Brote de histoplasmosis en el contexto de la pandemia por COVID-19 / Histoplasmosis outbreak in the context of the COVID-19 pandemic

La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas(AU)

Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated(AU)

Working together to overcome difficulties / 中华危重病急救医学

Objective:With the adjustment of epidemic prevention and control policies, the coronavirus disease infection has undergone incredible changes. The number of infected people has exploded in a geometric progression up to an astronomical number. In the face of a new round of stormy tests, it is not only necessary for the whole country to unite and help each other, unite as one, share weal and woe, and overcome the difficulties, but also for us to reflect on the current situation, problems and difficulties.

Diferencias entre formas de contagio intra y extradomiciliaria en tres brotes epidémicos de COVID-19 en Santiago de Cuba / Differences between Forms of Intra- and Extra-Domiciliary Contagion in Three Epidemic Outbreaks of COVID-19 in Santiago de Cuba

Introducción: En la transmisión de la COVID-19 en Santiago de Cuba se distinguieron tres brotes epidémicos entre 2020 y 2021. Objetivo: Identificar las diferencias entre los contagios intra y extradomiciliarios en tres brotes epidémicos de COVID-19 en Santiago de Cuba entre marzo de 2020 y mayo de 2021. Métodos: Se realizó un estudio descriptivo transversal de los casos de COVID-19 del territorio y el período referidos, mediante las técnicas bivariadas habituales de la estadística y el análisis estadístico implicativo, con una muestra de 6408 que se eligió por muestreo aleatorio simple de la base de datos de casos confirmados. Resultados: El contagio extradomiciliario fue significativamente mayor que el intradomiciliario sin diferencias por sexo, pero sí según grupos de edades y municipios dentro y entre ambos grupos. Fue significativo el predominio de los adultos mayores en el contagio intradomiciliario y de los adultos jóvenes en el extradomiciliario. Primaron los sintomáticos en el intradomiciliario; y, los asintomáticos, en el extradomiciliario, sin diferencias significativas entre ambas formas. Los menores de 20 años de edad, adultos mayores, asintomáticos y el municipio Mella fueron las características que se asociaron con el contagio intradomiciliario, mientras, con el extradomiciliario, los adultos jóvenes sintomáticos. Conclusiones: Las formas de contagio intra y extradomiciliaria se modularon según la conducta de las personas y el aislamiento propio de cada grupo de edades. La extradomiciliaria predominó en edades intermedias de la vida, como expresión de la conducta mediada por su responsabilidad económica en el hogar, mientras las edades extremas, que permanecieron en casa por cumplir medidas de aislamiento, fueron más propensas a la intradomiciliaria(AU)

Introduction: In the transmission of COVID-19 in Santiago de Cuba province, three epidemic outbreaks were observed between 2020 and 2021. Objective: To identify the differences between intra- and extra-domiciliary infections in three epidemic outbreaks of COVID-19 in Santiago de Cuba between March 2020 and May 2021. Methods: A cross-sectional descriptive study of COVID-19 cases in the territory and period above mentioned was carried out, using the usual bivariate techniques of statistics and implicative statistical analysis, to a sample of 6408 cass that was chosen by simple random sampling from the database of confirmed cases. Results: Extra-domiciliary contagion was significantly higher than intra-domiciliary contagion without differences by sex, but according to age groups and municipalities within and between both groups. The predominance of older adults in intra-domiciliary contagion and of young adults in extra-domiciliary contagion was significant. Symptomatic patients prevailed in the intra-domiciliary; and, the asymptomatic, in the extra-domiciliary, without significant differences between both forms. Children under 20 years of age, older adults, asymptomatic and Mella municipality were the characteristics that were associated with intra-domiciliary contagion, while, with the extra-domiciliary were related symptomatic young adults. Conclusions: The forms of intra- and extra-domiciliary contagion were modulated according to the behavior of the people and the isolation of each age group. Extra-domiciliary predominated in intermediate ages of life, as an expression of the behavior mediated by their economic responsibility at home, while extreme ages, who remained at home to comply with isolation measures, were more prone to intra-domiciliary contagion(AU)

Mental health of college students of different specialties during the epidemic of coronavirus disease 2019 / 西安交通大学学报(医学版)

【Objective】 To investigate the mental health status of college students of different specialties during the outbreak of coronavirus disease 2019 (COVID-19) so as to provide the basis for college students’ mental health assessment and psychological crisis intervention. 【Methods】 The survey conducted among students of a university in Xi’an was composed of common questionnaires like the Self-rating Anxiety Scale (SAS) and Self-Depression Rating Scale (SDS), and the students’ understanding of COVID-19. The differences among students of different specialties were compared by ANOVA and LSD-test. 【Results】 A total of 456 students’ questionnaires were collected online, with an effective rate of 93.68%. During the outbreak of the epidemic, the depression score was 42.51±10.65 points while the overall anxiety score was 38.37±7.46 points, which was higher than the Chinese adult norm score. Students of clinical medicine had a higher level of concern over and stress response to COVID-19 than those of other specialties. The average SAS and SDS sores differed significantly between the three groups (P<0.001 for SAS, and P=0.004 for SDS). Anxiety score reached 36.28±7.25 for students of clinical medicine, 39.75±7.00 for students of specialties related to clinical medicine, and 39.35±7.89 for other non-clinical majored students. The SAS score of clinical students was significantly lower than that of students of specialties related to clinical medicine (P<0.001) and non-clinical majored students (P=0.001). The SDS scores were significantly higher for clinical medicine related students (P=0.001) and non-clinical majored students (P=0.027) than for clinical students. 【Conclusion】 College students had higher levels of anxiety and depression than the norm score of other adults in China during the epidemic of COVID-19. Compared with students of other specialties, those of clinical medicine were found to have a high level of concern about and stress response to the epidemic of COVID-19, but a lower level of anxiety and depression.

Análisis de Modelo Matemático con percepción de riesgo para la CoVid19. Resultados para Cuba / Analysis of Mathematical Model with risk perception for the CoVid19. Results for Cuba

En Epidemiología, han jugado un importante papel los Modelos Poblacionales que dividen a la población de estudio en subpoblaciones según los atributos que las distinguen, lo que permite representar la dinámica de contagio social de una determinada enfermedad, especialmente en momentos de brote epidémico. En el presente trabajo se explica cómo se representa la transmisión de enfermedades a través de modelos matemáticos definidos por ecuaciones diferenciales. En esta propuesta se formula un modelo matemático definido por ecuaciones diferenciales para representar la transmisión del SarsCov2 distinguiendo entre las poblaciones de infectados sintomáticos y asintomáticos de la CoVid19, con funciones que simulan las acciones gubernamentales e individuales ante la percepción de riesgo. También se presenta un análisis de los resultados obtenidos en Cuba(AU)

In Epidemiology, Population Models have played an important role, dividing the study population into subpopulations according to the attributes that distinguish them, allowing the dynamics of social contagion of a given disease to be represented, especially at times of epidemic outbreak. This work explains how the transmission of diseases is represented through mathematical models defined by differential equations. In this proposal, a mathematical model defined by differential equations is formulated to represent the transmission of SarsCov2, distinguishing between symptomatic and asymptomatic infected populations of CoVid19, with functions that simulate government and individual actions in the face of risk perception. An analysis of the results obtained in Cuba is also presented(AU)

El virus del Zika y determinantes sociales en un área de salud de Santiago de Cuba / Zika virus and social determinants in a health area from Santiago de Cuba

El zika es una enfermedad transmitida por el mosquito del género Aedes, identificada por vez primera en Uganda. Entre los síntomas más comunes figuran: fiebre, artralgias, sarpullido, conjuntivitis no purulenta, cefalea, mialgias y dolor ocular. Se realizó un estudio descriptivo y transversal durante 2017 de las 204 viviendas de la manzana 1204 del Policlínico Docente 30 de Noviembre de Santiago de Cuba, con el objetivo de identificar los determinantes sociales del estado de salud de la población durante el brote de trasmisión de zika. La técnica utilizada para la recolección de los datos fue la observación y como variable se analizaron los determinantes del estado de salud de la población. Se observó que el nuevo brote de zika en la manzana estudiada, surgió bajo la influencia de dichos determinantes. Se concluyó que la biología humana, el estilo de vida, el medio ambiente y la organización de los servicios de salud, influyeron directamente en la aparición de esta enfermedad.

Zika is a disease transmitted by the mosquito from Aedes gender, identified for the first time in Uganda. Among the most common symptoms there are: fever, artralgias, heat rash, non-purulent conjunctivitis, migraine, myalgias and ocular pain. A descriptive and cross-sectional study was carried out during 2017, of the 204 houses of the block 1204 from 30 de noviembre Teaching Polyclinic in Santiago de Cuba, with the objective of identifying the social determinants of the population health state during the zika outbreak transmission. The technique used for the gathering data was observation and as variable the determinant of the health state of the population were analyzed. It was observed that the new zika outbreak in the studied block, emerged under the influence of these determinants. It is concluded that the human biology, lifestyle, environment and the organization of the health services, influenced directly in the emergence of this disease.

Characteristics of molecular typing and epidemic of norovirus infection in Wuhu region, 2017 / 中华实验和临床病毒学杂志

Objective@#To understand the status and genotype of norovirus in Wuhu, and provide the basic molecular epidemiological data for norovirus infection control and prevention, 2017.@*Methods@#Anal swab and vomit specimens were collected during outbreaks from patients, primarily using fluorescence quantitative PCR to preliminarily identify the genotype of norovirus; according to preliminary result , through their respective specific primer, RT-PCR was applied, and sequencing was done to identify virus genotypes. Sequence alignment and phylogenetic analysis of norovirus was performed by using biological software.@*Results@#Seventeen norovirus epidemics were observed in Wuhu area, a total of 137 specimens were collected. Real-time fluorescent quantitative PCR result showed that 77 specimens were norovirus nucleic acid testing positive, and all were GⅡ genotype. Through specific primers amplification, sequencing analysis showed that the 2017 outbreaks in Wuhu were caused only by two genotypes, GⅡ.3 and GⅡ. 2, including one case of GⅡ. 3, Six cases of GⅡ.2, and 10 epidemic aggregations, 8 cases of GⅡ. 2, and there were two cases of G Ⅱ. 4 Sydney 2012.@*Conclusions@#Norovirus GⅡ.2 genotype was dominant in norovirus outbreaks and the aggregation epidemics, other genotypes were occasionally seen in Wuhu, 2017.

Genetic characteristic analysis of haemagglutinin of two episodes of influenza B virus outbreaks in Guizhou ;Province in 2016 / 中华传染病杂志

Objective To understand the genetic variations of influenza B virus outbreaks in Guizhou province in 2016,and to compare the matching situation of outbreak epidemic strains with the vaccine strains recommended by WHO and representative strains in China.Methods The haemagglutinin HA1 gene of 8 strains isolated from two episodes of influenza B virus outbreaks in Tongren area was amplified and sequenced.The sequencing products were analyzed by bioinformatics software DNAStar. Results The two episodes of influenza outbreaks were both caused by influenza B Victoria lineage virus (BV).The homologies of the isolated strains were 99.8%—100.0% in nucleotide and 99.5 %—100.0%in amino acid.Mutation was only detected at 274 site in some strains.Compared with reference strain B/Victoria/2/87,the homologies were 91 .8%—92.0% and 91 .5 %—92.0%,respectively.Mutations developed at 17 amino acid sites,among which,I143V,V163I and V201I site were associated with the main antigenic determinant area B,C and D.Compared with previous vaccine strain B/Brisbane/60/2008, the homologies were 98.2%—98.3% and 98.5 %—99.0%,respectively,and mutations were detected at 3 sites.Mutations at I143V and N155D were detected in all 8 strains and at T247I in some strains.The mutation of I143V was associated with antigenic determinant area B.Compared with the representative strain B/Chongqing-Yuzhong/1384/2010,the homologies were 96.7%—96.8% and 97.0%—97.5 %, respectively.A total of 6 sites developed mutations,among which,5 sites were P84L,I143V,N155D, V172I and T223N mutations.The mutation of T247I was detected in some strains,and I143V was associated with area B.Compared with the epidemic strain in Guizhou in 2016,the homologies were 99.8%—100.0% and 99.5 %—100.0%,respectively.Mutation was only detected at site 247 in some strains and was not associated with the main antigenic determinant area.Conclusions The two episodes of influenza outbreaks in Guizhou are caused by the same BV lineage epidemic virus strain.Haemagglutinin gene of BV lineage virus is constantly changing.However,there is no new mutation emerged at important site.Compared with previous influenza vaccine strain B/Brisbane/60/2008 recommended by WHO,BV lineage virus is well matched and could provide a positive protection effect.

Dengue: aspectos epidemiológicos e o primeiro surto ocorrido na região do Médio Solimões, Coari, Estado do Amazonas, no período de 2008 a 2009 / Dengue: epidemiological aspects and the first outbreak in the Middle Solimões Region of Coari in the State of Amazonas from 2008 to 2009

INTRODUÇÃO: A dengue é uma das doenças infecciosas mais frequentes no Brasil e um dos principais problemas de saúde pública no mundo, principalmente em regiões tropicais e subtropicais, com 2,5 a 3 bilhões de pessoas expostas ao risco de serem infectadas atualmente. Deste modo, o presente estudo teve como objetivo demonstrar as características epidemiológicas dos indivíduos acometidos por dengue, sua prevalência e seu processo epidêmico na região do Médio Solimões, Coari, Amazonas, no período de 2008 e 2009. MÉTODOS: Os dados epidemiológicos foram obtidos na Vigilância Epidemiológica da Secretaria Municipal de Saúde da Cidade de Coari-AM. As variáveis analisadas foram: mês da notificação, casos confirmados, gênero (sexo), faixa etária e bairro de residência. RESULTADOS: No total, foram notificados 1.003 casos (635 em 2008 e 368 em 2009), sendo diagnosticados 639 casos positivos. Destes, ± 54% acometerem indivíduos do sexo feminino e ± 46% do sexo masculino. As faixas etárias mais acometidas foram às observadas entre 10-49 anos; quanto à distribuição espacial, observamos o acometimento de indivíduos de bairros próximos a igarapés, lagos e com processo recente e desordenado de habitação. CONCLUSÕES: Deste modo, conclui-se que, durante o período estudado, houve um surto epidêmico de dengue na Cidade de Coari, AM. Entretanto, deve-se considerar que uma epidemia de dengue anterior pode ter ocorrido em Coari, sem que tenha tido o devido diagnóstico etiológico, ou que houveram pessoas com infecção passada que se deslocaram para a capital do Amazonas (Manaus), onde os vírus circulam desde 1998.

INTRODUCTION: Dengue is one of the most prevalent infectious diseases in Brazil and is a major public health problem worldwide. It is most prevalent in tropical and subtropical regions with 2.5 to 3 billion people at risk of becoming infected. Thus, this study sought to demonstrate the epidemiological characteristics of individuals affected by dengue, its prevalence and its epidemic process in the Middle Solimões region of Coari in the state of Amazonas between 2008 and 2009. METHODS: Epidemiological data were obtained through epidemiological monitoring by the Municipal Health Facility of the city of Coari, AM. The variables analyzed were the month of notification, the number of confirmed cases, the cases' genders, the cases' ages and their neighborhoods of residence. RESULTS: In total, 1,003 cases were reported (635 in 2008 and 368 in 2009), and 639 cases were diagnosed as positive. Of these, +54% involved female subjects, and +46% were male. The majority of the affected individuals were between 10 and 49 years of age, and the spatial distribution was concentrated in neighborhoods near streams, lakes and areas in which housing had recently been disrupted. Conclusions: We concluded that, during the period studied, there was an outbreak of dengue in the City of Coari, AM. However, it is possible that a dengue epidemic may have occurred earlier in Coari without proper diagnosis or follow-up and that previously infected individuals may have traveled to the capital of Amazonas (Manaus), where the virus has circulated since 1998.

Two Cases of Pancreatitis in Children with Hemolytic Uremic Syndrome

An epidemic outbreak of food poisoning due to enterohemorrhagic Escherichia coli(EHEC) occurred throughout Korea from May to September, 2003. Patients infected via contaminated school lunch foods were found mainly in Seoul and Gyeonggi province. As a result of this food poisoning, 36 patients were diagnosed as hemolytic uremic syndrome(HUS) up to mid- September, 2003 and five of them visited our hospital. Before the outbreak this year, we had experienced only 23 cases of HUS, including diarrhea associated (D+) and atypical (D-) forms, for the last 14 years, and there had been no case with pancreatic enzyme elevation. Unlike the past HUS cases, those of this year presented with severe abdominal pain and spiking elevation of pancreatic enzyme levels in 2 cases. We report 2 cases of transient pancreatitis combined with HUS in children during the epidemic outbreak in 2003 with a brief review of related literatures.

Two Cases of Pancreatitis in Children with Hemolytic Uremic Syndrome

An epidemic outbreak of food poisoning due to enterohemorrhagic Escherichia coli(EHEC) occurred throughout Korea from May to September, 2003. Patients infected via contaminated school lunch foods were found mainly in Seoul and Gyeonggi province. As a result of this food poisoning, 36 patients were diagnosed as hemolytic uremic syndrome(HUS) up to mid- September, 2003 and five of them visited our hospital. Before the outbreak this year, we had experienced only 23 cases of HUS, including diarrhea associated (D+) and atypical (D-) forms, for the last 14 years, and there had been no case with pancreatic enzyme elevation. Unlike the past HUS cases, those of this year presented with severe abdominal pain and spiking elevation of pancreatic enzyme levels in 2 cases. We report 2 cases of transient pancreatitis combined with HUS in children during the epidemic outbreak in 2003 with a brief review of related literatures.

Identificação e linotiparem de amostras de Salmonella paratyphi A, causadora de surto epidêmico em Tucurui, Para, Brasil, em 1980 / Identification and lysotyping of strains of Salmonella paratyphi A, responsible for the disease outbreak in Tucurui, Para, Brazil, in 1980

Em agosto de 1980, em um canteiro de obras da hidrelétrica de Tucuruí, no Estado do Pará, ocorreu um surto epidêmico de salmonelose, durante o qual foram isoladas, no Hospital Vila Temporária, 101 cepas de Saimonellà sp., através de hemocultura e coprocultura; 62 cepas foram enviadas à Seção de Bacteriologia do Instituto Adolfo Lutz, São Paulo, e 39 à Seção de Bacteriologia do Instituto Evandro Chagas, Belém, onde foi feita a confirmação bioquímica do gênero e a sorotipagem. A lisotipagem de 55 cepas, efetuada no Centro de Lisotipia Entérica do Instituto Pasteur de Paris, França, demonstrou que todas pertenciam ao lisotipo lb, fato este que sugere origem única para o surto epidêmico em tela. Todas as cepas mostraram alta sensibilidade aos antimicrobianos aos quais foram submetidas: ampicilina, ácido nalidixico, cefalotina, estreptomicina, canamicina, cloranfenicol, tetraciclina, gentamicina, amicacina e colistina. Este foi o primeiro surto epidêmico de salmonelose por Salmonella pamtyphi A assinalado no Brasil (AU).