Developing a disease prevention strategy in the Caribbean: the importance of assessing animal health-related risks at regional level.

In 2009 CaribVET conducted a survey among Caribbean national Veterinary Services to assess perceptions of risk assessment and to identify the principal exotic diseases of concern in the region and their means of introduction. The results showed that the introduction of live animals was considered the most likely route of introduction of exotic animal pathogens, followed by the uncontrolled introduction of animal products by boat passengers. The results were used to define a regional strategy for assessing animal health risks that highlights the importance of within-region exchanges.

Interaction between research and diagnosis and surveillance of avian influenza within the Caribbean animal health network (CaribVET).

The Caribbean region is considered to be at risk for avian influenza (AI) because of predominance of the backyard poultry system, important commercial poultry production, migratory birds and disparities in the surveillance systems. The Caribbean animal health network (CaribVET) has developed tools to implement AI surveillance in the region: (i) a regionally harmonized surveillance protocol, (ii) specific web pages for AI surveillance on http://www.caribvet.net, and (iii) a diagnostic network for the Caribbean including AI virus molecular diagnostic capability in Guadeloupe and technology transfer. Altogether 303 samples from four Caribbean countries were tested between June 2006 and March 2009 by real time PCR either for importation purposes or following clinical suspicion. Following AI H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for risk analysis of AI spread in the region through fighting cocks. The infection pathway of Martinique commercial poultry sector by AI through introduction of infected cocks was designed and recommendations were provided to the Caribbean veterinary services to improve fighting cock movement controls and biosecurity measures. Altogether, these CaribVET activities contribute to strengthen surveillance of AI in the Caribbean region and may allow the development of research studies on AI risk analysis.

Metabolic syndrome in Argentinean patients with systemic lupus erythematosus.

The objective was to determine the prevalence of the metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE) in Argentina, to assess the factors associated to it, and to compare the results with a control group with non-inflammatory disorders. The study included 147 patients with SLE and 119 controls. MS was defined according to criteria by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Scientific Statement. Demographic characteristics, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) were assessed as well as administration, maximum dose and cumulative dose of prednisone and hydroxychloroquine (HCQ). MS prevalence was 28.6% (CI 95%: 21.4-36.6) in patients with SLE and 16% in controls (P = 0.0019). Patients with SLE presented higher arterial hypertension frequency compared with controls (43 vs 25%, P = 0.007). When comparing lupus patients with MS (n = 41) and without MS (n = 106), no significant differences were observed regarding duration of the disease, SLEDAI or cumulative prednisone dose. Cumulative damage was associated independently with MS (OR 1.98; P = 0.021), whereas HCQ use was found to be protective (OR 0.13; P = 0.015). Patients with lupus presented higher MS prevalence than controls with non-inflammatory disorders, and occurrence of arterial hypertension was also higher. MS was associated with cumulative damage; the use of HCQ showed to be protective against presence of MS.

Unusual manifestation of histoplasmosis in connective tissue diseases.

This report describes the coexistence of three patients with rheumatic diseases (systemic lupus erythematosus, rheumatoid arthritis, and dermatomyositis) and infections because of Histoplasma capsulatum. Connective tissue diseases and histoplasmosis share several clinical findings. Therefore, histoplasmosis could be misdiagnosed as connective tissue disease or a flare of these diseases. Such cases highlight the importance of awareness of histoplasmosis in immunocompromised patients, particularly in those originating from endemic areas.

Veterinary Services in Belize: adapting organisational models to the needs of small economies.

International trade in agricultural goods is governed by the Agreement on the Application of Sanitary and Phytosanitary Measures (the 'SPS Agreement') of the World Trade Organization. Small economies, such as the economy of Belize, must have the necessary infrastructure in place to meet their obligations and exercise their rights under the SPS Agreement. In response to the shortcomings of a small economy, the Belize Government has established the Belize Agricultural Health Authority (BAHA) as its organisational model, to meet the challenges of providing Veterinary Services in this new millennium, as well as the demands of the international trade in animals and plants and their products. This model became operational in the year 2000 and has received national and international recognition as an appropriate model for small economies. The success of BAHA is due to strong political support and its dual public and private sector characteristics.