Gripe aviar h5n1: h1n1: ¿la nueva pandemia del siglo? / Avian influenza h5n1: h1n1: the new pandemy of the century?

Las pandemias de gripe se han caracterizado hasta ahora por la adaptación en humanos de un virus que contiene determinantes antigénicos derivados de cepas de virus propios de aves para los cuales no existe inmunidad en humanos. La ausencia de vacunas y de fármacos eficaces contra una posible epidemia provoca una gran expectativa en cuanto a la repercusión que una pandemia de tales magnitudes tendrá sobre la humanidad no sólo en el aspecto económico sino sobre la tasa de mortalidad tan elevada que podría producirse. Este artículo va dirigido al personal de salud, tanto profesionales como estudiantes, con el fin de informarlos y prevenirlos frente a una nueva pandemia de influenza.

The influenza pandemies are characterized by the adaptation in humans of viruses that only affect the avian population. This is because there is not immunity by humans in front of these new serotypes of influenza. The absence of vaccines and efficient drugs against a possible pandemy, provoke huge expectations according to the repercussion of this kind of pandemy in the humanity, not only in the economical aspect but in a possible mortality rate that could be produced. This article is aimed at the professional and students of the health area. Its objective is to inform and prevent them in the case they need to face a new pandemy of influenza.

Desde las fuerzss mágicas hasta roberto koch: un enfoque epidemiológico de la tuberullosis

Desde tiempos inmemoriales, la tuberculosis, la "muerte blanca", ha sido una enfermedad que ha causado grandes daños a la Humanidad. Dado que se considera una epidemia, cuando no pandemia, analizamos el trayecto histórico de esta enfermedad, considerada una enfermedad transmisible. Veremos sus causas, mediante una revisión histórica, y los científicos que se dedicaron a estudiarla hasta llegar al descubrimiento que hiciera Roberto Koch (1843-1910) (Nobel en 1905) del bacilo. Las medidas preventivas y curativas también son revisadas hasta llegar al descubrimiento de la vacuna BCG (Bacilo Calmette-Guérin) en tiempos modernos, en 1919, lo cual debió ser el fin de tan temible flagelo. Empero, hoy en día la tenemos entre nosotros, recrudecida y virulenta. Es la llamada "enfermedad de la pobreza", enfermedad social de las masas. Así desde las Fuerzas Mágicas hasta la actualidad contendemos con la tuberculosis, enfermedad conocida por babilonios y egipcios y sufrida por la Humanidad en pleno siglo XXI.

Since the beginning of History tuberculosis, "the white death", has been a disease that has caused enormous impairment to Humanity. Since it is considered an epidemic, if not pandemic, we review the historical pathway of this illness, considered a transmissible disease. We will review its causes through history and the scientists who devoted themselves to study it, until the discovery of Robert Koch (1843-1910) (Nobel, 1905) of the bacillus. The preventive and curative measures are also revised until we get to the discovery of the vaccine BCG (Calmette-Guérin bacillus) in our modern age, 1919 to be precise, supposedly to be the end of this scourge. Nevertheless, nowadays we have the disease among us, increased and virulent. This is the so called "sickness of the poverty", social sickness of the masses. So, from the "Magic Forces" up to our age, we contend with TB, sickness already know by Egyptians and Babylonians and suffered still by Humanity in our newborn XXI Century.

Os primeiros cinco anos da sétima pandemia de cólera no Brasil / The seventh pandemy of cholera in Brazil - the first five years

Este trabalho avalia o comportamento da sétima pandemia de cólera no Brasil, através de uma análise descritiva da distribuição de casos diagnosticados e notificados ao Ministério da Saúde, entre abril de 1991 e março de 1996, totalizando um período de cinco anos, abordando questões gerais, tais como: incidência, distribuição geográfica, sazonalidade, distribuição por faixa etária e sexo, letalidade, critério diagnóstico e tipo de atendimento, podendo-se observar uma grande heterogeneidade entre as regiões e, nestas, entre os estados. Analisando-se as informações referentes ao critério diagnóstico adotado para confirmar os casos, ao tipo de atendimento que tiveram os doentes e a taxa de letalidade apresentadas, pode-se afirmar que a subnotificação de casos ocorreu em todo o país, sendo mais intensa em algumas unidades federadas. A incidência aumenta gradativamente a partir dos 15 anos de idade, mas mantém-se alta nas faixas etárias mais elevadas, e na faixa de menores de 15 anos é maior nos menores de cinco anos. Em todas as faixas etárias a incidência no sexo masculino foi maior que no sexo feminino. Somente no Estado do Amazonas pode-se observar um componente sazonal e continua a produção regular de casos, o que gera várias indagações sobre o porquê desta ocorrência

The study evaluates the pattern of the seventh pandemy of cholera in Brazil, through a descriptive analysis of the distribution of the cases diagnosed and notified by the Ministry of Health between April 1991 and March 1996, since its beginning, totalizing a five-year study. Several issues investigated such as: disease incidence, geographic distribution, seasonally-related, sex and age-groups distribution, mortality, diagnosis criteria, and type of medical assistance. An important heterogeneity among the five Macro-Regions as well as among the States within each of these regions, was observed. The analyses of information regarding the diagnosis criteria to confirm the cases, the type of medical assistance offered to the patients, and the mortality rates, indicate that the subnotification of cases took place throughout the country, being more intense in some states. According to the international literature, the pattern of incidence of cholera in Brazil is more frequent in the age-groups older than age fourteen, remains high among the eldery and it is also high in the age-group younger than age five. The incidence of cholera was higher among males than females and it remained such way in all five years age-groups. By taking the States into consideration in the analysis it was observed that the tendency of the number of cases notified was reduced after the two outbreaks observed within the five-year study. The only exception was the Amazon State which shows a consistent yearly seasonal pattern of outbreaks generating some hyphoteses in order to explain such findings