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Argentina: Children and influenza A observations

Shiloh

Editor, Senior Moderator
Source: http://www.laprensa.com.ar/337695-Los-ninos-y-la-gripe-A.note.aspx

Google translation:

Science and Health
Children and influenza A

19.07.2009 | After having participated in a symposium that brought together specialists to discuss country experiences on the influenza A virus, an infectious diseases expert at Children's Hospital Ricardo Gutierrez explained what are the characteristics that showed the disease in pediatric patients and what measures should be taken to prevent it.
By Agustina Sucri

The Pediatric Infectious Diseases Society of Argentina (SADIP) held a symposium last week on a new influenza virus A (H1N1) in which pediatricians, infectologists and other specialists in the medical community with the aim of sharing experiences in argentina.

In an interview with La Prensa, Dr. Maria Marta Contrini, infectologists Children's Hospital Ricardo Gutierrez and a member of SADIP, responded to some of the questions that exist about influenza A viruses:

- How is manifest influenza A in children?

- Demonstrations in children have a wide spectrum, ranging from mild to tables tables severely, as with seasonal influenza virus. We have had the opportunity to see children of different ages with influenza, but mostly we had the opportunity to serve children of school age, since the first affected were school children.

- What features were common in children who were more severely affected by influenza A?

- Children who are most severely affected are those who have always provided some basis in them the disease is much more severe. In fact, cases of death we are always children who have some basic condition, namely that there is a risk factor that made the disease much more severe.

- How can these risk factors?

- There are several risk factors: for example, cancer patients, patients immunocompromised by disease or some other treatment, those with chronic lung disease, congenital heart disease or heart disease.

- Treatment varies depending on the severity of the patient?

- All were given oseltamivir. The indication of oseltamivir fell by two different stages: at first you were all children who were affected initially, since it sought to contain the infection. This was because the outbreak was at school, were treated the patients were outpatients, who were healthy children, and prevention is also put in all those with a family environment, and to treat that disease is very limited.

- Does this mean that patients would watch to see they had flu-like symptoms were given oseltamivir even that was not confirmed as having influenza A virus?

- Exactly, all were included in that phase. The indication was that they were made to the nasal swabs and oropharyngeal swabs and sent to study. But if the patient had clear symptoms of flu, at this stage is medical, but all children were healthy because they were trying to contain the infection as possible.

- To the families of these children are also doctors?

- To his family were given an indication of prevention or prophylaxis: all cohabiting household receiving oseltamivir for treatment once a day for ten days, to try to have no secondary cases that child who was sick in the family initially .

- What was the second phase of treatment?

- Then move to another stage, in which we saw when the virus began to spread because we were receiving patients who came to attend by febrile illness caused by influenza viruses that had been approached, as we are currently doing in Children who have a risk factor because in them the infection is more severe and can be fatal.

- After having supplied the drug to the child, how long it takes to introduce improvements?

- It is estimated as shown by previous studies on oseltamivir-a question that when an influenza virus infection with this medication, as they pass the days of treatment (which is 5 days), decrease the expression of the virus. And around the fourth or fifth day, and virtually no expression of the virus.

EFFECTIVENESS

- There was talk of cases where there was resistance to oseltamivir ... You noted a lack of response in a pediatric patient?

- No one can speak of oseltamivir resistance in our area, because there are still no studies on the sensitivity of the virus to the antiviral, as far as I know.

- All patients who sought care from the hospital Gutierrez responded to treatment?

- That is another thing and is very premature. I have an assessment as to say all respondents could not say that at this time. Nor interpret whether or not this drug can be resistant to the virus. No data or analysis to talk about it.

- Did the hospital where Gutierrez had to change the drug, ie, opt for another option, zanamivir?

- Zanamivir is not yet available in Argentina. In addition, zanamivir is a certain age group, from seven years.

- What types of complications patients had died?

- In patients who have risk factors for the disease is more serious. And in dying patients, the disease is associated with your condition base.

PREVENTION

- What other topic was discussed at the symposium organized by SADIP?

- There was much emphasis on preventive measures at both the community and health personnel.
- The preventive measures were generated some controversy: if the chinstrap is effective or not, whether to use alcohol gel ... What are the main preventive actions?

- The use of chinstrap, while perhaps controversial, is half the barrier and in those children who are sick shows use to try to prevent the disease is spreading. Furthermore, the use of chinstrap is prioritized when the doctor is attending a pediatric patient in a condition of closeness. There are medical practices that are much more risk to the child's contact with secretions, such as having to take a sample of the aspirate secretions from the nose or throat, then the doctor compared to those conditions must be protected and indeed is indicated using chinstrap, goggles, gloves, camisol?n. There are special situations where the chinstrap actually serves as a barrier method to prevent disease transmission.

- So the people who are healthy should not use the chinstrap?

- Not to mention the use of chinstrap indiscriminately in the street for the entire world. There are some situations in which one can protect themselves, one has to take into account when we are going to get in contact with a patient who has to assist in the home-mom-for example it may be protected by the chinstrap.

- The chinstrap has a shelf life?

- Yes, number of hours that can be used depends on the type chinstrap. In any case, once the chinstrap is moistened or cracks, it ceases to be effective and of course should be discarded.

- The alcohol gel or alcohol 70% thinner cash?

- It is indicated as equivalent to hand washing. Hygiene measures are to prevent the spread of the virus.

- Hand washing is the most important hygiene measure?

- Yes, it is always a measure that one must take into account in the first instance.

- On environments is the virus progresses in wet or dry environments?

- In wet conditions. Environments should be well ventilated.

- What other measures are important?

- When coughing or sneezing should cover their nose and mouth with the elbow rather than by hand. And we need to avoid touching your eyes, nose and mouth with your hands. It is important to wash hands frequently so that if one inadvertently touches the nose, eyes or mouth to avoid the spread of the virus.

- Now that the kids are on holiday what is best to stay in their homes?

- The extension of the holiday is aimed at kids who do not attend gregarious type activities, such as the school where classrooms are sharing with many children, because it facilitates the spread of viruses. Group activities should be avoided or very close communication with other viruses. The fact of staying at home to help avoid contact.
 
Re: Argentina: Children and influenza A observations

http://www.losandes.com.ar/notas/2009/7/17/sociedad-435533.asp

(google translation)

Prohibit children under 18 entering enclosed public places
The restaurants will continue to only 50% of its capacity and may open the bowling but as "tearooms." It also extends the leave of fifteen days for pregnant women and immunocompromised.

Friday, 17 July 2009
In another attempt to try to curb cases of influenza A in the province, yesterday ruled today prohibit the entrance of minors under 18 years to all enclosed public spaces.

This means that kids can not go, for example, either the player or to the supermarket with their parents, nor a food court. The measure was taken from the Government-emphasized, because "there was no support from society in the last fortnight, in the care of the young."


So said Health Minister Aldo Sergio Saracco, arguing the measure noting that half of the inmates for being suspected cases of influenza A are children. A list of the new measures may be added, for seven days, that bowling alleys, casinos and players working as a confectioner and fifty percent of capacity, but remains barred from dancing.

He announced, extends leave for fifteen days for pregnant women and immunocompromised.

The ads brought more questions than certainties, and immediately the owner of the bowling expressed discomfort. "We are the only ones who obey the measure and we are still injured. How are we going to open the bowling for the kids to take something and not dance? Was going to go to underground parties," said Julian Albarracin, owner of a local , Mario Adaro, minister of Government.

The owners of the local dance argued that the only people who were met standards, while in the yards of food, Center and theaters were crowded during the weekend. "They have no economic losses, and we do," the officials said emphatically in the fifth floor of Government House.

The pressure of these entrepreneurs made Adaro "rethink" the measure. "Tomorrow (today) we will consult the Advisory Committee of Experts if they can do outdoor festivals and if you can dance on the premises, but with half the people," he said. Finally, there will be another meeting with businessmen during the day today.

Meanwhile, the owners of the players may make celebrations or festivities for over 18 years. The idea, said the government is able to work fifty percent as the rest of the business premises.

The boys still at home

One of the new rules announced yesterday categorically prohibits the admission of children under 18 years in enclosed public spaces. "We saw that the measures taken two weeks ago were not accompanied by large shopping centers, supermarkets and retailers in general. Now is the ban. The kids have no access to any of these places," the official said.

So, today begins to govern the resolution 2.427/09, which punishes those who do not meet the new standards. Saracco According to the Committee of Experts noted that "there are further measures that we are passing the peak of the new disease."

It is important to remember that the most affected by the H1N1 virus are young people, with an average of 22 years. Hence, emphasis in this age group. "We're starting to see that slowly decreases in number of consultations in hospitals, so it is very important to continue with prevention," said the owner of the portfolio of Health.

Casinos, 50%

During this weekend, the casinos will be able to work at half capacity, with the restriction of not smoking. Adaro said that the measures were extended to all restaurants and malls, with the sole aim of cutting the chain of infection.

Municipal leaders also were meeting yesterday with the Executive Branch, trying to organize joint inspections to Friend's Day. Adaro said that it is important to coordinate control activities because the provincial government does not have enough inspectors to be in the whole province.
 
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