Executive Summary of the Spanish Guidelines for the Diagnosis and Management of Imported Febrile Illnesses from the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Imported Pathology Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEPI-SEIMC), the Spanish Society of Family and Community Medicine (SEMFYC), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Emergency Medicine (SEMES).

The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool. The present executive summary shows a selection of some of the most relevant questions and recommendations included in the guidelines.

Risk factors associated with severe COVID-19 outcomes in Jamaica: a cross-sectional study of national surveillance data / Factores de riesgo asociados a la COVID-19 grave en Jamaica: estudio transversal de datos nacionales de vigilancia / Fatores de risco associados a desfechos graves da COVID-19 na Jamaica: estudo transversal de dados de vigilância nacional

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2-1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1-8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1-1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6-27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2-2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

Enfermedades emergentes, pobreza y hambre / Emerging diseases, poverty and hunger

La pobreza y el hambre son elementos significativos para la prevalencia de las enfermedades emergentes, además de la ignorancia, la indigencia, las falencias sanitarias y los cambios ambientales debidos al calentamiento global. La desnutrición es consecuencia de la pobreza y ésta es causa de desnutrición. Los niños que viven en condiciones de mayor vulnerabilidad tienen un riesgo alto de morir por diarrea, neumonía y enfermedades emergentes. La mayoría son desnutridos. Su futuro en la adultez guarda relación con la desnutrición en la infancia. En el mundo 820 millones de niños padecen hambre y mueren anualmente 3 millones de menores de 5 años, según datos del Fondo de las Naciones Unidas para la Infancia. En Argentina, según datos del segundo semestre de 2022, un 39,2% de la población es pobre (Instituto Nacional de Estadísticas y Censos). El 15,5% de niños y adolescentes padecen inseguridad alimentaria y 2 millones de niños padecen hambre (Médicos sin Fronteras). La tasa de mortalidad infantil en menores de 5 años tiene una prevalencia del 0,4%. Los cambios climáticos ejercen influencia sobre la salud, produciendo cambios en la epidemiologia de las enfermedades emergentes, mientras que la insuficiente alimentación ocasiona efectos negativos sobre la salud. El calentamiento global aumenta las inundaciones y las sequías, incidiendo en la escasez de alimentos e incrementando las enfermedades emergentes. La situación debe ser revertida mediante el desarrollo sostenido de la educación, el bienestar social y los proyectos sanitarios. (AU)

Poverty and hunger are significant elements for the prevalence of emerging diseases, in addition to ignorance, indigence, sanitary deficiencies and environmental changes due to global warming. Malnutrition is a consequence of poverty and poverty is a cause of malnutrition. Children living in more vulnerable conditions are at greater risk of dying from diarrhea, pneumonia and emerging diseases. Most are malnourished. Their future in adulthood is related to malnutrition in childhood. Worldwide, 820 million children suffer from hunger and 3 million children under 5 die annually (United Nations Children's Fund). In Argentina, according to data from the second half of 2022, 39.2% of the population is poor (Instituto Nacional de Estadísticas y Censos). 15.5% of children and adolescents are food insecure and 2 million children are hungry (Médecins Sans Frontières). The infant mortality rate in children under 5 years of age has a prevalence of 0.4%. Climate change influences health, producing changes in the epidemiology of emerging diseases, while insufficient food has negative effects on health. Global warming increases floods and droughts, leading to food shortages and increasing emerging diseases. The situation must be reversed through sustained development of education, social welfare and health projects. (AU)

Digitalización de la comunicación y atención a personas LGBTIQ+: dos conflictos éticos emergentes para la Psicología en la Atención Primaria de Salud chilena / Digitalització de la comunicació i atenció a persones LGBTIQ+: dos conflictes ètics emergents per a la psicologia en l'Atenció Primària de Salut xilena / Digitalization of communication and attention to LGBTIQ+ people: Two emerging ethical conflicts for psychology in Chilean Primary Health Care

El artículo analiza los conflictos éticos detectados por Psicólogas/os en la Atención Primaria de Salud en Chile, centrando la descripción y análisis en los percibidos como emergentes, a través de un estudio cualitativo, tipo exploratorio-descriptivo. Dos fueron los principales conflictos identificados: a) resguardo de información sensible en ficha clínica electrónica y b) atención a personas LGBTIQ+ sin capacitación correspondiente. El estudio transparenta la importancia de visibilizar demandas incipientesen salud pública a través de las perspectivas de los propios profesionales, dotándoles de notoriedad para avanzar en su priorización y resolución. Explorar la dimensión ética es relevante para el ejercicio de la psicología contemporánea, porque da cuenta de las necesidades de la sociedad, permitiendo incluso anticiparse a ellas.(AU)

L'article analitza els conflictes ètics detectats pels psicòlegs en l'Atenció Primària de Salut a Xile, centrant-se en la descripció i anàlisi dels que es perceben com a emergents mitjançant un estudi qualitatiu de tipus exploratori-descriptiu. Es van identificar dos conflictes principals: a) la protecció de la informació sensible en els registres clínics electrònics i b) l'atenció a persones LGBTIQ+ sense la formació adequada. L'estudi destaca la importància de fer visibles les demandes incipients en la salut pública a través de les perspectives dels mateixos professionals, donant-los rellevància per avançar en la seva prioritat i resolució. Explorar la dimensió ètica és rellevant per a l'exercici de la psicologia contemporània, ja que reflecteix les necessitats de la societat, fins i tot permetent anticipar-se a elles.(AU)

The article analyzesthe ethical conflicts detected by psychologists in Primary Health Care in Chile, centering the description and analysis on those perceived as emerging, through an exploratory-descriptive qualitative study. There were two main conflicts identified: a) safeguarding of sensitive information in electronic clinical records and b) healthcare for LGBTIQ+ persons without the corresponding qualification. The study illustrates the importance of highlighting developing demands in public healthcare through the perspectives of the professionals themselves, providing the demands with notoriety in order to advance in their prioritization and resolution. Exploring the ethical dimension is relevant for contemporary psychology practice because it accounts for the needs of society, even making it possible to anticipate them.(AU)

Romantic relationship dissolutions are significantly associated with posttraumatic stress symptoms as compared to a DSM-5 Criterion A event: a case-case-control comparison.

Background: Non-marital romantic relationship dissolutions (RRDs) are common among emerging adult students (EAS) and may result in severe distress and suicidality. However, studies on RRDs in youth are limited to mental health sequelae of depression and prolonged grief. Little is known about the association between RRDs and posttraumatic stress symptoms (PTSS), and how this compares to posttraumatic stress symptoms following a traumatogenic event.Objective: We aimed to determine the association between RRDs and PTSS in an EAS sample; and how this compared to the association between posttraumatic stress symptoms and a Diagnostic and Statistical Manual 5th edition (DSM-5) traumatic event.Method: University students (N = 2,022; female = 71.1%; 18-25 years) completed a demographic and relationship questionnaire, the Life Events Checklist, the Adverse Childhood Experiences questionnaire, and the Posttraumatic Stress Checklist (PCL). We compared EAS with an RRD (n = 886) or a DSM-5 criterion A traumatic event (n = 592) against a control group (n = 544) exposed to a non-traumatic stressful life event. Utilising ANOVAs and Pearson's correlations we determined demographic and clinical variables associated with PTSS. ANCOVA and stepwise hierarchical regression analyses were used to determine between-group differences in PTSS.Results: Total trauma exposure and adverse childhood experiences, sex, monthly income, sexual orientation, and attachment style were significantly associated with PTSS. The RRD group had significantly higher PCL scores compared to the DSM and control groups. The mean PCL scores for both the RRD and DSM groups were above the cut-off score of 33, consistent with a probable posttraumatic stress disorder diagnosis. Significantly more RRD participants (72.9%) scored above the cut-off score of 33 than DSM-5 Trauma Group participants (55.4%).Conclusion: An RRD is a potentially traumatic event and is significantly associated with PTSS, similar to a posttraumatic stress disorder diagnosis.

Students may experience non-marital romantic relationship breakups as very painful, with various negative psychological, physical, and academic consequences. However, their painful experiences are often trivialised as something to 'just get over' and not acknowledged as potentially traumatic. Yet, using an attachment theory framework, breakups can be reconceptualised as subjectively traumatic.We explored the differences in posttraumatic stress symptoms of students who experienced a breakup, a traumatic event (as defined in psychiatry), and other non-traumatic life events. Students who experienced a breakup reported significantly highly posttraumatic stress symptoms.Acknowledging students' pain following a self-defined traumatic breakup can increase help-seeking behaviour and reduce the risk of intergenerational attachment trauma. Our findings warrant further research of breakups as potentially traumatogenic events.

Epidemiología de la COVID-19 entre el personal de centros sanitarios y sociosanitarios del área sanitaria de A Coruña y Cee / COVID-19 epidemiology in health and social health workers in the health area of A Coruña and Cee

Objetivo Desde el comienzo de la pandemia ha sido necesario conocer la evolución epidemiológica del SARS-CoV-2. Es por ello que el objetivo de este estudio fue describir las características de la casuística de la COVID-19 en el personal de centros sanitarios y sociosanitarios del área sanitaria de A Coruña y Cee durante la primera ola epidémica, así como determinar la asociación entre el cuadro clínico y/o la duración del mismo y la condición de repositivizar la RT-PCR. Material y métodos En el periodo de estudio se diagnosticaron 210 casos de COVID-19 entre el personal sanitario y sociosanitario del área sanitaria de A Coruña y Cee. Se llevó a cabo un análisis descriptivo de los factores sociodemográficos, así como la búsqueda de asociación entre el cuadro clínico y la duración de la detección de una RT-PCR positiva. Resultados Las categorías profesionales más afectadas fueron enfermería (33,3%) y auxiliares de enfermería (16,2%). El tiempo medio que los casos tardaron en negativizar la RT-PCR fue de 18,3±9,1 días, con una mediana de 17 días. Se observó que 26 casos (13,8%) volvían a obtener un resultado positivo en alguna RT-PCR posterior, sin cumplir criterios de reinfección. La existencia de manifestaciones cutáneas y artralgias se asoció con la repositivización tras ajustar por edad y sexo (OR=4,6 y OR=6,5; respectivamente). Conclusiones En los profesionales sanitarios diagnosticados con COVID-19 durante la primera ola, los síntomas disnea, manifestaciones cutáneas y artralgias determinaron la repositivización de la RT-PCR tras un resultado negativo previo y sin cumplir criterios de reinfección (AU)

Objective Since the beginning of the pandemic, it has become necessary to know the epidemiological evolution of SARS-CoV-2. Therefore, this study aims to describe the characteristics of the casuistry of COVID-19 in health and social-health workers in the health area of A Coruña and Cee during the first epidemic wave, as well as to determine the association between the clinical profile and/or its duration and the condition of RT-PCR repositivization. Materials and methods During the study period, 210 cases belonging to healthcare and social-healthcare workers from the healthcare area of A Coruña and Cee were diagnosed. A descriptive analysis of sociodemographic factors was carried out, as well as the search for association between the clinical picture and the duration of detection of a positive RT-PCR. Results The most affected categories were nursing (33.3%) and nursing assistants (16.2%). The mean time taken for cases to become RT-PCR negative was 18.3±9.1 days, with a median of 17. It was observed that 26 cases (13.8%) had a positive result in a subsequent RT-PCR, without meeting criteria for reinfection. The existence of skin manifestations and arthralgias was associated with repositivization after adjusting for age and sex (OR=4.6 and OR=6.5, respectively). Conclusions In healthcare professionals diagnosed with COVID-19 during the first wave, symptoms such as dyspnea, skin manifestations and arthralgias led to RT-PCR repositivization after a previous negative result and without meeting criteria for reinfection (AU)

Ecologies of violence in urban peripheries during health emergencies / Ecología de violencias en las periferias urbanas durante emergencias sanitarias / Ecologia de violências nas periferias urbanas em tempos de emergências sanitárias

Violence is a health problem and a determinant of health emergencies, with structural dimensions going beyond interpersonal physical aggression. In the present text, we outline the ecologies of violence and relate them to pandemic experiences in a favela of São Paulo city, taking the perspective of One Health of Peripheries. We show how imposed precariousness, exploitation, persecution, territorial expulsions, incarceration practices, and household aggressions harm peripheral subjects and find in health emergencies the possibility of elevating themselves to the condition of a syndemic of violences. This has happened in the Covid-19 pandemic, in recent epidemics, and it is expected to happen in the next health emergency. Through de ecologies of violence, we hope to give more visibility to the entanglement that frustrates prevention and protection efforts in the face of health emergencies. Entanglement between marginalizing apparatuses, modalities of violence, and health emergencies, materialized in multispecies collectives.

La violencia es un problema de salud y un determinante de emergencias sanitarias, con dimensiones estructurales que van más allá de las agresiones físicas interpersonales. En el presente texto esbozamos la ecología de violencias y la relacionamos con vivencias de la pandemia en una favela de la ciudad de São Paulo, bajo la perspectiva de Una Salud de las Periferias. Mostromaos como precariedad impuesta, exploración, persecución, expulsiones territoriales, prácticas de encarcelamiento y agresiones intradomiciliares violentan sujetos periféricos y encuentran en las emergencias sanitarias posibilidades de convertirse en sindemia de violencias. Eso sucedió en la pandemia de Covid-19, en epidemias recientes y se espera que suceda en la próxima emergencia sanitaria. Por medio de la ecología de violencias le damos más visibilidad a la imbricación que frustra tentativas de prevención y protección frente a emergencias sanitarias. Imbricación entre dispositivos marginalizantes, modalidades de violencia e emergencias sanitarias, materializada en colectivos multiespécies.

A violência é um problema de saúde e um determinante das emergências sanitárias, com dimensões estruturais que vão além das agressões físicas interpessoais. No presente texto esboçamos a noção de ecologia de violências e a relacionamos com vivências da pandemia em uma favela paulistana, na perspectiva da Saúde Única em Periferias. Mostramos como marginalização, precariedade imposta, exploração, perseguição, expulsões territoriais, práticas de encarceramento e agressões no ambiente domiciliar violentam sujeitos periféricos e encontram nas emergências sanitárias possibilidades de se elevar à condição de sindemia de violências. Isso aconteceu na pandemia de Covid-19, em epidemias anteriores, e espera-se que aconteça na próxima emergência sanitária. Por meio da ecologia de violência damos mais visibilidade à imbricação que frustra tentativas de prevenção e proteção frente a emergências sanitárias. Imbricação entre dispositivos marginalizantes, modalidades de violência e emergências sanitárias, materializada em coletivos multiespécies.

[COVID-19 epidemiology in health and social health workers in the health area of A Coruña and Cee]. / Epidemiología de la COVID-19 entre el personal de centros sanitarios y sociosanitarios del área sanitaria de A Coruña y Cee.

OBJECTIVE: Since the beginning of the pandemic, it has become necessary to know the epidemiological evolution of SARS-CoV-2. Therefore, this study aims to describe the characteristics of the casuistry of COVID-19 in health and social-health workers in the health area of A Coruña and Cee during the first epidemic wave, as well as to determine the association between the clinical profile and/or its duration and the condition of RT-PCR repositivization. MATERIALS AND METHODS: During the study period, 210 cases belonging to healthcare and social-healthcare workers from the healthcare area of A Coruña and Cee were diagnosed. A descriptive analysis of sociodemographic factors was carried out, as well as the search for association between the clinical picture and the duration of detection of a positive RT-PCR. RESULTS: The most affected categories were nursing (33.3%) and nursing assistants (16.2%). The mean time taken for cases to become RT-PCR negative was 18.3±9.1 days, with a median of 17. It was observed that 26 cases (13.8%) had a positive result in a subsequent RT-PCR, without meeting criteria for reinfection. The existence of skin manifestations and arthralgias was associated with repositivization after adjusting for age and sex (OR=4.6 and OR=6.5, respectively). CONCLUSIONS: In healthcare professionals diagnosed with COVID-19 during the first wave, symptoms such as dyspnea, skin manifestations and arthralgias led to RT-PCR repositivization after a previous negative result and without meeting criteria for reinfection.

Presencia de Oligoryzomys microtis (Rodentia) en hábitats silvestres en Bolivia / Presence of Oligoryzomys microtis (Rodentia) in wild habitats in Bolivia

Rodents are very important organisms within ecosystems; however, some species are considered pests because they consume and damage crops and because they are vectors, hosts, or reservoirs in the transmission of emerging infectious diseases. Rodents in Bolivia are represented by 148 species, Oligoryzomys microtis (Allen, 1916) being a species of public health importance because it is considered a potential natural reservoir of the Chapare virus, which causes Chapare Hemorrhagic Fever, and it is a deadly disease for humans. Its impact on public health is still unknown. The present study consisted of recording the presence of the species O. microtis through the use of Sherman-type live capture traps for small mammals arranged in linear transects in the wild and intervened habitats of the Samuzabety community, where the Chapare virus was detected for the first time, this community is located in the Chapare Province of the department of Cochabamba, Bolivia. The species recorded were the rodents Oligoryzomys microtis (morphotype matogrossae), Proechimys brevicauda, Neacomys vargasllosai, Hylaeamys perenensis, and the marsupial Metachiurus nudicaudatus. The presence of the species O. microtis (morphotype matogrossae) in the community of Samuzabety is confirmed. This species is associated with forest habitats with nearby and surrounding crops. The species O. microtis has epidemiological relevance as it is the natural reservoir of the Río Mamoré Hantavirus and is currently considered a potential reservoir of the Chapare virus and other Arenaviruses.

Los roedores son organismos muy importantes dentro de los ecosistemas; sin embargo, algunas especies son consideradas como plagas porque consumen y dañan cultivos y porque son vectores, hospederos o reservorios en la trasmisión de enfermedades infecciosas emergentes. Los roedores en Bolivia están representados por 148 especies, entre las cuales Oligoryzomys microtis (Allen, 1916) es una especie de importancia en salud pública, debido a que es considerada como potencial reservorio natural del virus Chapare, el cual produce la fiebre hemorrágica Chapare, enfermedad mortal para el ser humano y con un impacto en la salud pública aún desconocido. En este estudio se registró la presencia de la especie O. microtis?/i>, mediante el uso de trampas de captura viva tipo Sherman para pequeños mamíferos dispuestas en transectos lineales, en los hábitats silvestres e intervenidos de la comunidad de Samuzabety, sitio en el que se detectó por primera vez el virus Chapare. Esta comunidad se encuentra ubicada en la Provincia Chapare del departamento de Cochabamba, Bolivia. Las especies registradas fueron los roedores Oligoryzomys microtis (morfotipo matogrossae), Proechimys brevicauda, Neacomys vargasllosai, Hylaeamys perenensis y el marsupial Metachiurus nudicaudatus. Se confirma la presencia de la especie O. microtis (morfotipo matogrossae) en la comunidad de Samuzabety, la cual se encuentra asociada con hábitats de bosques, con cultivos cercanos y a su alrededor. La especie O. microtis tiene relevancia epidemiológica al ser el reservorio natural del hantavirus Río Mamoré y al ser considerado actualmente como potencial reservorio del virus Chapare y de otros arenavirus.

Estudo descritivo de casos notificados de febre maculosa em São Paulo, Rio de Janeiro e Minas Gerais entre 2007 e 2016 / Descriptive study of reported cases of spotted fever in São Paulo, Rio de Janeiro and Minas Gerais between 2007 and 2016

Resumo Introdução A febre maculosa é uma doença infecciosa aguda causada por bactérias do gênero Rickettsia e transmitida por carrapatos que pode levar à hospitalização e, eventualmente, a óbito por causa de quadros mais graves. Objetivo O objetivo deste artigo foi descrever o cenário epidemiológico da doença nas três unidades federativas de maior número de notificações e óbitos pela doença no Brasil entre 2007 e 2016. Método Estudo epidemiológico descritivo com base nos dados das fichas de investigação para a doença, sendo analisados dados demográficos, geográficos, ambientais e de hospitalização, diagnóstico e desfecho dos casos na área de estudo. Resultados Foram confirmados 953 casos da doença, em sua maioria por critérios laboratoriais, sendo observada maior prevalência entre homens com idade média de 35 anos, pouco relacionados ao ambiente de trabalho, mas amplamente relacionados ao meio urbano. Do total de casos confirmados, 64% pacientes afirmaram ter tido algum contato com carrapato, assim como com cães (36%), capivaras (20%) e equinos (19%). Conclusão Existem questionamentos a respeito da doença que não foram elucidados neste artigo, entretanto abordagens criativas, validadas e ancoradas na associação de áreas de conhecimento distintas poderão dar bons resultados se objetivamente aplicadas em ações estratégicas da gestão da saúde.

Abstract Background Spotted fever is an acute infectious disease caused by bacteria of the genus Rickettsia and transmitted by ticks, which can lead to hospitalization and, eventually, death due to more severe conditions. Objective The purpose of this article was to describe the epidemiological scenario of the disease in the three federal states with the highest number of notifications and deaths due to the disease in Brazil between 2007 and 2016. Method A descriptive epidemiological study was carried out based on data from the investigation forms for the disease, with data being analyzed on demographic, geographic, environmental, and hospitalization, diagnosis, and outcome of cases in the study area. Results 953 cases of the disease were confirmed, mostly by laboratory criteria, with a higher prevalence being observed among men with an average age of 35 years, little related to the work environment, but largely related to the urban environment. Of the total confirmed cases, 64% of patients said that they had had some contact with ticks, as well as with dogs (36%), capybaras (20%), and horses (19%). Conclusion We believe that there are questions about the disease that were not elucidated in this article, however, creative approaches, validated and anchored in the association of different areas of knowledge can give good results if objectively applied in strategic health management actions.

Reverse-Transcription Loop-Mediated Isothermal Amplification and alternative protocols for lower cost, large-scale COVID-19 testing: lessons from an emerging economy / Amplificación isotérmica mediada por bucle de transcripción inversa y protocolos alternativos para pruebas COVID-19 a gran escala y de bajo costo: lecciones de una economía emergente

Abstract Introduction: Most successful cases of COVID-19 pandemic mitigation and handling have relied on extensive reverse-transcription quantitative polymerase chain reaction (RT-qPCR). However, many emerging economies have struggled with current molecular testing demands due to economic, technical and technological constraints. Objective: To define a potential diagnostic protocol to increase testing capacity in current and post-pandemic conditions. Methods: We reviewed the literature, patents and commercial applications, for alternatives. Results: We found a good potential in saliva samples, viral inactivation and quick RNA extraction by heating; the use of an isothermal technology such as loop mediated isothermal amplification (LAMP) and naked eye test-result visualization by in-tube colorimetry or turbidity. Conclusions: Saliva samples with quick RNA extraction by heating and colorimetric LAMP are promising options for countries with economic and infrastructure limitations.

Resumen Introducción: La mayoría de los casos exitosos de mitigación y manejo de la pandemia de COVID-19 se han dado mediante pruebas basadas en la reacción en cadena de la polimerasa cuantitativa (RT-qPCR por sus siglas en inglés). Sin embargo, muchas economías emergentes han tenido problemas con las demandas actuales de pruebas moleculares debido a limitaciones económicas, técnicas y tecnológicas. Objetivo: Definir un protocolo de diagnóstico potencial para aumentar la capacidad de prueba en las condiciones actuales y posteriores a la pandemia. Métodos: Revisamos la literatura, las patentes y las aplicaciones comerciales, en busca de alternativas. Resultados: Encontramos un buen potencial en muestras de saliva, inactivación viral y extracción rápida de ARN por calentamiento; el uso de una tecnología isotérmica como la amplificación isotérmica mediada por horquillas (LAMP, por sus siglas en inglés) y la visualización del resultado de la prueba a simple vista mediante colorimetría o turbidez en el tubo. Conclusiones: Las muestras de saliva con extracción rápida de ARN por calentamiento y LAMP colorimétrico son opciones prometedoras para países con limitaciones económicas y de infraestructura.

Viruela símica: zoonosis emergente con impacto global / Monkeypox: emerging zoonosis with unprecedentedglobal impact

El virus de la viruela símica es un orthopoxvirus de características zoonóticas endémico en las regiones de África Central y África Occidental, donde causa brotes desde 1970. En las últimas décadas se registró un aumento exponencial de casos, probablemente asociado a la disminución en la inmunidad conferida por la vacuna antivariólica, discontinuada luego de la erradicación de la viruela. En los últimos años se registraron casos esporádicos fuera del continente africano, siempre relacionados epidemiológicamente a la permanencia en áreas endémicas o contacto con animales infectados. Desde el 13 de mayo de 2022 se encuentra en curso el mayor brote de viruela símica registrado fuera de las áreas endémicas de África, con casos en los cinco continentes. La extensión, el impacto y la duración del brote permanecen aún inciertos.

Monkeypox virus is an orthopoxvirus with zoonotic characteristics endemic in Central and West Africa regions, where it has caused outbreaks since 1970. An exponential increase in cases has been registered in the last decades, probably associated with a decrease in the immunity conferred by the smallpox vaccine, discontinued after smallpox eradication. In recent years, sporadic cases have been reported outside the African continent, always epidemiologically related to permanence in endemic areas or contact with infected animals. Since May 13, 2022, the largest monkeypox outbreak ever reported outside Africa endemic areas, with cases on the five continents, is unfolding. The extent, impact and duration of this outbreak still remain uncertain

Possible Trichosporon asahii urinary tract infection in a critically ill COVID-19 patient.

BACKGROUND: Trichosporon asahii, an emerging fungal pathogen, has been frequently associated with invasive infections in critically ill patients. CASE REPORT: A 74-year-old male patient diagnosed with COVID-19 was admitted to an Intensive Care Unit (ICU). During hospitalization, the patient displayed episodes of bacteremia by Staphylococcus haemolyticus and a possible urinary tract infection by T. asahii. While the bacterial infection was successfully treated using broad-spectrum antibiotics, the fungal infection in the urinary tract was unsuccessfully treated with anidulafungin and persisted until the patient died. CONCLUSIONS: With the evolving COVID-19 pandemic, invasive fungal infections have been increasingly reported, mainly after taking immunosuppressant drugs associated with long-term broad-spectrum antibiotic therapy. Although Candida and Aspergillus are still the most prevalent invasive fungi, T. asahii and other agents have emerged in critically ill patients. Therefore, a proper surveillance and diagnosing any fungal infection are paramount, particularly in COVID-19 immunocompromised populations.

Comprensiones alrededor del concepto de tránsito a la vida adulta y su relación con la autonomía desde el paradigma sistémico / Understandings Around the Concept of Transition to Adulthood and its Relationship with Autonomy From the Systemic Paradigm

Resumen El presente artículo parte de la importancia que el tránsito a la vida adulta ha adquirido a lo largo del tiempo, por ser un tema de reflexión y de múltiples estudios para conocer cómo las condiciones de hoy en día permiten este proceso en los jóvenes. Este artículo es un estudio cualitativo de revisión sistemática y tuvo como objetivo describir el tránsito a la adultez desde dos perspectivas. La primera, una construcción por medio de investigaciones realizadas por varios autores, los cuales encontraron que la transición a la adultez está mediada por aspectos como la autonomía, los nuevos roles, las expectativas individuales, las demandas, entre otras. Y la segunda, una visión anclada a paradigmas emergentes y el enfoque sistémico, que plantean que el tránsito a la vida adulta se ve permeado por elementos como la desvinculación, la individuación y las dinámicas familiares. La revisión permitió concluir que las condiciones familiares y sociales en las que se desarrolla el individuo son determinantes en su tránsito a la vida adulta, favoreciendo o dificultando este proceso.

Abstract This article is based on the importance that the transition to adulthood has had over time, as it is a subject of reflection and multiple studies that aim to understand how the current conditions allow this process in young people. This is a qualitative study of systematic review and its objective is to describe the transition to adulthood from two perspectives. The first, a construction through research conducted by different authors, who found that the transition to adulthood is mediated by aspects such as autonomy, new roles, individual expectations, and demands, among others. The second one, a vision anchored to emerging paradigms and the systemic approach, which suggests that the transition to adulthood is influenced by elements such as decoupling, individuation, and family dynamics. The review made it possible to conclude that the social and family conditions in which the individual develops are determining factors in his/her transition to adulthood, either favoring or hindering this process.

Pediatric hospitalization due to COVID-19: experience in a regional hospital.

BACKGROUND: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is usually mild in children, although it can become severe in some cases. Initially, doubts arose due to vertical perinatal transmission in infected mothers. Therefore, the first recommendations were very restrictive, suggesting mother-newborn separation. This study aimed to describe the clinical behavior of newborns born to mothers with SARS-CoV-2 infection and of children admitted to hospital due to COVID-19 (coronavirus-2 disease). METHODS: We conducted a retrospective descriptive study of pediatric patients hospitalized between May 1, 2020, and April 30, 2021. RESULTS: We included 19 patients: 47.4% were neonates born to mothers infected with SARS-CoV-2 (1.63% of deliveries), and 52.6% were pediatric patients aged 2 months to 12 years with confirmed COVID-19 infection (3.43% of all pediatric admissions). All patients presented mild symptomatology and remained isolated with a family member in the room. Vertical transmission was not found, although a positivity rate of 88.89% was detected in fathers. CONCLUSIONS: Pediatric admissions for COVID-19 did not represent an overload of care. No patient developed complications or required specific treatment. The incidence of COVID-19 deliveries was low, and vertical perinatal transmission was not observed. Admission with a companion facilitated pediatric care, which was favorable for the patient and the healthcare staff.

INTRODUCCIÓN: La infección por SARS-CoV-2 (coronavirus tipo 2 del síndrome respiratorio agudo grave) es habitualmente leve en niños, aunque llega a evolucionar de forma grave en algunos casos. Inicialmente surgieron dudas por la transmisión perinatal vertical en madres infectadas, por lo que las primeras recomendaciones fueron muy restrictivas, ya que sugerían la separación madre-hijo. El objetivo de este estudio fue describir el comportamiento clínico de los recién nacidos de madres con infección por SARS-CoV-2 y de los niños ingresados al hospital por COVID-19 (enfermedad por coronavirus 2). MÉTODOS: Se llevó a cabo un estudio descriptivo retrospectivo de pacientes pediátricos hospitalizados entre el 1 de mayo de 2020 y el 30 de abril de 2021. RESULTADOS: Se incluyeron 19 pacientes: el 47.4% eran neonatos hijos de madres infectadas con SARS-CoV-2 (1.63% de los partos) y el 52.6%, pacientes pediátricos de entre 2 meses y 12 años de edad con COVID-19 (3.43% de los ingresos pediátricos). Todos los pacientes presentaron sintomatología leve y permanecieron aislados en la habitación con un familiar. No se constató la transmisión vertical, aunque se detectó una tasa de positividad en el padre del 88.89. CONCLUSIONES: Los ingresos pediátricos por COVID-19 no supusieron sobrecarga asistencial. Ningún paciente desarrolló complicaciones ni precisó tratamiento específico. La incidencia de partos COVID-19 fue baja y no se constató la transmisión vertical. El ingreso con un acompañante facilitó los cuidados pediátricos, lo que resultó favorable para el paciente y para el personal del servicio.

Schreber: an approach to soul androgyny.

Nowadays Jungian analysts are invited to understand what has been presenting as new emerging sexualities. Although we cannot find a theory of homosexuality in Jung's work, we will find references to this issue in clinical situations, interpretation of dreams, as well as his theory of anima and animus. Jung's theoretical perspective distinguishes sex and gender, anticipating contemporary gender issues and making the approach to the psyche even more complex. Jung was ahead of his time. Contemporary authors present critical reflection on the bases of innatism or culturalism as expressions of new sexualities. The paper present fragments of clinical situations and images, for a reflection on coniunctio of opposites, with their telos and psychic force, in the direction of soul androgyny. It presents a Jungian contribution to Memoirs of My Nervous Illness by Daniel Paul Schreber. Freud's Schreber Case, with his psychopathological interpretation related to paranoia and homosexuality, seems reductive and contrasts with the Jungian approach that introduces a synthetic-hermeneutic analysis.

De nos jours les analystes Jungiens sont invités à comprendre ce qui est présenté comme des sexualités émergentes. Bien que nous ne puissions pas trouver dans le travail de Jung une théorie de l'homosexualité, nous trouvons des références à cette question dans des situations cliniques, l'interprétation des rêves, ainsi que dans sa théorie de l'anima et de l'animus. La perspective théorique de Jung différencie le sexe et le genre, ce qui anticipe les questions contemporaines concernant le genre. Cela donne une approche de la psyché encore plus complexe. Jung était en avance sur son temps. Les auteurs contemporains présentent une réflexion critique sur la base de l'innéisme ou du culturalisme en tant qu'expressions de nouvelles sexualités. Cet article présente des extraits de situations cliniques, des images, pour une réflexion sur le coniunctio des opposés, avec leur télos et leur force psychique, dans la direction de l'androgynie de l'âme. Il offre une contribution Jungienne aux « Mémoires d'un névropathe ¼ de Daniel Paul Schreber. Le cas Schreber de Freud - avec son interprétation psychopathologique en lien avec la paranoïa et l'homosexualité - semble réductive et en contraste avec l'approche Jungienne qui introduit une analyse herméneutique et synthétique.

En la actualidad analistas Junguianos están siendo invitados a comprender aquello que se presenta como las nuevas sexualidades. Si bien, no encontramos una teoría acerca de la homosexualidad en la obra de Jung, encontraremos referencias, a esta temática en situaciones clínicas, interpretaciones de sueños, así como también em su teoría sobre anima y animus. La perspectiva teórica de Jung distingue sexo y género, anticipando cuestiones contemporáneas de género y haciendo aún más complejo el acercamiento a la psique. Jung se anticipó a su tiempo. Autores contemporáneos ofrecen reflexiones críticas acerca del innatismo o culturalismo como expresiones de las nuevas sexualidades. El trabajo presenta fragmentos de situaciones clínicas, imágenes, para una reflexión sobre la coniunctio de opuestos, con su telos y fuerza psíquica en la dirección del alma andrógina. Presenta una contribución Junguiana a 'Memorias de Mi Enfermedad Nerviosa' de Daniel Paul Schreber. El caso Schreber de Freud, con su interpretación psicopatológica relacionada con la paranoia y la homosexualidad, parece reductiva y contrasta con la aproximación Junguiana que introduce un análisis sintético-hermenéutico.

Hoje em dia, analistas junguianos são convidados a entender o que vem se apresentando como novas sexualidades emergentes. Embora não possamos encontrar uma teoria da homossexualidade na obra de Jung, encontraremos referências a essa questão em situações clínicas, em interpretações de sonhos, bem como em sua teoria de anima e animus. A perspectiva teórica de Jung distingue sexo e gênero, antecipando questões contemporâneas de gênero e tornando a abordagem da psique ainda mais complexa. Jung estava à frente de seu tempo. Autores contemporâneos apresentam uma reflexão crítica sobre as bases do inatismo ou do culturalismo como expressões de novas sexualidades. O artigo apresenta fragmentos de situações clínicas, imagens, para uma reflexão sobre coniunctio de opostos, com seu telos e força psíquica, na direção da androginia da alma. Apresenta uma contribuição junguiana para Memórias da Minha Doença Nervosa de Daniel Paul Schreber. O Caso Schreber de Freud, com sua interpretação psicopatológica relacionada à paranóia e homossexualidade, parece redutor e contrasta com a abordagem junguiana que introduz uma análise sintético-hermenêutica.

Abordaje farmacológico del dolor neuropático: pasado, presente y futuro / Pharmacological approach to neuropathic pain: past, present and future

Introducción: El dolor neuropático (DN) es difícil de tratar debido a la heterogeneidad de causas, síntomas y mecanismos subyacentes. Constituye una gran necesidad médica que no está cubierta y cuenta con un número elevado de fracasos terapéuticos en ensayos clínicos aleatorizados recientes. Desarrollo: En esta revisión narrativa se presenta una actualización sobre el tratamiento farmacológico del DN con énfasis en las nuevas guías clínicas publicadas, los nuevos fármacos en desarrollo y los nuevos retos que se presentan en el manejo terapéutico de esta entidad. Conclusiones: Los fármacos propuestos como primera línea incluyen antidepresivos tricíclicos (particularmente amitriptilina), inhibidores de la recaptación de la serotonina y la noradrenalina (particularmente duloxetina), pregabalina y gabapentina. Sin embargo, las últimas recomendaciones siguen siendo relevantes y los estudios clínicos más recientes incluso cuestionan el papel de la pregabalina como tratamiento de primera línea. Por tanto, consideramos necesarias las actualizaciones periódicas de las guías clínicas en DN para guiar mejor nuestra práctica clínica diaria y racionalizar el uso de todas las opciones terapéuticas disponibles. Por otro lado, la expansión del conocimiento en DN ha generado una serie de desafíos, como el desarrollo de nuevos fármacos basados en mecanismos fisiopatológicos investigados en animales y el desarrollo de planteamientos terapéuticos óptimos en ensayos clínicos, más basados en enfoques personalizados que etiológicos.(AU)

Introduction: Neuropathic pain (NP) is difficult to treat due to the heterogeneity of causes, symptoms and underlying mechanisms. It constitutes a great medical need that is not covered, and has a high number of therapeutic failures in recent randomized clinical trials. Development: This narrative review presents an update on the pharmacological treatment of NP with emphasis on the new published clinical guidelines, new drugs in development, and the new challenges that arise in the therapeutic management of this entity. Conclusions: First-line drugs proposed include tricyclic antidepressants (particularly amitriptyline), serotonin and norepinephrine reuptake inhibitors (particularly duloxetine), pregabalin, and gabapentin. However, the latest recommendations are still relevant and the most recent clinical studies even question the role of pregabalin as a first-line treatment. Therefore, we consider that periodic updates of the clinical guidelines in NP are necessary to better guide our daily clinical practice and rationalize the use of all available therapeutic options. Furthermore, the expansion of knowledge in NP has generated a series of challenges, such as the development of new drugs based on pathophysiological mechanisms investigated in animals, and the development of optimal therapeutic approaches in clinical trials, based more on personalized than etiological approaches.(AU)

Possible Trichosporon asahii urinary tract infection in a critically ill COVID-19 patient

Background:Trichosporon asahii, an emerging fungal pathogen, has been frequently associated with invasive infections in critically ill patients.Case report:A 74-year-old male patient diagnosed with COVID-19 was admitted to an Intensive Care Unit (ICU). During hospitalization, the patient displayed episodes of bacteremia by Staphylococcus haemolyticus and a possible urinary tract infection by T. asahii. While the bacterial infection was successfully treated using broad-spectrum antibiotics, the fungal infection in the urinary tract was unsuccessfully treated with anidulafungin and persisted until the patient died.Conclusions:With the evolving COVID-19 pandemic, invasive fungal infections have been increasingly reported, mainly after taking immunosuppressant drugs associated with long-term broad-spectrum antibiotic therapy. Although Candida and Aspergillus are still the most prevalent invasive fungi, T. asahii and other agents have emerged in critically ill patients. Therefore, a proper surveillance and diagnosing any fungal infection are paramount, particularly in COVID-19 immunocompromised populations. (AU)

Antecedentes:Trichosporon asahii, un hongo patógeno emergente, se ha asociado con frecuencia con infecciones invasivas en pacientes enfermos en estado crítico.Caso clínico:Un paciente de sexo masculino de 74 años de edad, con diagnóstico positivo para la COVID-19, ingresó en una unidad de cuidados intensivos. Durante la hospitalización el paciente presentó episodios de bacteriemia por Staphylococcus haemolyticus y una posible infección del tracto urinario por T. asahii. Mientras la infección bacteriana fue tratada exitosamente con antibióticos de amplio espectro, la infección micótica urinaria no remitió con anidulafungina y persistió hasta la muerte del paciente.Conclusiones:Con la pandemia de la COVID-19 se han notificado cada vez más casos de infecciones micóticas invasivas, principalmente después del uso de fármacos inmunosupresores, asociados con terapia de antibióticos de amplio espectro. Aunque Candida y Aspergillus siguen siendo los hongos invasores más prevalentes, T.asahii y otras especies han emergido en pacientes enfermos en estado crítico. Por lo tanto, la vigilancia y el diagnóstico de las infecciones micóticas es primordial, particularmente en poblaciones inmunodeficientes por la COVID-19. (AU)

Factores emocionales que median la relación entre inteligencia emocional y problemas psicológicos en adultos emergentes / [Emotional factors that mediate the relationship between emotional intelligence and psychological problems in emerging adults]

En las últimas décadas han aumentado las tasas de depresión y ansiedad en adultos emergentes en comparación con otros grupos de edad. El objetivo del estudio fue examinar la relación entre inteligencia emocional y problemas psicológicos, teniendo en cuenta el rol mediador de los factores emocionales como empatía, autoestima y felicidad. Participaron 399 jóvenes adultos (M= 20,38; DT= 2,46; 76,9% mujeres) que completaron un dosier de evaluación que incluía medidas de inteligencia emocional, empatía, autoestima, felicidad, síntomas emocionales y quejas somáticas. Se estimó un modelo de ecuaciones estructurales (SEM) con análisis de mediación. La inteligencia emocional se asoció positivamente con felicidad, empatía y autoestima y negativamente con ansiedad, depresión, estrés y quejas somáticas. La felicidad fue la variable mediadora más relevante en la relación entre inteligencia emocional y síntomas emocionales. Estos resultados ponen de manifiesto la necesidad de promover el desarrollo de las habilidades emocionales en los adultos emergentes, lo que fomenta un estado de ánimo feliz y una buena salud mental.

In the last decades, the rates of depression and anxiety in emerging adults have increased compared to other age groups. The aim of the study was to examine the relationship between emotional intelligence and psychological problems, considering the mediating role of emotional factors such as empathy, self-esteem and happiness. The participants were 399 young adults (M= 20.38, SD= 2.46, 76.9% women) who completed an assessment dossier that included measures of emotional intelligence, empathy, self-esteem, happiness, emotional symptoms and somatic complaints. A cross-sectional design with self-report data was used and structural equation modeling (SEM) with mediation analysis was performed. Emotional intelligence was positively associated with happiness, empathy and self-esteem, and negatively with anxiety, depression, stress and somatic complaints. Happiness was the most relevant mediator in the relationship between emotional intelligence and emotional symptoms. These results stress the need to promote the development of emotional abilities in emerging adults, which fosters happiness and good mental health.

The threat of mosquito-borne arboviral disease in Spain: A bibliographic review / La amenaza de las arbovirosis transmitidas por mosquitos: revisión bibliográfica

Over the last two decades there has been an increase in outbreaks of arboviral diseases, being Spain at high risk for disease emergence. This paper reviews the current evidence regarding the transmissibility, disease epidemiology, control strategies and mosquito-borne disease drivers and maintaining factors in Spain. There is risk of autochthonous cases and outbreaks in Spain due to recent transmission occurrence. Recently, there has been an expansion of Aedes Albopticus, a vector for Dengue, Zika and Chikungunya; and Cullex spp., vector for West Nile Virus, already endemic in Spain. Their establishment has been facilitated by climate and environmental drivers. If climate change projections are to be met, an increase in disease transmission is to be expected, as well as the re-establishment of other vectors such as Aedes Aegypti. Our review supports the need to understand the threat of these emerging diseases and implement preventive strategies in order to minimise their impact. (AU)

En las últimas dos décadas se ha producido un incremento de las epidemias provocadas por arbovirus. El objetivo de esta revisión es describir las circunstancias que permiten la transmisión de arbovirus en España, así como actualizar la epidemiología de estas enfermedades, sus estrategias de control, y profundizar en el conocimiento de los factores que impulsan su aparición. En España existe un elevado riesgo de aparición de casos autóctonos y de brotes epidémicos. Recientemente, se ha producido una expansión del mosquito Aedes albopticus, vector competente para Dengue, Zika y Chikungunya, así como de Cullex spp., vector del virus del Nilo Occidental, ya considerado endémico en España. Las condiciones climáticas y ambientales han permitido el establecimiento de estos mosquitos y, si se cumplen las proyecciones de cambio climático, podemos esperar un incremento del riesgo de transmisión arboviral, así como la reaparición de Aedes aegypti. Esta revisión apoya la necesidad de asumir la amenaza que suponen estas enfermedades emergentes e implementar las medidas necesarias para minimizar su impacto. (AU)