[Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces]. / Implementación del Reglamento Sanitario Internacional en Cuba: evaluación de capacidades básicas del sector salud en provincias seleccionadas.

OBJECTIVE: Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). METHODS: A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. RESULTS: The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. CONCLUSIONS: The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.

Implementación del Reglamento Sanitario Internacional en Cuba: evaluación de capacidades básicas del sector salud en provincias seleccionadas / Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces

Objetivo. Obtener información de línea base sobre el estado de las capacidades básicas delsector salud a nivel local, municipal y provincial, a fin de facilitar la identificación de prioridadesy orientar las políticas públicas dirigidas a garantizar los requisitos y capacidades establecidosen el Anexo 1A del Reglamento Sanitario Internacional de 2005 (RSI-2005).Métodos. Se realizó un estudio descriptivo de corte transversal mediante la aplicación de uninstrumento de evaluación de capacidades básicas referidas a la autonomía legal e institucional,el proceso de vigilancia e investigación y la respuesta frente a emergencias sanitarias en36 entidades involucradas en el control sanitario internacional de los niveles local, municipaly provincial en las provincias de La Habana, Cienfuegos y Santiago de Cuba.Resultados. Los policlínicos y centros provinciales de higiene y epidemiología de las tres provinciascontaban con más del 75% de las capacidades básicas requeridas. Doce de 36 unidadesdisponían del 50% del marco legal e institucional implementado. La vigilancia e investigaciónde rutina presentaron una disponibilidad variable, mientras que las entidades de La Habanacontaron con más del 40% de capacidades básicas en el campo de la respuesta ante eventos.Conclusiones. Las provincias evaluadas cuentan con capacidades básicas instaladas quepermitirán la implementación del RSI-2005 según el plazo previsto por la Organización Mundialde la Salud. Es necesario establecer y desarrollar planes de acción eficaces para consolidara la vigilancia como una actividad esencial de seguridad nacional e internacional en términosde salud pública.

Objective. Obtain baseline information on the status of the basic capacities ofthe health sector at the local, municipal, and provincial levels in order to facilitateidentification of priorities and guide public policies that aim to comply with therequirements and capacities established in Annex 1A of the International HealthRegulations 2005 (IHR-2005).Methods. A descriptive cross-sectional study was conducted by application ofan instrument of evaluation of basic capacities referring to legal and institutionalautonomy, the surveillance and research process, and the response to healthemergencies in 36 entities involved in international sanitary control at the local,municipal, and provincial levels in the provinces of Havana, Cienfuegos, andSantiago de Cuba.Results. The polyclinics and provincial centers of health and epidemiology in thethree provinces had more than 75% of the basic capacities required. Twelve out of36 units had implemented 50% of the legal and institutional framework. There wasvariable availability of routine surveillance and research, whereas the entities inHavana had more than 40% of the basic capacities in the area of events response.Conclusions. The provinces evaluated have integrated the basic capacities thatwill allow implementation of IHR-2005 within the period established by the WorldHealth Organization. It is necessary to develop and establish effective action plans toconsolidate surveillance as an essential activity of national and international securityin terms of public health.

West Nile Virus Infection in Humans and Horses, Cuba

West Nile virus was first detected in the Western Hemisphere during an outbreak of encephalitis in New York State in 1999 (1). Genetic analyses showed that the virus responsible for the 1999 outbreak was nearly identical to a WNV strain circulating in Israel in 1998 (2). Recent outbreaks of WNV disease in the United States and Canada have been accompanied by a high proportion of deaths in birds (3,4), substantial illness in equines (4,5), and thousands of cases of severe neurologic disease in humans (6). The range of WNV has rapidly expanded across the continental United States and Canada (7). WNV infection in humans, equines, and birds in Mexico (8), the Caribbean (9), and South and Central America (10,11) shows southward movement of the virus. Because Cuba is close to areas of the United States where WNV is endemic and because of recent evidence that suggests spread of WNV into the Caribbean, surveillance was established to monitor for WNV in Cuba. Beginning in 2002, the Medical Services and Ministry of Agriculture and Veterinarian Services of Cuba established a national surveillance program by using birds, horses, and humans to detect WNV activity. In this report, we summarize the key findings of surveillance activities(AU)

El virus del Nilo Occidental se detectó por primera vez en el Hemisferio Occidental durante un brote de encefalitis en el estado de Nueva York en 1999 (1). Análisis genéticos mostraron que el virus responsable del brote de 1999 fue casi idéntico a una cepa de virus que circulan en Israel en 1998 (2). Los recientes brotes de la enfermedad del VNO en Estados Unidos y Canadá se han visto acompañadas por una elevada proporción de muertes en las aves (3,4), enfermedad importante en equinos (4,5), y miles de casos de enfermedad neurológica en los seres humanos (6 ). La gama de virus se ha expandido rápidamente en todo el territorio continental de Estados Unidos y Canadá (7). La infección por el VNO en los seres humanos, equinos y aves en Mexico (8), el Caribe (9), América del Sur y Centroamérica (10,11) muestra el movimiento hacia el sur del virus. Porque Cuba está cerca de zonas de Estados Unidos, donde el virus es endémico y debido a las pruebas recientes sugieren que la propagación de virus en el Caribe, la vigilancia se estableció para supervisar VNO en Cuba. A partir de 2002, los Servicios Médicos y el Ministerio de Agricultura y Servicios Veterinarios de Cuba estableció un programa nacional de vigilancia mediante el uso de aves, caballos, y los seres humanos para la detección de VNO actividad. En este informe, resumimos las principales conclusiones de las actividades de vigilancia

West Nile Virus infection in humans and horses, Cuba.

A surveillance system to detect West Nile virus (WNV) was established in Cuba in 2002. WNV infection was confirmed by serologic assays in 4 asymptomatic horses and 3 humans with encephalitis in 2003 and 2004. These results are the first reported evidence of WNV activity in Cuba.