Análisis Biomecánico de una Prótesis de Cadera mediante Elementos Finitos / Biomechanical Analysis of a Hip Prosthesis Using a Finite Element

Resumen En el presente trabajo se plantea un análisis biomecánico de una prótesis de cadera bajo condiciones de cargas estáticas asociadas a actividades cotidianas, en el cual se comparan tres materiales metálicos para la fabricación de una prótesis personalizada a partir de imágenes médicas. Se utilizaron plataformas en la nube de diseño asistido por computadora y de análisis por elementos finitos. Se diseñaron dos modelos de la prótesis a analizar, uno hueco y otro sólido mediante curvas spline paramétricas. Para el análisis biomecánico se requirió un tamaño de malla de 2,537,684 de elementos tetraédricos y 471,335 nodos para estudiar siete casos de posturas para una persona de 75 kg de peso, mismos que se analizaron tomando como materiales base acero inoxidable 316L, aleación Ti-6AL-4V y L-605. Se observó que con actividades tales como trotar, subir y bajar escaleras los materiales 316L y L-605, presentan el riesgo de deformación plástica e inclusive fractura. Los resultados mostraron que el material más idóneo para la fabricación de este tipo de prótesis es el Ti-6Al-4V, además de que este nos permite realizar modelos tanto sólidos como huecos, suponiendo este último, un ahorro de material y proporcionando mayor ligereza en la prótesis.

Abstract This paper shows a biomechanical analysis of a hip prosthesis under conditions of static loads associated with daily activities. For which it compared three metallic materials for the manufacture of a customized prosthesis from medical images, it was used cloud platforms with computer-aided design and finite element analysis. Two models of prosthesis one hollow and the other one solid using parametric spline curves were designed and analyzed. The biomechanical analysis required a mesh size consisting of 2,537,684 tetrahedral elements and 471,335 nodes to study seven cases of postures for a person weighing 75 kg. These cases were analyzed based on 316L stainless steel, Ti-6AL-4V alloy, and another L-605 alloy. It was observed that with activities such as jogging, climbing and descending stairs, materials 316L, and L-605 present the risk of plastic deformation and even fracture. The results show that the most suitable material for the manufacture of this type of prosthesis is the Ti-6Al-4V, which allows us to make both solid and hollow models. Assuming this last material is saved and improves the prosthesis lightness.

Mumps epidemiology in Cuba between 2004 and 2015.

Vaccination with the measles, mumps and rubella vaccine decreased the mumps incidence in Cuba, but in 2006 and 2007 an outbreak with more than 1000 laboratory confirmed cases occurred, mainly among high school and university students. The objective of the study was to investigate mumps epidemiology in Cuba between 2004 and 2015 and provide an in-depth laboratory characterization of selected samples from mumps patients. Samples from 116 cases (throat swabs, urines, paired acute and convalescent serum samples) were tested for mumps-specific IgM antibodies by ELISA, in a hemagglutination inhibition assay (HIA) or by RT-PCR. IgM antibodies were found in 80.2% of cases. 48.3% of first sera were positive, 30 of which were collected within two days after symptom onset. Testing of all 116 paired sera by HIA showed seroconversion in 55.2% individuals and an at least fourfold increase in antibodies in 44.8% of cases. In 18 out of the 111 vaccinated people (16.2%) no IgM antibodies were detected, neither in the acute nor the convalescent sera, but 14 of them showed seroconversion by HIA and 4 had an at least fourfold increase of hemagglutinin antibody titers. In the RT-PCR, 23 acute phase sera, 4 throat swabs and 5 urines were positive. Detection of mumps-specific IgM antibodies by ELISA and additional diagnostic methods may be required in settings with high vaccination coverage rates.

Cuba's Scientific Contributions to Global Polio Eradication.

Cuba eliminated polio in 1962 and was among the first countries to do so. Since then, only 20 cases of vaccine-derived paralytic poliomyelitis have been reported. Because Cuba used oral poliovirus vaccine exclusively in two mass campaigns usually in February and April each year, Sabin viruses were detected only within approximately 6-8 weeks after each annual campaign. This made Cuba a very attractive site to study the epidemiology of poliomyelitis in a tropical country without risk of secondary transmission of Sabin viruses for a large part of each year, an advantage over countries that used oral poliovirus vaccine continuously throughout the year in routine immunization programs. This report summarizes the unique scientific collaboration between Cuba's Ministry of Public Health and WHO, with participation by US scientists, in the global effort to eradicate polio. KEYWORDS Poliomyelitis, disease eradication, disease elimination, oral poliovirus vaccine, Sabin vaccine, inactivated poliovirus vaccine, Salk vaccine, Cuba, WHO.

Effect of the Various Steps in the Processing of Human Milk in the Concentrations of IgA, IgM, and Lactoferrin.

INTRODUCTION: Human milk immune components are unique and important for the development of the newborn. Milk processing at the Human Milk Banks (HMB), however, causes partial destruction of immune proteins. The objective of this study was to determine the effects that heating during the milk processing procedure at the HMB had on the concentrations of IgA, IgM, and lactoferrin at three critical points in time. MATERIALS AND METHODS: Fifty milk samples (150 mL) were collected from voluntary donors at the HMB at the Hospital Nacional Pedro de Bethancourt, located in Antigua Guatemala. Samples from three critical points in time during the milk processing procedure were selected for analysis: freezing/thawing I, freezing/thawing II, and pasteurization. IgA, IgM, and lactoferrin concentrations were determined during each critical point and compared with a baseline concentration. RESULTS: After milk processing, IgA, IgM, and lactoferrin mean concentrations were reduced by 30.0%, 36.0%, and 70.0%, respectively (p < 0.001). Reduction of biological activity was mainly attributed to pasteurization for IgA and lactoferrin (p < 0.001); the first freezing/thawing processes before pasteurization showed no significant reduction difference between mean concentrations of IgA (p = 0.160) and lactoferrin (p = 0.345) but showed a significant effect on IgM concentration (p = 0.016), and the second freezing/thawing procedure only showed a significant effect on IgA (p < 0.001). CONCLUSIONS: The effects of milk processing on the immune proteins that were evaluated in this study demonstrated a significant reduction.

Massive bleaching of coral reefs induced by the 2010 ENSO, Puerto Cabello, Venezuela

El Niño Southern Oscillation (ENSO) has generated global coral massive bleaching. The aim of this work was to evaluate the massive bleaching of coral reefs in Puerto Cabello, Venezuela derived from ENSO 2010. We evaluated the bleaching of reefs at five localities both at three and five meter depth. The coral cover and densities of colonies were estimated. We recorded living coral cover, number and diameter of bleached and nonbleached colonies of each coral species. The colonies were classified according to the proportion of bleached area. Satellite images (Modis Scar) were analyzed for chlorophyll-a concentration and temperature in August, September, October and November from 2008-2010. Precipitation, wind speed and air temperature information was evaluated in meteorological data for 2009 and 2010. A total of 58.3% of colonies, belonging to 11 hexacoral species, were affected and the greatest responses were observed in Colpophyllia natans, Montastraea annularis and Montastraea faveolata. The most affected localities were closer to the mainland and had a bleached proportion up to 62.73±36.55%, with the highest proportion of affected colonies, whereas the farthest locality showed 20.25±14.00% bleached and the smallest proportion. The salinity in situ varied between 30 and 33ppm and high levels of turbidity were observed. According to the satellite images, in 2010 the surface water temperatura reached 31ºC in August, September and October, and resulted higher than those registered in 2008 and 2009. Regionally, chlorophyll values were higher in 2010 than in 2008 and 2009. The meteorological data indicated that precipitation in November 2010 was three times higher than in November 2009. Massive coral bleaching occurred due to a three month period of high temperatures followed by one month of intense ENSO-associated precipitation. However, this latter factor was likely the trigger because of the bleaching gradient observed. Rev. Biol. Trop. 60 (2): 527-538. Epub 2012 June 01.

El Niño ha generado blanqueamientos masivos en todo el mundo. El objetivo del estudio fue evaluar el blanqueamiento masivo de los arrecifes coralinos de Puerto Cabello, Venezuela debido al efecto del ENSO, 2010. En cada arrecife se seleccionaron dos profundidades: tres y cinco metros. Para determinar las concentraciones de clorofila-a y la temperatura en los meses de Agosto a Noviembre 2008 al 2010 se analizaron imágenes de satélite (tipo Modis Scar 1km2 de resolución). La precipitación, la velocidad del viento y la temperatura del aire fueron evaluadas según datos metereológicos del 2009 y 2010. La cobertura coralina y la densidad de colonias fue estimada, se anotó la cobertura de coral vivo de cada especie y el número y diámetro de colonias sanas y con blanqueamiento. Cada colonia fue clasificada según su área con blanqueamiento. Un 58.3% del total de las colonias fueron afectadas, estas pertenecen a 11 especies hexacoralinas. Las localidades con mayor afectación fueron las más cercanas al continente, la cuales presentaron una proporción de blanqueamiento de hasta 62.73±36.55% y un mayor porcentaje de colonias afectadas, mientras que la localidad más lejana presentó un 20.25±14.00% y una menor proporción de colonias afectadas, respectivamente. La salinidad registrada in situ varió entre 30 y 33ppm y se observó un alto nivel de turbidez. Según las imágenes de satélite, en el 2010 se observó una temperatura del agua de hasta 31ºC en los meses de agosto, septiembre y octubre. Los valores de clorofila fueron mayores en 2010 que en 2008 y 2009. Los datos meterorológicos indicaron que los valores de precipitación del 2010 triplicaron los del 2009. El blanqueamiento masivo fue la consecuencia de tres meses de altas temperaturas seguido de un mes de intensas precipitaciones asociadas al ENSO. Sin embargo, este último factor probablemente fue el detonante debido al gradiente observado.

Vaccine-related adverse events in Cuban children, 1999-2008.

INTRODUCTION Cuba has implemented an effective National Immunization Program since 1962. The schedule, administered primarily to children, comprises 11 vaccines (8 domestically produced) protecting against 13 diseases. In 1999 Cuba launched a national vaccine adverse event surveillance system to monitor and assess the safety of the immunization program, its vaccination procedures and the products administered. OBJECTIVES Describe adverse events following vaccination reported in children aged <16 years in Cuba from 1999 through 2008. METHODS A retrospective descriptive study was conducted of adverse events following vaccination reported from January 1999 through December 2008. Variables used: year, number of adverse events, province, type of vaccine, type and severity of adverse events (common minor, rare, severe), vaccination program errors, number of deaths, and final results of investigations of severe events. Percentages and rates per dose administered were calculated. Adverse event rates were calculated per 100,000 doses administered and by percentages of individual effects among events reported. RESULTS A total of 45,237,532 vaccine doses were administered, and 26,159 vaccine-associated adverse events were reported (overall rate: 57.8 per 100,000 doses). The group aged 0-5 years reported the highest rate of vaccine-associated adverse events (82/100,000 doses). The DTwP vaccine exhibited the highest rate of adverse events. Common minor events were: fever (17,538), reactions at injection site (4470) and systemic side effects (2422). Rare events (by WHO definition) reported were: persistent crying (2666), hypotonic-hyporesponsive episodes (3), encephalopathy (2) and febrile seizures (112). Severe events included: anaphylaxis (2), respiratory distress (1), multiple organ failure (1), sudden death (1), vaccine-associated paralytic poliomyelitis (2), toxic shock syndrome (3), and sepsis (1). The 10 deaths and 3 cases of disability were investigated by an expert commission, which concluded that 8 of the 13 severe events were vaccination-related. CONCLUSIONS Low rates of severe vaccine-associated adverse events observed in this study underline the low risk of vaccination relative to its demonstrated benefits in Cuba. Decision-making for the continued success of the National Immunization Program is supported by reliable information from comprehensive national surveillance with standarized reporting, along with multidisciplinary expert analysis of rare and severe adverse events and program errors. KEYWORDS Immunization; immunization programs; vaccines; vaccination; product surveillance, postmarketing; adverse drug event; communicable disease control; Cuba.

INTRODUCCIÓN Cuba tiene implementado un efectivo Programa Nacional de Inmunización desde 1962. El programa, dirigido principalmente a los niños, incluye 11 vacunas (8 de producción nacional) que protegen contra 13 enfermedades. En 1999, Cuba comenzó un programa de vigilancia de eventos adversos para monitorizar y evaluar la seguridad del programa de inmunización, los procedimientos de vacunación, y los productos utilizados. OBJETIVO Describir los eventos adversos asociados a la vacunación de niños de menos de 16 años, notifi cados en Cuba entre los años 1999­2008. MÉTODOS Se realizó un estudio descriptivo retrospectivo de los eventos adversos comunicados después de una vacunación, desde enero de 1999 hasta diciembre de 2008. Las variables utilizadas fueron: año, número de eventos adversos, provincia, tipo de vacuna, tipo y gravedad de los eventos adversos (leves y comunes, raros, severos), errores en el programa de vacunación, número de fallecidos y resultados fi nales de la investigación de los eventos severos. Se calcularon los porcentajes y las tasas por dosis aplicadas. Las tasas de eventos adversos se calcularon por 100,000 dosis aplicadas y según el porcentaje de efectos individuales entre los eventos comunicados. RESULTADOS Un total de 45,237,532 dosis de vacunas fueron administradas y se notifi caron 26 159 eventos adversos (tasa total: 57,8 por 100,000 dosis). La tasa más alta de eventos adversos asociados a la vacunación se identifi có en el grupo de 0­5 años (82/100,000 dosis). La vacuna DTPe (difteria, tétanos y pertusis de células enteras) mostró la tasa más alta de eventos adversos. Los eventos leves comunes fueron: fi ebre (17 538), reacciones en el sitio de inyección (4470) y efectos colaterales a nivel sistémico (2422). Los eventos raros comunicados (según defi nición de la OMS) fueron: llanto persistente (2666), episodios de hipotonía-hipo reactividad (3), encefalopatía (2) y convulsiones febriles (112). Los eventos graves incluyeron: anafi laxia (2), distrés respiratorio (1), síndrome de shock tóxico (3) y sepsis (1). Los 10 casos fallecidos y los 3 con incapacidad fueron investigados por una comisión de expertos, que concluyó que 8 de los 13 eventos severos estuvieron relacionados con la vacunación. CONCLUSIONES Las bajas tasas de eventos adversos graves asociados a la vacunación, observadas en este estudio, subrayan el bajo riesgo de la vacunación con respecto a sus benefi cios en Cuba. La toma de decisiones para mantener exitosamente el Programa Nacional de Inmunización se apoya en la información fi dedigna y en los informes estandarizados suministrados por el exhaustivo sistema de vigilancia nacional, conjuntamente con el análisis, por expertos multidisciplinarios, de los eventos adversos raros y severos y de los errores del programa. PALABRAS CLAVE Inmunización; programas de inmunización, vacunas, vacunación, sistema de vigilancia de productos, eventos adversos, control de enfermedades transmisibles, Cuba

Massive bleaching of coral reefs induced by the 2010 ENSO, Puerto Cabello, Venezuela.

El Niño Southern Oscillation (ENSO) has generated global coral massive bleaching. The aim of this work was to evaluate the massive bleaching of coral reefs in Puerto Cabello, Venezuela derived from ENSO 2010. We evaluated the bleaching of reefs at five localities both at three and five meter depth. The coral cover and densities of colonies were estimated. We recorded living coral cover, number and diameter of bleached and non-bleached colonies of each coral species. The colonies were classified according to the proportion of bleached area. Satellite images (Modis Scar) were analyzed for chlorophyll-a concentration and temperature in August, September, October and November from 2008-2010. Precipitation, wind speed and air temperature information was evaluated in meteorological data for 2009 and 2010. A total of 58.3% of colonies, belonging to 11 hexacoral species, were affected and the greatest responses were observed in Colpophyllia natans, Montastraea annularis and Montastraeafaveolata. The most affected localities were closer to the mainland and had a bleached proportion up to 62.73+/-36.55%, with the highest proportion of affected colonies, whereas the farthest locality showed 20.25+/-14.00% bleached and the smallest proportion. The salinity in situ varied between 30 and 33ppm and high levels of turbidity were observed. According to the satellite images, in 2010 the surface water temperature reached 31 degree C in August, September and October, and resulted higher than those registered in 2008 and 2009. Regionally, chlorophyll values were higher in 2010 than in 2008 and 2009. The meteorological data indicated that precipitation in November 2010 was three times higher than in November 2009. Massive coral bleaching occurred due to a three month period of high temperatures followed by one month of intense ENSO-associated precipitation. However, this latter factor was likely the trigger because of the bleaching gradient observed.

Cuba's National Immunization Program.

The National Immunization Program (NIP) begun in 1962 has considerably reduced the infectious disease burden in Cuba over the years, especially among children. The Ministry of Public Health estimates that some 560,000 children would have contracted these diseases, some with fatal outcomes, had it not been for the aggressive vaccination strategy begun 45 years ago and developed since then.

Presencia de anticuerpos a sarampión, rubéola y parotiditis en una población cubana de 7 meses a 23 años / Presence of measles, rubella and parotiditis antibodies in a Cuban population aged 7-23

Se creó un programa a partir de 1988 por las autoridades de salud en Cuba, en el cual se trazó como meta eliminar el sarampión, la rubéola y la parotiditis. Sus bases fundamentales fueron alcanzar coberturas de vacunación superiores a 95 % con la vacuna triple viral (sarampión, rubéola y parotiditis), implantar un sólido sistema de vigilancia seroepidemiológica y lograr medidas de control de foco, con lo cual cesaría la transmisión del virus salvaje productor de estas entidades. Con el fin de conocer el estado inmune de la población a más de 10 años de iniciarse la vacunación con la triple viral, se realizó una encuesta seroepidemiológica a una muestra representativa de la población cubana entre 7 meses y 23 años. Se estudió un total de 1 593 muestras mediante la prueba de inhibición de la hemaglutinación. La prevalencia de anticuerpos detectada fue de 86,75 % para sarampión, 64,72 % para rubéola y 86 % para parotiditis. La inmunidad a los virus del sarampión y rubéola fue menor en el grupo de 6 a 10 años y en el caso de la parotiditis en los niños entre 2 y 5 años. Se sugirió incluir en el programa nacional de vacunación, una segunda dosis de la vacuna triple viral en los niños de 6 años o más, para eliminar la circulación de estos agentes infecciosos en la población.

The Cuban health authorites implemented a program in 1988 aimed at eradicating measles, rubella and parotiditis. Its fundamental bases were to attain vaccination coverages over 95 % with the viral triple vaccine (measles, rubella and parotiditis), to establish a solid system of seroepidemiological surveillance and to take measures to control the focus, with which the trasmission of the wild virus producing these entities would stop. In order to know the immune state of the population a seroepidemiological survey was done in a representative sample of the Cuban population from 7 months old to 23 years old. A total of 1 593 samples were studied by the hemagluttination inhibition test. The prevalence of antibodies detected was 86.75 % for measles, 64.72 % for rubella and 86 % for parotiditis. The immunity to the measles and rubella viruses was slower in the group aged 6-10 and in children aged 2-5 in the case of parotiditis. It was suggested to include in the national vaccination program a second dose of the viral triple vaccine in children 6 or over to eliminate the circulation of these infectious agents in the population.

Role of the virology diagnosis laboratory in the surveillance of rubella virus Cuba 1988/2000.

In Cuba, on the basis of Measles Elimination Program, the incidence of this disease decline, and was necessary to test rubella virus as a possible etiology agent that produce fever and rash illness. To reach this goal, Cuba developed rubella elimination strategies with integrated epidemiologic and laboratory surveillance. In the country, the vaccination program against rubella started in 1982 by vaccinating 12-14 years old females, with a special surveillance program with laboratory study of all suspected cases. Through 1988-2000, the Serology Diagnosis Laboratory in the Virology Branch of Pedro Kouri Institute had the responsibility to do the measles and rubella surveillance and play a key roll in the elimination strategies of these diseases. For confirmation of all suspected cases, 8566 serum samples with the suspected diagnosis of measles or rubella from different provinces in Cuba were studied in the laboratory using different techniques as haemagglutination inhibition test (HIA), ultra micro analytic assay (UMA); and in 1995 by the newly introduced IgM ELISA, which was used taken only one sample in the acute phase of the disease. These techniques allowed knowing that the annual number of reported rubella cases in the country decreased substantially after the implementation, in 1986, of the second vaccine policy, that of vaccinating women of childbearing age. However, in 1989, was detected an outbreak of rubella virus infection that had occurred in young adults male 15-19 age groups in Matanzas' province. The last three indigenous cases of this disease were confirmed by our laboratory in 1995, after national vaccine coverage over 95%.

La eliminación del sarampión en Cuba / Measles elimination in Cuba

La vacuna antisarampionosa se empezó a usar en Cuba en 1971. En los años setenta se implantó una estrategia inicial para el control del sarampión, y a ella le siguieron iniciativas adicionales a principios de los años ochenta. Pese a haberse mejorado el programa de control, siguieron produciéndose brotes de la enfermedad. En 1986, después de revisar las experiencias recogidas a partir de las iniciativas de control ya establecidas, se adoptó una nueva estrategia de vacunación antisarampionosa. Con el tiempo, la nueva estrategia de vacunación contra el sarampión llegó a tener tres componentes principales: primero, una campaña única de vacunación de "puesta al día" dirigida a niños de 1 a 14 años de edad. Segundo, se procuró lograr y mantener una alta cobertura con la vacuna mediante el ofrecimiento de servicios de vacunación obligatoria para niños de 12 meses de edad ("vacunación de mantenimiento"). Por último, se llevaron a cabo periódicamente campañas de "seguimiento" para niños de 2 a 6 años de edad. Con el fin de monitorear el territorio recorrido hacia le eliminación del sarampión, se ha hecho un esfuerzo por fortalecer la vigilancia de la enfermedad, de la cual forma parte la investigación de casos sospechados. Tanto la campaña general de "puesta al día" como la de "seguimiento" alcanzaron coberturas de más de 98% en los grupos de edad a los que fueron dirigidas. El programa de vacunación de rutina también ha mantenido una alta cobertura. La alta inmunidad poblacional contra el sarampión lograda mediante estas estrategias de vacunación dio por resultado una rápida reducción de la incidencia de la enfermedad. De 1989 a 1992, se notificaron menos de 20 casos anuales confirmados por laboratorios. En Cuba, el último caso confirmado por pruebas serológicas se presentó en julio de 1993. La estrategia para la eliminación del sarampión que se ha aplicado en Cuba ha interrumpido la transmisión de la enfermedad y ha impedido la circulación...

The vaccine against measles came into use in Cuba in 1971. During the seventies, a new early strategy for measles control was established, and it was followed by further efforts in the early eighties. Despite improvements to the control program, disease outbreaks continued to occur. In 1986, after examining the experience acquired through the control initiatives that were already in place, a new measles vaccination strategy was adopted. In time, the new vaccination strategy against measles came to have three main components: first, a single vaccination "catching-up" campaign targeting children 1 to 14 years of age. Second, efforts were made to achieve and maintain high vaccine coverage through mandatory vaccination services for 12-month-old children ("maintenance vaccination"). Finally, periodic "follow-up" campaigns were carried out for children 2 to 6 years of age. Steps were taken, for the purpose of monitoring the progress made so far toward eliminating measles, to strengthen disease surveillance systems, including the screening of suspected cases. The "catching-up" and "follow-up" campaigns both achieved greater than 98% coverage within targeted age groups. The routine vaccination program has also maintained high coverage. The high population immunity against measles that has been attained through these vaccination strategies has resulted in a rapid decrease in the incidence of the disease. From 1989 to 1992, less than 20 laboratory-confirmed cases were reported annually. In Cuba, the last case confirmed through serologic screening was reported in July 1993. Cuba's strategy for measles elimination has interrupted disease transmission and kept the causal virus from circulating on the island. Cuba's experience with measles elimination suggests that if an appropriate vaccination strategy is applied, measles can be globally eradicated.

La eliminación del sarampión en Cuba / Elimination of measles in Cuba

Tiene por objeto hacer un repaso de la epidemiología de la enfermedad en territorio cubano y describir la estrategia especial para la eliminación del sarampión que se creó y puso en marcha en el país.(AU)

Marcador serológico como indicador de no circulación de Poliovirus en Cuba / Serological marker as an indicator of no circulation of Poliovirus in Cuba

En la erradicación de la poliomielitis la vigilancia de la circulación del Poliovirus salvaje es un elemento esencial. La organización Panamericana de la Salud está enfatizando con estos fines el estudio etiológico de la parálisis fláccidas agudas. Las características de nuestro programa de lucha contra esta enfermedad, permitió utilizar la presencia de anticuerpos en una muestra, obtenida en febrero, de la población infantil nacida en el mes de julio del año anterior como criterio para conocer la circulación del Poliovirus salvaje. En 727 niños estudiados en el país (5 por ciento del total de los nacimientos de julio), no mostraron anticuerpos en títulos igual o mayor de 1:10 el 99,1 por ciento . Los títulos bajos encontrados en 7 niños fueron considerados como remanentes de los trasmitidos por la madre. Los resultados obtenidos son un fuerte argumento de no existir circulación ambiental de Poliovirus en el período que históricamente existía mayor incidencia de la enfermedad

Marcador serológico como indicador de circulación de poliovirus / Serological tracer as indicator of poliovirus circulation

Para erradicar la poliomielitis, resulta esencial demostrar la no circulación de poliovirus salvaje. Debido a que las vacunaciones antipoliomielíticas en Cuba se realizan en forma de campañas de cobertura nacional de muy corta duración, podemos adoptar como criterio de circulación la presencia de anticuerpos en los nacimientos que ocurran entre las campañas una vez perdida la inmunidad trasmitida por la madre. El estudio del 5 por ciento de esa población mostró anticuerpos neutralizantes a poliovirus sólo en 7(1.2 por ciento ) de 724 niños estudiados. Los bajos títulos encontrados, la dispersión geográfica, la no ocurrencia de casos de poliomielitis durante el período, la no circulación en la región del serotipo al cual pertenecen estos anticuerpos son, entre otros, elementos que permiten intepretar la presencia de los mismos como remanentes de la inmunidad pasiva trasmitida por la madre