenes complementarios. El paciente evolucionó satisfactoriamente y fue egresado a los 16 días
The case history of a 11 year-old adolescent that was admitted in the Progressive Care Unit of Dr Juan de la Cruz Martínez Maceira Northern Children Hospital in Santiago de Cuba is presented because he had diffuse discomfort, fever, cough, sore throat and apnea during 4 days. A community acquired pneumonia was diagnosed, caused by the A H1N1 influenza virus, which was confirmed with the results of the additional tests. The patient evolved satisfactorily and he was discharged in 16 days
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Humans , Male , Adolescent , Influenza A Virus, H1N1 Subtype , Pneumonia/complications , Pneumonia/diagnosis , Pneumonia/etiology , Pneumonia , Respiratory InsufficiencyABSTRACT
Objective To evaluate the safety and epidemiological effects on the first mass vaccination program, using the China-made A (H1N1) influenza vaccine. Methods Descriptive epidemiology and cohort study design were used to assess the influenza A H1N1 vaccine on its safety and epidemiological effects. Results 95 244 subjects were immunized with A (H1N1) influenza vaccine. 193 adverse events were reported through AEFI Management System, with the Reported rates after immunization was carried out. Of 81 adverse reactions confirmed to be related to immunization,reported through the AEFI Management System. The epidemiological protection rate of A (H1N1)influenza vaccine showed a similar safety profile to seasonal flu vaccine. The vaccine demonstrated a good epidemiological effects against A (H1N1) influenza virus infection.
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OBJECTIVE To improve the compliance of medical institutions in the prevention and treatment of influenza A(H1N1) by introduction of game theory.METHODS Solving the mixed strategy Nash equilibrium with the application of game theory model.RESULTS There was inevitable relationship between the proportion of inspections,amercement amount and compliance of prevention and treatment.CONCLUSIONS If the health administration departments decrease the proportion of inspection,the probability will be reduced on the attitude of the medical staff;If the health administration departments increase the proportion of inspection,the probability will also be increased.
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In March 2009,Mexico reported the first case of human infection with a novel influenza (H1N1).By 11 April 2010,a total of 17798 Laboratory-confirmed cases were fatal which were officially reported to WHO by State Parties to the IHR (International Health Regulations,2005).It has already been qiute clear that clinical management of severe cases is the vital session of the strategies of 'fighting the swine flu'.Some topics on diagnosis and treatment of severe H1N1 cases will be discussed insightfully.Inspirations will spark on early diagnosis/intervention,oxygen/mechanical ventilation,antiviral therapy,antibiotics,corticosteroids and extracorporeal membrane oxygenation,according to the author's clinical experience.
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Preventing and curing emergency infectious diseases,such as A H1N1 influenza,is a public health practice,and its relevant ethical problems are pubic health ethical problems,mainly manifesting as the conflicts between individual interests and public interests,individual freedom and quarantine,individual privacy right and releasing partial medical information,and choosing one's own doctors and compulsory treatment.The core of the issue is that individual interests should be submitted to the public interests,and at the same time government and society should respect individual's freedom,privacy and right of health.
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Protection for privacy is the guarantee for sustaining personal dignity and individual liberty.Protection for patients' privacy has a long history and is of great realistic significance.However,patients with A H1N1 Influenza are facing the risk of exposing privacy in current circumstances.This paper argues that the privacy protection for this particular population is beneficial both for social and public interests,and also can be justified from an ethical perspective.
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The epidemic situation of influenza A(H1N1) throughout the world had evoked close attention of the World Health Organization(WHO).WHO director-general pointed out that the pandemic alert level had been set at 3,which was then raised by WHO from 3 to 4 and from 4 to 5 two days later.The present paper focused on the finding of influenza virus,the influenza prevalence in history,and introduced the scientific countermeasures for influenza A(H1N1),including the spreading of influenza virus,the clinical features,treatment,main measures of prevention and control,etc.