Posts filed under ‘FIEBRE en el POST-VIAJE’

Correlación entre criterios clínicos y de laboratorio de casos notificados por sospecha de hantavirosis y el resultado de la técnica de referencia.

Rev. Chil. Infectol. Junio 2016 V.33 N.3 P.275-281

Actualmente en Chile, debido a la elevada sospecha clínica de enfermedad por hantavirus y el alto impacto en salud pública que esto provoca, se hace necesario reforzar al equipo de salud, los criterios de sospecha clínica y epidemiológica de hantavirosis.

Objetivo:

Analizar la información contenida en las notificaciones de sospecha de infección por hantavirus versus la técnica de referencia para el diagnóstico confirmatorio de casos sospechosos, ELISA IgM de captura anti-hantavirus.

Material y Método:

Mediante cálculo de precisión diagnóstica se analizó la correlación que existe entre la información entregada en las notificaciones versus el resultado de la confirmación mediante la técnica de referencia.

Resultados:

De 1.566 pacientes estudiados 3,4% (53 casos) fue confirmado para SCPH. De las notificaciones analizadas 58,6% estaban con datos incompletos. Los porcentajes de positividad de la técnica de referencia asociada a fiebre, mialgia y cefalea, fueron de 80-85%. Destaca que la presencia de inmunoblastos (> 10%), presenta: S: 25%, E: 98%, VPP: 37%, VPN: 97%. Paratrombocitopenia se obtuvo: S: 98%, E: 74%, VPP: 16%, VPN: 100%.

Conclusión:

Se hace necesario reiterar a nivel del sistema sanitario chileno la importancia de contar con datos completos en los formularios de notificación. La presencia de trombocitopenia e inmunoblastos (> 10%) fue altamente sensible y especifica, respectivamente, en la detección de pacientes con SCPH. Con el fin de optimizar la sospecha de infección por hantavirus, según la definición de caso sospechoso, se plantea la necesidad de desarrollar programas de capacitación para la sospecha clínica y lectura de parámetros de laboratorio, tales como presencia de inmunoblastos en el hemograma, así como incluir un algoritmo con el fin de optimizar la sospecha y el uso adecuado de los recursos sanitarios.

PDF

https://scielo.conicyt.cl/pdf/rci/v33n3/art04.pdf

 

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January 20, 2019 at 8:05 pm

1er caso de SCPH diagnosticado en la Región de Antofagasta, Chile. 

Rev. Chil. Infectol. Agosto 2012 V.29 N.4 P.477-477

En Chile, desde 1995 se han confirmado casos del SCPH desde Valparaíso hasta Aysén, correspondiendo la mayor incidencia a las regiones de Aysén, Los Lagos, Araucanía y Bío Bío. El agente etiológico del SCPH es un virus ARN del género hantavirus, familia Bunyaviridae, variedad Andes.

El reservorio es el “ratón de cola larga” (Oligoryzomis longicaudatus) el cual se distribuye desde la Región de Atacama hasta la Región de Magallanes (XII°). El virus es eliminado por el ratón a través de sus secreciones (saliva, orina y heces) e ingresa al hombre por vía digestiva, cutánea o aérea, siendo esta última la más frecuente1. La transmisión de persona a persona está documentada, pero se considera excepcional.

El SCPH es un cuadro agudo grave con alta letalidad (30-55%) y sin tratamiento específico. El período de incubación puede durar hasta 45 días. Los primeros síntomas son fiebre, mialgias, cefalea y ocasionalmente diarrea; días después aparece la fase de compromiso respiratorio, con disnea progresiva e insuficiencia respiratoria grave. Es indispensable la terapia de soporte hemodinámico y manejo de la falla respiratoria en una UCI.

PDF

https://scielo.conicyt.cl/pdf/rci/v29n4/art22.pdf

January 20, 2019 at 8:02 pm

Hantavirus Cardiopulmonary Syndrome Due to Imported Andes Hantavirus Infection in Switzerland: A Multidisciplinary Challenge, Two Cases and a Literature Review.

Clin Infect Dis. November 13, 2018 V.67 N.11 P.1788-1795.

Kuenzli AB1, Marschall J1, Schefold JC1, Schafer M1, Engler OB2, Ackermann-Gäumann R2, Reineke DC1, Suter-Riniker F3, Staehelin C1.

Author information

1 Bern University Hospital and University of Bern, Switzerland.

2 Spiez Laboratory, Federal Office for Civil Protection, Switzerland.

3 Institute for Infectious Diseases, University of Bern, Switzerland.

Abstract

Two travellers returning from South America were diagnosed with Andes hantavirus infection, the only member of the Hantaviridae family known to be transmitted from person to person.

We describe the clinical course and therapeutic and infection control measures.

While both patients showed high viral load (VL) and shedding over several months, 1 patient recovered within 1 week from severe respiratory illness that required noninvasive ventilation, whereas the second patient developed severe hantavirus cardiopulmonary syndrome that required extracorporeal membrane oxygenation for 27 days.

The clinical course in the latter patient was complicated by severe disseminated intravascular coagulopathy with diffuse hemorrhage that necessitated mass transfusions, as well as by multiple organ failure, including the need for renal replacement therapy.

Results of VL in blood, respiratory secretions, and semen for the first 9 months of follow-up are reported. To our knowledge, these are the first cases of Andes hantavirus infection detected in Europe.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233683/pdf/ciy443.pdf

January 19, 2019 at 11:17 am

Incubation period of hantavirus cardiopulmonary syndrome.

Emerg Infect Dis. August 2006 V.12 N.8 P.1271-3.

Vial PA1, Valdivieso F, Mertz G, Castillo C, Belmar E, Delgado I, Tapia M, Ferrés M.

Author information

1 Faculdad se Medicina Clinica Alemana, Universidad del Desarrollo, Las Condes 12438, Lo Barnechea, Santiago 0000, Chile. pvial@udd.cl

Abstract

The potential incubation period from exposure to onset of symptoms was 7-39 days (median 18 days) in 20 patients with a defined period of exposure to Andes virus in a high-risk area.

This period was 14-32 days (median 18 days) in 11 patients with exposure for <48 hours.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291207/pdf/05-1127.pdf

January 19, 2019 at 11:15 am

Notes from the Field: Contact Tracing Investigation after First Case of Andes Virus in the United States – Delaware, February 2018

MMWR Morb Mortal Wkly Rep.October 19, 2018 V.67 N.41 P.1162-1163.

Kofman A, Eggers P, Kjemtrup A, Hall R, y cols.

In January 2018, a woman admitted to a Delaware hospital tested positive for New World hantavirus immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Subsequent testing by CDC’s Viral Special Pathogens Branch detected New World hantavirus by nested reverse transcription–polymerase chain reaction (RT-PCR) and Andes virus by nucleic acid sequencing.

This case represents the first confirmed importation of Andes virus infection into the United States; two imported cases have also been reported in Switzerland (1).

Before her illness, the patient had traveled to the Andes region of Argentina and Chile from December 20, 2017, to January 3, 2018. She stayed in cabins and youth hostels in reportedly poor condition. No rodent exposures were reported.

After returning to the United States on January 10, she developed fever, malaise, and myalgias on January 14. On January 17, while ill, she traveled on two commercial domestic flights.

She was hospitalized during January 20–25 in Delaware and discharged to her home after clinical recovery. . . .

FULL TEXT

https://www.cdc.gov/mmwr/volumes/67/wr/mm6741a7.htm?s_cid=mm6741a7_w

PDF

https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6741a7-H.pdf

January 19, 2019 at 8:59 am

Distributional ecology of Andes hantavirus: a macroecological approach.

Int J Health Geogr. June 22, 2018 V.17 N.1 P.22.                     

Astorga F1, Escobar LE2, Poo-Muñoz D3,4, Escobar-Dodero J3, Rojas-Hucks S3, Alvarado-Rybak M3, Duclos M3, Romero-Alvarez D5, Molina-Burgos BE3, Peñafiel-Ricaurte A3, Toro F3, Peña-Gómez FT6,7, Peterson AT5.

Author information

1 Campus Huechuraba, Facultad de Ciencias, Universidad Mayor, 8580745, Santiago, Chile. fran.astorga.vet@gmail.com .

2 Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, 24061, USA.

3 Centro de Investigación para la Sustentabilidad y Programa de Doctorado en Medicina de la Conservación, Facultad de Ciencias de la Vida, Universidad Andres Bello, 8320000, Santiago, Chile.

4 Escuela de Medicina Veterinaria, Facultad de Ciencias, Universidad Mayor, Santiago, Chile.

5 Department of Ecology and Evolutionary Biology, Biodiversity Institute, University of Kansas, Lawrence, KS, 66045, USA.

6 Departamento de Ciencias Ecológicas, Facultad de Ciencias, Universidad de Chile, Santiago, Chile.

7 Instituto de Ecología y Biodiversidad, Facultad de Ciencias, Universidad de Chile, Santiago, Chile.

Abstract

BACKGROUND:

Hantavirus pulmonary syndrome (HPS) is an infection endemic in Chile and Argentina, caused by Andes hantavirus (ANDV). The rodent Oligoryzomys longicaudatus is suggested as the main reservoir, although several other species of Sigmodontinae are known hosts of ANDV. Here, we explore potential ANDV transmission risk to humans in southern South America, based on eco-epidemiological associations among: six rodent host species, seropositive rodents, and human HPS cases.

METHODS:

We used ecological niche modeling and macroecological approaches to determine potential geographic distributions and assess environmental similarity among rodents and human HPS cases.

RESULTS:

Highest numbers of rodent species (five) were in Chile between 35° and 41°S latitude. Background similarity tests showed niche similarity in 14 of the 56 possible comparisons: similarity between human HPS cases and the background of all species and seropositive rodents was supported (except for Abrothrix sanborni). Of interest among the results is the likely role of O. longicaudatus, Loxodontomys micropus, Abrothrix olivaceus, and Abrothrix longipilis in HPS transmission to humans.

CONCLUSIONS:

Our results support a role of rodent species’ distributions as a risk factor for human HPS at coarse scales, and suggest that the role of the main reservoir (O. longicaudatus) may be supported by the broader rodent host community in some areas.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013855/pdf/12942_2018_Article_142.pdf

January 11, 2019 at 8:45 am

Rodent Abundance and Hantavirus Infection in Protected Area, East-Central Argentina.

Emerg Infect Dis. January 2018 V.24 N.1 P.131-134.                       

Maroli M, Vadell MV, Padula P, Villafañe IEG.

Abstract

We captured 3 hantavirus rodent hosts in Otamendi Natural Reserve, Argentina, during 2007-2012. Hantavirus antibodies were found only in Akodon azarae grass mice, mainly in males and old animals. Higher abundance of this species was associated with warm and rainy weather and high water levels, which peaked after a strong El Niño event

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749438/pdf/17-1372.pdf

January 11, 2019 at 8:44 am

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