RESUMO
One of the 4 pillars of the World Health Organization (WHO) strategy for the prevention and control of snake bite envenomings is to ensure safe and effective pharmacotherapeutic treatments [1]. The mainstay in the pharmacotherapy of these envenomings, as well as of envenomings by scorpions and spiders, is the timely administration of safe and effective antivenoms [2,3]. Antivenoms are composed of immunoglobulins, or immunoglobulin fragments, purified from the plasma of animals, usually horses, immunized with venoms. Currently, there is an urgent need to improve antivenom availability, accessibility, and affordability on a global basis, particularly for use in sub-Saharan Africa, Asia, and Latin America [1]. There is a long tradition in snake, scorpion, spider, and, more recently, caterpillar antivenoms production in Latin America, especially centered in public manufacturing laboratories in Argentina, Brazil, Peru, Bolivia, Ecuador, Colombia, Venezuela, Costa Rica, and Mexico [4–6]. A network of public laboratories devoted to the production and quality control of antivenoms was established in this region in the last decade [4,5], which has recently led to the creation of the Latin American Network of Public Antivenom Manufacturing Laboratories (RELAPA, Red Latinoamericana de Laboratorios Públicos Productores de Antivenenos) [6]. RELAPA aims at consolidating governance mechanisms within a regional platform for technical cooperation, technology transfer, research, and training for the regional improvement of antivenom availability, under the coordination of the Pan American Health Organization (PAHO) and its office Centro Panamericano de Fiebre Aftosa (Panaftosa). As part of the ongoing activities of RELAPA, a survey was sent by PAHO/Panaftosa to the institutions integrating this network to assess the situation of antivenom manufacture in these laboratories during the period January 2020 to July 2020, with the goal of analyzing in which ways has antivenom production been affected in this extraordinary year, especially regarding the impact of the Coronavirus Disease 2019 (COVID-19) pandemic, which has profoundly stricken Latin America [7]. The survey was sent to the directors of the institutions of RELAPA (the list of institutions is detailed in Fan and colleagues [6]). The survey included the following aspects: (a) What was the demand and the production of antivenoms (including snake, scorpion, spider, and caterpillar antivenoms) during the period January 2020 to July 2020? (b) What was the effect of the COVID-19 pandemic in (i) the number of professional and technical staff working to manufacture antivenom, (ii) acquisitions of consumables and laboratory equipment, (iii) overall budget devoted to antivenom manufacture, and (iv) attention to the COVID-19 crisis in terms of development of therapeutic equine preparations against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), preparation of diagnostic reagents, quality control activities, or assignment of staff to attend other pandemic issues? (c) Which are the priorities of the laboratories in the near future regarding regional cooperation in the field of antivenom manufacture and quality control? The survey was carried out between October 1 and October 19, 2020, using the platform Qualtrics (Qualtrics XM Platform, Seattle, Washington, United States of America).
RESUMO
The situation of public laboratories manufacturing antivenoms in Latin America was analyzed, based on the results of a workshop coordinated by the Pan American Foot-and-Mouth Disease Center (PANAFTOSA) of the Pan American Health Organization (PAHO). Nine countries in the region have 12 public laboratories that produce and distribute antivenoms for use against different venomous animals. The situation of each laboratory was discussed, and an analysis was conducted of the current scenario, which is characterized by increasing regulatory requirements that vary in terms of infrastructure and production capacity. The authors identified a need to organize regional cooperation processes to improve the availability of antivenoms, including: research and development projects to improve processes and technologies; studies of the capacity of antivenoms to neutralize different poisons; and technical training programs for professionals and technical personnel. In the current context, in which the World Health Organization has prepared a global strategy for the prevention and control of snakebite envenoming, PANAFTOSA has taken on coordination of this initiative in the Americas. Improving the availability of antivenoms is the priority. As a result of the workshop, the RELAPA network was created, bringing together public laboratories that manufacture antivenoms in Latin America, in order to strengthen these laboratories and increase the availability of, and access to effective and safe antivenoms throughout Latin America.
RESUMO
The situation of public laboratories manufacturing antivenoms in Latin America was analyzed, based on the results of a workshop coordinated by the Pan American Foot-and-Mouth Disease Center (PANAFTOSA) of the Pan American Health Organization (PAHO). Nine countries in the region have 12 public laboratories that produce and distribute antivenoms for use against different venomous animals. The situation of each laboratory was discussed, and an analysis was conducted of the current scenario, which is characterized by increasing regulatory requirements that vary in terms of infrastructure and production capacity. The authors identified a need to organize regional cooperation processes to improve the availability of antivenoms, including: research and development projects to improve processes and technologies; studies of the capacity of antivenoms to neutralize different poisons; and technical training programs for professionals and technical personnel. In the current context, in which the World Health Organization has prepared a global strategy for the prevention and control of snakebite envenoming, PANAFTOSA has taken on coordination of this initiative in the Americas. Improving the availability of antivenoms is the priority. As a result of the workshop, the RELAPA network was created, bringing together public laboratories that manufacture antivenoms in Latin America, in order to strengthen these laboratories and increase the availability of, and access to effective and safe antivenoms throughout Latin America.
RESUMO
Identificar e investigar precocemente surtos causados por alimentos é um dos componentes essenciais da vigilância epidemiológica das doenças transmitidas por alimentos. Doenças veiculadas por alimentos representam, atualmente, na maior parte dos países, a principal causa de surtos de diarréia. A globalização da economia, as alterações nos hábitos alimentares, o crescente consumo de alimentos preparados fora de casa, dentre outros aspectos, alteraram o perfil epidemiológico dessas doenças, expondo a população a vários tipos de contaminantes. Por sua vez, o desemprego tem sido um fator importante para o crescimento do setor de prestação de serviços alimentícios, do comércio ambulante de alimentos e mesmo de bufês, principalmente nos países em desenvolvimento; e não apenas permanecem como clandestinos perante a legislação sanitária, mas também desconhecem as boas práticas de preparação de alimentos, constituindo-se em grande risco para a saúde da população. Esse trabalho tem o objetivo de apresentar os resultados da investigação realizada para a identificação de um surto de toxinfecção alimentar ocorrido em um evento científico promovido por uma instituição pública, que contratou um bufê para o fornecimento das refeições. Dentre os 55 participantes que almoçaram no primeiro dia do evento, 28 (51%) adoeceram, tendo sido identificada a Salmonella Typhimurium como causadora do surto e implicado, o sanduíche de tomate seco com queijo branco [TA = 61,5% (24 doentes/39 expostos); RR = 2,46; IC de 95% = 1,02 -5,96; X2 = 4,69; p < 0,05]. Medidas sanitárias foram tomadas a partir da identificação da epidemiologia do surto e do rastreamento dos alimentos visando à prevenção de novos surtos.