Wednesday , October 5 2022

"We must rule out that we are facing an epidemic for hantavirus"


the situation in Epuyén for the outbreak of hantavirus, although "it is not controlled, it would enter a control path", said the Secretary of Health of the Nation, Adolfo Rubinstein. In an exclusive interview with Los Andes, the highest national responsible for the health area needs that The total number of cases in the country totals 36: 28 in Epuyén and eight in Salta, Jujuy, Entre Ríos and the province of Buenos Aires.

– Is the situation in Epuyén controlled?

-The situation remains the same, we continue with 28 positive cases reported and 10 deaths, the epidemiological picture has not been modified, and the number of people in selective respiratory isolation in Epuyén and in two or three neighboring localities is decreasing, because some are being donated.

The situation is not controlled, but we are reasonably optimistic about the fact that the situation would go into a way of control. I can reasonably say that I can not guarantee it: between the first week, which is when the first patient appeared, the index case, and the first infected of Epuyén's feast, when we established that the contagion was interum, it could have been filtered Any contact that came out of the area and eventually could appear cases that we have not identified yet.

What we can say is that an exhaustive search was done and the criterion of home insulation was very broad. So far, the 28 cases of Epuyén are referenced and refer to the case index, the woodcutter who was with symptoms at the party, at the beginning of November. In addition, several days have elapsed without new cases, and the last ones were of people who were in selective isolation, so we know there were no infections. It's a good picture, but we can not guarantee anything.

-There were cases in Entre Ríos and Buenos Aires. Are you afraid of an epidemic?

-No, this must be ruled out because it is something else. It has absolutely nothing to do with the outbreak of Epuyén with the endemic cases that are reporting now in Salta, Jujuy, Entre Ríos and the province of Buenos Aires. It's different, this occurs every year; Moreover, there are more than one hundred annual cases on average that are reported forever. In 2018, for example, the provinces that most cases contributed were Buenos Aires, Salta and Jujuy.

These are endemic cases of environmental contamination that occur in rural areas where there is the Hanta: to the north, to Salta and Jujuy; In the center, Entre Ríos, Buenos Aires and Santa Fe; and in Patagonia. And they are different strains. The vine that is today on the outbreak of Epuyén and which was on the outbreak of Bolsón in 1996 is the South Andes strains. In contrast, those that are circulating in the north or in the province of Buenos Aires are endemic, different.

-How many cases are counted in the whole country so far?

– The report came fifteen minutes ago (the interview was late yesterday). Removing the cases of Chubut, we have confirmed eight cases of endemic Hanta. In the province of Buenos Aires there are five; to Entre Rius, one; to Jujuy, one in Salta, one. That's all we have reported in 2019. If we compare with the different genres of recent years, we are in the same numbers as always.

-Why does he think that the cases of Epuyén were so rapidly multiplied?

-The Epuyén is an outbreak. There was a famed epidemic in El Bolsón in 1996, which was much worse than this, it had almost 60% mortality. Then it was not known that there could be a route of interhuman, respiratory infection, it was thought that Hanta's contagion was environmental, by inhalation of secretions of infected mice, in rural areas, weeds, enclosed spaces, and so on. There is no specific treatment for hantavirus, but at this time we are designing experimental protocols for specific treatments.

-Here other countries with this problem?

-Yes, there are many jokes, with different clinical manifestations. This South Andes strain is in Chilean Patagonia as well. But there is Hanta in the United States, in Africa, with different complications.

-Delete assigned to Chubut for the control of endemic diseases was eliminated?

-No. This is sanitary sovereignty. It has nothing to do with anything. The entire budget of the vectors programs increased a lot. Nothing to see Not only was there no decrease, but there was an increase. They are political Xicanas that have to do with the degradation of the ministry to secretary, they say that the programs of prevention are disarmed, but without no evidence. Forget & # 39; t, it's not true. The reality is that this is an outbreak similar to the one of 1996, with the difference that then the path of interhuman transmission was not known. The 28 cases reported so far in Epuyén refer to this case index. It is an outbreak of a book.

-Hantavirus leaves sequels?

– No, there are patients who begin with clinical symptoms, flu-like syndrome, abdominal pain, diarrhea, headache, congestion, muscle aches and nothing happens. The most feared complication is pulmonary syndrome that is very severe and has heart afflictions, and it is the one that produces a very high mortality rate.

– Is there any type of budget allocation to attend to these people, if they can not attend their work?

– At Epuyén we have at this moment more than one hundred people in compulsory home insulation. Anyone who has come into contact with a patient who had a positive case is in home isolation. And it is mandatory. Chubut is providing them with food and help, of course. In addition, the Secretary of Health of the Nation is giving Chubut a lot of help in tickets, equipment, human resources.

In fact, I returned from Epuyen and Esquel yesterday and we were working with our teams of Epidemiology Management, the Undersecretary of Communicable Diseases, the Malbrán Institute, and the intensive therapy of the # 39; Hospital del Cruïlla, by Florencio Varela, to assess how intensive hospital therapy works in Esquel; In addition, the Argentine Society of Infectology. We did a very intense, very productive work.

-The flood could complicate the situation with dengue and other diseases.

– I went to Chaco and Corrents today to see a bit the flooded areas and the needs and the panorama there. The problem is when the waters go down, this is when one has to start responding, because there are evacuees, and it always increases the risk of diseases, especially gastrointestinal, diarrhea, and mosquitoes.

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