Havana syndrome: Overview for otolaryngologists.

Havana Syndrome is used to describe the array of deficits seen in diplomats stationed in Cuba from August 2016 to September 2017.1 Patients from this cohort were clinically studied, investigating their symptoms, audition and vestibular deficits, and imaging abnormalities seen on MRI.1-3 The primary studies were retrospective, looking at how these symptoms could be classified or fit into diagnostic criteria. The cohort had many similarities: a sound at the onset of symptoms, a mix of neurologic and otologic symptoms, and persistent symptoms that lasted for months.1-3 Theories of the cause of Havana Syndrome have led to no conclusive answer. Potential viral etiologies, mass psychogenic illness, and head trauma were examined as causes.1-5 Diseases with established diagnostic criteria were used to compare the patients' symptoms to try to find a disease that fits Havana Syndrome.3 Recent information from the Office of the Director of National Intelligence suggested the most likely cause to be mass psychogenic illness. With the cause of Havana Syndrome still unknown, a review of reported cases and reports helps otolaryngologists understand Havana Syndrome so they diagnose it only when appropriate and do not miss other conditions that may present with similar symptoms and that might respond well to targeted treatment.

A regulatory pathway model of neuropsychological disruption in Havana syndrome.

Introduction: In 2016 diplomatic personnel serving in Havana, Cuba, began reporting audible sensory phenomena paired with onset of complex and persistent neurological symptoms consistent with brain injury. The etiology of these Anomalous Health Incidents (AHI) and subsequent symptoms remains unknown. This report investigates putative exposure-symptom pathology by assembling a network model of published bio-behavioral pathways and assessing how dysregulation of such pathways might explain loss of function in these subjects using data available in the published literature. Given similarities in presentation with mild traumatic brain injury (mTBI), we used the latter as a clinically relevant means of evaluating if the neuropsychological profiles observed in Havana Syndrome Havana Syndrome might be explained at least in part by a dysregulation of neurotransmission, neuro-inflammation, or both. Method: Automated text-mining of >9,000 publications produced a network consisting of 273 documented regulatory interactions linking 29 neuro-chemical markers with 9 neuropsychological constructs from the Brief Mood Survey, PTSD Checklist, and the Frontal Systems Behavior Scale. Analysis of information flow through this network produced a set of regulatory rules reconciling to within a 6% departure known mechanistic pathways with neuropsychological profiles in N = 6 subjects. Results: Predicted expression of neuro-chemical markers that jointly satisfy documented pathways and observed symptom profiles display characteristically elevated IL-1B, IL-10, NGF, and norepinephrine levels in the context of depressed BDNF, GDNF, IGF1, and glutamate expression (FDR < 5%). Elevations in CRH and IL-6 were also predicted unanimously across all subjects. Furthermore, simulations of neurological regulatory dynamics reveal subjects do not appear to be "locked in" persistent illness but rather appear to be engaged in a slow recovery trajectory. Discussion: This computational analysis of measured neuropsychological symptoms in Havana-based diplomats proposes that these AHI symptoms may be supported in part by disruption of known neuroimmune and neurotransmission regulatory mechanisms also associated with mTBI.

A Brief Primer on the Concept of the Neuroweapon for U.S. Military Medical Personnel.

The malevolent application of neuroscience is an emerging threat to the U.S. military. At present, U.S. military medical personnel are not capable of adequately diagnosing or treating the injuries and illnesses that may result from exposure to potential neuroweapons. This fact was illustrated in 2016 when U.S. diplomats serving in Havana, Cuba reported hearing strange noises accompanied by a constellation of unexplained health effects. Similar incidents have been reported in China and Russia. Although various hypotheses have been put forward to explain these symptoms, none of them have been verified. The reported symptoms were analogous to the physiological responses that have been produced in the laboratory by exposing volunteers to pulsed microwave energy. However, these incidents of undetermined origin demonstrate that widespread neurological illness can be disruptive to U.S. government operations and that it is currently not possible to identify the cause, determine the correct treatment, or ascribe attribution to potential neuroweapon use in an overseas setting. Since it is likely that Special Operations medical personnel will be among the first to respond to neuroweapon attacks in the deployed environment, it is essential that they be made aware of this emerging threat and that efforts be made to incorporate potential directed energy neuroweapons and other neuroweapon configurations into future Chemical, Biological, Radiological, Nuclear, and high yield Explosives (CBRN-E) training modules. The intention of this article is to introduce the concept of the neuroweapon to military medical personnel and to provide a brief review of the relevant literature.

Havana syndrome: a scoping review of the existing literature.

Since 2016, numerous American and Canadian diplomats and secret (intelligence) agents in Cuba, China, and other places in the world have experienced an abrupt onset of unusual clinical symptoms including, tinnitus, visual problems, vertigo, and cognitive difficulties, after they encountered strange sounds; this has been called "Havana syndrome" (HS). MEDLINE, Scopus, and Ovid databases from 2016 until 24 September 2021 were systematically searched for the related published manuscripts. The following search strategy was implemented: "Havana syndrome" OR "Neurological Symptoms and US Diplomats". The primary search yielded 120 publications. Only five original studies and 18 non-original articles were considered to be relevant. While these studies provided a constellation of signs and symptoms for HS, none provided a good level of evidence. In conclusion, Havana syndrome is a nonspecific neurological illness with an unidentified causative factor(s), an acute phase of auditory-vestibular symptoms and a chronic phase of nonspecific neurobehavioral symptoms. This syndrome should be considered and investigated as a health concern, and not as a political issue.

Brote de transmisión comunitaria de COVID-19 en un municipio de La Habana (marzo-abril, 2021)

Introducción: Una oportuna investigación de los eventos epidemiológicos de la COVID-19 garantiza minimizar la propagación de la enfermedad en la población. Objetivos: Caracterizar el brote de transmisión comunitaria de COVID-19 en un municipio de La Habana. Métodos: Estudio transversal de casos positivos de infección por SARS-CoV-2 del brote Catedral en La Habana Vieja, en 2021. Las variables analizadas fueron: edad, sexo, manzana de residencia, fecha de inicio de síntomas, fecha de diagnóstico, forma clínica, tipo de caso. Se utilizó la metodología para el estudio de brotes. Se calcularon porcentajes, diferencias de proporciones, tasas, número reproductivo efectivo y parámetro de dispersión con intervalos de confianza de 95 %. Resultados: Se notificó el brote el 23 de marzo y se cerró el 22 de abril con 106 casos (tasa de ataque 4,51 %), el pico en la notificación se produjo el 29 de marzo con 40 casos (37,73 %). La edad media fue de 43 años. Resultaron más afectados los adultos de 60 y más años (30,18 %), las mujeres (58,49 %) y la manzana 0024 (45,28 % de los casos). El 77,3 % no presentó síntomas, entre ellos dos superdispersores; los sintomáticos fueron leves y no hubo fallecidos. El número reproductivo efectivo global fue de 0,94 (IC: 0,70-1,21); superior en los asintomáticos (11,43 versus 4,00); y el parámetro de dispersión de 0,89 (IC: 0,51-2,09), superior en los sintomáticos (1,06 versus 0,69). Conclusiones: El control epidemiológico oportuno ante cada caso permitió la corta duración del brote y que no hubiesen fallecidos.

Introduction: A timely investigation of COVID-19 epidemiological events guarantees to minimize the spread of the disease in the population. Objective: To characterize the COVID-19 outbreak of community transmission in a municipality in Havana. Methods: Cross-sectional study of positive cases of SARS-CoV-2 infection of the "Cathedral" outbreak in Old Havana in 2021. The variables analyzed were: age, sex, city block of residence, date of symptom onset, date of diagnosis, clinical manifestations, and type of case. The methodology for the study of outbreaks was used. Percentages, differences in proportions, rates, effective reproductive number, and dispersion parameter with 95% confidence intervals were calculated. Results: The outbreak was reported on March 23 and closed on April 22 with 106 cases (attack rate of 4.51%). The peak was notified on March 29 with 40 cases (37.73%). The mean age was 43 years. Adults aged 60 years and older (30.18%), women (58.49%), and block 0024 (45.28% of cases) were most affected. A total of 77.3% were asymptomatic, including two superspreaders; symptomatic cases were mild and there were no deaths. The overall effective reproductive number was 0.94 (CI: 0.70-1.21); higher in asymptomatic cases (11.43 versus 4.00); and the dispersion parameter was 0.89 (CI: 0.51-2.09), higher in symptomatic cases (1.06 versus 0.69). Conclusions: Timely epidemiological control of each case ensured the short duration of the outbreak and no deaths.

Contribución de la Facultad de Biología de la Universidad de La Habana en el diagnóstico molecular del SARS-CoV-2 en el IPK / Contribution of the School of Biology of the University of Havana in the molecular diagnosis of SARS-CoV-2 at IPK

RESUMEN A finales del año 2019 el mundo conoció de la existencia y propagación de un nuevo coronavirus denominado SARS-CoV-2, capaz de provocar la enfermedad COVID-19. Las autoridades gubernamentales y de salud cubanas trazaron desde el principio estrategias de control epidemiológico, y fue el diagnóstico molecular por PCR en tiempo real una tarea de suma importancia para el control de la enfermedad en nuestro país. Un gran número de jóvenes profesionales y estudiantes de la Facultad de Biología de la Universidad de La Habana se sumaron a esta tarea. El presente trabajo aborda las principales actividades desarrolladas por estos últimos durante el diagnóstico molecular del SARS-CoV-2 en el Instituto de Medicina Tropical Pedro Kourí (IPK) en los primeros meses de la pandemia en nuestro país. El ejercicio de la profesión a partir de la puesta en práctica de habilidades y conocimientos teórico-prácticos, la adquisición de nuevos conocimientos, así como el fomento de valores éticos y morales como la solidaridad, el compañerismo y el trabajo mancomunado en colectivo, caracterizaron esta experiencia llena de desafíos y logros.

ABSTRACT At the end of 2019, the existence and spread of a novel coronavirus called SARS-CoV-2, responsible of the disease COVID-19 was known worldwide. From the beginning, the Cuban governmental and health authorities drawn up epidemiological control strategies, in which the molecular diagnosis by real-time PCR was of paramount importance for the control of the disease in our country. A large number of young professionals and students from the School of Biology of the University of Havana joined this task. This paper deals with the main activities performed by the students related to the molecular diagnosis of SARS-CoV-2 at the "Pedro Kourí" Institute of Tropical Medicine (IPK) in the first months of the pandemic in our country. The exercise of the profession in the implementation of the skills, and theoretical and practical knowledge; the acquisition of new knowledge; and the promotion of ethical and moral values such as solidarity, companionship, and joint work characterized this experience full of challenges and achievements.

Symptoms reported by Canadians posted in Havana are linked with reduced white matter fibre density.

Diplomats representing the USA have reported with unusual neurologic symptoms and MRI changes after being posted in Havana, Cuba between late 2016 and 2018. Here, we examined white matter microstructure and network connectivity of individuals stationed in Havana, using diffusion-weighted MRI, fixel-based analysis and structural connectomics as implemented in MRtrix3. MRI data acquisition and clinical assessments were done in a total of 24 diplomats and their family members and 40 healthy controls. The diplomat data were grouped into an exposed cohort (n = 16) and an unexposed cohort (n = 10), and among these, two individuals were assessed before and after potential exposure. Fixel-based analysis revealed a reduction in fibre density in two specific regions: the fornix and the splenium, in exposed individuals, relative to unexposed individuals and healthy controls. Post hoc analyses showed the effect remained present (P < 0.05) in both regions when comparing exposed and unexposed diplomats; and reduced fibre density was correlated with longer time period stationed in Cuba after age correction. Reduction of fibre density was also found to be linked with clinical symptoms of persistent migraine, tinnitus, sound sensitivity and fatigue. Network statistical comparisons revealed decreased structural connectivity in two distinct networks, comprising subcortical and cortical systems in exposed individuals, relative to unexposed and normative data. While the cause for the differences between the groups remains unknown, our results reveal region-specific white matter injury, that is, significantly correlated with clinical symptoms.

Estomatología 2020, un congreso en tiempos de la pandemia de COVID-19 / Dentistry 2020, a congress in the time of COVID-19

Introducción: La pandemia de COVID-19 introdujo un cambio en la realización del Congreso Internacional en conmemoración el 120 aniversario de la fundación de la Facultad de Estomatología de La Habana, efectuándose de manera virtual en noviembre del 2020. Objetivo: Caracterizar el Congreso Internacional de carácter virtual Estomatología 2020, realizado en tiempos de COVID-19. Métodos: Se realizó una investigación descriptiva, con la aplicación del método histórico-lógico y el de revisión documental, utilizándose los reportes estadísticos finales que brindó el sitio del cónclave. Resultados: En la página del congreso se inscribieron 970 usuarios, de ellos, 899 cubanos y 71 de otros países; todas las provincias estuvieron representadas. El 81 por ciento de los usuarios fueron profesionales y el 16,8 por ciento, estudiantes. Fueron aprobados y publicados 391 trabajos, para un 82,8 por ciento, 373 trabajos eran de autores cubanos y 18 de autores extranjeros. El 18 por ciento de los trabajos correspondieron a estomatología general integral en la atención primaria de salud, seguida de ortodoncia (14,3 por ciento). Se realizaron 2405 comentarios en total, el 92,3 por ciento de los trabajos publicados recibieron comentarios, figuran en las Actas del Congreso 354 trabajos. Conclusiones: La mayoría de los usuarios inscritos fueron cubanos, del sexo femenino y profesionales. Todas las provincias tuvieron representación. La mayoría de los trabajos recibidos reunieron los requisitos para ser publicados y, prácticamente, la quinta parte correspondió a la estomatología general integral en la atención primaria de salud. Fue destacada para participación de estudiantes(AU)

Introduction : Due to the COVID-19 pandemic, the International Congress programmed to mark the 120th anniversary of the Dental School of Havana had to change its format and was held virtually in November 2020. Objective: Characterize the virtual International Congress Dentistry 2020, held in the time of COVID-19. Methods: A descriptive study was conducted based on the final statistical reports provided by the Congress website and applying historical-logical and document review methods. Results: A total 970 users were registered in the Congress page. Of these, 899 were Cuban and 71 were foreign. All the provinces were represented. 81 percent of the users were professionals and 16.8 percent were students. 391 papers were accepted and published, for 82.8 percent; 373 papers were written by Cuban authors and 18 by foreign authors. 18 percent of the papers dealt with general comprehensive dentistry in primary health care, followed by orthodontics (14.3 percent). 2 405 comments were made, with 92.3 percent of the published papers receiving comments. 354 papers were recorded in the Congress Proceedings. Conclusions: Most of the users registered were Cuban, female and professionals. All the provinces were represented. Most of the papers received met the publication requirements and almost one fifth dealt with general comprehensive dentistry in primary health care. Students had an outstanding participation(AU)

Análisis de los patrones de colaboración del Programa de Doctorado en Documentación e Información Científica / Analysis of collaboration patterns in the Documentation and Scientific Information doctoral training program

El propósito del presente artículo fue analizar los patrones de colaboración del programa de formación doctoral en Bibliotecología y Documentación Científica desarrollado entre la Universidad de La Habana y la Universidad de Granada en el período 2007-2017. Para esto se creó una base de datos en EndNote® x.9, con 396 documentos. Se crearon listados de frecuencia de acuerdo con los indicadores analizados, los cuales se procesaron con los programas Excel y Tableau Public 2020.3 para generar tablas y gráficos. Se utilizó Bibexcel (Olle Persson, Universidad de Umeå, Suecia) para realizar los conteos de frecuencia generales, la generación de matrices y el análisis de las redes de coautoría, cotutoría y de colaboración entre instituciones, en aras de procesarlas con UCINET 6.175. Para su representación reticular se utilizaron NetDraw 2.38 y VOSviewer 1.6.16. La colaboración fue analizada de manera global, por grupos y por tipología documental. Se valoraron las relaciones establecidas para el desarrollo de las investigaciones y para la dirección de las tesis. Para los artículos se analizaron las redes de coautoría y los nexos interinstitucionales. En las tesis se analizaron las relaciones establecidas para la tutoría. Se identificó un predominio de autoría múltiple, mayoritariamente en los artículos científicos. Se aprecian nexos relativamente importantes en la tutoría a partir del establecimiento de relaciones entre los tutores más productivos del programa. A nivel institucional se aprecia un protagonismo de la Universidad de Granada y la Universidad de La Habana por ser las coordinadoras del programa. No obstante, se aprecia una amplia gama de instituciones nacionales. Se reflejan los participantes y tutores más representados(AU)

The purpose of the study was to analyze the collaboration patterns in the Library Science and Scientific Documentation doctoral training program conducted jointly by the University of Havana and the University of Granada in the period 2007-2017. To achieve this end, a database of 396 documents was created on EndNote® x.9. Frequency lists were developed for the indicators analyzed, which were processed with the software Excel and Tableau Public 2020.3 to generate tables and charts. Bibexcel (Olle Persson, Umeå University, Sweden) was used to carry out overall frequency counts, generate matrices, and analyze co-authorship, co-tutorship and collaboration networks between institutions, with a view to processing them with UCINET 6.175. NetDraw 2.38 and VOSviewer 1.6.16 were used for their reticular representation. Collaboration was analyzed globally, by group and by document typology. An assessment was made of the relationships established for research development and thesis guidance. Analysis of papers included co-authorship networks and interinstitutional links, whereas the analysis of theses included the tutoring relationships established. A predominance was found of multiple authorship, mainly in scientific papers. Relatively important links were found in tutoring based on the establishment of relationships between the most productive authors in the program. On an institutional level, leadership by the University of Granada and the University of Havana was observed, being as they are the program coordinators. However, a wide range of national institutions was also found. Reference is made to the best represented participants and tutors(AU)

Propuesta de requisitos generales para el sistema de gestión documental de la Universidad de La Habana / Proposal of general requirements for the document management system at the University of Havana

El objetivo de la presente investigación fue proponer una especificación de requisitos generales para el sistema de gestión documental de la Universidad de La Habana consecuente con un ejercicio de gobierno más responsable, abierto, transparente e inclusivo, con un enfoque orientado a la rendición de cuentas y a un mayor control social. La investigación presentó un diseño descriptivo y un enfoque mixto, con predominio cualitativo. Para contribuir al desarrollo de un sistema de información que creara capacidades sobre la base de información de calidad en esta institución, el estudio se basó en la triangulación de dos metodologías: una desde el dominio de la gestión documental y otra desde la ingeniería de requisitos. Como resultado, se presentaron 22 elementos y 201 requisitos, entre funcionales y no funcionales, con un carácter flexible y modular, que deben ser establecidos para el funcionamiento efectivo del sistema de gestión documental de esta Universidad(AU)

The purpose of the study was to propose a general requirements specification for the document management system at the University of Havana, in keeping with more responsible, open, transparent and inclusive governance, an accountability-oriented approach and greater social control. The research had a descriptive design, a mixed approach and qualitative predominance. To contribute to the development of an information system which would build capacities on the basis of quality information in this institution, the study was based on the triangulation of two methodologies: one from the document management domain and the other from requirements engineering. As a result, 22 items and 201 requirements were presented, both functional and non-functional, of a flexible and modular nature, which should be established for the effective operation of the document management system at this university(AU)

Lycopene ß-cyclase expression influences plant physiology, development, and metabolism in tobacco plants.

Carotenoids are important isoprenoids produced in the plastids of photosynthetic organisms that play key roles in photoprotection and antioxidative processes. ß-Carotene is generated from lycopene by lycopene ß-cyclase (LCYB). Previously, we demonstrated that the introduction of the Daucus carota (carrot) DcLCYB1 gene into tobacco (cv. Xanthi) resulted in increased levels of abscisic acid (ABA) and especially gibberellins (GAs), resulting in increased plant yield. In order to understand this phenomenon prior to exporting this genetic strategy to crops, we generated tobacco (Nicotiana tabacum cv. Petit Havana) mutants that exhibited a wide range of LCYB expression. Transplastomic plants expressing DcLCYB1 at high levels showed a wild-type-like growth, even though their pigment content was increased and their leaf GA1 content was reduced. RNA interference (RNAi) NtLCYB lines showed different reductions in NtLCYB transcript abundance, correlating with reduced pigment content and plant variegation. Photosynthesis (leaf absorptance, Fv/Fm, and light-saturated capacity of linear electron transport) and plant growth were impaired. Remarkably, drastic changes in phytohormone content also occurred in the RNAi lines. However, external application of phytohormones was not sufficient to rescue these phenotypes, suggesting that altered photosynthetic efficiency might be another important factor explaining their reduced biomass. These results show that LCYB expression influences plant biomass by different mechanisms and suggests thresholds for LCYB expression levels that might be beneficial or detrimental for plant growth.

Sitio Web institucional de la Universidad de Ciencias Médicas de La Habana / Institutional website of the University Of Medical Sciences Of Havana

Introducción: El siglo XXI caracterizado por el avance científico- tecnológico, impone desafíos. Se diseñó un sitio web como instrumento de apoyo a la participación colectiva y colaborativa, en el que se socializan las proyecciones, actividades y desafíos que desarrollan y enfrentan los recursos humanos que se forman en las disciplinas de la Universidad de Ciencias Médicas de La Habana Objetivo: Caracterizar el sitio web institucional de la Universidad de Ciencias Médicas de La Habana como contribución a la comunicación institucional. Métodos: Se realizó revisión documental. Para analizar y garantizar el intercambio académico, institucional y social; se determina la utilización del soporte tecnológico diseñado, para establecer un proceso de socialización del conocimiento docente, investigativo y extensionista, institucional de forma efectiva. Resultados: El sitio web institucional de la UCM H garantiza intercambio permanente e interactivo de la información con los interesados en los servicios académicos. Soportado sobre la plataforma Wordpress 4.1.9, tema Semiologic, con espacio de almacenamiento de 200 MB, publicadas 184 páginas, hasta la fecha de publicación de este trabajo. Conclusiones: El diseño realizado y la estructura organizativa creada preserva el proceso interactivo docente, investigativo y extensionista institucional, para garantizar el suministro y socialización de la información, apoyados en las Tecnologías de la Información y las Comunicaciones(AU)

Introduction: The 21st century characterized by scientific-technological advance, imposes challenges. A website was designed as an instrument to support collective and collaborative participation, in which the projections, activities and challenges that develop and face the human resources that are trained in the disciplines of the University Of Medical Sciences Of Havana are socialized. Objective: Characterize the institutional website of the University Of Medical Sciences Of Havana as a contribution to institutional communication. Methods: Documentary review was carried out, to analyze and guarantee ensure academic, institutional and social exchange; the use of technological support designed to establish a process of effective socialization of teaching, research and extension knowledge is determined. Results: The UCM H institutional website guarantees permanent and interactive exchange of information with those interested in academic services. Supported on the Wordpress 4.1.9 platform, Semiologic theme, with storage space of 200 MB, published 184 pages, until the date of publication of this work. Conclusions: The design made and the organizational structure created preserves the interactive teaching, research and institutional extension process, to guarantee the provision and socialization of information, supported by Information and Communication Technologies(AU)

Dinámica de aparición de criaderos de Aedes aegypti (Diptera: Culicidae) en la provincia La Habana, 2013-2017 / Dynamics of the appearance of breeding sites of Aedes aegypti (Diptera: Culicidae) in the province of Havana, 2013-1017

Introducción: El Programa Nacional de Control de Aedes aegypti realiza actividades de rutina para controlar la trasmisión de arbovirosis en el país, pero siempre quedan poblaciones residuales del vector, que demandan de una vigilancia entomológica sostenible. Objetivo: Determinar la presencia de estadios inmaduros de Ae. aegypti en la provincia La Habana en el periodo 2013-2017. Métodos: Se realizó un análisis del número de criaderos larvales, detectados por los trabajadores del Programa Nacional de Control de Ae. aegypti, en La provincia La Habana entre 2013-2017. La frecuencia de los muestreos fue mensual y se siguió la metodología de encuestas del programa. Resultados: Al analizar el número de criaderos larvales por meses de los 15 municipios de provincia La Habana, se observó un incremento de estos en el periodo de junio a octubre en todos los años y un pico entre los meses de enero a marzo en los años 2014, 2016 y 2017. La incidencia de Ae. aegypti resultó homogénea al comparar las medias por año, excepto para el año 2015 en el cual se observó una disminución significativa en el número de criaderos en comparación solo con el año 2017. Conclusiones: A pesar del esfuerzo que realizan los trabajadores del programa, no se ha logrado una disminución significativa de criaderos de Ae. aegypti, lo que evidencia la necesidad de fortalecer los sistemas de vigilancia y mantener la sostenibilidad de las acciones para controlar de forma efectiva la trasmisión de arbovirosis en la provincia La Habana(AU)

Introduction: The National Aedes aegypti Control Program carries out routine activities to control the transmission of arbovirus infections in the country. However, there still exist residual populations of the vector which require sustainable entomological surveillance. Objective: Determine the presence of immature stage Ae. aegypti in the province of Havana in the period 2013-2017. Methods: An analysis was conducted of the number of larval breeding sites detected by workers from the National Ae. aegypti Control Program in the province of Havana in the period 2013-2017. Sampling was performed on a monthly basis following the surveying methodology of the Program. Results: Analysis of the data on larval breeding sites per month in the 15 municipalities of the province of Havana revealed an increase in their number in the June-October period of every year, and a peak between the months of January and March in the years 2014, 2016 and 2017. Comparison of mean values per year found that incidence of Ae. aegypti was homogeneous, except for the year 2015, when a significant decrease was observed in the number of breeding sites only with respect to the year 2017. Conclusions: Despite the effort made by workers from the Program, a significant reduction has not been achieved in the number of Ae. aegypti breeding sites, which is evidence of the need to strengthen the surveillance systems and maintain the sustainability of the actions performed to effectively control the transmission of arbovirus infections in the Havana province(AU)

Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms.

Between 2016 and 2017, several U.S. Diplomats in Havana, Cuba, experienced perplexing vestibular and neurological symptoms attributed to an unknown source. They presented with significant vestibular and headache symptoms similar to individuals who experience vestibular migraine (VM). As such, we hypothesize that VM may be a possible explanation for the Havana cohort's presenting symptoms. To evaluate this hypothesis, we compared symptoms reported by the affected individuals in Havana, Cuba, to symptoms reported by corresponding patients from a tertiary academic neurotology clinic with a chief complaint of vertigo or disequilibrium, who met the International Classification of Headache Disorders criteria for VM. The prevalence of the Havana subjects experiencing various symptomatic domains was compared with the VM cohort, leading to 26 unique domains and statistical comparisons between the cohorts. Of the 26 domains compared between the two cohorts, 18 were not significantly different. This included the two most important components of meeting criteria for VM, namely the co-existence of headache and vestibular symptoms. On regression analysis, the only feature which kept its significant difference between the two cohorts was acute intense head pressure (P = 0.007). The domains with similar occurrence ratios included dizziness, headache, light sensitivity, hearing reduction, and tinnitus. In other words, multiple headache and vestibular symptoms, consistent with VM criteria, were similar between the two cohorts. The considerable similarities across various domains between VM patients and Havana subjects could be due to migraine as a possible common etiology for both groups. We propose VM as a potential etiology for the symptomatology in the U.S. diplomats in Cuba.

Riqueza de mosquitos en La Habana: su importancia para fomentar la participación comunitaria en su control / Species mosquito richness in Havana: its importance to promote community participation in its control

Introducción: La identificación de las especies de mosquitos a nivel de cada municipio forma parte del Programa de Vigilancia y Control de Aedes aegypti y Aedes albopictus vigente en Cuba. Objetivo: Identificar las especies de mosquitos en sitios de crías artificiales y naturales y relacionarlo con el papel de la comunidad en el control de sus poblaciones en la provincia La Habana. Métodos: Se identificaron las muestras larvarias de mosquitos enviadas al laboratorio provincial de Entomología, colectadas en depósitos artificiales y en sitios naturales en los municipios de La Habana desde enero del 2000 hasta el 2016. Resultados: En el estudio se identificaron un total de 48 especies de mosquitos. Aedes aegypti, Gymnometopa mediovittata, Culex quinquefasciatus y Culex nigripalpus, estuvieron presentes en todos los municipios de La Habana. Los depósitos abandonados en los alrededores de las viviendas y terrenos baldíos como: latas, bebederos, chatarra metálica, neumáticos de autos usados, entre otros, relacionados con actividades humanas, aportaron la mayor riqueza de especies al ecosistema urbano, seguido por los huecos de árboles y sitios de cría naturales. Los depósitos artificiales de almacenamiento de agua con fines domésticos en las viviendas, tales como: tanques, cisternas, cubos, entre otros, fueron los de menor riqueza, pero fundamentales para la presencia de Ae. aegypti. Conclusiones: Disponer de datos actualizados sobre la distribución de las especies de mosquitos y sus sitios de cría en La Habana constituyen una información valiosa para fomentar la participación de la comunidad en la eliminación de estos en momentos de epidemias en que se involucren estos vectores(AU)

Introduction: Identification of the mosquito species present in each municipality is part of the Aedes aegypti and Aedes albopictus Surveillance and Control Program currently in place in Cuba. Objective: Identify the mosquito species in artificial and natural breeding sites and relate that information to the role played by the community in the control of their populations in the province of Havana. Methods: Identification was performed of mosquito larval samples submitted to the Provincial Entomology Laboratory and collected from artificial containers and natural breeding sites in Havana municipalities from January 2000 to 2016. Results: A total 48 mosquito species were identified in the study. Aedes aegypti, Gymnometopa mediovittata, Culex quinquefasciatus and Culex nigripalpus were found to be present in all Havana municipalities. Unused containers scattered around households and in uncultivated fields, such as cans, troughs, scrap metal and used car tires, among other items related to human activities, contribute the greatest species richness to the urban ecosystem, followed by tree holes and natural breeding sites. Artificial water storage containers in households, such as elevated and underground water tanks and buckets, among others, contributed lesser richness, but were fundamental for the presence of A. aegypti. Conclusions: Updated data about the distribution of mosquito species and their breeding sites in Havana is valuable information to foster community participation in their elimination in the event of epidemics involving these vectors(AU)

Strongylides in Achatina(Lissachatina)fulica (Mollusca, Achatinidae) in Havana, Cuba / Strongylides in Achatina(Lissachatina)fulica (Mollusca, Achatinidae) in Havana, Cuba

ABSTRACT Achatina (Lissachatina) fulica was introduced in Cuba in 2014 for african religious purposes and nowadays, mainly by human activity, it is widespread all over the country and, where besides a general nuisance for people it is a pest and also a public health concern, since it is one of the natural intermediate host of Angiostrongylus cantonensis, ethiological agent of the meningoencephalitis. As in Havana is experiencing the explosive phase of the invasion, LABCEL has been receiving samples of these molluscs for identification and search for Angiostrongylus cantonensis larvae. While examining samples of A. fulica different larvae were obtained, as strongylides found in the interior of the pallial cavity of A. fulica.This is the first report in San Miguel del Padron and Regla municipalities of the development of larvae in A. Fulica evidencing the health importance of this mollusc in the potential transmission of eosinophilic meningoencephalitis. Since the spread of A. fulica is pointed out in the literature as one of the main causative spread of the meningoencephalitis caused by A. cantonensis the authors emphasize the need of sanitary vigilance of snails and rats from vulnerable areas for A. cantonensis introduction as the port side areas like these municipalities.

RESUMEN Achatina (Lissachatina) fulica se introdujo en Cuba en 2014 con fines religiosos africanos y hoy en día, principalmente por actividad humana, está muy extendida en todo el país y, además de una molestia general para las personas, es una plaga y también un problema de salud pública, ya que es uno de los huéspedes intermedios naturales de Angiostrongylus cantonensis, agente etiológico de la meningoencefalitis. Como en La Habana está experimentando la fase explosiva de la invasión, LABCEL ha estado recibiendo muestras de estos moluscos para su identificación y búsqueda de larvas de Angiostrongylus cantonensis. Mientras se examinaban muestras de A. fulica, se obtuvieron diferentes larvas, como strongylides encontrados en el interior de la cavidad paliar de A. fulica. Este es el primer informe en los municipios de San Miguel del Padrón y Regla sobre el desarrollo de larvas en A. Fulica evidenciando La importancia para la salud de este molusco en la transmisión potencial de la meningoencefalitis eosinofílica. Dado que la propagación de A. fulica se señala en la literatura como una de las principales causas de la meningoencefalitis causada por A. cantonensis, los autores enfatizan la necesidad de vigilancia sanitaria de caracoles y ratas de áreas vulnerables para la introducción de A. cantonensis como zonas de babor como estos municipios.

An outbreak and case-control study of Salmonella Havana linked to alfalfa sprouts in South Australia, 2018.

An epidemiological investigation and a retrospective case-control study were conducted into an outbreak of Salmonella Havana in alfalfa sprouts, in Adelaide, Australia. In total, 31 cases of S. Havana were notified during June and July 2018 and linked to the outbreak. Eighteen cases and 54 unmatched controls were included in a case-control study. Results from the case-control study indicated an increased risk of illness linked to the consumption of alfalfa sprouts; this was supported by trace-back, sampling and environmental investigations. This outbreak of S. Havana was caused by consumption of alfalfa sprouts from one local sprouts producer. It is unclear as to when in the production of alfalfa sprouts the contamination occurred. However, contaminated seeds and poor pest control are the most likely causes. This investigation highlights the importance of ensuring that producers take appropriate action to minimise the likelihood of contamination and to comply with legislation and standards for primary production and food safety.

Evaluación de las larvitrampas como método de vigilancia de Aedes aegypti (Diptera: Culicidae) y otros culícidos / Assessment of larval traps as a method of surveillance of Aedes aegypti (Diptera:Culicidae) and other culicidae

Introducción: La larvitrampa es uno de los componentes del sistema de vigilancia de Aedes aegypti en Cuba. Objetivo: Evaluar el comportamiento de la positividad a Ae. aegypti y otros culícidos además de la presencia o no de huevos residuales del mosquito en las larvitrampas en un área del ecosistema urbano de La Habana. Métodos: Se realizaron las revisiones de las larvitrampas ubicadas en el municipio Boyeros como parte del sistema de vigilancia de Ae. aegypti semanalmente durante tres años (2010-2012). Posteriormente las positivas al mosquito se sembraron en recipientes con agua para buscar la presencia de huevos en ellas. Resultados: Se identificaron cuatro especies de mosquitos en larvitrampas: Aedes aegypti, Aedes albopictus, Gymnometopa mediovittata y Culex quinquefasciatus. El número de larvitrampas positivas a mosquitos con respecto al total de colocadas en dos de los años estuvo por encima de la mitad; correspondieron gran número de estas a Ae. aegypti durante el período estudiado. El método de la siembra de las larvitrampas demostró la presencia de huevos residuales de Ae. aegypti. Conclusiones: Los resultados confirman la utilización de las larvitrampas en la vigilancia de Ae. aegypti; no obstante, debe revisarse la ubicación de algunas de ellas, y ante la presencia de huevos residuales continuar con la siembra de estas una vez positivas a Ae. aegypti o aplicarles Bacillus thuringiensis variedad israelensis serotipo H - 14 al 0,6 por ciento (Bactivec®), para evitar que se desarrollen las larvas y emerjan adultos, ante la presencia de errores operacionales en tiempo de su revisión(AU)

Introduction: The larval trap is one of the components of the Aedes aegypti surveillance´s system in Cuba. Objective: To evaluate the behavior of positive patterns of Ae. aegypti and other culicidae, and also the presence or not of residual eggs of mosquitoes in larval traps, in an urban area of Havana. Methods: The larval traps installed as part of the surveillance system of Ae. aegypti in Boyeros municipality in Havana were reviewed weekly during three years (2010-2012), after which the mosquito-positive ones were planted in containers with water to search for the presence of eggs in them. Results: Four species of mosquitoes were identified in larval traps:Aedes aegypti, Aedes albopictus, Gymnometopa mediovittata and Culex quinquefasciatus. The number of positive mosquito larval traps was more than half of the total, and a great number of those were Ae. aegypti. The method of larval traps´ planting showed the presence of residual Ae aegypti eggs. Conclusions : The results confirm the use of the larval traps in the surveillance of Ae. Aegypti; however, the installation of some of them should be checked. In the presence of residual eggs is recommended to continue planting them once positive or apply Bacillus thuringiensis, israelensis variety, serotype H - 14 with 0.6 percent (Bactivec®) to prevent the development of larvae and the emergence of adults in the presence of operational errors in the moment of its review(AU)