Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.012
Filtrar
1.
Zootaxa ; 5419(3): 301-347, 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38480321

RESUMEN

The genus Galapa Huber, 2000 includes tiny spiders (body length <1.5 mm) restricted to semi-arid habitats. It has long been thought to be endemic to the Galapagos Islands until G. spiniphila Huber, 2020 was described from the Venezuelan Paraguan Peninsula. Here, we support this generic assignment with molecular (CO1) data and describe two new species from Colombia (G. gabito Huber sp. n.) and Costa Rica (G. murphyi Huber sp. n.), showing that the genus is actually widely distributed. Distribution modelling identifies several high suitability areas for Galapa, all of which are poorly sampled with respect to Pholcidae (ranging from Nicaragua to northern Peru and Guiana). Our results suggest a strong sampling bias against spiders restricted to dry tropical regions and habitats.


Asunto(s)
Arañas , Animales , Distribución Animal
2.
Travel Med Infect Dis ; : 102699, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38452991

RESUMEN

Dengue virus (DENV) is one of the most significant vector-borne pathogens worldwide. In this report, we describe clinical features and laboratory detection of dengue in a 45-year-old traveler to Nicaragua on return home to the United States in 2019. Clinical presentation was mild, with rash, headache, and fatigue, with only low-grade transient fever. Infection dynamics were documented by serology and PCR of serially collected body fluids. DENV serotype 2 was detected in whole blood 1 day after symptoms emerged, with viral RNA isolated to the red cell fraction, and remained detectable through day 89. DENV-2 RNA was detected in serum only on day 4, and IgM was undetectable on day 4 but evident by day 13. Viral RNA was also detected in urine. This report of DENV-2 RNA persistence in blood cells but only transient appearance in serum, supports the potential diagnostic value of whole blood over serum for PCR and opportunity of an expanded testing window. Informed testing approaches can improve diagnostic accuracy and inform strategies that preserve individual and public health.

3.
Heliyon ; 10(3): e25563, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38327481

RESUMEN

The aim of this study was to determine the effect of various methods of processing, such as natural, washed, honey, anaerobic fermentation, and carbonic maceration, on the contents of heavy metals in green and roasted specialty coffees from various countries of origin (Ethiopia, Kenya, Rwanda, Burundi, Guatemala, Nicaragua, and Peru). The heavy metals aluminium (Al), nickel (Ni), chromium (Cr), cadmium (Cd), copper (Cu), and lead (Pb) were identified by a multi-element technique using inductively coupled plasma mass spectrometry. Mercury (Hg) content was determined by atomic absorption spectrometry. The processing method affected the contents of Hg, Al, Ni, Cr, Cd, and Pb in the green and roasted coffees (p < 0.001). Hg content varied in the green coffees processed by fermentation methods vs natural or washed methods (i.e. Rwandan and Guatemalan coffees). Cd content was highest in Guatemalan green coffee processed using carbonic maceration (0.062 mg/kg). Pb content differed between the Ethiopian and Rwandan roasted coffees, with the highest content in the washed method (0.252 mg/kg). The correlations between the contents of Cu and Al, Ni and Cr, and Pb and Cr were significant for both the roasted and green beans. In conclusion, the method of processing can affect the contents of heavy metals in green and roasted specialty coffees. Monitoring heavy metals when processing coffee with new methods, even though further processing such as roasting can substantially reduce their content in some cases, is therefore important.

4.
medRxiv ; 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38405964

RESUMEN

Background: Dengue virus, a major global health threat, consists of four serotypes (DENV1-4) that cause a range of clinical manifestations from mild to severe and potentially fatal disease. Methods: This study, based on 19 years of data from the Pediatric Dengue Cohort Study and Pediatric Dengue Hospital-based Study in Managua, Nicaragua, investigates the influence of serotype and immune status on dengue severity. Study participants 6 months to 17 years old were followed during their hospital stay or as ambulatory patients, with dengue cases confirmed by molecular, serological, and/or virological methods. Results: We enrolled a total of 14071 participants, of whom 2954 (21%) were positive for DENV infection. Of 2425 cases with serotype result by RT-PCR, 541 corresponded to DENV1, 996 to DENV2, 718 to DENV3 and 170 to DENV4. Severe disease was more prevalent among secondary DENV2 and DENV4 cases, while similar disease severity was observed in both primary and secondary DENV1 and DENV3 cases. According to the 1997 World Health Organization (WHO) severity classification, both DENV2 and DENV3 had a higher proportion of severe disease compared to other serotypes, whereas DENV3 had the greatest percentage of severity under the WHO-2009 classification. DENV2 was associated with pleural effusion and low platelet count, while DENV3 correlated with both hypotensive and compensated shock. Conclusions: These findings emphasize the critical need for a dengue vaccine with balanced efficacy against all four serotypes, particularly as existing vaccines show variable efficacy by serotype and immune status, posing challenges for comprehensive protection, particularly in dengue-naïve individuals.

5.
Diseases ; 12(2)2024 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-38391778

RESUMEN

Zika virus (ZIKV) and chikungunya virus (CHIKV) are arthropod-borne viruses with significant pathogenicity, posing a substantial health and economic burden on a global scale. Moreover, ZIKV-CHIKV coinfection imposes additional therapeutic challenges as there is no specific treatment for ZIKV or CHIKV infection. While a growing number of studies have documented the ZIKV-CHIKV coinfection, there is currently a lack of conclusive reports on this coinfection. Therefore, we performed a systematic review and meta-analysis to determine the true statistics of ZIKV-CHIKV coinfection in the global human population. Relevant studies were searched for in PubMed, Scopus, and Google Scholar without limitation in terms of language or publication date. A total of 33 studies containing 41,460 participants were included in this meta-analysis. The study protocol was registered with PROSPERO under the registration number CRD42020176409. The pooled prevalence and confidence intervals of ZIKV-CHIKV coinfection were computed using a random-effects model. The study estimated a combined global prevalence rate of 1.0% [95% CI: 0.7-1.2] for the occurrence of ZIKV-CHIKV coinfection. The region of North America (Mexico, Haiti, and Nicaragua) and the country of Haiti demonstrated maximum prevalence rates of 2.8% [95% CI: 1.5-4.1] and 3.5% [95% CI: 0.2-6.8], respectively. Moreover, the prevalence of coinfection was found to be higher in the paediatric group (2.1% [95% CI: 0.0-4.2]) in comparison with the adult group (0.7% [95% CI: 0.2-1.1]). These findings suggest that the occurrence of ZIKV-CHIKV coinfection varies geographically and by age group. The results of this meta-analysis will guide future investigations seeking to understand the underlying reasons for these variations and the causes of coinfection and to develop targeted prevention and control strategies.

6.
medRxiv ; 2024 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-38370822

RESUMEN

Dengue is widespread in tropical and subtropical regions globally and leads to a considerable burden of disease. Annually, dengue virus (DENV) causes up to 400 million infections, of which ~25% present with clinical symptoms ranging from mild to fatal. Despite its significance as a growing public health concern, the development of effective DENV vaccines has been highly challenging. One of the reasons is the lack of comprehensive understanding of the influence exerted by prior DENV infections and immune responses with cross-reactive properties. To investigate this, we collected samples from a pediatric cohort study in dengue-endemic Managua, Nicaragua. We characterized T cell responses in a group of 71 healthy children who had previously experienced one or more natural DENV infections and who, within one year after sample collection, had a subsequent DENV infection that was either symptomatic (n=25) or inapparent (n=46, absence of clinical disease). Thus, our study was designed to investigate the impact of pre-existing DENV specific T cell responses on the clinical outcomes of subsequent DENV infection. We assessed the DENV specific T cell responses using an activation-induced marker assay (AIM). Children who had experienced only one prior DENV infection displayed heterogeneous DENV specific CD4+ and CD8+ T cell frequencies. In contrast, children who had experienced two or more DENV infections showed significantly higher frequencies of DENV specific CD4+ and CD8+ T cells that were associated with inapparent as opposed to symptomatic outcomes in the subsequent DENV infection. Taken together, these findings demonstrate the protective role of DENV specific T cells against symptomatic DENV infection and constitute an advancement toward identifying protective immune correlates against dengue fever and clinical disease.

7.
Port J Card Thorac Vasc Surg ; 30(4): 59-62, 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38345879

RESUMEN

Q fever is an ubiquitous zoonosis caused by Coxiella burnetii, an intracellular bacterium that can produce acute or chronic infections in humans. These forms are characterized by different evolution, serological profile and treatment that must be very long to achieve a cure in chronic forms. However, the serological profile for diagnosis and the real value of serology for predicting outcome are controversial, and management dilemmas for many patients with Q fever infection are continuously emerging. In this case report, we present a 20-year-old man from Nicaragua who worked as a farmer with a culture-negative infective endocarditis who presented with a mycotic aneurysm. The present report reviews the clinical presentation and diagnosis of Q fever IE.


Asunto(s)
Aneurisma Infectado , Coxiella burnetii , Endocarditis , Aneurisma Intracraneal , Fiebre Q , Masculino , Humanos , Adulto Joven , Adulto , Fiebre Q/complicaciones , Aneurisma Infectado/diagnóstico , Aneurisma Intracraneal/complicaciones
9.
PLoS Negl Trop Dis ; 18(2): e0011948, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38416797

RESUMEN

Chikungunya can result in debilitating arthralgia, often presenting as acute, self-limited pain, but occasionally manifesting chronically. Little is known about differences in chikungunya-associated arthralgia comparing children to adults over time. To characterize long-term chikungunya-associated arthralgia, we recruited 770 patients (105 0-4 years old [y/o], 200 5-9 y/o, 307 10-15 y/o, and 158 16+ y/o) with symptomatic chikungunya virus infections in Managua, Nicaragua, during two consecutive chikungunya epidemics (2014-2015). Participants were assessed at ~15 days and 1, 3, 6, 12, and 18 months post-fever onset. Following clinical guidelines, we defined participants by their last reported instance of arthralgia as acute (≤10 days post-fever onset), interim (>10 and <90 days), or chronic (≥90 days) cases. We observed a high prevalence of arthralgia (80-95%) across all ages over the study period. Overall, the odds of acute arthralgia increased in an age-dependent manner, with the lowest odds of arthralgia in the 0-4 y/o group (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.14-0.51) and the highest odds of arthralgia in the 16+ y/o participants (OR: 4.91, 95% CI: 1.42-30.95) relative to 10-15 y/o participants. Females had higher odds of acute arthralgia than males (OR: 1.63, 95% CI: 1.01-2.65) across all ages. We found that 23-36% of pediatric and 53% of adult participants reported an instance of post-acute arthralgia. Children exhibited the highest prevalence of post-acute polyarthralgia in their legs, followed by the hands and torso - a pattern not seen among adult participants. Further, we observed pediatric chikungunya presenting in two distinct phases: the acute phase and the subsequent interim/chronic phases. Thus, differences in the presentation of arthralgia were observed across age, sex, and disease phase in this longitudinal chikungunya cohort. Our results elucidate the long-term burden of chikungunya-associated arthralgia among pediatric and adult populations.

10.
Washington, D.C.; PAHO; 2024-02-09.
en Inglés, Español | PAHO-IRIS | ID: phr-59280

RESUMEN

[WEEKLY SUMMARY]. Regional Situation: Over the past four Epidemiological Weeks (EWs), there has been a decline in the activity of Influenza-Like Illness (ILI) in the Americas region, stabilizing at medium levels. Similarly, a decrease has been observed in the activity of Severe Acute Respiratory Infection (SARI), currently at low levels. In both cases, the observed activity has been associated with positive cases of influenza and SARS-CoV-2. ILI activity has been mainly linked to moderate activity observed in North America and the Caribbean, which is currently declining, while SARI activity has been particularly influenced by activity in North America. Regarding the circulation of respiratory viruses, a moderate activity of SARS-CoV-2 has been maintained at the regional level compared to previous epidemic waves. Likewise, an epidemic activity of influenza has been observed for this time of year with a decreasing trend, and a moderate activity of Respiratory Syncytial Virus (RSV) has shown a decline. North America: ILI cases, after a slight decrease in previous EWs, have remained at medium-high levels, with the majority of cases attributable to influenza, although showing a decline in this proportion. SARI cases have decreased, with the majority of cases attributable to influenza and, to a lesser extent, SARS-CoV-2. Influenza activity has remained at epidemic levels after a slight decrease in previous EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with concurrent circulation of influenza B/Victoria and, to a lesser extent, influenza A(H3N2). RSV activity has shown a decline in the last four EWs, remaining at moderate levels. SARS-CoV-2 activity has decreased in the last four EWs to low levels. By countries: In Canada, SARS-CoV-2 activity has markedly decreased in the last four EWs to medium levels. Influenza activity remains at epidemic levels, and RSV activity has remained stable at high levels during this period. In Mexico, influenza circulation has remained fluctuating at epidemic levels in the last four EWs, while an increase in SARS-CoV-2 circulation has been observed. In the United States, influenza activity has remained above the epidemic threshold with a slight increase in the last two EWs, RSV activity has decreased to moderate levels, and although SARS-CoV-2 has remained at high levels, it has shown a decreasing trend. Hospitalization rates for influenza, RSV, and SARS-CoV-2, after reaching similar high levels to the previous season, have shown a downward trend in the last four EWs. Caribbean: ILI cases have shown an increase in the last four weeks associated with an increase in positive influenza cases, while SARI cases have remained on the decline. Influenza activity has decreased in the last four EWs, reaching low circulation levels. During the last four EWs, the predominant viruses have been type A(H1N1)pdm09, followed by A(H3N2) and, to a lesser extent, B/Victoria. RSV activity has remained at low levels. SARS-CoV-2 activity has remained at high levels, although showing a decreasing trend. By countries: Elevated influenza activity has been observed in Jamaica. Elevated SARS-CoV-2 activity has been observed in Belize, Dominican Republic, Dominica, Jamaica, Barbados, the Cayman Islands, and Guyana. Central America: After an increase observed in previous weeks, ILI cases have shown a decrease in the last four weeks, with the majority of positive cases attributable to SARS-CoV-2 and, to a lesser extent, influenza. SARI cases have also shown a decrease, reaching low levels. Influenza activity, after the increase observed in previous weeks, has shown a decrease in the last two EWs, reaching medium levels. During this period, the predominant viruses have been type A(H1N1)pdm09, followed by B/Victoria and, to a lesser extent, A(H3N2). RSV activity has shown a decrease to low levels. SARS-CoV-2 activity, although remaining at low levels, has increased in the last four EWs. By countries: In El Salvador, SARS-CoV-2 activity has shown a marked increase in the last four EWs to high levels. In Guatemala, an increase in ILI cases associated with influenza and, to a lesser extent, SARS-CoV-2 has been observed, reaching moderate activity levels, while SARI cases have remained on the decline at epidemic levels. In Honduras, after the increase in ILI and SARI cases associated with positive influenza and SARS-CoV-2 cases observed in previous weeks, a decrease has been detected in the last two EWs, reaching levels below the epidemic threshold. In Nicaragua, RSV activity has shown a decrease to low levels in the last four weeks, and both influenza and SARS-CoV-2 levels have remained low. In Panama, SARS-CoV-2 activity, after reaching high levels, has shown a decrease, and influenza activity has fluctuated around the epidemic threshold in the last four EWs. ILI and SARI cases, after the increase observed in previous EWs, have shown a decrease in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2. Andean: ILI activity has remained stable at low levels, and SARI cases, after an increase, have shown a decrease with the highest proportion of positive cases attributable to SARS-CoV-2. Influenza activity has remained at low levels in the last four EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with circulation of B/Victoria and A(H3N2) to a lesser extent. RSV activity has remained at low levels. SARS-CoV-2 activity has remained at high levels and increasing. By countries: In Bolivia, SARS-CoV-2 circulation has remained high. In Colombia, SARS-CoV-2 activity has shown a pronounced increase in the last four EWs, reaching high levels; SARI cases, after the recent increase associated with positive influenza and SARSCoV- 2 cases, have experienced a decrease in the last two EWs. In Ecuador, SARS-CoV-2 has shown a decrease in activity, reaching medium-low levels; influenza activity has continued to decline around epidemic thresholds, and RSV activity has shown a slight increase in the last four EWs. Following the recent increase in SARI cases associated with positive influenza, SARS-CoV-2, and to a lesser extent RSV cases, a decrease has been observed in the last four EWs, remaining at epidemic levels. In Venezuela, a fluctuating influenza activity below the epidemic threshold has been observed in the last four EWs. Brazil and the Southern Cone: SARI and ILI activity has remained low in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2, with a percentage of positive cases increasing. Influenza activity has remained at low circulation levels during the last four EWs. During this period, the predominant influenza viruses have been type A(H3N2) and A(H1N1)pdm09, followed by B/Victoria. RSV activity has remained at low levels. SARS-CoV-2 activity has remained on the rise at high levels. By countries: In Argentina, ILI and SARI levels have remained below the epidemic threshold. However, an increase in the positivity rate of SARS-CoV-2 has been observed, reaching high levels in the last four EWs. In Brazil, SARS-CoV-2 activity has remained stable at high levels. In Chile, after a marked decrease, SARS-CoV-2 activity has recently increased again in the last four EWs, with ILI cases at epidemic levels and SARI cases below this threshold, mostly attributable to SARS-CoV-2 and, to a lesser extent, influenza, whose activity has exceeded the epidemic threshold. In Paraguay, SARS-CoV-2 circulation has shown a decrease in the last two EWs, reaching moderate levels, and influenza activity has decreased to levels below the epidemic threshold, while SARI activity has remained at epidemic levels with the majority of positive cases attributable to SARS-CoV-2. In Uruguay, SARI activity has continued at levels below the epidemic threshold, with the majority of the few positive cases attributable to SARS-CoV-2.


[RESUMEN SEMANAL]. Situación regional: Durante las últimas cuatro semanas epidemiológicas (SE), se ha registrado un descenso en la actividad de la Enfermedad Tipo Influenza (ETI) en la región de las Américas, situándose en niveles medios. Del mismo modo se ha observado una disminución en la actividad de Infección Respiratoria Aguda Grave (IRAG), actualmente en niveles bajos. En ambos casos la actividad observada se ha asociado a casos positivos de influenza y SARS-CoV-2. La actividad de ETI se ha relacionado principalmente con la actividad moderada observada en Norteamérica y el Caribe, que actualmente está en descenso, mientras que la actividad de IRAG se ha visto especialmente influenciada por la actividad en Norteamérica. En cuanto a la circulación de virus respiratorios, a nivel regional se ha mantenido una actividad moderada de SARS-CoV-2 en comparación con olas epidémicas previas. Asimismo, se ha observado una actividad epidémica de influenza para esta época del año con tendencia decreciente, y una actividad moderada del Virus Respiratorio Sincitial (VRS) que ha mostrado un descenso. América del Norte: Los casos de ETI, tras un ligero descenso en SE previas, se han mantenido en niveles medio-altos con la mayoría de los casos atribuibles a influenza, aunque mostrando un descenso a su vez en esta proporción. Los casos de IRAG han mostrado un decremento con la mayoría de los casos atribuibles a influenza y en menor medida a SARS-CoV-2. La actividad de influenza se ha mantenido en niveles epidémicos de circulación tras mostrar un ligero descenso en SE previas. Durante este periodo, los virus de influenza predominantes han sido del tipo A(H1N1)pdm09, con circulación concurrente de influenza B/Victoria y, en menor medida, influenza A(H3N2). La actividad del VRS ha mostrado un descenso en las últimas cuatro SE, manteniéndose en niveles moderados. La actividad del SARS-CoV-2 ha presentado un decremento en las últimas cuatro SE hasta niveles bajos. Por países: En Canadá, la actividad del SARS-CoV-2 ha presentado un marcado descenso en las últimas cuatro SE hasta niveles medios. La actividad de influenza se ha mantenido en niveles epidémicos, y la actividad del VRS ha permanecido estable en niveles altos durante este periodo. En México, la circulación de influenza se ha mantenido fluctuante en niveles epidémicos en las cuatro últimas SE, a su vez se ha observado un incremento en la circulación del SARS-CoV-2. En Estados Unidos, la actividad de influenza se ha mantenido por encima del umbral epidémico con un ligero incremento en la últimas dos SE, la actividad del VRS ha descendido hasta niveles medios y el SARS-CoV-2 aunque ha permanecido en niveles elevados ha mostrado una tendencia decreciente. Las tasas de hospitalización por influenza, VRS y SARS-CoV-2, tras alcanzar niveles elevados similares a la temporada previa, han presentado una tendencia a la baja en las cuatro últimas SE. Caribe: Los casos de ETI han mostrado un incremento en las cuatro últimas semanas asociado a un incremento en los casos positivos a influenza, mientras que los casos de IRAG han permanecido en descenso. La actividad de influenza ha presentado un descenso en las últimas cuatro SE, alcanzando niveles bajos de circulación. Durante las cuatro últimas SE, los virus predominantes han sido de tipo A(H1N1)pdm09, seguido de A(H3N2) y en menor medida B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en niveles elevados, aunque mostrando una tendencia decreciente. Por países: Se ha observado una actividad elevada de influenza en Jamaica. Se ha observado una actividad elevada de SARS-CoV-2 en Belice, República Dominicana, Dominica, Jamaica, Barbados, las Islas Caimán y, Guyana. América Central: tras un incremento observado en las semanas previas, los casos de ETI han mostrado un descenso en las cuatro últimas SE, siendo la mayoría de los casos positivos atribuibles a SARS-CoV-2 y en menor medida a influenza. Los casos de IRAG han mostrado a su vez un descenso situándose en niveles bajos. La actividad de influenza tras el incremento observado en semanas previas, he presentado un descenso en las dos últimas SE, situándose en niveles medios. Durante este periodo, los virus predominantes han sido de tipo A(H1N1)pdm09, seguido de B/Victoria y en menor medida de A(H3N2). La actividad del VRS ha presentado un descenso hasta niveles bajos. La actividad del SARS-CoV-2, aunque ha permanecido en niveles bajos, ha presentado un incremento en las últimas cuatro SE. Por países: En El Salvador, la actividad de SARS-CoV-2 ha mostrado un marcado incremento en las cuatro últimas SE hasta niveles elevados. En Guatemala, se ha observado un incremento en los casos de ETI asociados a influenza y en menor medida SARS-CoV-2, encontrándose en niveles de actividad moderados; en cuanto a los casos de IRAG se mantienen en descenso con niveles epidémicos. En Honduras, tras el incremento en casos de ETI e IRAG asociados a casos positivos a influenza observado en semanas previas, se ha detectado un descenso en las dos últimas SE, alcanzando niveles por debajo del umbral epidémico. En Nicaragua, la actividad del VRS ha mostrado un descenso hasta niveles bajos en las cuatro últimas semanas, y los niveles tanto de influenza como de SARSCoV- 2 se han mantenido bajos. En Panamá, la actividad del SARS-CoV-2 tras alcanzar niveles elevados ha presentado un descenso y la actividad de influenza ha fluctuado en torno al umbral epidémico en las cuatro últimas SE. Los casos de ETI e IRAG tras el incremento observado en SE previas, han presentado un descenso en las cuatro últimas SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2. Andina: Los casos de ETI se ha mantenido estables en niveles bajos, y los casos de IRAG tras un incremento en recientes semanas han mostrado un descenso en las catro últimas SE, con la mayor proporción de casos positivos atribuibles a SARS-CoV-2. La actividad de influenza ha permanecido en niveles bajos en las cuatro últimas SE. Durante este periodo, los virus de influenza predominantes han sido de tipo A(H1N1)pdm09 con circulación en menor medida de B/Victoria y A(H3N2). La actividad del VRS se ha mantenido en niveles bajos. La actividad de SARS-CoV-2 se ha mantenido en niveles elevados y en ascenso. Por países: En Bolivia, la circulación del SARS-CoV-2 se ha mantenido elevada. En Colombia, la actividad de SARS-CoV-2 ha presentado un pronunciado incremento en las cuatro últimas SE situándose en niveles elevados; los casos de IRAG tras presentar el incremento observado recientemente asociado a casos positivos a influenza y SARS-CoV-2, ha experimentado un descenso en las dos últimas SE. En Ecuador, el SARS-CoV-2 ha presentado un descenso en la actividad situándose en niveles medio-bajos, la actividad de influenza a su vez ha continuado en descenso en torno al umbral epidémico y la actividad del VRS ha presentado un ligero incremento en las cuatro últimas SE. Tras el incremento observado recientemente en los casos de IRAG, asociado a casos positivos a influenza, SARS-CoV-2 y en menor medida a VRS, en las cuatro últimas SE se ha observado un descenso manteniéndose en niveles epidémicos. En Venezuela durante las cuatro últimas SE se ha observado una actividad fluctuante de influenza por debajo del umbral epidémico. Brasil y el Cono Sur: La actividad de IRAG y ETI ha permanecido baja en las últimas cuatro SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2 con un porcentaje de casos positivos en ascenso. La actividad de influenza se ha mantenido en niveles bajos de circulación durante las últimas cuatro SE. En este periodo, los virus de influenza predominantes han sido de tipo A(H3N2) y A(H1N1)pdm09 seguidos de B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en ascenso en niveles altos. Por países: En Argentina, los niveles de ETI e IRAG han permanecido por debajo del umbral epidémico. Sin embargo, se ha observado un aumento en el porcentaje de positividad de SARS-CoV-2, alcanzando niveles elevados en las cuatro últimas SE. En Brasil, la actividad del SARS-CoV-2 se ha mantenido estable en niveles elevados. En Chile, tras el marcado descenso la actividad de SARS-CoV-2 experimentado recientemente, se ha observado de nuevo un incremento en las cuatro últimas SE, con los casos de ETI en niveles epidémicos y los casos de IRAG por debajo de este umbral, siendo en su mayoría atribuibles a SARS-CoV-2 y en menor medida a influenza, cuya actividad ha superado el umbral epidémico. En Paraguay, la circulación del SARS-CoV-2 ha mostrado un descenso en las dos últimas SE, encontrándose en niveles moderados, y la actividad de influenza ha descendido a niveles por debajo del umbral epidémico. La actividad de IRAG se ha mantenido en niveles epidémicos con la mayoría de los casos positivos atribuibles a SARS-CoV-2. En Uruguay, la actividad de IRAG ha continuado con niveles por debajo del umbral epidémico, siendo la mayoría de los escasos casos positivos atribuibles a SARS-CoV-2.


Asunto(s)
Gripe Humana , SARS-CoV-2 , COVID-19 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Reglamento Sanitario Internacional , Américas , Región del Caribe
11.
Washington, D.C.; PAHO; 2024-02-02.
en Inglés, Español | PAHO-IRIS | ID: phr-59275

RESUMEN

[WEEKLY SUMMARY]. Regional Situation: Over the past four epidemiological weeks (EWs), there has been a decline in the activity of Influenza-Like Illnesses (ILIs) in the Americas region, reaching low levels, along with a decrease in Severe Acute Respiratory Infections (SARIs), both associated with positive cases of influenza and SARS-CoV-2. ILI activity has been primarily related to moderate activity observed in North America and the Caribbean, which is currently declining, while SARI activity has been particularly influenced by moderate activity in North America. Regarding the circulation of respiratory viruses, moderate activity of SARS-CoV-2 has been maintained at the regional level compared to previous epidemic waves. Additionally, epidemic activity of influenza has been observed for this time of year with a decreasing trend, and moderate activity of Respiratory Syncytial Virus (RSV) has shown a slight decrease. North America: ILI cases have shown a marked decrease, with most cases attributable to influenza, although there has also been a decrease in this proportion. Similarly, SARI cases have decreased, with most cases attributable to influenza and to a lesser extent to SARS-CoV-2. Influenza activity has remained at epidemic circulation levels, with a decrease in the last four EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with concurrent circulation of influenza B/Victoria and, to a lesser extent, influenza A(H3N2). RSV activity has shown a slight decrease in the last four EWs, remaining at moderate levels. SARS-CoV-2 activity continues at moderate levels, showing a decrease in the last four EWs. By country: In Canada, SARS-CoV-2 activity has remained high in the last four EWs, although showing a decreasing trend. Influenza activity has also shown a decrease but remains above the epidemic threshold, and RSV activity has remained stable at high levels during this period. In Mexico, influenza circulation has remained fluctuating at epidemic levels in the last four EWs, and a slight increase in SARS-CoV-2 circulation has been observed. In the United States, influenza activity has remained above the epidemic threshold with a slight increase in the last EW, and RSV and SARS-CoV-2 activity, although remaining at high levels, have shown a decreasing trend. Hospitalization rates for influenza, RSV, and SARS-CoV-2, after reaching similar high levels to the previous season, have shown a downward trend in the last four EWs Caribbean: ILI cases have shown an increase in the last four weeks associated with an increase in positive cases of influenza, while SARI cases have remained on the decline. Influenza activity has shown a decrease in the last four EWs, reaching intermediate levels of circulation. During the last four EWs, the predominant viruses have been type A(H1N1)pdm09, followed by A(H3N2) and, to a lesser extent, B/Victoria. RSV activity has remained at low levels. SARS-CoV-2 activity has increased in the last four EWs, reaching high levels. By country: Elevated influenza activity has been observed in the Dominican Republic, Jamaica, Saint Lucia, the Cayman Islands, and Saint Vincent and the Grenadines. Elevated SARS-CoV-2 activity has been observed in Belize, the Dominican Republic, Dominica, Jamaica, Saint Lucia, Barbados, the Cayman Islands, Guyana, and Saint Vincent and the Grenadines. Central America: ILI cases have shown an increase in the last four weeks, with most positive cases attributable to SARS-CoV-2 and, to a lesser extent, influenza. SARI cases have also shown an increase, with a slight increase in the proportion of positive cases for SARS-CoV-2. Influenza activity has increased in the last four EWs, reaching moderate levels. During this period, the predominant viruses have been type A(H1N1)pdm09, followed by B/Victoria and, to a lesser extent, A(H3N2). RSV activity has decreased to low levels. SARS-CoV-2 activity, although remaining at low levels, has increased in the last four EWs. By country: In El Salvador, SARS-CoV-2 activity has shown a marked increase in the last three EWs, reaching high levels. In Guatemala, an increase in ILI cases associated with influenza and, to a lesser extent, SARS-CoV-2 has been observed, with activity levels considered moderate, while SARI cases have also shown a slight increase, with positive cases attributable to both influenza and RSV, also at epidemic levels. In Honduras, a slight increase has been observed in both ILI and SARI cases associated with positive influenza cases, with activity fluctuating around epidemic levels. In Nicaragua, RSV activity has shown a decrease to low levels in the last four weeks. In Panama, SARS-CoV-2 activity has shown a decrease after reaching high levels, and influenza activity has fluctuated around the epidemic threshold in the last four EWs. ILI and SARI cases have shown an increase in the last four EWs, with most positive cases attributable to SARS-CoV-2. Andean: ILI activity has remained stable at low levels, while SARI cases have shown an increase associated with an increase in positivity for SARS-CoV-2, influenza, and RSV. Influenza activity has remained at low levels in the last four EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with circulation of B/Victoria and A(H3N2) to a lesser extent. RSV activity has remained at low levels. SARS-CoV-2 activity has remained at high levels. By country: In Bolivia, SARS-CoV-2 circulation has remained high. In Colombia, SARS-CoV-2 activity has shown a pronounced increase in the last four EWs, reaching high levels, with SARI cases increasing associated with positive cases of influenza followed by SARS-CoV-2 and RSV. In Ecuador, SARS-CoV-2 activity remains active, while influenza activity has continued to decrease around the epidemic threshold, and RSV activity has shown a slight increase in the last four EWs. This has been accompanied by an increase in SARI cases in the last four EWs, with epidemic levels in the last EW, with most positive cases predominantly for influenza and SARS-CoV-2 and, to a lesser extent, RSV. In Venezuela, fluctuating activity of influenza and RSV has been observed. Brazil and the Southern Cone: SARI and ILI activity has remained low in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2 with a rising percentage of positive cases. Influenza activity has remained at low circulation levels in the last four EWs. During this period, the predominant influenza viruses have been type A(H3N2) and A(H1N1)pdm09 followed by B/Victoria. RSV activity has remained at low levels. SARSCoV- 2 activity has continued to rise at high levels. By country: In Argentina, ILI and SARI levels have remained below the epidemic threshold. However, an increase in SARS-CoV- 2 positivity has been observed, reaching high levels in the last four EWs. In Brazil, SARS-CoV-2 activity has remained stable at high levels during this period. In Chile, a decrease in SARS-CoV-2 activity has been observed, with ILI cases at epidemic levels and SARI cases below this threshold, mostly attributable to SARS-CoV-2 and, to a lesser extent, influenza. In Paraguay, SARSCoV- 2 circulation has remained high in the last four EWs, and influenza activity has decreased below the epidemic threshold, while SARI activity has remained at epidemic levels with the majority of positive cases attributable to SARS-CoV-2. In Uruguay, SARI activity has continued below the epidemic threshold, with the majority of the few positive cases attributable to SARSCoV- 2.


[RESUMEN SEMANAL]. Situación regional: Durante las últimas cuatro semanas epidemiológicas (SE), se ha registrado un descenso en la actividad de la Enfermedad Tipo Influenza (ETI) en la región de las Américas, situándose en niveles bajos, al igual que una disminución en la actividad de Infección Respiratoria Aguda Grave (IRAG), ambas asociadas a casos positivos de influenza y SARS-CoV-2. La actividad de ETI se ha relacionado principalmente con la actividad moderada observada en Norteamérica y el Caribe, que actualmente está en descenso, mientras que la actividad de IRAG se ha visto especialmente influenciada por la actividad moderada en Norteamérica. En cuanto a la circulación de virus respiratorios, a nivel regional se ha mantenido una actividad moderada de SARS-CoV-2 en comparación con olas epidémicas previas. Asimismo, se ha observado una actividad epidémica de influenza para esta época del año con tendencia decreciente, y una actividad moderada del Virus Respiratorio Sincitial (VRS) que ha mostrado un ligero descenso. América del Norte: Los casos de ETI han presentado un marcado descenso con la mayoría de los casos atribuibles a influenza, aunque mostrando un descenso a su vez en esta proporción. Del mismo modo, los casos de IRAG han mostrado un decremento con la mayoría de los casos atribuibles a influenza y en menor medida a SARS-CoV-2. La actividad de influenza se ha mantenido en niveles epidémicos de circulación presentando un descenso en las cuatro últimas SE. Durante este periodo, los virus de influenza predominantes han sido del tipo A(H1N1)pdm09, con circulación concurrente de influenza B/Victoria y, en menor medida, influenza A(H3N2). La actividad del VRS ha mostrado un ligero descenso en las últimas cuatro SE, manteniéndose en niveles moderados. La actividad del SARS-CoV-2 continúa en niveles moderados, presentando un decremento en las últimas cuatro SE. Por países: En Canadá, la actividad del SARS-CoV-2 se ha mantenido elevada en las últimas cuatro SE, aunque muestra una tendencia decreciente. La actividad de influenza ha mostrado asimismo un descenso, aunque permanece por encima del umbral epidémico, y la actividad del VRS ha permanecido estable en niveles altos durante este periodo. En México, la circulación de influenza se ha mantenido en fluctuante en niveles epidémicos en las cuatro últimas SE, y se ha observado un ligero incremento en la circulación del SARS-CoV-2. En Estados Unidos, la actividad de influenza se ha mantenido por encima del umbral epidémico con un ligero incremento en la última SE y la actividad del VRS y el SARS-CoV-2 aunque han permanecido en niveles elevados ha mostrado una tendencia decreciente. Las tasas de hospitalización por influenza, VRS y SARS-CoV-2 tras alcanzar niveles elevados similares a la temporada previa han presentado una tendencia a la baja en las cuatro últimas SE.. Caribe: Los casos de ETI han mostrado un incremento en las cuatro últimas semanas asociado a un incremento en los casos positivos a influenza, mientras que los casos de IRAG han permanecido en descenso. La actividad de influenza ha presentado un descenso en las últimas cuatro SE, alcanzando niveles intermedios de circulación. Durante las cuatro últimas SE, los virus predominantes han sido de tipo A(H1N1)pdm09, seguido de A(H3N2) y en menor medida B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 ha presentado un incremento en las cuatro últimas SE, situándose en niveles elevados. Por países: Se ha observado una actividad elevada de influenza en, República Dominicana, Jamaica, santa Lucía las Islas Caimán y Saint Vincent and the Grenadines. Se ha observado una actividad elevada de SARS-CoV-2 en Belice, República Dominicana, Dominica, Jamaica, Santa Lucía, Barbados, las Islas Caimán, Guyana y Saint Vincent and the Grenadines.. América Central: Los casos de ETI han mostrado un ascenso en las cuatro últimas semanas, siendo la mayoría de los casos positivos atribuibles a SARS-CoV-2 y en menor medida a influenza. Los casos de IRAG han mostrado a su vez un ascenso, con un ligero aumento en la proporción de casos positivos a SARS-CoV-2. La actividad de influenza ha presentado un incremento en las cuatro últimas SE, situándose en niveles medios. Durante este periodo, los virus predominantes han sido de tipo A(H1N1)pdm09, seguido de B/Victoria y en menor medida de A(H3N2). La actividad del VRS ha presentado un descenso hasta niveles bajos. La actividad del SARS-CoV-2, aunque ha permanecido en niveles bajos, ha presentado un incremento en las últimas cuatro SE. Por países: En El Salvador, la actividad de SARS-CoV-2 ha mostrado un marcado incremento en las tres últimas SE hasta niveles elevados. En Guatemala, se ha observado un incremento en los casos de ETI asociados a influenza y en menor medida SARS-CoV-2, encontrándose en niveles de actividad moderados, en cuanto a los casos de IRAG han mostrado a su vez un ligero ascenso con los casos positivos atribuibles tanto a influenza como a VRS, con niveles asimismo epidémicos. En Honduras, se ha observado un ligero incremento tanto en los casos de ETI como de IRAG asociados a casos positivos a influenza cuya actividad se encuentra fluctuante en torno a niveles epidémicos. En Nicaragua, la actividad del VRS ha mostrado un descenso hasta niveles bajos en las cuatro últimas semanas. En Panamá, la actividad del SARS-CoV-2 tras alcanzar niveles elevados ha presentado un descenso y la actividad de influenza ha fluctuado en torno al umbral epidémico en las cuatro últimas SE. Los casos de ETI e IRAG han presentado un incremento en las cuatro últimas SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2. Andina: La actividad de ETI se ha mantenido estable en niveles bajos, mientras que los casos de IRAG han mostrado un ascenso asociado al aumento en la proporción de positivos a SARS-CoV-2, influenza y VRS. La actividad de influenza ha permanecido en niveles bajos en las cuatro últimas SE. Durante este periodo, los virus de influenza predominantes han sido de tipo A(H1N1)pdm09 con circulación en menor medida de B/Victoria y A(H3N2). La actividad del VRS se ha mantenido en niveles bajos. La actividad de SARS-CoV-2 se ha mantenido en niveles elevados Por países: En Bolivia, la circulación del SARS-CoV-2 se ha mantenido elevada. En Colombia, la actividad de SARS-CoV-2 ha presentado un pronunciado incremento en las cuatro últimas SE situándose en niveles elevados, los casos de IRAG han presentado un incremento asociado a casos positivos a influenza en primer lugar seguido de SARS-CoV-2 y VRS. En Ecuador, el SARS-CoV-2 mantiene niveles de actividad, igualmente la actividad de influenza ha continuado en descenso en torno al umbral epidémicos y la actividad del VRS ha presentado un ligero incremento en las cuatro últimas SE. Esto se ha acompañado de un incremento en los casos de IRAG en las cuatro últimas SE, con niveles epidémicos en la última SE, siendo los casos positivos mayoritariamente a influenza y SARS-CoV-2 y en menor medida a VRS. En Venezuela se ha observado una actividad fluctuante de influenza y de VRS. Brasil y el Cono Sur: La actividad de IRAG y ETI ha permanecido baja en las últimas cuatro SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2 con un porcentaje de casos positivos en ascenso. La actividad de influenza se ha mantenido en niveles bajos de circulación durante las últimas cuatro SE. En este periodo, los virus de influenza predominantes han sido de tipo A(H3N2) y A(H1N1)pdm09 seguidos de B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en ascenso en niveles altos. Por países: En Argentina, los niveles de ETI e IRAG han permanecido por debajo del umbral epidémico. Sin embargo, se ha observado un aumento en el porcentaje de positividad de SARS-CoV-2, alcanzando niveles elevados en las cuatro últimas SE. En Brasil, la actividad del SARS-CoV-2 se ha mantenido estable en niveles elevados en este periodo. En Chile, se ha observado un descenso en la actividad de SARS-CoV-2, con los casos de ETI en niveles epidémicos y los casos de IRAG por debajo de este umbral, siendo en su mayoría atribuibles a SARS-CoV-2 y en menor medida a influenza. En Paraguay, la circulación del SARS-CoV-2 ha permanecido elevada en las cuatro últimas SE y la actividad de influenza ha descendido a niveles por debajo del umbral epidémico, la actividad de IRAG se ha mantenido en niveles epidémicos con la mayoría de los casos positivos atribuibles a SARS-CoV-2. En Uruguay, la actividad de IRAG ha continuado con niveles por debajo del umbral epidémico, siendo la mayoría de los escasos casos positivos atribuibles a SARS-CoV-2.


Asunto(s)
Gripe Humana , COVID-19 , SARS-CoV-2 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Américas , Región del Caribe
12.
Washington, D.C.; PAHO; 2024-02-23.
en Inglés, Español | PAHO-IRIS | ID: phr-59331

RESUMEN

[WEEKLY SUMMARY]. Regional Situation: Over the past four Epidemiological Weeks (EWs), there has been a decline in Influenza-Like Illness (ILI) activity in the Americas region, stabilizing at medium levels. Similarly, a decrease has been observed in the activity of Severe Acute Respiratory Infection (SARI), currently at low levels. In both cases, the observed activity has been associated with positive cases of influenza and SARS-CoV-2. ILI activity has been mainly linked to moderate activity observed in North America, which showed a mild increase in the past four weeks. Regarding the circulation of respiratory viruses, SARS-CoV-2 activity has remained moderate at the regional level compared to previous epidemic waves. Influenza activity has increased over the past four weeks period; respiratory syncytial virus (RSV) activity, while remaining moderate, has also declined. North America: ILI cases, after a slight decrease in previous EWs, have remained at medium-high levels, with most cases attributable to influenza, although showing a decline in this proportion. SARI cases have decreased, with most cases attributable to influenza and, to a lesser extent, SARS-CoV-2. Influenza activity has remained at epidemic levels after a slight decrease in recent EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with concurrent circulation of influenza B/Victoria and, to a lesser extent, influenza A(H3N2). RSV activity has declined in the last four EWs, remaining at moderate levels. SARS-CoV-2 positivity has slightly decreased in the last four EWs and remains below late 2023 levels. By countries: In Canada, SARS-CoV-2 activity has markedly decreased in the last four EWs to medium levels. Influenza activity remains at epidemic levels, and RSV activity has remained stable at high levels during this period. In Mexico, influenza circulation has remained fluctuating at epidemic levels in the last four EWs, while an increase in SARS-CoV-2 circulation has been observed. In the United States, influenza activity has remained above the epidemic threshold with a slight increase in the last four EWs, RSV activity has decreased to moderate levels. Although SARS-CoV-2 has remained at high levels, it has shown a decreasing trend. Hospitalization rates for influenza, RSV, and SARS-CoV-2, after reaching similar high levels to the previous season, have shown a downward trend in the last four EWs. Caribbean: ILI cases have shown an increase in the last four weeks associated with an increase in positive influenza and SARS-CoV-2 cases, while SARI cases have remained on the decline. Influenza activity has decreased in the last four EWs, reaching low circulation levels. During the last four EWs, the predominant viruses have been type A(H1N1)pdm09, followed by A(H3N2) and, to a lesser extent, B/Victoria. RSV activity has remained at low levels. SARS-CoV-2 activity has remained at high levels, although showing a decreasing trend. By countries: Elevated influenza activity has been observed in Belize and Suriname. Elevated SARS-CoV-2 activity has been observed in Belize, Dominica, Jamaica, The Cayman Islands, and Guyana. Central America: After an increase observed in previous weeks, ILI cases have decreased in the last four weeks, with most positive cases attributable to SARS-CoV-2 and, to a lesser extent, influenza. SARI cases have also shown a decrease, reaching low levels. After the increase observed in previous weeks, influenza activity has decreased in the last four EWs, reaching low levels. During this period, the predominant viruses have been type A(H1N1)pdm09, followed by B/Victoria and, to a lesser extent, A(H3N2). RSV activity has decreased to low levels. SARS-CoV-2 activity has decreased to low levels as well. By countries: In El Salvador, SARS-CoV-2 activity has declined in the last four EWs after an initial increase over the preceding four EWs. In Guatemala, an increase in ILI cases associated with influenza was observed in late January 2024, with a steady decline in the number of reported ILI cases in the last three EWs, reaching moderate activity levels, while SARI cases have remained declining at epidemic levels. In Honduras, after the increase in ILI and SARI cases associated with positive influenza and SARS-CoV-2 cases observed in previous weeks, a decrease has been detected in the last three EWs, reaching levels below the epidemic threshold. In Nicaragua, RSV activity has increased slightly in the past EW after declining over the prior four EWs; both influenza and SARS-CoV-2 levels have remained low. After reaching high levels in early January 2024 in Panama, SARS-CoV-2 activity has decreased. However, after fluctuating around the epidemic threshold in the last four EWs, influenza activity levels rose sharply in the most recent EW. ILI and SARI cases, have steadily declined in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2. Andean: ILI activity has remained stable at low levels, and SARI cases, have increased in recent weeks with the highest proportion of positive cases attributable to SARS-CoV-2. Influenza activity has remained at low levels in the last four EWs. During this period, the predominant influenza viruses have been type A(H1N1)pdm09, with circulation of A(H3N2) and B/Victoria to a lesser extent. RSV activity has remained at low levels. SARS-CoV-2 activity has declined over the past four EWs. By countries: In Bolivia, influenza circulation has increased in the most recent EW with influenza A(H3N2) dominating. SARI and ILI numbers have, however, remained low. In Colombia, SARS-CoV-2 activity have declined after an initial increase in mid-January 2024. SARI cases, after the increase associated with positive influenza and SARS-CoV-2 cases, have experienced a decrease in the last four EWs. In Ecuador, SARS-CoV-2 has remained stable at moderate levels of circulation; influenza activity has declined and has remained below the epidemic threshold for the past four weeks, and RSV activity has remained stable at high levels. SARI cases have increased in the most recent EW, associated with increased SARS-CoV-2 positivity. In Peru, SARS-CoV-2 activity has steadily declined over the past four EWs. Influenza activity in Venezuela has remained fluctuating below the epidemic threshold over the past four EWs with A(H1N1)pdm09, influenza A(H3N2), and influenza B/Victoria each contributing almost equally. Brazil and the Southern Cone: SARI and ILI activity has remained low in the last four EWs, with most positive cases attributable to SARS-CoV-2. Influenza activity has remained at low circulation levels during the last four EWs. During this period, the predominant influenza viruses have been type A(H3N2) and A(H1N1)pdm09, followed by B/Victoria. RSV activity has remained at low levels. SARSCoV- 2 positivity has remained at high levels. By countries: In Argentina, ILI and SARI levels have remained below the epidemic threshold. However, SARS-CoV-2 activity has persisted at elevated levels over the past four epidemiological weeks. In Brazil, SARS-CoV-2 activity has increased in the past two EWs, remaining at high levels. In Chile, after a marked decrease, SARS-CoV-2 activity has recently increased again in the last four EWs, with ILI cases remaining above the epidemic threshold, and, SARI cases below the epidemic threshold, mostly attributable to SARS-CoV-2 and, to a lesser extent, influenza. In Paraguay, SARS-CoV-2 circulation has shown a decrease in the last four EWs, reaching low levels, and influenza activity has decreased to levels below the epidemic threshold, SARI and ILI activity has been below epidemic levels, with most positive cases attributable to SARS-CoV-2. In Uruguay, SARI activity has continued at levels below the epidemic threshold, with most of the few positive cases attributable to SARS-CoV-2.


[RESUMEN SEMANAL]. Situación regional: Durante las últimas cuatro Semanas Epidemiológicas (SE), se ha observado una disminución en la actividad de Enfermedad Tipo Influenza (ETI) en la región de las Américas, estabilizándose en niveles medios. De igual forma, se ha observado una disminución en la actividad de Infección Respiratoria Aguda Grave (IRAG), actualmente en niveles bajos. En ambos casos, la actividad observada se ha asociado con casos positivos de influenza y SARS-CoV-2. La actividad de ETI se ha relacionado principalmente con la actividad moderada observada en América del Norte, que ha mostrado un leve aumento en las últimas cuatro semanas. En cuanto a la circulación de virus respiratorios, la actividad del SARS-CoV-2 se ha mantenido moderada a nivel regional en comparación con olas epidémicas anteriores, observándose una ligera disminución en las últimas cuatro SE. Asimismo, la actividad de influenza ha aumentado y se mantiene en niveles epidémicos; La actividad del virus respiratorio sincicial (VSR), aunque sigue siendo moderada, también ha disminuido. América del Norte: Los casos de ETI, tras de una ligera disminución en SE anteriores, se han mantenido en niveles medio-altos, siendo la mayoría de los casos atribuibles a influenza, aunque mostrando una disminución en esta proporción. Los casos de IRAG han disminuido, y la mayoría de los casos son atribuibles a la influenza y, en menor medida, al SARS-CoV-2. La actividad de la influenza se ha mantenido en niveles epidémicos después de una ligera disminución en las SE recientes. Durante este período, los virus de influenza predominantes han sido el tipo A(H1N1)pdm09, con circulación concurrente de influenza B/Victoria y, en menor medida, influenza A(H3N2). La actividad del VRS ha disminuido en las últimas cuatro SE, manteniéndose en niveles moderados. La positividad del SARS-CoV-2 ha disminuido ligeramente en las últimas cuatro SE, y se mantiene por debajo de los niveles de finales de 2023. Por países: En Canadá, la actividad del SARS-CoV-2 ha disminuido notablemente en las últimas cuatro SE hasta niveles medios. La actividad de la influenza se mantiene en niveles epidémicos y la actividad del VSR se ha mantenido estable en niveles altos durante este período. En México, la circulación de influenza se ha mantenido fluctuante en niveles epidémicos en las últimas cuatro SE, y se ha observado un aumento en la circulación de SARS-CoV-2. En Estados Unidos, la actividad de influenza se ha mantenido por encima del umbral epidémico con un ligero aumento en las cuatro últimas SE, la actividad del VSR ha disminuido a niveles moderados y, aunque el SARS-CoV-2 se ha mantenido en niveles altos, ha mostrado una tendencia decreciente. Las tasas de hospitalización por influenza, VSR y SARS-CoV-2, tras alcanzar niveles similares a los de la temporada anterior, han mostrado una tendencia a la baja en las últimas cuatro SE. Caribe: Los casos de ETI han mostrado un aumento en las últimas cuatro semanas asociado con un aumento de casos positivos de influenza y SARS-CoV-2, mientras que los casos de IRAG se han mantenido en descenso. La actividad de influenza ha disminuido en las últimas cuatro SE, alcanzando niveles bajos de circulación. Durante las últimas cuatro SE, los virus predominantes han sido el tipo A(H1N1)pdm09, seguido del A(H3N2) y, en menor medida, el B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en niveles elevados, aunque muestra una tendencia decreciente. Por países: Se ha observado una elevada actividad de influenza en Belice y Surinam. Se ha observado una actividad elevada del SARS-CoV-2 en Belice, Dominica, Jamaica, las Islas Caimán y Guyana. Centroamérica: Tras un aumento observado en semanas anteriores, los casos de ETI han disminuido en las últimas cuatro SE, siendo la mayoría de los casos positivos atribuibles al SARS-CoV-2 y, en menor medida, a influenza. Los casos de IRAG también han mostrado un descenso, alcanzando niveles bajos. Tras el incremento observado en semanas anteriores, la actividad de influenza ha disminuido en las cuatro últimas SE, alcanzando niveles bajos. Durante este periodo, los virus predominantes han sido el tipo A(H1N1)pdm09, seguido del B/Victoria y, en menor medida, el A(H3N2). La actividad del RSV ha disminuido a niveles bajos. La actividad del SARS-CoV-2, ha descendido hasta niveles bajos. Por países: En El Salvador, la actividad del SARS-CoV-2 ha disminuido en las últimas cuatro SE, tras un aumento inicial respecto de las cuatro SE anteriores. En Guatemala, desde finales de enero de 2024 se ha observado un aumento en los casos de ETI asociados a influenza, con una disminución constante en el número de casos de ETI reportados en las últimas tres SE, alcanzando niveles de actividad moderados, mientras que los casos de IRAG se han mantenido en descenso en niveles epidémicos. En Honduras, tras el aumento de casos de ETI e IRAG asociados a casos positivos de influenza y SARS-CoV-2 observado en semanas anteriores, se ha detectado una disminución en las últimas tres SE, alcanzando niveles por debajo del umbral epidémico. En Nicaragua, la actividad del VRS ha aumentado ligeramente en la última SE después de haber disminuido durante las cuatro SE anteriores; tanto los niveles de influenza como de SARS-CoV-2 se han mantenido bajos. En Panamá, después de alcanzar niveles elevados a principios de enero de 2024, la actividad del SARS-CoV-2 ha disminuido. Sin embargo, después de fluctuar alrededor del umbral epidémico en las últimas cuatro SE, los niveles de actividad de influenza aumentaron bruscamente en la SE más reciente. Los casos de ETI e IRAG han disminuido constantemente en las últimas cuatro SE, y la mayoría de los casos positivos son atribuibles al SARS-CoV-2. Andina: La actividad de ETI se ha mantenido estable en niveles bajos y los casos de IRAG han aumentado en la última semana con la mayor proporción de casos positivos atribuibles al SARS-CoV-2. La actividad de influenza se ha mantenido en niveles bajos en las últimas cuatro SE. Durante este período, los virus de influenza predominantes han sido el tipo A(H1N1)pdm09, con circulación de A(H3N2) y B/Victoria en menor medida. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 ha disminuido en las últimas cuatro SE. Por países: En Bolivia la circulación de influenza ha aumentado en la última SE, predominando la influenza A(H3N2). Sin embargo, las cifras de IRAG y ETI se han mantenido bajas. En Colombia, la actividad del SARS-CoV-2 ha disminuido tras un aumento inicial a mediados de enero de 2024. Los casos de IRAG, tras el aumento asociado a influenza y SARS-CoV-2, han experimentado una disminución en las últimas cuatro SE. En Ecuador, el SARS-CoV-2 se ha mantenido estable en niveles medios de circulación; la actividad de influenza ha continuado en descenso y se ha mantenido por debajo del umbral epidémico durante las últimas cuatro SE, y la actividad del VRS se ha mantenido estable en niveles elevados. Los casos de IRAG han aumentado en la SE más reciente, asociado a una mayor positividad del SARS-CoV-2. En Perú, la actividad del SARS-CoV-2 ha mantenido un descenso constante durante las últimas cuatro SE. La actividad de influenza en Venezuela se ha mantenido fluctuante por debajo del umbral epidémico durante las últimas cuatro SE, con A(H1N1)pdm09, influenza A(H3N2) e influenza B/Victoria contribuyendo casi por igual. Brasil y Cono Sur: La actividad de IRAG y ETI se ha mantenido baja en las últimas cuatro SE, siendo la mayoría de los casos positivos atribuibles al SARS-CoV-2. La actividad de influenza se ha mantenido en niveles de circulación bajos durante las últimas cuatro SE. Durante este período, los virus de influenza predominantes han sido tipo A(H3N2) y A(H1N1)pdm09, seguidos por B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La positividad del SARS-CoV-2 se ha mantenido en niveles elevados. Por países: En Argentina los niveles de ETI e IRAG se han mantenido por debajo del umbral epidémico. Sin embargo, la actividad de SARS-CoV-2se ha mantenido en niveles elevados en las últimas cuatro SE. En Brasil, la actividad del SARS-CoV-2 ha aumentado en las últimas dos SE, manteniéndose en niveles elevados. En Chile, tras una marcada disminución, la actividad del SARS-CoV-2 ha mostrado un ascenso en las últimas cuatro SE, con los casos de ETI permaneciendo por encima del umbral epidémico y los casos de IRAG se por debajo de este umbral, en su mayoría atribuibles al SARS-CoV-2. y, en menor medida, influenza. En Paraguay, la circulación de SARS-CoV-2 ha mostrado una disminución en las cuatro últimas SE, alcanzando niveles bajos, y la actividad de influenza ha disminuido a niveles por debajo del umbral epidémico, la actividad de ETI e IRAG ha estado por debajo de niveles epidémicos, siendo la mayoría de los casos positivos atribuibles a SARS-CoV-2. En Uruguay, la actividad de IRAG ha continuado en niveles por debajo del umbral epidémico, y la mayoría de los pocos casos positivos son atribuibles al SARS-CoV-2.


Asunto(s)
Gripe Humana , SARS-CoV-2 , COVID-19 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Américas , Región del Caribe
13.
Washington, D.C.; PAHO; 2024-02-16.
en Inglés, Español | PAHO-IRIS | ID: phr-59330

RESUMEN

[WEEKLY SUMMARY]. Regional Situation: Over the past four epidemiological weeks (EWs), intermediate levels of Influenza-Like Illness (ILI) activity have been observed in the Americas region. Simultaneously, there has been a decrease in Severe Acute Respiratory Infection (SARI) activity, currently at low levels. In both cases, the observed activity has been associated with positive cases of influenza and SARS-CoV-2. ILI activity has been mainly linked to moderate activity observed in North America and elevated activity observed in the Caribbean, while SARI activity has been particularly influenced by activity detected in North America. Regarding the circulation of respiratory viruses, there has been an increase in SARS-CoV-2 activity at the regional level, which remains moderate compared to previous epidemic waves. Additionally, epidemic influenza activity has been observed for this time of year, with moderate activity of Respiratory Syncytial Virus (RSV) showing a decline in the last four EWs. North America: ILI cases, after a slight decrease in previous EWs, have remained at medium-high levels, with the majority of cases attributable to influenza, although showing a corresponding decrease in this proportion. SARI cases have shown a decrease, with most cases attributable to influenza and, to a lesser extent, SARS-CoV-2. Influenza activity has remained at epidemic circulation levels after a slight decrease in previous EWs. During this period, the predominant influenza viruses have been A(H1N1)pdm09, with concurrent circulation of influenza B/Victoria and, to a lesser extent, influenza A(H3N2). RSV activity has shown a decline in the last four EWs, remaining at moderate levels. SARS-CoV-2 activity has decreased in the last four EWs to low levels compared to previous waves. By countries: In Canada, SARS-CoV-2 activity has markedly decreased in the last four EWs to medium levels. Influenza activity remains at epidemic levels, and RSV activity has remained stable at high levels during this period. In Mexico, influenza circulation has remained fluctuating at epidemic levels in the last four EWs, while an increase in SARS-CoV-2 circulation has been observed to intermediate levels compared to previous waves. In the United States, influenza activity has remained above the epidemic threshold with a slight increase in the last three EWs, RSV activity has decreased to moderate levels, and although SARS-CoV-2 has remained at high levels, it has shown a decreasing trend. Hospitalization rates for influenza, RSV, and SARS-CoV-2, after reaching similar elevated levels to the previous season, have shown a downward trend in the last four EWs. ILI cases have remained stable at epidemic levels. Caribbean: ILI cases have shown an increase in the last four weeks associated with an increase in positive cases of influenza, while SARI cases have remained in decline, with the majority associated with SARS-CoV-2 followed by influenza. Influenza activity has decreased in the last four EWs, reaching low circulation levels. During the last four EWs, the predominant viruses have been A(H1N1)pdm09, with concurrent circulation to a lesser extent of influenza A(H3N2) and B/Victoria. RSV activity has remained low. SARS-CoV-2 activity has remained at high levels, although showing a decreasing trend. By countries: Increased influenza activity has been observed in Jamaica and Suriname. Elevated SARS-CoV-2 activity has been observed in Belize, Dominica, Haiti, Jamaica, the Cayman Islands, and Guyana. Central America: Following the increase observed in previous weeks in ILI cases associated with positive cases of SARS-CoV-2, ILI activity has shown a decrease in the last four weeks, with the majority of positive cases attributable to SARS-CoV-2 and influenza. SARI cases have also shown a decrease, reaching low levels, with the majority of positive cases attributable to influenza and SARS-CoV-2. Influenza activity has decreased in the last four EWs, reaching low levels. During this period, the predominant viruses have been A(H1N1)pdm09, followed by B/Victoria and to a lesser extent A(H3N2). RSV activity has decreased to low levels. SARS-CoV-2 activity has decreased in the last four EWs to low levels. By countries: In El Salvador, SARS-CoV-2 activity remains at moderate levels. In Guatemala, an increase in ILI cases associated with influenza and to a lesser extent SARS-CoV-2 has been observed, reaching moderate levels of activity, while SARI cases have remained in decline at epidemic levels. In Honduras, following the increase in ILI and SARI cases associated with positive cases of influenza observed in previous weeks, a decrease has been detected in the last four EWs, reaching levels below the epidemic threshold. In Nicaragua, RSV activity has shown a decrease to low levels in the last four weeks, and both influenza and SARS-CoV-2 levels have remained low. In Panama, SARS-CoV-2 activity, after reaching high levels, has shown a decrease to low levels in the last four EWs. ILI and SARI cases, following the increase observed in previous EWs, have shown a decrease in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2 Andean: ILI activity has remained stable at low levels, and SARI cases, after an increase, have shown a decrease with the highest proportion of positive cases attributable to SARS-CoV-2. Influenza activity has remained low in the last four EWs. During this period, the predominant influenza viruses have been A(H1N1)pdm09, with circulation to a lesser extent of B/Victoria and A(H3N2). RSV activity has remained low. SARS-CoV-2 activity has remained at high levels and on the rise. By countries: In Bolivia, SARS-CoV-2 circulation has shown a marked decrease in the last EW to medium levels, with SARI activity below the epidemic threshold. In Colombia, SARS-CoV-2 activity has shown a pronounced increase in the last four EWs, reaching high levels; SARI cases, after the recent increase associated with positive cases of influenza and SARS-CoV-2, have experienced a decrease in the last two EWs, and deaths among SARI cases positive for SARS-CoV-2 have increased in the last two EWs. In Ecuador, SARS-CoV-2 has shown a decrease in activity to medium-low levels, influenza activity has continued to decline below the epidemic threshold, and RSV activity has shown a slight increase in the last four EWs. Following the recent increase in SARI cases associated with positive cases of influenza, SARS-CoV-2, and to a lesser extent RSV, a decrease in activity has been observed in the last four EWs, maintaining epidemic levels. In Venezuela, fluctuating influenza activity below the epidemic threshold has been observed in the last four EWs. Brazil and Southern Cone: SARI and ILI activity have remained on a decreasing trend in the last four EWs, with the majority of positive cases attributable to SARS-CoV-2 with a rising percentage of positive cases. Influenza activity has remained at low circulation levels in the last four EWs. During this period, the predominant influenza viruses have been A(H3N2) and A(H1N1)pdm09, followed by B/Victoria. RSV activity has remained low. SARS-CoV-2 activity has remained on the rise at high levels. By countries: In Argentina, ILI and SARI levels have remained below the epidemic threshold, showing a slight increase in the last three EWs. Additionally, an increase in the positivity rate of SARS-CoV-2 has been observed, reaching high levels in the last four EWs. In Brazil, SARS-CoV-2 activity has remained on the rise at high levels. In Chile, following the marked decrease in SARS-CoV-2 activity recently experienced, an increase has been observed again in the last four EWs, with ILI cases at epidemic levels and SARI cases below this threshold, mostly attributable to SARS-CoV-2 and to a lesser extent influenza, whose activity has exceeded the epidemic threshold. In Paraguay, SARS-CoV-2 circulation has shown a decrease in the last four EWs, reaching moderate levels, and influenza activity has decreased to levels below the epidemic threshold. SARI activity has remained at epidemic levels with a downward trend, and the majority of positive cases are attributable to SARS-CoV-2. In Uruguay, SARI activity has continued at levels below the epidemic threshold, with a slight increase in the last four weeks, with the majority of the few positive cases attributable to SARS-CoV-2.


[RESUMEN SEMANAL]. Situación regional: Durante las últimas cuatro semanas epidemiológicas (SE) se han observado niveles intermedios en la actividad de la Enfermedad Tipo Influenza (ETI) en la región de las Américas. A su vez se ha observado una disminución en la actividad de Infección Respiratoria Aguda Grave (IRAG), actualmente en niveles bajos. En ambos casos la actividad observada se ha asociado a casos positivos de influenza y SARS-CoV-2. La actividad de ETI se ha relacionado principalmente con la actividad moderada observada en Norteamérica y la actividad elevada observada en el Caribe, mientras que la actividad de IRAG se ha visto especialmente influenciada por la actividad detectada en Norteamérica. En cuanto a la circulación de virus respiratorios, a nivel regional se ha observado un ascenso en la actividad de SARS-CoV-2 que se mantiene moderada en comparación con olas epidémicas previas. Asimismo, se ha observado una actividad epidémica de influenza para esta época del año, y una actividad moderada del Virus Respiratorio Sincitial (VRS) que ha mostrado un descenso en las cuatro últimas SE. América del Norte: Los casos de ETI, tras un ligero descenso en SE previas, se han mantenido en niveles medio-altos con la mayoría de los casos atribuibles a influenza, aunque mostrando un descenso a su vez en esta proporción. Los casos de IRAG han mostrado un decremento con la mayoría de los casos atribuibles a influenza y en menor medida a SARS-CoV-2. La actividad de influenza se ha mantenido en niveles epidémicos de circulación tras mostrar un ligero descenso en SE previas. Durante este periodo, los virus de influenza predominantes han sido del tipo A(H1N1)pdm09, con circulación concurrente de influenza B/Victoria y, en menor medida, influenza A(H3N2). La actividad del VRS ha mostrado un descenso en las últimas cuatro SE, manteniéndose en niveles moderados. La actividad del SARS-CoV-2 ha presentado un decremento en las últimas cuatro SE hasta niveles bajos en comparación con ola previas. Por países: En Canadá, la actividad del SARS-CoV-2 ha presentado un marcado descenso en las últimas cuatro SE hasta niveles medios. La actividad de influenza se mantiene en niveles epidémicos, y la actividad del VRS ha permanecido estable en niveles altos durante este periodo. En México, la circulación de influenza se ha mantenido en fluctuante en niveles epidémicos en las cuatro últimas SE, a su vez se ha observado un incremento en la circulación del SARS-CoV-2 hasta niveles intermedios en comparación con olas previas. En Estados Unidos, la actividad de influenza se ha mantenido por encima del umbral epidémico con un ligero incremento en la últimas tres SE, la actividad del VRS ha descendido hasta niveles medios y el SARS-CoV-2 aunque ha permanecido en niveles elevados ha mostrado una tendencia decreciente. Las tasas de hospitalización por influenza, VRS y SARS-CoV-2 tras alcanzar niveles elevados similares a la temporada previa han presentado una tendencia a la baja en las cuatro últimas SE. Los casos de ETI se han mantenido estables en niveles epidémicos.. Caribe: Los casos de ETI han mostrado un incremento en las cuatro últimas semanas asociado a un incremento en los casos positivos a influenza, mientras que los casos de IRAG han permanecido en descenso, siendo la mayoría asociados a SARS-CoV-2 seguido de influenza. La actividad de influenza ha presentado un descenso en las últimas cuatro SE, alcanzando niveles bajos de circulación. Durante las cuatro últimas SE, los virus predominantes han sido de tipo A(H1N1)pdm09, y se ha observado circulación concurrente en menor medida de influenza tipo A(H3N2) y B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en niveles elevados, aunque mostrando una tendencia decreciente. Por países: Se ha observado una actividad aumentada de influenza en Jamaica y Surinam. Se ha observado una actividad elevada de SARSCoV- 2 en Belice, Dominica, Haití, Jamaica, las Islas Caimán y Guyana. América Central: tras el incremento observado en las semanas previas en los casos de ETI asociados a casos positivos a SARS-CoV-2, la actividad de ETI ha mostrado un descenso en las cuatro últimas semanas, siendo la mayoría de los casos positivos atribuibles a SARS-CoV- 2 e influenza. Los casos de IRAG han mostrado a su vez un descenso situándose en niveles bajos, con la mayoría de los casos positivos atribuibles a influenza y SARS-CoV-2. La actividad de influenza ha presentado un descenso en las cuatro últimas SE, situándose en niveles bajos. Durante este periodo, los virus predominantes han sido de tipo A(H1N1)pdm09, seguido de B/Victoria y en menor medida de A(H3N2). La actividad del VRS ha presentado un descenso hasta niveles bajos. La actividad del SARS-CoV-2 ha descendido en las cuatro últimas SE hasta niveles bajos. Por países: En El Salvador, la actividad de SARS-CoV-2 se mantiene en niveles moderados. En Guatemala, se ha observado un incremento en los casos de ETI asociados a influenza y en menor medida SARS-CoV-2, encontrándose en niveles de actividad moderados, en cuanto a los casos de IRAG se mantienen en descenso con niveles epidémicos. En Honduras, tras el incremento en casos de ETI e IRAG asociados a casos positivos a influenza observado en semanas previas, se ha detectado un descenso en las cuatro últimas SE, alcanzando niveles por debajo del umbral epidémico. En Nicaragua, la actividad del VRS ha mostrado un descenso hasta niveles bajos en las cuatro últimas semanas, y los niveles tanto de influenza como de SARS-CoV-2 se han mantenido bajos. En Panamá, la actividad del SARS-CoV-2 tras alcanzar niveles elevados ha presentado un descenso hasta niveles bajos en las cuatro últimas SE. Los casos de ETI e IRAG tras el incremento observado en SE previas, han presentado un descenso en las cuatro últimas SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2. Andina: La actividad de ETI se ha mantenido estable en niveles bajos, y los casos de IRAG tras un incremento han mostrado un descenso con la mayor proporción de casos positivos atribuibles a SARS-CoV-2. La actividad de influenza ha permanecido en niveles bajos en las cuatro últimas SE. Durante este periodo, los virus de influenza predominantes han sido de tipo A(H1N1)pdm09 con circulación en menor medida de B/Victoria y A(H3N2). La actividad del VRS se ha mantenido en niveles bajos. La actividad de SARS-CoV-2 se ha mantenido en niveles elevados y en ascenso. Por países: En Bolivia, la circulación del SARS-CoV-2 ha mostrado un marcado descenso en la última SE hasta niveles medios, con actividad de IRAG por debajo del umbral epidémico. En Colombia, la actividad de SARS-CoV-2 ha presentado un pronunciado incremento en las cuatro últimas SE situándose en niveles elevados; los casos de IRAG tras presentar el incremento observado recientemente asociado a casos positivos a influenza y SARS-CoV-2, ha experimentado un descenso en las dos últimas SE, las defunciones entre los casos IRAG positivos a SARS-CoV-2 han aumentado en las dos últimas SE. En Ecuador, el SARS-CoV-2 ha presentado un descenso en la actividad situándose en niveles medio-bajos, la actividad de influenza a su vez ha continuado en descenso situándose por debajo del umbral epidémico y la actividad del VRS ha presentado un ligero incremento en las cuatro últimas SE. Tras el incremento observado recientemente en los casos de IRAG asociado a los casos positivos a influenza, SARS-CoV-2 y en menor medida a VRS, en las cuatro últimas SE se ha observado un descenso en la actividad manteniéndose en niveles epidémicos. En Venezuela durante las cuatro últimas SE se ha observado una actividad fluctuante de influenza por debajo del umbral epidémico. Brasil y el Cono Sur: La actividad de IRAG y ETI ha permanecido con tendencia decreciente en las últimas cuatro SE, con la mayoría de los casos positivos atribuibles a SARS-CoV-2 con un porcentaje de casos positivos en ascenso. La actividad de influenza se ha mantenido en niveles bajos de circulación durante las últimas cuatro SE. En este periodo, los virus de influenza predominantes han sido de tipo A(H3N2) y A(H1N1)pdm09 seguidos de B/Victoria. La actividad del VRS se ha mantenido en niveles bajos. La actividad del SARS-CoV-2 se ha mantenido en ascenso en niveles altos. Por países: En Argentina, los niveles de ETI e IRAG han permanecido por debajo del umbral epidémico, mostrando un ligero incremento en las tres últimas SE. A su vez se ha observado un aumento en el porcentaje de positividad de SARS-CoV-2, alcanzando niveles elevados en las cuatro últimas SE. En Brasil, la actividad del SARS-CoV-2 se ha mantenido en ascenso en niveles elevados. En Chile, tras el marcado descenso en la actividad de SARS-CoV-2 experimentado recientemente, se ha observado de nuevo un incremento en las cuatro últimas SE, con los casos de ETI en niveles epidémicos y los casos de IRAG por debajo de este umbral, siendo en su mayoría atribuibles a SARS-CoV-2 y en menor medida a influenza, cuya actividad ha superado el umbral epidémico. En Paraguay, la circulación del SARS-CoV-2 ha mostrado un descenso en las cuatro últimas SE, encontrándose en niveles moderados y la actividad de influenza ha descendido a niveles por debajo del umbral epidémico, la actividad de IRAG se ha mantenido en niveles epidémicos con una tendencia descendente y la mayoría de los casos positivos atribuibles a SARS-CoV-2. En Uruguay, la actividad de IRAG ha continuado con niveles por debajo del umbral epidémico, aunque con un ligero incremento en las cuatro últimas semanas siendo la mayoría de los escasos casos positivos atribuibles a SARS-CoV-2.


Asunto(s)
Gripe Humana , SARS-CoV-2 , COVID-19 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Reglamento Sanitario Internacional , Américas , Región del Caribe
14.
Parasite ; 31: 1, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38353582

RESUMEN

Blood parasites of the genus Hemolivia Petit, Landau, Baccam and Lainson, 1990 (Adeleorina: Karyolysidae) are hemogregarines of ectothermic vertebrates, such as lizards, chelonians, and toads. Only five species of Hemolivia from vertebrate hosts and one from their tick vector have been described so far. In the present study, Central American wood turtles (Rhinoclemmys pulcherrima manni) originating from Southern Nicaragua were screened for the presence of hemogregarines. Ten out of 30 specimens (33.3%) were positive for Hemolivia using both approaches - microscopy and PCR-based analyses. Phylogenetic analyses based on the 18S rRNA gene revealed the presence of two haplotypes, both placed as sister taxa in the Hemolivia clade. Their phylogenetic position was supported by high bootstrap values and high posterior probabilities, suggesting that there are at least two new distinct haplotypes corresponding to two distinct species. However, the specimens of each haplotype were microscopically indistinguishable from each other based on the gamont morphology, therefore, only a single species could be described and named, as Hemolivia pulcherrima n. sp. We consider that the uniform morphology of the most common blood stages of species of the genus Hemolivia complicates their differential diagnosis. Sequence divergence and different host spectra, therefore, remain the only differentiating tools.


Title: Espèces d'Hemolivia infectant les tortues peintes d'Amérique centrale (Rhinoclemmys pulcherrima manni) et problèmes de diagnostic différentiel au sein du genre Hemolivia. Abstract: Les parasites sanguins du genre Hemolivia Petit, Landau, Baccam et Lainson, 1990 (Adeleorina : Karyolysidae) sont des hémogrégarines de vertébrés ectothermes, tels que les lézards, les tortues et les crapauds. Seules cinq espèces d'Hemolivia provenant d'hôtes vertébrés et une de leur tique vectrice ont été décrites jusqu'à présent. Dans cette étude, des tortues peintes d'Amérique centrale (Rhinoclemmys pulcherrima manni) originaires du sud du Nicaragua ont été examinées pour détecter la présence d'hémogrégarines. Dix tortues sur 30 (33,3 %) étaient positives pour Hemolivia en utilisant les deux approches de microscopie et d'analyse de PCR. Les analyses phylogénétiques basées sur le gène de l'ARNr 18S ont révélé la présence de deux haplotypes, tous deux placés comme taxons frères dans le clade Hemolivia. Leur position phylogénétique était étayée par des valeurs de bootstrap et des probabilités postérieures élevées, suggérant qu'il existe au moins deux nouveaux haplotypes distincts correspondant à deux espèces distinctes. Cependant, les spécimens de chaque haplotype étaient impossibles à distinguer les uns des autres au microscope sur la base de la morphologie des gamontes. Par conséquent, une seule espèce a pu être décrite et nommée, comme Hemolivia pulcherrima n. sp. Nous considérons que l'uniformité de la morphologie des stades sanguins les plus courants des espèces du genre Hemolivia complique leur diagnostic différentiel. Les divergences de séquences et les différents spectres d'hôtes restent donc les seuls outils de différenciation.


Asunto(s)
Lagartos , Tortugas , Animales , Filogenia , Diagnóstico Diferencial , Lagartos/parasitología , América Central
15.
J Environ Manage ; 354: 120285, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38368800

RESUMEN

In the world there are approximately 608 million farms, of which 84% are small farms and produce 35% of the food of the world population. Training programs have been promoted by different organizations to achieve a more sustainable and efficient agricultural practice. Within this context, this article has classified a set of smallholders located in central Nicaragua with regard to how they apply Land Use Management Initiatives (LUMI). The aim is to outline their weaknesses and strengths and thus identify key elements that can contribute to improving soil resource management. We focus on the LUMI carried out in Nicaragua in the municipalities of El Tuma-La Dalia, El Cuá and Waslala between 1992 and 2022. To conduct this study, eight LUMI were identified and analysed, and 25 indicators linked to the Malawi Principles were extracted and selected for the design of a survey in order to collect land use management information from 455 farms in the study area. Simple random sampling was used to select the farms. Subsequently, the collected data were analysed using descriptive statistics and Multivariate Analysis techniques. The results reveal that in the study area, the LUMI incorporate between one and five Malawi Principles. The multivariate analysis techniques employed identified three clusters of farms, with either Active, Moderate or Improvable ecosystem management. The study area as a whole displays strengths in social participation, local capacity building, soil and environmental conservation practices, with the farm as the main source of income. Weaknesses lie in the fact that indicators referring to household income and productivity are less frequent. In terms of farm management, the results revealed that combined male and female management was similar in percentage to male-only management. The results highlight the need to continue with the implementation of environmental goals linked to the design of initiatives that promote productivity, income and gender equity in farm management in an integrated manner. At the same time, existing local capacities for sustainable soil and ecosystem management should be brought together and strengthened.


Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , Nicaragua , Productos Agrícolas , Agricultura/métodos , Granjas , Suelo
16.
Lancet Glob Health ; 12(2): e257-e270, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38245116

RESUMEN

BACKGROUND: About half of the world's population lives in dengue-endemic areas. We aimed to evaluate the long-term efficacy and safety of two doses of the tetravalent dengue vaccine TAK-003 in preventing symptomatic dengue disease of any severity and due to any dengue virus (DENV) serotypes in children and adolescents. METHODS: In this ongoing double-blind, randomised, placebo-controlled trial, we enrolled healthy participants aged 4-16 years at 26 medical and research centres across eight dengue-endemic countries (Brazil, Colombia, Dominican Republic, Nicaragua, Panama, Philippines, Sri Lanka, and Thailand). The main exclusion criteria were febrile illness (body temperature ≥38°C) at the time of randomisation, hypersensitivity or allergy to any of the vaccine components, pregnancy or breastfeeding, serious chronic or progressive disease, impaired or altered immune function, and previous receipt of a dengue vaccine. Participants were randomly assigned 2:1 (stratified by age and region) using an interactive web response system and dynamic block assignment to receive two subcutaneous doses of TAK-003 or placebo 3 months apart. Investigators, participants, and their parents or legal guardians were blinded to group assignments. Active febrile illness surveillance and RT-PCR testing of febrile illness episodes were performed for identification of virologically confirmed dengue. Efficacy outcomes were assessed in the safety analysis set (all randomly assigned participants who received ≥1 dose) and the per protocol set (all participants who had no major protocol violations), and included cumulative vaccine efficacy from first vaccination to approximately 4·5 years after the second vaccination. Serious adverse events were monitored throughout. This study is registered with ClinicalTrials.gov, NCT02747927. FINDINGS: Between Sept 7, 2016, and March 31, 2017, 20 099 participants were randomly assigned (TAK-003, n=13 401; placebo, n=6698). 20 071 participants (10 142 [50·5%] males; 9929 [49·5%] females; safety set) received TAK-003 or placebo, with 18 257 (91·0%) completing approximately 4·5 years of follow-up after the second vaccination (TAK-003, 12 177/13 380; placebo, 6080/6687). Overall, 1007 (placebo: 560; TAK-003: 447) of 27 684 febrile illnesses reported were virologically confirmed dengue, with 188 cases (placebo: 142; TAK-003: 46) requiring hospitalisation. Cumulative vaccine efficacy was 61·2% (95% CI 56·0-65·8) against virologically confirmed dengue and 84·1% (77·8-88·6) against hospitalised virologically confirmed dengue; corresponding efficacies were 53·5% (41·6-62·9) and 79·3% (63·5-88·2) in baseline seronegative participants (safety set). In an exploratory analysis, vaccine efficacy was shown against all four serotypes in baseline seropositive participants. In baseline seronegative participants, vaccine efficacy was shown against DENV-1 and DENV-2 but was not observed against DENV-3 and low incidence precluded evaluation against DENV-4. During part 3 of the trial (approximately 22-57 months after the first vaccination), serious adverse events were reported for 664 (5·0%) of 13 380 TAK-003 recipients and 396 (5·9%) of 6687 placebo recipients; 17 deaths (6 in the placebo group and 11 in the TAK-003 group) were reported, none were considered study-vaccine related. INTERPRETATION: TAK-003 demonstrated long-term efficacy and safety against all four DENV serotypes in previously exposed individuals and against DENV-1 and DENV-2 in dengue-naive individuals. FUNDING: Takeda Vaccines. TRANSLATIONS: For the Portuguese, Spanish translations and plain language summary of the abstract see Supplementary Materials section.


Asunto(s)
Vacunas contra el Dengue , Dengue , Adolescente , Niño , Femenino , Humanos , Masculino , Dengue/prevención & control , Vacunas contra el Dengue/efectos adversos , Virus del Dengue , Método Doble Ciego , Hipersensibilidad , Vacunación/métodos , Preescolar
17.
J Pediatric Infect Dis Soc ; 13(2): 148-151, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38168703

RESUMEN

Norovirus is a common and highly transmissible gastrointestinal pathogen. Among 34 Nicaraguan households with a norovirus-infected child, 48% experienced norovirus transmission within 1 week, infecting 18% of household members; GII norovirus was more commonly transmitted than GI. Pediatric norovirus vaccines could prevent both index cases and transmission to close contacts.


Asunto(s)
Infecciones por Caliciviridae , Gastroenteritis , Norovirus , Niño , Humanos , Lactante , Gastroenteritis/epidemiología , Nicaragua/epidemiología , Composición Familiar , Infecciones por Caliciviridae/epidemiología , Heces , Genotipo , Filogenia
18.
Artículo en Inglés | MEDLINE | ID: mdl-38205676

RESUMEN

In biogeography, vicariance and long-distance dispersal are often characterised as competing scenarios. However, they are related concepts, both relying on collective geological, ecological, and phylogenetic evidence. This is illustrated by freshwater fishes, which may immigrate to islands either when freshwater connections are temporarily present and later severed (vicariance), or by unusual means when ocean gaps are crossed (long-distance dispersal). Marine barriers have a strong filtering effect on freshwater fishes, limiting immigrants to those most capable of oceanic dispersal. The roles of vicariance and dispersal are debated for freshwater fishes of the Greater Antilles. We review three active hypotheses [Cretaceous vicariance, Greater Antilles-Aves Ridge (GAARlandia), long-distance dispersal] and propose long-distance dispersal to be an appropriate model due to limited support for freshwater fish use of landspans. Greater Antillean freshwater fishes have six potential source bioregions (defined from faunal similarity): Northern Gulf of México, Western Gulf of México, Maya Terrane, Chortís Block, Eastern Panamá, and Northern South America. Faunas of the Greater Antilles are composed of taxa immigrating from many of these bioregions, but there is strong compositional disharmony between island and mainland fish faunas (>90% of Antillean species are cyprinodontiforms, compared to <10% in Northern Gulf of México and Northern South America, and ≤50% elsewhere), consistent with a hypothesis of long-distance dispersal. Ancestral-area reconstruction analysis indicates there were 16 or 17 immigration events over the last 51 million years, 14 or 15 of these by cyprinodontiforms. Published divergence estimates and evidence available for each immigration event suggests they occurred at different times and by different pathways, possibly with rafts of vegetation discharged from rivers or washed to sea during storms. If so, ocean currents likely provide critical pathways for immigration when flowing from one landmass to another. On the other hand, currents create dispersal barriers when flowing perpendicularly between landmasses. In addition to high salinity tolerance, cyprinodontiforms collectively display a variety of adaptations that could enhance their ability to live with rafts (small body size, viviparity, low metabolism, amphibiousness, diapause, self-fertilisation). These adaptations likely also helped immigrants establish island populations after arrival and to persist long term thereafter. Cichlids may have used a pseudo bridge (Nicaragua Rise) to reach the Greater Antilles. Gars (Lepisosteidae) may have crossed the Straits of Florida to Cuba, a relatively short crossing that is not a barrier to gene flow for several cyprinodontiform immigrants. Indeed, widespread distributions of Quaternary migrants (Cyprinodon, Gambusia, Kryptolebias), within the Greater Antilles and among neighbouring bioregions, imply that long-distance dispersal is not necessarily inhibitory for well-adapted species, even though it appears to be virtually impossible for all other freshwater fishes.

19.
Otol Neurotol ; 45(2): 176-183, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38206066

RESUMEN

OBJECTIVE: Evaluate whether a portable, tablet-based central auditory processing (CAP) test system using native language training videos and administered by minimally trained community health workers can produce CAP results comparable to previously published norms. Our secondary aim was to determine subject parameters that influence test results. STUDY DESIGN: Cross-sectional study. SETTING: Community-based settings in Chontales, Nicaragua, New Hampshire, and Florida. PATIENTS: English- and/or Spanish-speaking children and adolescents (n = 245; average age, 12.20 yr; range, 6-18 yr). MAIN OUTCOME MEASURES: Completion of the following tests with responses comparable to published norms: Pure-tone average (PTA), gap detection threshold (GDT), fixed-level frequency threshold, masking level difference (MLD), Hearing in Noise Test (HINT), Dichotic Digits Test (DDT), and Frequency Pattern Recognition (FPR) test. RESULTS: GDT, HINT, and DDT had comparable results to previously published normative values. MLD and FPR results differed compared with previously published normative values. Most CAP tests (MLD, GDT, HINT) results were independent of age and PTA (p = 0.1-0.9). However, DDT was associated with age and PTA (p < 0.0001). CONCLUSIONS: Pediatric CAP testing can be successfully completed in remote low- and middle- income country environments using a tablet-based platform without the presence of an audiologist. Performance on DDT improved with age but deteriorated with hearing loss. Further investigation is warranted to assess the variability of FPR.


Asunto(s)
Sordera , Países en Desarrollo , Adolescente , Humanos , Niño , Estudios Transversales , Percepción Auditiva , Pruebas Auditivas
20.
BMC Oral Health ; 24(1): 116, 2024 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-38243206

RESUMEN

BACKGROUND: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. METHODS: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. RESULTS: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. CONCLUSION: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders.


Asunto(s)
Personas con Discapacidad , Carga Global de Enfermedades , Humanos , Prevalencia , Incidencia , Calidad de la Atención de Salud , Salud Global , Años de Vida Ajustados por Calidad de Vida
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...