Síndrome diarreico por rotavirus en niños menores de 5 años inmunizados y no de la ciudad de Maracaibo, estado Zulia, Venezuela / Diarrheic syndrome due to rotavirus in immunized and non-immunized children under 5, in the city of Maracaibo, state of Zulia, Venezuela

La diarrea aguda es la causa más común de morbi-mortalidad infantil, donde el Rotavirus es uno de los principales agentes involucrados en las diarreas severas en niños menores de 5 años. El presente estudio tiene como objetivo determinar la presencia de rotavirus en una población infantil con cuadros diarreicos, vacunados y no vacunados que acuden a observación pediátrica del Hospital de Niños y Hospital Universitario de Maracaibo, estado Zulia en el período de Abril 2011 hasta Abril 2012, para ello se recolectaron 100 muestras de heces y para el diagnóstico se utilizó la técnica de Aglutinación Directa en partículas de Látex. Resultaron positivos un 43,6% (24/55) de niños no vacunados y 33,3% (10/30) de niños vacunados afectando principalmente a los menores de 1 año con predominio del sexo masculino con un 65,9% sobre el sexo femenino con 40%, la diarrea por el agente viral estudiado representó casi la mitad de las hospitalizaciones por gastroenteritis, encontrándose una diferencia estadística significativa de p= 0.027 en el numero de evacuaciones del cuarto día, entre niños no vacunados (5) y vacunados (3). Los resultados de esta investigación muestran la circulación de rotavirus en niños vacunados y no vacunados, es por ello importante considerar que el presente reporte tiene como fin último alertar a la comunidad médica a considerar en todo niño con gastroenteritis la posibilidad de que se trate de un cuadro por RV.

Acute diarrhea is the most common cause of morbidity and mortality in infants, where rotavirus is one of the main agents involved in severe diarrhea for children under five years. The present study aims to determine the presence of rotavirus in a vaccinated and unvaccinated pediatric population with acute diarrhea that came to the Children’s Hospital and the University Hospital of Maracaibo, State of Zulia, for observation from April 2011 to April 2012. One-hundred stool samples were collected and direct agglutination of latex particles was used for diagnosis. 43.6% of the unvaccinated children were positive (24/55) as were 33.3% (10/30) of the vaccinated children. Principally, children under 1 year were affected, predominantly males with 65.9% and females with 40%. Diarrhea due to the viral agent under study accounted for nearly half the hospitalizations for gastroenteritis. A statistically significant difference of p = 0.027 was found between the number of evacuations on the fourth day in unvaccinated (5) and vaccinated (3) children. Results of this research show rotavirus circulating in vaccinated and unvaccinated children. Therefore, the purpose of this report is to alert the medical community to consider that every child with gastroenteritis could possibly have RV.

Diagnóstico etiológico de pacientes con exantemas o cuadros febriles atendidos en 1998. Estado Zulia, Venezuela / Laboratory diagnosis of patients with exanthematic or febrile syndromes occurring in the Zulia State, Venezuela, during 1998

BACKGROUND: Exanthematic diseases are a group of syndromes mainly caused by acute viral infections. AIM: To obtain information about the viruses that cause exanthematic diseases in our region. PATIENTS AND METHODS: During 1998, 267 serum samples from patients with an acute rash or patients presenting a febrile syndrome accompanied by enlarged lymph nodes, headache and other symptoms, were collected. Specific antibody of the IgM class (anti-IgM) against Rubella, Measles, Dengue types 1-4 and Cytomegalovirus (CMV) were measured by immunoenzymatic assay (EIA). Epstein-Barr virus (EBV) antibodies were measured by immunofluorescence. RESULTS: An etiologic agent was detected in 208 cases (77.9%). Cases due to Dengue (40.6%) and Rubella (21%) viruses predominated, but the frequency of other agents was also high in specific age groups. The agreement between the clinical suspicion and the laboratory findings varied broadly, from a 100% for suspected Dengue to just a 14.8% for cases of suspected CMV infection. CONCLUSIONS: Dengue was the most common viral exanthematic disease in the Zulia State during 1998.

[Seroepidemiology of Herpes simplex virus type 2 in the Amerindian Yukpa population of Zulia state, Venezuela]. / Seroepidemiología del virus Herpes simplex 2 en una población indígena Yukpa. Estado Zulia. Venezuela.

BACKGROUND: Yukpa aborigines start early in life their sexual activity and promiscuity with native and foreign individuals is common among women. This behavior allows the installation and propagation of Herpes simplex virus type 2 (HSV-2). AIM: To determine the presence of antibodies to HSV-2 in a Yukpa Amerindian community at Zulia State, Venezuela. SUBJECTS AND METHODS: We studied 96 natives, between 13 and 49 years old (62.3% of the whole population, 100% of individuals in fertile age). Control population consisted of 76 individuals, with similar sex and age range distribution, of the urban population from Maracaibo, Zulia State, Venezuela. HSV-2 serologic status was determined by an indirect fluorescent antibody test. RESULTS: Antibodies to HSV-2 were detected in 53.1% of Yukpa population and 21.1% of urban population. Aboriginal women aged 21 to 40 years old had a prevalence of antibodies against HSV-2 of 66.7%. Among pregnant native women, the prevalence of antibodies against HSV-2 was 54.6%. CONCLUSIONS: There is a high prevalence of antibodies against HSV-2 among Yukpa natives in Venezuela.

[Serum levels of soluble CD30 molecule in hepatitis B virus infection]. / Niveles séricos de la molécula CD30 soluble en la infección por el virus de hepatitis B.

BACKGROUND: The release of CD30 molecule in the soluble form (sCD30) is considered a feature of Th2 activation and proliferation of the cellular phenotype Th2. AIM: To analyze the immunoregulatory role of sCD30 in the evolution of hepatitis B virus (HBV) infection. PATIENTS AND METHODS: Three study groups were formed: 15 patients with acute infection by HBV who remitted toward the resolution of the infection; 15 patients who evolved to the carrier state and 15 subjects without clinical history of infection by this or other viruses. The determination of serological markers for the HBV was done by the Microparticles Enzymatic Immunoanalysis techniques (MEIA). The method of double antibody by ELISA was used For sCD30 determination. RESULTS: A significant sCD30 increase (p < 0.05) was observed in patients with acute infection, during the acute phase (135.7 +/- 36.7). These values decreased to 16.2 +/- 2.5 during the convalescent phase. Patients that evolved to the carrier state, did not experience a rise in sCD30 values (40.2 +/- 6.7, 38 +/- 9.2 and 36.1 +/- 8.3 during the acute phase, at 120 and 240 days respectively). The value in the control group was 34.8 +/- 6.7. CONCLUSIONS: The group that evolved towards remission experienced a higher activation of the Th2 cellular phenotype, promoting humoral immune response. An inactivity of sCD30 values was observed in the group that evolved to the carrier state.

[Effect of climatic factors on the epidemiology of rotavirus infection in children under 5 years of age in the city of Maracaibo, Venezuela]. / Influencia de los factores climatológicos en la epidemiología de la infección por rotavirus en los niños menores de 5 años de la ciudad de Maracaibo, Venezuela.

Diarrhea is one of the most common problem of public health worldwide, specially in developing countries. In Venezuela, this affection must be weekly reported when it occurs in children under five years of age. During June 1993 to May 1995, 379 stool specimens were obtained from children under five years of age with diarrhea admitted in Hospital de Niños of Maracaibo, Venezuela. Control group was conformed by 93 asymptomatic children. The rotavirus RNA was extracted with phenol-chloroform and precipitated with ethanol. Finally, polyacrylamide-gel-electrophoresis (PAGE), followed by silver staining was employed for rotavirus detection. Our results showed 62 (16.4%) positive cases for rotavirus in symptomatic children and 9 (9.7%) in control group. The highest incidence was showed in the infants under one year of age (21.5%). The electrophoretic analysis revealed only one long electropherotype pattern in studied samples. It was observed a close relationship between the increase of rotavirus cases and the increase of the pluviometric index and a decrease of mean temperature observed during the period of study. Both variables determine the increase or decrease of viral infection in our region. This result shows the importance of the climatic factors in the rotavirus epidemiology.

[Molecular epidemiology of subgroups and serotypes of rotavirus in children less than 4 years of age in the city of Maracaibo with a diarrheal syndrome]. / Epidemiología molecular de subgrupos y serotipos de rotavirus en niños menores de cuatro años de la ciudad de Maracaibo con síndrome diarreico.

Between november 1989 and january 1991, two hundred stool samples were obtained from children under 4 years of age, hospitalized with diarrhea. Sixty stool samples from apparently healthy children were used as controls. Rotavirus infections were diagnosed in 28 (14%) specimens using two enzyme immunoassays, (Abbott Laboratories' kit and monoclonal antibodies). PAGE, ELISA and PCR were used to determine electropherotypes, subgroups and serotypes respectively. The study of electropherotypes detected two migration patterns: a short one in 4 samples (14.3%) and a long pattern in 16 cases (57.1%). These results were verified by a specific subgroup monoclonal antibodies ELISA. The polymerase chain reaction showed that serotype 1 accounted for 46.4% of positive samples, while serotypes 3 and 4 present in 3.6% and 7.4% of the specimens respectively. Serotype 2 was not detected and 42.8% samples were untypable. Males between 0 and 12 months of age were the most affected. There was no correlation between human rotavirus serotypes, subgroups and electropherotypes, and age of the patients. All detected genetic variants were present in children under two years of age.