[SARS-CoV-2 infection in children: Clinical characteristics and dynamics of SARS-CoV-2 transmission in a private health center. Uruguay]. / Infección por SARS-CoV-2 en niños: Características clínicas y dinámica de la transmisión de SARS-CoV-2 en un centro de salud privado. Uruguay.

BACKGROUND: To date, the prevalence and severity of the COVID-19 disease in children is lower than in adults. There are controversies regarding the dynamics of transmission and the role they play in the spread of the disease. AIM: To describe the clinical characteristics and transmission dynamics of patients under 15 years of age reported for suspicion and/or contact for COVID-19 in the period March 13 - November 20, 2020, in a private comprehensive health provider (Médica Uruguaya Medical Assistance Corporation, MUCAM). METHODS: Descriptive, retrospective study, in which clinical manifestations, epidemiological notion, secondary cases, severity and evolution are described. The risk and rate of secondary intradomiciliary attack were estimated. RESULTS: 539 patients met the inclusion criteria. The diagnosis was confirmed in 29 (5.3%): 13 (7.0%) of the 351 symptomatic children and 16 (4.5%) of the 188 asymptomatic. 100% of the confirmed cases and 85% of the unconfirmed cases had the notion of contact (p < 0.05). The OR for infection from an indoor contact was 26.5 (9.8-71.7) and the rate of secondary indoor attack 23% ± 4.1. CONCLUSIONS: In this series, mild and asymptomatic forms predominated in patients under 15 years of age. One in five exposed indoors contracted the disease, this notion of contact being decisive to indicate confirmatory studies. Most of the children did not continue the chain of transmission.

Tos convulsa: brote epidémico 2011-2012, Hospital Las Piedras: características clínico-evolutivas de los pacientes hospitalizados / Whooping cough: epidemic outbreak 2011-2012, Hospital Las Piedras: clinical-evolutionary characteristics of hospitalized patients

Introducción: la tos convulsa es una enfermedad infecciosa respiratoria aguda debida a Bordetella pertussis y Bordetella parapertussis. Factores de mal pronóstico son edad menor a 6 meses, hiperleucocitosis, coinfección bacteriana. En Uruguay, desde la incorporación de la vacuna antipertussis en 1963, disminuyeron significativamente las notificaciones con comportamiento endémico con brotes. En el 2011, luego del fallecimiento de dos niños con tos convulsa, se registró un aumento de casos en el Hospital Las Piedras (HLP). Objetivo: describir las características clínico-evolutivas de los niños hospitalizados por tos convulsa en el HLP entre el 1º de agosto de 2011 y el 30 de abril de 2012. Material y método: estudio descriptivo, prospectivo, de los niños hospitalizados por tos convulsa. La confirmación se realizó por reacción en cadena de polimerasa (PCR) en secreciones respiratorias. Se analizan variables epidemiológicas, características clínicas y evolutivas. Resultados: se hospitalizaron 41 niños con tos convulsa confirmada (6,4%); 48,8% fueron menores de 6 meses. Diez fueron derivados a centros de tratamiento intensivo (CTI), ocho de ellos menores de 6 meses; dos fallecieron. Tuvieron contacto con casos confirmados 10% y con casos sospechosos 51%. Presentaron leucocitosis > 20.000 cel/mm3, 39%. En tres casos existió coinfección con adenovirus. Discusión y conclusiones: el brote de tos convulsa comenzó en 2011, siendo el HLP el centro que alertó su inicio y registró la tasa más elevada de hospitalización. Las características clínico-evolutivas de los niños afectados son similares a las descritas en la región. Su abordaje requiere accesibilidad a nuevas herramientas diagnósticas de biología molecular. Para el control y la prevención se requiere reforzar las estrategias de vacunación.

Abstract Introduction: whooping cough is an acute respiratory infectious disease caused by a type of bacteria called Bordetella pertussis and Bordetella parapertussis. Being younger than 6 months, hyperleukocytosis and bacterial coinfection are some bad prognosis factors. In Uruguay, since the antipertussis vaccination was included in the vaccination schedule in 1963, notifications with endemic outbreak behavior significantly diminished. In 2011, after two children with whooping cough died, an increase of the cases was recorded at the Las Piedras Hospital. Objective: to describe the clinical characteristics and evolution of children hospitalized for whooping cough at the Las Piedras Hospital from August 1st, 2011 through April 30, 2012. Method: descriptive, prospective study, of the children hospitalized for whooping cough. Confirmation was made by polymerase chain reaction in respiratory secretions. Epidemiological variables, clinical characteristics and evolution are analysed. Results: 41 children were hospitalized with confirmed whooping cough (6.4%); 48.8% were younger than 6 months. Ten of them were referred to intensive care units, eight of them were younger than 6 months and two of them died. Ten per cent were in contact with confirmed cases and 51% were in contact with suspicious cases. Leukocytosis > 20.000 cel/mm3 was seen in 39% of children. There was coinfection with adenovirus in three cases. Discussion and conclusions: the whooping cough outbreak started in 2011, being the Pereira Rossell the health center that issued the warning and had the highest hospitalization rate. Clinical characteristics and evolution of the children affected are the similar to those described in the region. Access to new diagnostic tools of molecular biology is necessary to address this condition. Control and prevention requires strengthening vaccination strategies.

Resumo Introdução: a coqueluche é uma doença infecciosa respiratória aguda devida a Bordetella pertussis e Bordetella parapertussis. Idade menor a 6 meses, hiperleucocitoses e co-infecção bacteriana são fatores de mal prognóstico. No Uruguai, desde a incorporação da vacina contra a coqueluches em 1963, as notificacoes com comportamento endêmico com surtos diminuiram significativamente. Em 2011, depois dos óbitos de duas crianças com coqueluche, registrou-se um aumento de casos no Hospital Las Piedras (HLP). Objetivo: descrever as características clínico-evolutivas das crianças hospitalizadas por coqueluche no HLP no período 1º de agosto de 2011 - 30 de abril de 2012. Material e método: estudo descritivo e prospectivo das crianças hospitalizadas por coqueluche. A confirmação do diagnóstico foi feita por reação em cadeia de polimerase (PCR) em secreções respiratórias. Foram analisadas variáveis epidemiológicas, características clínicas e evolutivas. Resultados: 41 crianças foram hospitalizadas com diagnóstico confirmado de coqueluche (6,4%); 48,8% tinham menos de 6 meses de vida. Dez foram derivadas a unidades de terapia intensiva (UTII) sendo que oito tinham menos de 6 meses; duas faleceram. 10% teve contato com casos confirmados e 51% com casos suspeitos. 39% apresentou leucocitose > 20.000 cel/mm3. Em três casos foi observada co-infecção com adenovirus. Discussão e conclusões: o surto de coqueluche começou em 2011, sendo o HLP o centro que alertou sobre seu inicio e registrou a taxa mais elevada de hospitalização. As características clínico-evolutivas das crianças afetadas foram similares às descritas na região. A abordagem desta patologia requer acesso a novas ferramentas diagnósticas de biologia molecular. Para o controle e a prevenção é necessário reforçar as estratégias de vacinação.

Xanthomonas axonopodis pv. citri enters the VBNC state after copper treatment and retains its virulence.

The most severe form of citrus canker disease is caused by Xanthomonas axonopodis pv. citri (Xac) and affects all types of important citrus crops, reducing fruit yield and quality. Copper-based products are routinely used as a standard control measure for citrus canker. In this work we demonstrate that copper treatment induces the viable but nonculturable (VBNC) state in Xac but does not prevent the development of symptoms in susceptible plants. Short-term exposures to different concentrations of copper solutions were assayed to determine which treatment resulted in Xac nonculturability. Treatment of 10(6) mL(-1) Xac cells for 10 min in a 135-muM CuSO(4) solution (equivalent to three times the free soluble copper concentration applied in one field treatment) resulted in nonculturability. However, 16% of cells were viable based on 5-cyano-2,3-ditolyl tetrazolium chloride staining and 1% were capable of producing canker lesions after infiltrating grapefruit plants. If induction of the VBNC state in Xac cells were to occur under field conditions, this would have to be taken into consideration for an effective control of canker disease.