[The health worker and counseling about HIV and AIDS]. / El trabajador de salud y la consejería sobre el VIH y SIDA.

By December 1993, more than 17,000 AIDS cases had been reported in Mexico and some estimates indicate approximately 100,000 individuals currently infected with HIV. From the patient's perspective, being HIV positive or having AIDS, places an enormous burden on psychosocial coping mechanisms. Thus, psychosocial support is required for all of these patients. This paper summarizes our educational intervention on counseling techniques and provides information of our demonstration project on the effectiveness of the educational intervention among 89 Mexican health care workers. Overall, these professionals showed improvement in their knowledge and goals of providing counseling. One of the more striking was the discovery of homophobic attitudes among them, particularly those with no previous experience in the care of HIV infected people. This exploratory study allowed us to identify research and educational needs of health care workers. The overwhelming number of estimated cases of HIV infections and the current trends of the epidemic reveal the necessity for training in medical counseling that over 73,000 physicians in Mexico will face in the immediate future.

[Protection of health personnel against hepatitis B by DNA recombinant vaccine]. / Protección contra hepatitis B en trabajadores de salud con vacuna de DNA recombinante.

Hepatitis B (HVB) is a worldwide spread health problem. It has been assessed that there are more than 300 millions of carriers. HVB has a special concern for health care workers (HCW's) due to the high risk among them of getting the infection in clinic-setting areas. According to some estimation, the risk for hepatitis B among HCW's is 2 to 10 times higher than the risk for general population. The risk is related to the degree of direct contact with blood and body fluids, as well as, with the frequency of traumatic exposure in the work place. The control of this infection is based on the observance of universal precautions and the vaccination, since there is not treatment against this disease. The results of an efficacy-evaluation of DNA recombinant vaccine against hepatitis B are reported; 174 HCW's were studied; three dosages of vaccine were administered (0.1st and 6th month) by I.M. via. In addition, three serum samples were collected at 0, 1st and 9th month after vaccine administration. We did not find carriers of surface antigen of hepatitis B. With regards to seroconverted individuals we observed the following results: there were a satisfactory response to the vaccine in 163 individuals (93.7%); however, 8 (4.6%) persons did not reach titles of protective antibodies and 3 (1.7%) did not show seroconversion at all. Therefore, 11 persons (6.3% of the total) did not result immunized. The secondary reactions to the vaccines were low in frequency and mainly of local presentation. Among the study population we did not find chronic carries of hepatitis B.(ABSTRACT TRUNCATED AT 250 WORDS)

Shigella dysenteriae type 1 infections in US travellers to Mexico, 1988.

In 1988, the number of Shigella dysenteriae type 1 (Sd1) infections reported in the USA increased five-fold over the annual mean from the previous decade. 44 (94%) of 47 interviewed patients reported recent travel to Mexico; 33 (75%) of these had been tourists to the Yucatan peninsula. 27 patients who had travelled to Mexico were admitted to hospital, of whom 2 had a haemolytic uraemic syndrome; none died. The antimicrobial resistance pattern and plasmid profile of the Yucatan strain were similar to those of the 1969-72 pandemic strain. Antimicrobial resistances and plasmid profiles were different in sporadic Western hemisphere strains. This is the first outbreak of Sd1 among US tourists and it is the largest known outbreak in the Western hemisphere since the early 1970s. The dominant Sd1 strain is similar to that which caused the catastrophic 1969-72 pandemic. Surveillance and control measures have been instituted in the Yucatan peninsula.