Descripción del brote de poliomielitis en la Argentina de 1971 / Description of the 1971 poliomyelitis outbreak in Argentina

La poliomielitis es una enfermedad de antigua data que afecta exclusivamente a los humanos. Sus secuelas de parálisis se encuentran ya documentadas en escritos del antiguo Egipto. Es producida por el poliovirus y se transmite por vía fecal-oral. Uno de cada doscientos niños infectados sufre un ataque vírico a las neuronas motoras del sistema nervioso central, que deja como secuela una parálisis flácida muscular. En la Argentina, las últimas epidemias de poliomielitis ocurrieron entre 1955 y1957, en 1971 y en 1983. La epidemia de 1953 registró 2.700 casos, mientras que en la de 1956 hubo 6.490 casos, con una tasa de mortalidad del 33,7%. Durante 1971, 46 pacientes fueron internados con diagnóstico de poliomielitis en las salas que dependían de la cátedra de Enfermedades Infecciosas de la Facultad de Ciencias Médicas de la Universidad de Buenos Aires, en el predio del Hospital Francisco Javier Muñiz. La cohorte estaba compuesta por 26 varones y 20 mujeres. Hemos realizado una revisión de las historias clínicas de aquellos pacientes, obrantes en el archivo de la cátedra. (AU)

Poliomyelitis is a human disease of ancient origin. Evidence of sequelae of paralysis is documented in ancient Egyptian writings. It is caused by the poliovirus and is transmitted through the fecal-oral route. One out of 200 infected children suffers a viral attack on the central nervous system´s motor neurons, which results in flaccid muscle paralysis. In Argentina, the last polio epidemics occurred between 1955 and 1957, in 1971 and in 1983. The 1953 poliomyelitis epidemic reported a total of 2,700 cases, while in the 1956 outbreak 6,490 cases were recorded with a mortality rate of 33.7%. In 1971, 46 patients were diagnosed with poliomyelitis and admitted to the wards of the Department of Infectious Diseases at the Faculty of Medical Sciences, University of Buenos Aires, located in the Javier Muñiz Hospital. The cohort consisted of 26 men and 20 women. We reviewed the medical records of those patients, recorded in the Department´s archive. (AU)

Las epidemias de viruela y la introducción de la vacuna en el Virreinato del Río de la Plata / Smallpox epidemics and vaccine introduction in the Viceroyalty of the Río de la Plata

La viruela fue una de las enfermedades epidémicas más temidas desde la antigüedad debido a su alta mortalidad y a las secuelas que dejaba en aquellos que lograban sobrevivir. En el presente trabajo se abordará el ingreso de esta enfermedad en nuestro continente, así como su manifestación a través de epidemias, brotes y focos endémicos. Al mismo tiempo se verá qué reacciones provocó dentro del ámbito médico durante los años del Virreinato del Río de la Plata. Se analizarán los problemas que surgieron con el uso de la vacuna importada, así como el hallazgo de nuestra vacuna local, finalizando con los comienzos de la organización de los servicios de vacunación obligatoria. (AU)

Smallpox was one of the most feared epidemic diseases since ancient times due to its high mortality and the sequelae caused in those that managed to survive. In the present work, the introduction of this disease into our continent will be addressed as well as its manifestation through epidemics, outbreaks, and endemic foci. At the same time, the reactions this disease caused inside the medical field during the years of the Viceroyalty of the Río de la Plata will be observed. The problems that arose from the usage of the imported vaccine and the discovery of our local vaccine will be analyzed, and it will finish with the beginnings of the organization of the mandatory vaccination services. (AU)

A cien años de la gripe "española / One hundred years after the "Spanish" flu

La pandemia de gripe "española", de la que se cumplen 100 años, es considerada la más devastadora de la historia. Se estima que afectó a un tercio de la población mundial, y más del 2.5% de los enfermos murieron. Esta pandemia se presentó en dos oleadas principales, en 1918 y 1919, y la morbimortalidad por edades tuvo una curva en W. En general, la muerte no ocurría como consecuencia directa de la gripe, sino por bronconeumonías bacterianas, para las que se carecía de tratamiento. Hubo, además, una mayor mortalidad en enfermos con tuberculosis preexistente con respecto al resto de los afectados de influenza. En Argentina la epidemia también se presentó en dos oleadas principales, con amplias variaciones en la mortalidad por regiones. El tratamiento disponible incluía dieta, antisepsia de garganta, valerianato de quinina, salicilato, codeína para la tos y aceite alcanforado. También se aplicaban primitivas vacunas y sueros anti-neumococos. Con la disponibilidad de la secuencia de ARN completa del genoma del virus de la influenza 1918 ha sido posible ensamblar, mediante genética inversa, partículas virales semejantes a las de la pandemia mortal. El virus reconstituido demostró ser extraordinariamente virulento para ratones. En la actualidad, la vacunación contra la gripe estacional reduce el riesgo de otra pandemia, pero por el momento no puede eliminarlo. El desarrollo de vacunas "universales" contra la gripe, que confieran inmunidad confiable y duradera, podrá evitar en el futuro su propagación mundial.

The "Spanish" flu pandemic, which occurred a century ago, is considered the most devastating in human history. An estimated one third of world population fell ill with flu and more than 2.5% of them died. The course of the epidemic had two main waves (1918 and 1919) and showed an unusual W-shaped morbidity/mortality distribution. Death was not a direct outcome of flu itself but rather a consequence of secondary bacterial bronchopneumonia, for which antibiotics had not yet been discovered. Pre-existing pulmonary tuberculosis was also accountable for increased flu death rates during the pandemic. As it happened in Europe, in Argentina the epidemic had two main waves, with ample variation in mortality by region. Available treatment at the time included diet, throat antiseptic rinses, low doses of quinine valerianate, salicylates, codeine as a cough suppressant, and camphor oil. Primitive anti-pneumococcal vaccines and immune sera were also applied. Upon the disclosure of the whole RNA sequence of the 1918 influenza virus genome, by means of reverse genetics it was possible to assemble viral particles resembling those of the deadly pandemic. The reconstituted virus proved to be extraordinarily virulent for mice. Current seasonal flu vaccines help to reduce, but not to abolish, the risk of another pandemic. The ongoing development of "universal" vaccines against influenza conferring reliable and long-lasting immunity may prevent its global spread in the future.

Os mosquitos e o Estado no relatório do chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, 1922 / Mosquitos and the State in the report by the head of the Rural Sanitation and Prophylaxis Service of Bahia, 1922

Resumo Em 1923, o doutor Sebastião Barroso, chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, apresenta um relatório das atividades desenvolvidas no ano anterior. O documento reúne informações sobre as iniciativas coordenadas pela autoridade no tocante às epidemias e à profilaxia rural, acompanhadas de uma compilação dos relatórios dos profissionais responsáveis pelos postos de profilaxia rural e de tabelas contendo dados sobre os trabalhos nas diferentes regiões do estado, as notificações recebidas e as despesas realizadas. O trecho desse documento aqui apresentado permite uma aproximação das discussões em relação ao papel do Estado no enfrentamento dos problemas de saúde pública, num contexto marcado pela recorrente eclosão de surtos epidêmicos, dentre os quais se destacam os surtos de febre amarela.

Abstract In 1923, Doctor Sebastião Barroso, head of the Rural Sanitation and Prophylaxis Service of Bahia, submitted a report on the previous year's activities. The document contains information on initiatives coordinated by the entity on rural epidemics and prophylaxis, accompanied by a compilation of the reports by the professionals responsible for the rural prophylaxis units and tables containing data on the different regions in the state, notifications received, and expenses. The section of this document presented here enables us to investigate the state's role in addressing public health issues in a context marked by recurring outbreaks of epidemics, especially yellow fever.

History of influenza pandemics in China during the past century / 中华流行病学杂志

Five influenza pandemics had occurred during the past century (1918 "Spanish flu" , 1957 "Asian flu" , 1968 "Hong Kong flu" , 1977 "Russian flu" and 2009 H1N1 Pandemic), accounting for hundreds of millions of people infected and tens of millions dead. China was influenced by all the five pandemics, and three of them (1957 "Asian flu" , 1968 "Hong Kong flu" and 1977 "Russian flu" ) were originated from China. The pandemics triggered the establishment of public health agencies and influenza surveillance capacities. In addition, more resources were allocated to influenza-related research, prevention and control. As a leader in the field of influenza, China should further strengthen its pandemic preparedness and response to contribute to global health.

A cien años del inicio de la Gran Guerra: brote de triquinosis en marinos del Dresden en Chile: Crónica de una infección anunciada / A hundred years since the beginning of the Great War: trichinosis outbreak in Dresden marine in Chile: Chronicle of an announced infection

In commemoration of one hundred years of the beginning of World War I, the occurrence of an outbreak of trichinosis in the crew of the SMS Dresden, a German ship that participated in that world conflagration, is re-viewed. In September 1915, while the sailors of SMS Dresden were forcibly detained on Isla Quiriquina, Bío Bío Region, Chile, 60 individuals became ill. The cause of the outbreak was the consumption of sausages made from pork infected with the parasite Trichinella spiralis. There was a fatal case. The review of the epidemiological aspects that facilitated the presentation and spread of human trichinosis at that time allows to conclude that, pork breeded in poor hygienic conditions, meat and its by-products clandestinely sold without sanitary inspection and the language barrier were determinant in the occurrence of the epidemic outbreak.

A propósito de la conmemoración de los cien años del inicio de la Primera Guerra Mundial, se revisa la ocurrencia de un brote epidémico de triquinosis en tripulantes del SMS Dresden, buque alemán que participó en esa conflagración mundial. Este suceso, acaecido en septiembre de 1915, ocurrió mientras los marinos se encontraban forzosamente recluidos en la Isla Quiriquina, Región del Bío Bío, Chile. La causa del brote fue el consumo de embutidos fabricados a partir de carne de cerdo infectada con el parásito Trichinella spiralis e involucró a 60 mari-neros, de los cuales hubo un caso fatal. La revisión de los aspectos epidemiológicos que favorecían la presentación de triquinosis humana en la época permite concluir que, la crianza porcina en malas condiciones higiénicas, la venta clandestina de carnes y subproductos sin inspección sanitaria y la barrera idiomática fueron determinantes en la ocurrencia del brote epidémico.

Equine influenza in Brazil / A influenza equina no Brasil

Equine influenza virus (EIV) (H3N8 and H7N7) is the causative agent of equine influenza, or equine flu. The H7N7 subtype has been considered to be extinct worldwide since 1980. Affected animals have respiratory symptoms that can be worsened by secondary bacterial respiratory infection, thereby leading to great economic losses in the horse-breeding industry. In Brazil, equine influenza outbreaks were first reported in 1963 and studies on hemagglutination antibodies against viral subtypes in Brazilian horses have been conducted since then. The objective of the present review was to present the history of the emergence of EIV around the world and in Brazil and the studies that have thus far been developed on EIV in Brazilian equines...

O vírus da influenza equina (EIV) (H3N8 e H7N7) é o agente causador da influenza equina, ou gripe equina. O subtipo viral H7N7 é considerado como mundialmente extinto desde 1980. Os animais afetados têm sintomas respiratórios característicos que podem ser agravados por uma infecção respiratória bacteriana secundária causando grandes prejuízos no ramo equestre. No Brasil, os surtos da EI têm sido relatados desde 1963 e desde então vem sendo efetuados estudos sobre a presença de anticorpos hemaglutinantes contra os subtipos virais nos equídeos brasileiros. O presente artigo tem o objetivo de apresentar um histórico sobre o surgimento do EIV no mundo e no Brasil destacando os estudos conduzidos no Brasil até o momento acerca da infecção pelo EIV nos equídeos brasileiros...

Dengue contando uma história (Série Meio Ambiente Saudável) / Dengue telling a story (Series Healthy Environment)

Através de uma linguagem acessível, utilizando imagens desde 1846, conhecemos a história do mosquito da dengue. Temos também a orientação de como a doença é transmitida e o que deve-se fazer para a sua prevenção...

Control, contención y educación higiénica en las campañas de vacunación contra la viruela en México durante la década de 1940 / Control, containment and health education in the smallpox-vaccination campaigns in Mexico in the 1940s

El artículo examina algunas transformaciones por las que atravesaron los programas mexicanos de vacunación, a partir de 1943, al establecerse la Campaña Nacional contra la Viruela. Se analiza por qué se procuró implementar un método uniforme y coordinado de vacunación para terminar con los brotes epidémicos de esa enfermedad endémica, sobre todo en la región central del país; se estudian las acciones de su amplio y heterogéneo personal y los argumentos por los que se consideró que la vacunación antivariolosa era central para consolidar una cultura de prevención. En suma, se estudia por qué se favoreció la vacunación selectiva, la persuasión y la extensión de los programas de educación higiénica, temáticas que han sido escasamente abordadas en la historiografía.

This article examines some of the changes that the Mexican vaccination programs underwent starting in 1943, the year when the National Smallpox Campaign (Campaña Nacional contra la Viruela) was established. It analyzes why a uniform and coordinated vaccination method was adopted to counter the outbreaks of this endemic disease, especially in central Mexico; the actions of its numerous and heterogeneous staff; and the reasons why smallpox vaccination was considered critical to establish a culture of prevention. In summary, the article examines why selective vaccination was chosen and the expansion of the health-education programs, topics that have been seldom addressed in historical research.

Outbreaks of Ebola virus disease in Africa: the beginnings of a tragic saga

The tremendous outbreak of Ebola virus disease occurring in West Africa since the end of 2013 surprises by its remoteness from previous epidemics and dramatic extent. This review aims to describe the 27 manifestations of Ebola virus that arose after its discovery in 1976. It provides an update on research on the ecology of Ebola viruses, modes of contamination and human transmission of the disease that are mainly linked to close contact with an infected animal or a patient suffering from the disease. The recommendations to contain the epidemic and challenges to achieve it are reminded.

1918: a gripe espanhola desvendada? / 1918: the Spanish flu unveiled?

Em 1918, o mundo testemunhou uma das maiores tragédias de sua história, quando uma epidemia de gripe arrasou a população. Acredita-se que 15 a 25 milhões de pessoas tenham perdido a vida em consequência de uma grave insuficiência respiratória. O comportamento não usual de levar jovens entre 20 e 40 anos à morte mantém acesas as discussões a respeito de sua natureza. O objetivo deste estudo foi rever na literatura os primórdios da epidemia e suas consequências, além dos estudos que tentaram e tentam desvendá-la. A gripe espanhola tem sido estudada por meio de diferentes pontos de vista. A dimensão social da doença envolve constatações de semelhanças entre outras epidemias do passado, como os sentimentos de desorientação, impotência e terror, e por ter vitimado principalmente a parcela mais carente da população. Porém, em 1918, já se conheciam os micro-organismos patogênicos, impedindo que houvesse o apontamento milenar de culpa de membros segregados pela sociedade. Pesquisas sobre o agente causal, a fisiopatologia e as causas dos óbitos mobilizaram os laboratórios ao redor do mundo. As causas de seu estranho comportamento não estão totalmente esclarecidas. Os mistérios da gripe espanhola ainda intrigam a ciência...

In 1918, the world witnessed one of the greatest tragedies in its history, when an epidemic flu devastated the population. It is believed that 15 to 25 million people died due to a severe respiratory failure. The unusual behavior of killing young people between 20-40 years old keeps discussions about its nature lively. The objective of this study was to review the epidemic beginnings and its consequences, as well as the studies that tried and are trying to unveil it. Spanish Flu has been extensively studied from different points of view. The social dimension of the disease involves findings of similarity with other epidemics of the past, such as disorientation, helplessness and the terror felt by the population, and also the fact that it victimized mainly the poorest. However, in 1918, the pathogenic microorganisms were already known, avoiding members segregated by society to be made responsible for the disease. Researches on the agent, the pathophysiology, and cause of deaths mobilized laboratories around the world. The causes of its strange behavior are not totally clear, and still intrigue science...

A epidemia de variola e o medo da vacina em Goias / The smallpox epidemic and fear of the vaccine in Goias

Analisa dois aspectos referentes à varíola em Goiás. Um se refere à reconstituição histórica dos principais surtos no estado, nos séculos XIX e nas três primeiras décadas do XX, focalizando o aumento dos surtos epidêmicos da doença como consequência da modernização dos meios de transportes e do crescimento demográfico. O outro centra-se na resistência da população goiana do século XIX à vacina antivariólica, que pode ser compreendida num quadro mais amplo de resistência às medidas civilizadoras implantadas pelo Estado em Goiás. Em termos metodológicos, o artigo considera a varíola evento hermenêutico, procurando situá-la na proposta de normatização higiênica pretendida pelos administradores públicos, então em choque com os valores e atitudes da população local.

An analysis is made of two aspects of smallpox in the Brazilian state of Goiás. One is a historical reconstruction of the main outbreaks in the state in the nineteenth century and the first three decades of the twentieth century, focusing on the increased number of epidemics of the disease as transportation was modernized and the population grew. The other concerns the people's resistance in the nineteenth century to the smallpox vaccine, which may be understood in a broader context of resistance to the modernizations introduced by the State in Goiás. According to the methodology used, smallpox is regarded as a hermeneutic event within the broader efforts to standardize public health made by the public authorities, which ran counter to the local people's values and attitudes.

Mortalidade escrava durante a epidemia de cólera no Rio de Janeiro (1855-1856): uma análise preliminar / Slave mortality during the cholera epidemic in Rio de Janeiro (1855-1856): a preliminary analysis

Apresenta uma primeira análise do perfil sociodemográfico dos óbitos registrados durante a primeira epidemia de cólera no Rio de Janeiro, a partir de dados coletados nos registros de óbito da Santa Casa de Misericórdia. Desde a manifestação do cólera, em 1855, relatos médicos brasileiros apontam seu viés social, que, no caso do país, implicava a alta mortalidade de escravos e livres pobres. Do ponto de vista histórico, entretanto, a epidemia e sua dinâmica foram pouco estudadas. A recuperação de dados originais sobre o cólera e a análise das taxas de mortalidade associadas à doença auxiliam-nos a melhor compreender aspectos do universo escravo na zona urbana da cidade, no período subsequente ao fim do tráfico negreiro.

The article offers a preliminary analysis of the sociodemographic profile of deaths recorded during the first cholera epidemic in Rio de Janeiro, based on data gathered from death records at Santa Casa de Misericórdia Hospital. After cholera appeared in the country in 1855, Brazilian medical reports indicated a social bias, with slaves and the free poor suffering high mortality. From a historical perspective, however, little research has been done on the epidemic and its dynamics. The recovery of original data on cholera and the analysis of cholera mortality rates help us to better understand aspects of the slave universe in the urban zone of Rio de Janeiro in the period following the end of the slave trade.

De miasmas a mosquitos: el pensamiento médico sobre la fiebre amarilla en Yucatán, 1890-1920 / From miasmas to mosquitoes: medical thought on yellow fever in Yucatan, 1890-1920

La fiebre amarilla fue un problema de salud pública desde la época colonial debido a la frecuencia con que se presentaba en forma epidémica y a su alta letalidad. El objetivo de este trabajo es analizar el pensamiento médico y su evolución con respecto al vómito prieto entre 1890 y 1921 en Yucatán. Dos aspectos serán abordados: algunos antecedentes con respecto a la enfermedad y las ideas predominantes hasta 1881; y la propuesta de Carlos Finlay para vencer el escepticismo ante su teoría por parte de la comunidad médica. En segundo lugar se analizará la mezcla de las ideas miasmáticas y bacterianas. En tercer lugar, se mostrará cómo, a partir de la demostración de sus postulados, la mirada médica se dirigió al exterminio del mosquito transmisor de este padecimiento.

Yellow fever has been a public health concern since colonial days because of its frequent epidemics and high mortality rate. This analysis of medical thought about "the black vomit" in the Yucatan and the evolution of this thinking from 1890 through 1921 first addresses some of the disease's antecedents and preponderant ideas prior to 1881 as well as Carlos Finlay's efforts to convince the medical community that his theory was right. The article goes on to analyze the co-existence of miasmatic and bacterial ideas and to show how medical initiatives began focusing on eradication of the mosquito transmitter once Finlay's postulates had been demonstrated.

A epidemia de cólera de 1853-1856 na imprensa portuguesa / The 1853-1856 cholera epidemic in the Portuguese press

A investigação em curso debruça-se sobre a divulgação da ciência e da tecnologia a um público não especializado. A principal fonte utilizada é a imprensa generalista, com a qual se pretende obter uma imagem da popularização da ciência em Portugal. Considerando a intenção explícita da imprensa do século XIX em formar audiências e espalhar o conhecimento, utilizam-se notícias, artigos desenvolvidos e anúncios sobre a epidemia de cólera de 1853-1856 para avaliar os conhecimentos científicos da época, especialmente sobre prevenção e tratamento, e o modo como eram divulgados e usados pela sociedade.

The article examines science and technology communication aimed at a non-specialized audience, using the general press as the main source in this endeavor to capture an image of the popularization of science in Portugal. Based on the fact that the nineteenth-century press was overtly concerned with garnering an audience and spreading knowledge, the study uses news, articles, and advertisements about the 1853-1856 cholera epidemic to assess the era's scientific knowledge (especially about prevention and treatment) and how this information was conveyed to society and used by it.

'Formidável contágio': epidemias, trabalho e recrutamento na Amazônia colonial (1660-1750) / 'Formidable contagion': epidemics, work and recruitment in Colonial Amazonia (1660-1750)

Analisa em que medida epidemias de varíola e de sarampo ensejaram transformações nas formas de aquisição e uso de força de trabalho na Amazônia colonial, de meados do século XVII a meados do século XVIII, com o incremento de descimentos privados de índios e a tentativa de organização de uma rota de tráfico negreiro para a região. Trata igualmente de entender como a mortandade de indígenas significou, no fim do século XVII, uma preocupação com a defesa da região e motivou o recrutamento de soldados da Madeira.

The text analyzes the extent to which smallpox and measles epidemics provoked transformations in the ways in which workforces were acquired and used in colonial Amazonia from the mid-seventeenth to mid-eighteenth century, with an increase in slave raids on the indigenous population and the attempt to organize a trade route in African slaves to the region. It also explores how indigenous mortality rates at the end of the seventeenth century led to a concern with the region's defence and prompted the recruitment of soldiers from the Madeira islands.