Quantitative detection of SARS-CoV-2 RNA in nasopharyngeal samples from infected patients with mild disease.

Diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) cases is based on the count of real-time reverse transcription-plymerase chain reaction (RT-PCR) positive people. Viral load by real-time RT-PCR has been suggested as a biomarker of the SARS-CoV-2 infection. However, the association of viral load and severity of the disease is not yet resolved. Nasopharyngeal samples from 458 patients were tested by RT-PCR for SARS-CoV-2 diagnosis. Relative quantitation was made by the comparative threshold cycle (ΔΔCt ) formula between ORF1ab viral and RNase P housekeeping genes. Absolute viral load was calculate using a reference positive control. Most prevalent clinical signs were cough (75.8%), myalgia (66.7%), and fever (48.5%). Hypertension (18.2%), neurological diseases (15.1%), and asthma and hypothyroidism (12.1%) were most frequent comorbidities. Fever, either as an exclusive symptom or combined with others, was associated with high viral loads ( 2-∆∆Ct range, 35.65-155.16; 4.25-4.89 log10 RNA copies/test]). During the first week after onset of symptoms in mild patients up to 60 years-old was detected the peak of viral load. Children under 10 years old have a high viral load (313.84; 2.50) in the first 2 days postinfection with a sharp decline thereafter. Cases between 10 and 49 years old mostly showed low and moderate viral load during the first 2 days postinfection (range, 0.03 to 17.24; -1.50 to 1.24). Patients over 60 years old have high viral load up to the second week after the onset of symptoms (range, 25.32-155.42; 1.40-2.19), indicating the longer presence of the virus in them. These findings suggest the viral load in nasopharyngeal swabs would help to monitor the SARS-CoV-2 infection in mild coronavirus disease 2019 cases.

Geographical Distribution of Genetic Variants and Lineages of SARS-CoV-2 in Chile.

The pandemic caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a worldwide public health concern. First confined in China and then disseminated widely across Europe and America, SARS-CoV-2 has impacted and moved the scientific community around the world to working in a fast and coordinated way to collect all possible information about this virus and generate new strategies and protocols to try to stop the infection. During March 2020, more than 16,000 full viral genomes have been shared in public databases that allow the construction of genetic landscapes for tracking and monitoring the viral advances over time and study the genomic variations present in geographic regions. In this work, we present the occurrence of genetic variants and lineages of SARS-CoV-2 in Chile during March to April 2020. Complete genome analysis of 141 viral samples from different regions of Chile revealed a predominance of variant D614G like in Europe and the USA and the major presence of lineage B.1. These findings could help take control measures due to the similarity of the viral variants present in Chile, compared with other countries, and monitor the dynamic change of virus variants in the country.

Phylogenetic analysis of the first four SARS-CoV-2 cases in Chile.

The current pandemic caused by the new coronavirus is a worldwide public health concern. To aboard this emergency, and like never before, scientific groups around the world have been working in a fast and coordinated way to get the maximum of information about this virus when it has been almost 3 months since the first cases were detected in Wuhan province in China. The complete genome sequences of around 450 isolates are available, and studies about similarities and differences among them and with the close related viruses that caused similar epidemics in this century. In this work, we studied the complete genome of the first four cases of the new coronavirus disease in Chile, from patients who traveled to Europe and Southeast Asia. Our findings reveal at least two different viral variants entries to Chilean territory, coming from Europe and Asia. We also sub-classified the isolates into variants according to punctual mutations in the genome. Our work contributes to global information about transmission dynamics and the importance to take control measures to stop the spread of the infection.

Host characteristics predict outcome among adult patients admitted by severe acute respiratory infection.

BACKGROUND: Except for influenza pandemics, different observational studies have failed to demonstrate differences in mortality between various etiologies in adult patients hospitalized for respiratory infections. AIM: To compare clinical and mortality differences between different viral pathogens associated with severe acute respiratory infections (SARI) in hospitalized adults. MATERIAL AND METHODS: One-year prospective study in a sentinel center. We included 132 patients with SARI hospitalized for any of the nine viruses under study by PCR. Clinical variables were compared, excluding cases of coinfection. RESULTS: A viral coinfection was identified in 12% and influenza infection in 56% of cases. Eighty percent of patients were aged ≥ 65 years, with a high frequency of comorbidities, 27% were bedridden. Twenty four percent were admitted to critical care units, 20% required ventilatory assistance and 16% died. Cases occurred throughout the year, with an expected seasonal peak between autumn and spring and a predominance of infections not associated with influenza during summer months. In the multivariate analysis, only being bedridden was significantly associated with mortality at discharge (Odds ratio 23.46; 95% confidence intervals 3.33-165.12, p < 0.01), without association with age, comorbidity, viral pathogen involved, laboratory parameters, clinical presentation or CURB65 score. No major clinical dissimilarities were found between different viral pathogens. CONCLUSIONS: In our series of patients, mostly elderly, only bedridden status was significantly associated with mortality at discharge in patients hospitalized for SARI. Viral pathogens were not relevant.

Host characteristics predict outcome among adult patients admitted by severe acute respiratory infection / Características del huésped predicen el desenlace en adultos hospitalizados por infección respiratoria aguda grave

Background: Except for influenza pandemics, different observational studies have failed to demonstrate differences in mortality between various etiologies in adult patients hospitalized for respiratory infections. Aim: To compare clinical and mortality differences between different viral pathogens associated with severe acute respiratory infections (SARI) in hospitalized adults. Material and Methods: One-year prospective study in a sentinel center. We included 132 patients with SARI hospitalized for any of the nine viruses under study by PCR. Clinical variables were compared, excluding cases of coinfection. Results: A viral coinfection was identified in 12% and influenza infection in 56% of cases. Eighty percent of patients were aged ≥ 65 years, with a high frequency of comorbidities, 27% were bedridden. Twenty four percent were admitted to critical care units, 20% required ventilatory assistance and 16% died. Cases occurred throughout the year, with an expected seasonal peak between autumn and spring and a predominance of infections not associated with influenza during summer months. In the multivariate analysis, only being bedridden was significantly associated with mortality at discharge (Odds ratio 23.46; 95% confidence intervals 3.33-165.12, p < 0.01), without association with age, comorbidity, viral pathogen involved, laboratory parameters, clinical presentation or CURB65 score. No major clinical dissimilarities were found between different viral pathogens. Conclusions: In our series of patients, mostly elderly, only bedridden status was significantly associated with mortality at discharge in patients hospitalized for SARI. Viral pathogens were not relevant.

Los factores del huésped son más importantes que el tipo viral para predecir el desenlace en pacientes hospitalizados por infecciones respiratoria aguda grave. Exceptuando las pandemias de influenza, diferentes estudios observacionales no han logrado demostrar diferencias en mortalidad entre diferentes patógenos en pacientes adultos hospitalizados por infecciones respiratorias. Objetivo: Comparar diferencias clínicas y en mortalidad entre diferentes patógenos virales asociados a infección respiratoria aguda grave (IRAG) en adultos hospitalizados. Método: Estudio prospectivo durante un año en un centro centinela. Se incluyeron casos de IRAG hospitalizados por alguno de los 9 virus bajo estudio por RCP. Se compararon variables clínicas y desenlace. Resultados: Ingresaron 132 pacientes con IRAG. Se identificó coinfección viral en 12,1% e infección por influenza en 56,1%. La mayor parte era de la tercera edad (80,3%) con una alta frecuencia de comorbilidad y 27,3% estaba postrado. Veintitres coma cinco por ciento ingresó a unidad de cuidados críticos, 19,7% requirió asistencia ventilatoria y 15,9% fallecieron. Los casos ocurrieron todo el año, con un aumento estacional esperado entre otoño y primavera y predominio de infecciones no asociadas a influenza en verano. En el análisis multivariado, sólo la postración se asoció significativamente a mortalidad al egreso (ORa 23,46 IC95 3,33-165,12, p = 0,002), sin asociación con la edad, comorbilidad, patógeno viral involucrado, parámetros de laboratorio, presentación clínica o puntuación CURB65. No se encontraron discordancias clínicas mayores entre diferentes agentes virales. Conclusiones: En nuestra serie de pacientes, mayoritariamente de la tercera edad, sólo la postración se asoció significativamente a mortalidad al egreso en pacientes hospitalizados por IRAG. El patógeno viral no resultó ser relevante.

Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014.

BACKGROUND: Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases). METHODS: For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity. RESULTS: The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I2>90%) for most sRIRs. The variations of countries' geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play. CONCLUSIONS: These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type.

[Acute glomerulonephritis with hemodialysis requirement secondary to influenza A H1N1pdm09 infection: Report of two cases]. / Glomerulonefritis aguda con requerimiento de diálisis asociada a influenza A H1N1pdm09: Comunicación de dos casos.

Acute renal failure (ARF) requiring hemodialysis is not common among patients affected by influenza. We report two unvaccinated adult patients with smoking habit, which were admitted with severe influenza A H1N1pdm09 that evolved with shock and required mechanical ventilation. Both patients developed progressive renal failure with oliguria/anuria, associated with urinary of inflammatory sediment with proteinuria, microhematuria and in one case also with hypocomplementemia, suggesting acute glomerulonephritis. Renal replacement therapy (RRT) was required in both cases. In one patient, who died of late complications, sequencing of the HA1 segment revealed the previously described D222N mutation associated to severe cases. ARF with RRT appears to be an uncommon complication of patients hospitalized for influenza A H1N1pdm09 and may be secondary to acute glomerulonephritis.

Glomerulonefritis aguda con requerimiento de diálisis asociada a influenza A H1N1pdm09: comunicación de dos casos / Acute glomerulonephritis with hemodialysis requirement secondary to influenza A H1N1pdm09 infection: report of two cases

Acute renal failure (ARF) requiring hemodialysis is not common among patients affected by influenza. We report two unvaccinated adult patients with smoking habit, which were admitted with severe influenza A H1N1pdm09 that evolved with shock and required mechanical ventilation. Both patients developed progressive renal failure with oliguria/anuria, associated with urinary of inflammatory sediment with proteinuria, microhematuria and in one case also with hypocomplementemia, suggesting acute glomerulonephritis. Renal replacement therapy (RRT) was required in both cases. In one patient, who died of late complications, sequencing of the HA1 segment revealed the previously described D222N mutation associated to severe cases. ARF with RRT appears to be an uncommon complication of patients hospitalized for influenza A H1N1pdm09 and may be secondary to acute glomerulonephritis.

La insuficiencia renal aguda (IRA) que requiere hemodiálisis no es una complicación común entre los pacientes afectados por influenza. Se comunican los casos clínicos de dos pacientes adultos fumadores no vacunados, que se internaron por influenza A H1N1pdm09 grave por shock y necesidad de ventilación mecánica. Ambos desarrollaron una falla renal progresiva con oliguria/anuria, asociada a un sedimento de orina inflamatorio con proteinuria, microhematuria y en un caso además con hipocomplementemia, sugiriendo una glomerulonefritis aguda. Se requirió terapia de reemplazo renal (TRR) en ambos casos. En uno de los pacientes, que falleció por complicaciones tardías, la secuenciación del segmento HA1 reveló la mutación D222N previamente descrita en casos graves. La IRA con TRR parece ser una complicación infrecuente de los pacientes ingresados por influenza A H1N1pdm09 y puede ser secundaria a una glomerulonefritis aguda.

Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?

INTRODUCTION: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. METHODS: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with ≥80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics. RESULTS: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics. DISCUSSION: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate.

Clinical relevance of rhinovirus infections among adult hospitalized patients

Human rhinovirus (HRV) is an emerging viral pathogen. Aim: To characterize a group of patients admitted due to infection by this agent in a general hospital in Chile. Methods: Cases were identified by RT-PCR for 1 year through active surveillance of patients admitted with severe respiratory illness. Diagnosis was not available during hospitalization. Thirty-two cases were identified, 90% were ≥60 years old or had co-morbid conditions. Human rhinovirus-related admissions represented 23.7% of hospitalization due to severe acute respiratory infections among adults and ranked second to influenza (37.8%). Patients presented with pneumonia (68.8%), decompensated chronic lung conditions (21.9%), heart failure or influenza-like illness (6.3% each). Admission to intensive or intermediate care units was required by 31.2% and in-hospital mortality reached 12.5%. A CURB-65 score ≥3 was significantly associated to in-hospital mortality (p < 0.05). Most patients received antibiotics (90%). Conclusions: Human rhinovirus infections in elderly patients with co-morbid conditions are associated with hospitalizations, requiring critical or semi-critical antibiotics use. A high CURB-65 score was associated to in-hospital mortality. .

Clinical relevance of rhinovirus infections among adult hospitalized patients.

UNLABELLED: Human rhinovirus (HRV) is an emerging viral pathogen. AIM: To characterize a group of patients admitted due to infection by this agent in a general hospital in Chile. METHODS: Cases were identified by RT-PCR for 1 year through active surveillance of patients admitted with severe respiratory illness. Diagnosis was not available during hospitalization. Thirty-two cases were identified, 90% were ≥60 years old or had co-morbid conditions. Human rhinovirus-related admissions represented 23.7% of hospitalization due to severe acute respiratory infections among adults and ranked second to influenza (37.8%). Patients presented with pneumonia (68.8%), decompensated chronic lung conditions (21.9%), heart failure or influenza-like illness (6.3% each). Admission to intensive or intermediate care units was required by 31.2% and in-hospital mortality reached 12.5%. A CURB-65 score ≥3 was significantly associated to in-hospital mortality (p<0.05). Most patients received antibiotics (90%). CONCLUSIONS: Human rhinovirus infections in elderly patients with co-morbid conditions are associated with hospitalizations, requiring critical or semi-critical antibiotics use. A high CURB-65 score was associated to in-hospital mortality.

Vigilancia de influenza en Chile: 2010 / Influenza surveillance in Chile: 2010

Se analizó el comportamiento de la influenza en el 2010, a través de los componentes de la vigilancia. Desde la semana epidemiológica (SE) 32 aumenta la notificación de ETI en los centinela, con un máximo de casos en la SE 37 (tasa 80 por 105), inferior a 2009. Este aumento coincide con el alza de las consultas respiratorias (especialmente infecciones respiratorias agudas altas e influenza) que llega a 43 por ciento en la SE 36. Destaca la cocirculación de influenza AH1N1 (2009) y H3N2, con predominio de esta última y un máximo en la SE 36. La gravedad (hospitalizaciones por infecciones respiratorias agudas graves y fallecidos) fue menor que en 2009 y se concentró en los casos de H3N2. El aumento observado el 2010 fue de intensidad elevada, de carácter epidémico, y se desplazó a los meses de agosto-septiembre. Se requiere mantener y reforzar los componentes de la vigilancia influenza en el actual período pospandémico.

It was analyzed the 2010 influenza behaviour through surveillance components. Since epidemiologic week (EW) 32, influenza like disease notification increases in sentinel centers, with a maximum of cases on EW 37 (rate of 80 per 105), less than2009. This increase coincide with the rise in respiratory hospital visits (especially upper acute respiratory infections) reaching 43 percent on EW 36. it is registered co-circulation of influenza AH1N1 (2009) and H3N2, the last prevailing over the first one anda maximum on EW 36. Severity (severe acute respiratory infections hospitalizations and deaths) was lower than 2009 and was concentrated in H3N2 cases. The observed increase in 2010 was of high intensity, epidemic nature and shifted to August-September. It is required maintaining and reinforcing influenza surveillance components, in the current pos-pandemic period.

[Genetic characterization of the virus causing H1N1 influenza pandemic in Chile: analysis of the first detected cases]. / Inicio del brote de Influenza A (H1N1) pandémica en Chile: caracterización genética de los primeros casos detectados.

BACKGROUND: Following the announcement of the Influenza A(H1N1) pandemic by the World Health Organization in April 2009, a surveillance program was carried out in Chile to detect the introduction of the virus in the country and to monitor its propagation and impact. AIM: To describe the onset of the outbreak and the genetic characterization of the pandemic H1N1 influenza virus in the first detected cases in Chile. MATERIAL AND METHODS: Analysis of18 clinical samples coming from suspicious patients, received in a National Reference Laboratory. RNA reverse transcription and real time influenza gene DNA amplification was carried out in a 7500 Fast and Step One Real Time PCR Systems of Applied Biosystems and MxPro-Mx3000P thermocycler from Stratagene. Super Script III Platinum One-Step Quantitative RT-PCR was used. RESULTS: The virus was first detected in three persons returning from the Dominican Republic via Panamá and a child from the east zone of Santiago. Genetic characterization of the virus showed that the child was infected by a different variant of the pandemic virus than the three persons returning from the Caribbean. CONCLUSIONS: The onset of the Influenza outbreak in Chile apparently carne from two different epidemiological groups. The spread of the virus detected in the voyagers was limited immediately However the virus of the fourth case was found in different regions of Chile.

Rubella outbreaks following virus importations: the experience of Chile.

BACKGROUND: Strategies for accelerated control of rubella and congenital rubella syndrome (CRS) in Chile included mass vaccination of women of childbearing age in 1999 but did not include vaccination of adult men. METHODS: We reviewed data from Chile's integrated surveillance system for measles, rubella, and CRS from 2004 through 2009 and describe the epidemiology of rubella outbreaks and implementation of control measures in 2005 and 2007 following mass vaccination of women. Population estimates from census data were used to calculate rubella incidence rates. The age distribution of rubella cases during 2007 was compared with rubella vaccination opportunities by birth cohort to orient mass vaccination of adult men. RESULTS: In 2005, an institutional outbreak of rubella occurred among male naval recruits 18-22 years of age, with 46 confirmed cases over a 5-month period. Beginning in March 2007, rubella outbreaks among young adults in the capital of Santiago spread throughout Chile, resulting in >4000 confirmed rubella cases. Delayed control measures and rapid dissemination among young adults led to widespread transmission. From 2007 through 2009, rubella incidence was highest among adult men not included in previous vaccination strategies. Mass vaccination of men 19-29 years of age was conducted in November 2007 to interrupt rubella transmission. CONCLUSIONS: Chile's experience suggests that vaccination strategies for rubella and CRS elimination need to include both men and women.

Inicio del brote de Influenza A (H1N1) pandémica en Chile: caracterización genética de los primeros casos detectados / Genetic characterization of the virus causing H1N1 influenza pandemic in Chile: Analysis of the first detected cases

Background: Following the announcement of the Influenza A(H1N1) pandemic by the World Health Organization in April 2009, a surveillance program was carried out in Chile to detect the introduction of the virus in the country and to monitor its propagation and impact. Aim: To describe the onset of the outbreak and the genetic characterization of the pandemic H1N1 influenza virus in the first detected cases in Chile. Material and Methods: Analysis of18 clinical samples coming from suspicious patients, received in a National Reference Laboratory. RNA reverse transcription and real time influenza gene DNA amplification was carried out in a 7500 Fast and Step One Real Time PCR Systems of Applied Biosystems and MxPro-Mx3000P thermocycler from Stratagene. Super Script III Platinum One-Step Quantitative RT-PCR was used. Results: The virus was first detected in three persons returning from the Dominican Republic via Panamá and a child from the east zone of Santiago. Genetic characterization of the virus showed that the child was infected by a different variant of the pandemic virus than the three persons returning from the Caribbean. Conclusions: The onset of the Influenza outbreak in Chile apparently carne from two different epidemiological groups. The spread of the virus detected in the voyagers was limited immediately However the virus of the fourth case was found in different regions of Chile.

Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa.

UNLABELLED: INTRODUCTION AND SETTING: Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory-confirmed H1N1pdm patients between 1 April 2009 - 31 January 2010 from five temperate countries in the Southern Hemisphere-Argentina, Australia, Chile, New Zealand, and South Africa. OBJECTIVE: We evaluate transmission dynamics, indicators of severity, and describe the co-circulation of H1N1pdm with seasonal influenza viruses. RESULTS: In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza-like illness (ILI) activity in four of the five countries was 3-6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2-1.6. The median age of patients in all countries increased with increasing severity of disease, 4-14% of all hospitalized cases required critical care, and 26-68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population-based hospitalization rates among children <5 years old. National population-based mortality rates ranged from 0.8-1.5/100,000. CONCLUSIONS: The difficulty experienced in tracking the progress of the pandemic globally, estimating its severity early on, and comparing information across countries argues for improved routine surveillance and standardization of investigative approaches and data reporting methods.

Descentralización del diagnóstico de influenza pandémica en Chile: implementación laboratorios regionales de RT-PCR / Decentralization of pandemic influenza diagnosis in Chile: implementing regional laboratories RT-PCR

Debido a la pandemia de influenza A (H1N1) en el mundo, el Ministerio de Salud en Chile desarrolló un proyectodestinado a fortalecer la capacidad de los laboratorios descentralizados, mediante utilización de la técnica de biología molecular RT-PCR. El proyecto contempló: 1) Readecuación de los espacios físicos en los laboratorios clínicos, 2) compra de equipamiento, 3) adquisición de reactivos e insumos de laboratorio, 4) adquisición de materiales para la toma de muestra, 5) capacitación del recurso humano y 6) verificación del correcto funcionamiento del laboratorio. Al 2010, se encuentran funcionando 6 laboratorios que emplean RT-PCR; se ha obtenido un 100 por ciento de concordancia de las muestras y las autoridades centrales han elaborado un algoritmo de derivación de muestras respiratorias por parte de los 29 Servicios de Salud a los laboratorios regionales, basado en grupos objetivos establecidos en la vigilancia de influenza.

Due to pandemic influenza A (H1N1) in the world, the Ministry of Health in Chile developed a project to strengthen decentralized laboratory capacity through the use of molecular biology technique RT-PCR. The project included: 1) Renovating the physical space in clinical laboratories, 2) purchasing equipment, 3) purchasing laboratory reagents and supplies, 4) acquiring materials for sample collection, 5) human resource training 6) verifying the proper functioning of the laboratory. By 2010, 6 laboratories employing RT-PCR are running, a 100 percent match of the samples has been obtained and the central authorities have developed an algorithm for derivation of respiratory specimens from the 29 Health Services to regional laboratories based on target groups established in the surveillance of influenza.

[Clinical study of measure of parasitemia in patients infected with Trypanosoma cruzi in Atacama, Chile]. / Estudio clínico y determinación de la parasitemia en un grupo de pacientes infectados por Trypanosoma cruzi de la región de Atacama, Chile.

BACKGROUND: Trypanosoma cruzi infection is endemic in Northern/Central Chile. AIM: To perform a clinical assessment of patients infected with Trypanosoma cruzi. PATIENTS AND METHODS: Two hundred sixty three subjects with a positive serology for Trypanosoma cruzi, were invited by mail to a clinical assessment in a Regional Hospital. In a subsample of these, a polymerase chain reaction for Trypanosoma cruzi, was done. RESULTS: Of all the invited subjects, 183 responded and were assessed at the hospital. Of these, 60 had cardiac affections, 52 had colon problems and 17, esophageal disease. Seventy four were asymptomatic. Of the 64 patients in whom polymerase chain reaction was done, 35 had a positive result. CONCLUSIONS: A high percentage of subjects infected with Trypanosoma cruzi, had clinical consequences of the infection. Polymerase chain reaction showed persistency of the parasite in more than half of the infected patients.