Argentina - Outbreak of bilateral pneumonia: 22 cases, 6 deaths, Tucumán - September 1, 2022 - Legionella confirmed

[tetano]

The Ministry of Public Health of Tucuman warned that a bilateral pneumonia outbreakl in that province, where six cases have already been registered, of unknown origin and etiology. Two people died and four others remain hospitalized.

“We have detected an outbreak of bilateral pneumonia in six patients, this disease is a manifestation of many respiratory diseases”, he explained louis medina ruizhead of the provincial health portfolio, at a press conference.

Bilateral pneumonia is a lung infection which is among the frequent sequelae of covid. It can happen through a bacteria or virus acquired during hospitalization or involvement of the lungs with a respiratory disease.


Medina Ruiz explained that, before diagnosing with the appropriate disease, suspicions first pointed to covid, influenza, influenza A, influenza B and Hantavirus, but all were discarded.



The official stated that “we have not yet found the etiologydespite continuing to study not only viruses, but also bacteria, with cultures through a study called FilmArray, which investigates 25 germs, and they also tested negative.

https://www.newstimes.com.ng/tucuma...-and-etiology-are-unknown-more-breaking-news/

 

[tetano]

Third death from pneumonia of unknown origin in Argentina

Argentina has reported a third death from bilateral pneumonia of unknown origin in the province of Tucumán (northwest) and it is being investigated whether it is patient zero of the outbreak, health authorities reported this Thursday. 'This is a 70-year-old patient who was hospitalized in a private sanatorium,' said the provincial Minister of Health, Luis Medina Ruiz, at a press conference.

Among those infected, the Ministry of Health ruled out Covid, flu and influenza as causes. 'We are studying the origin of the outbreak and the epidemiological link, we are still in the process of investigation,' explained the minister. Until Wednesday, the authorities had reported six cases and this Thursday they reported three more infections.

The third deceased was the only one among those infected who did not belong to the health personnel of the private clinic in San Miguel de Tucumán (1,300 km north of Buenos Aries), where the cases were reported and who has been isolated as a precaution.

The new fatal victim “had undergone surgery for a gallbladder problem and reoperated twice. From then on, she had a lung infection that coincides with the date of appearance (of symptoms) of the other patients », said the minister. “It is not very clear what the start was because everything is around August 20. We understand that she is patient zero at first, but that is under study, 'added Medina Ruiz.

The samples of the first six cases are being investigated by the laboratory of the Malbrán Institute, the main benchmark in the country.

https://www.abc.es/sociedad/muertes-...122724-nt.html

 

[Pathfinder]

Translation Google

PUBLIC HEALTH September 1, 2022
The Ministry of Public Health reported on the health situation of the bilateral pneumonia outbreak

listen to this note

In a new press conference, the head of the Health Portfolio, Dr. Luis Medina Ruiz, reported the death of a 70-year-old patient and the identification of 3 employees of the sanatorium experiencing the same outbreak.

In this regard, the minister announced: “The sanatorium informed us of the death of a 70-year-old patient who was hospitalized there, we needed the family to know first to be able to communicate it. In addition, we identified 3 more employees of the private agent who began with symptoms around August 20 to 23 (that is, they correspond to the same outbreak and place of contagion in principle). That is why at this moment 3 more people are added to the 6 initial patients”. [TABLE="width: 713, height: 24"]
[TR]
[TD]Regarding the 70-year-old patient who died on that date, the minister stated: “She was hospitalized and underwent surgery for a gallbladder problem. She was re-operated twice. From then on, an infectious pulmonary disease took place, the date of which coincides with the onset of symptoms in the other patients, around August 20. Although it is not yet clear which came first, at first she was considered patient zero, but she is under study based on the deepening of the analyzes that are being carried out”.[/TD]
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At the same time he added: “We reported on the 3 identified employees, one of them is a 40-year-old pharmacy assistant and has been hospitalized a few days ago in a public hospital with a fever. In the active search that we are carrying out, especially in health personnel, we detected that it is a person who has non-severe bilateral pneumonia with an oxygen requirement under study. The other person is a 44-year-old nurse, she is at her home and we are following her evolution, since her clinic does not warrant hospitalization. The third case is a 30-year-old nurse with comorbidities, who was recently admitted to hospital this morning, symptoms began around the same days and on the date he was present to be evaluated, at which time we decided to hospitalize him. [TABLE="width: 713, height: 24"]
[TR]
[TD]Following this line, the official explained that these three people have bilateral pneumonia as a clinical characteristic and in common the origin of the focus, the epidemiological link with the 6 initial patients. The criterion of incorporating them as suspected patients to the outbreak in principle is based on the employment relationship with the sanatorium, bilateral pneumonia and that with all the study panels its etiology has not yet been found.[/TD]
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“Last night and this morning we had information from the Malbrán Institute and so far all the studies that we had as negative -for Covid, Hantavirus and some strains of Legionella- are also giving negative results there. We continue to carry out the research protocol for blood cultures, sputum cultures, urine cultures and all the viruses and bacteria that we have available in the province. We are in direct communication with Minister Carla Vizzotti, who is available, as well as all the epidemiology and infectology teams of the Nation, we are working as a large medical board in which we all participate with the information we have, there are hypotheses of the etiology that are being put on the table, although what we have specifically is the common origin and evolution of the disease, "he added.

In the same way Medina Ruiz stressed that Sanitary Control is doing an exhaustive analysis in the sanatorium and so far nothing has been found that gives suspicion of being the origin of the problem.​

“We are all on alert about this issue, that is why it is essential to inform ourselves through official means, we are issuing communications to the guards and public and private intensive therapies, due to the possible appearance of a patient who has these characteristics, especially to make an adequate diagnosis. with all the necessary protocols and PPE, as recommended with all patients with respiratory conditions. If the patient had a work history from the private sanatorium, they should receive a different protocol regarding the taking of samples before starting the antibiotic scheme, so that the bacteria or germ that is causing this health problem can eventually be found” he warned.

And he continued: “We are still in the middle of the days determined for the restriction of the clinic, whether it is extended or not will depend on the epidemic situation and whether new cases appear. Isolation is complied with and from the Ministry we issue recommendations from the first moment, which are still in force, we are still in the midst of a pandemic, we continue to have patients with respiratory conditions and what is usually done when a patient is hospitalized is to investigate it , Covid, flu etiology is ruled out, based on that it is determined where the patient is hospitalized and in these cases there is a third differential isolation, with a differential human resource ”.

Continuing Medina Ruiz explained that all possible etiologies are being evaluated and even capturing DNA samples to eventually make a genomic identification of any virus or viral particle that can be found. At the toxicological level, in addition, samples are being studied since they do not want to leave any hypothesis out.​

“Our teams are going to the clinic offering support to do an examination of the patients identified according to the pathology and treatment. Although the private clinic has its autonomy and responsibility carried out by its management, we have offered to support it with resources and advice, ”he explained. [TABLE="width: 713, height: 24"]
[TR]
[TD]Likewise, the official emphasized that there is no patient who has an epidemiological link with the sick. In any case, he advises the population to continue with the care. “The most important thing is that if someone had a working relationship during those days with these patients and presents any symptoms, they present themselves at our on-call services and report it. This situation is unpredictable, in principle more than eleven days have passed, each patient has a different evolution, for example, one of them presents a bilateral pneumonia with an important compromise from the tomographic point of view, but we have to wait for the evolution that it is a disease whose origin is still unknown, therefore, the evolution is also unpredictable”, he stated.[/TD]
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“Regarding the close contact group, the personnel who were sharing work space, which were around twenty people, are being closely followed. In principle, all patients have some type of comorbidity, such as smoking, COPD, a history of respiratory symptoms, obesity, diabetes, and high blood pressure. We do not leave any hypotheses closed, we have more than thirty possible germs with the ability to detect them and they are giving negative results, but we must also take into account that many times there may be a previous intake of antibiotics that can hide the etiology, "he said.

It should be noted that first a meeting was held in the Ministry's office with the committee of experts and managers, infectologists and epidemiologists from the Centro de Salud, Eva Perón and Ángel C. Padilla hospitals. “The committee of experts with whom we are working and concluding that it is an outbreak that has to do with the sanatorium, that in one or two moments he was exposed to the germ or bacteria, and that from that the infections began since after the first exposure around August 20, there were no new infections either in the family or with work contacts,” he concluded.​

The Medical Executive Secretary of Siprosa, Dr. Miguel Ferre Contreras , the Director of Health Management, Dr. Alejandra Mattiacci , the Director of Epidemiology of the Provincial Health System, Dr. Rogelio Calli , were present .
...

https://msptucuman.gov.ar/el-ministe...nia-bilateral/

 

[sharon sanders]

Also please see:

Argentine MOH Statement On Investigation Into A Hospital Outbreak Of A Pneumonia Outbreak of Unknown Origin

Argentina: 2022 Monkeypox

Identification of Coronavirus in Bats and Rodents From Northern and Central Argentina - Research Square Preprint

Argentina: Trichinosis cases rise to 23 in Rufino, Santa Fe

Argentina reports hantavirus death in 8-year-old girl from Chubut

 

[Shiloh]

Source: https://www.telegraph.co.uk/global-...ry-pneumonia-kills-two-infects-six-argentina/

Mystery pneumonia kills three and infects nine in Argentina
Doctors rule out Covid, influenza and hantavirus as culprits but continue to run more tests
By Sarah Newey, Global Health Security Correspondent 1 September 2022 • 6:11pm

Three people have died and five are in hospital after developing a “pneumonia of unknown origin”, Argentinian health authorities have announced.

According to the Ministry of Health in Tucumán – a small region in the northwest of the country some 800 miles from the capital, Buenos Aires – nine people in the sameprivate clinic unit have contracted mystery pneumonia.

Authorities are concerned about the deadly outbreak because the usual suspects – including Covid, influenza and hantavirus – have been ruled out. Five of the six affected, and both of those who so far died, are also health care workers, suggesting an infectious agent may be involved.

“What these patients have in common is the severe respiratory condition with bilateral pneumonia and compromise in [x-ray] images very similar to Covid, but that is ruled out,” Luis Medina Ruiz, Tucumán’s minister of health, said on Wednesday, according to local media.

He added that the six patients have had a series of tests for “Covid, cold, influenza of both types A + and B +, Hantavirus and 25 other germs” but no virus has yet been identified.

Samples have been sent to the prestigious Malbran Institute in Buenos Aires for further analysis. Contacts of the first patients are being tracked and the healthcare centre has been isolated.

The first six patients developed symptoms between August 18 and 22. On Thursday, health authorities said a futher three people had been infected, but did not say when their symptoms developed.
‘This shows our vulnerability to pathogens’

Experts are also analysing the water, and air conditioning units to determine whether the cause is toxic or environmental – for instance, whether legionella bacteria may have accumulated in the air conditioning duct...

 

[Pathfinder]

Previous reports from the Tucumán Ministry of Health, latest one posted above (post #3)

Translation Google

PUBLIC HEALTH August 30, 2022

Official Statement
listen to this note

The Ministry of Public Health reported that an outbreak of bilateral pneumonia has been detected in six patients, without having been able to find its origin and etiology.

In the framework of a press conference, the Minister of Public Health, Dr. Luis Medina Ruiz , reported: “We have detected an outbreak of bilateral pneumonia in six patients suffering from bilateral pneumonia, this disease is a way of manifesting many respiratory diseases. At this time we first suspect covid and influenza, both influenza A and B; even Hanta Virus, but through research they have been ruled out. We have not yet found the etiology despite continuing to study not only viruses, but also bacteria, with cultures through a study called FilmArray. We have that technology in Tucumán, which investigates 25 germs, and they also tested negative.

“This investigation that was done from Epidemiology of the province, is what we always do, regardless of whether the patient is in the public sector or not. In the case of these six patients, unfortunately one of them has died yesterday, without the etiology detected so far, he is a health personnel, "he added.

Likewise, the official explained that the current situation is as follows: two patients hospitalized in a private sanatorium on mechanical respiratory assistance, two patients hospitalized in a public hospital with mechanical respiratory assistance and one patient, who is a health worker, in preventive isolation in her home with a non-severe condition.

“This is why we want to make this official statement since it is possibly an infectious etiological agent, we must demonstrate that and find out what it is, if it is a viral infectious germ of not so severe contagion. We are taking all preventive measures since we have gained a lot of experience with influenza and covid, those are the use of the chinstrap and hand washing, which is what we have been preaching from the beginning. Of course, when an outbreak appears, we carry out the isolation. We have completed a meeting with the committee of experts to make a joint decision that is the most appropriate and timely to protect our society, ”he emphasized.

At the same time he added: "Whenever a germ of unknown origin or undetected from the beginning appears, we investigate, and when there is a suspicion we communicate it so that the population knows how to care for and prevent it."

Participating in the delegation of experts were the Medical Executive Secretary of Siprosa, Dr. Miguel Ferre Contreras , the Undersecretary of Health, Dr. Cristina Majul ; the director of Health Management, Dr. Alejandra Mattiacci , the director of Epidemiology of the Provincial Health System, Dr. Rogelio Calli , the head of the General Directorate of Health Control, Dr. Orlando Di Marco and the General Administrative Secretary of Siprosa, Dr. Conrado Mosqueira .

For his part, the director of Epidemiology of the Provincial Health System, Dr. Rogelio Calli , explained: “Both viruses and bacteria generate the same picture, in this case a flu-like picture with muscle pain, fever, shortness of breath. . It is very similar to COVID, hantavirus; It can be virus or bacteria. Treatment is always supportive. For those whose vital signs are working well, helping the body to resolve this situation; In addition, other types of interventions are carried out preventively”.

And he added: “Seasonally, every year we have a peak of diarrhea in summer and in winter we have another peak. They are known as winter diarrhea, it is what we are detecting now. Diarrhea has multiple causes, it can be due to water, hygiene, food that was not stored well, it is not only due to water.

“The recommendations are those that the minister said, general measures: hand washing, vaccination in all age groups and their appropriate schemes, use of the chinstrap, social distancing, avoiding crowds. All these general measures helped us to get through the waves, not only of COVID but also for Influenza A, for example. Protection and isolation that we do in case of the sick, ”he concluded.

https://msptucuman.gov.ar/comunicado-oficial-18/

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PUBLIC HEALTH August 31, 2022

“We want to bring peace of mind to the population and ask that they continue with the usual care”
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This was stated by the head of the Health portfolio at a press conference in which he explained that the situation is under control and without new cases of contagion.

In this regard, the Minister of Public Health stated: “The novelty is that no new cases have been registered, those already reported remain: one deceased patient, four seriously hospitalized, and one in home isolation. Bilateral pneumonia, which have already been investigated for Covid, flu: influenza A and B, hanta virus and a panel with FilmArray to rule out 25 germs, giving all this negative, of which there are four patients who are serious.

“There are no new infected patients, this is positive news because it means that, if it is an infectious or contagious agent, there was no close contact, neither work nor family that has symptoms in relation to them. From the etiological investigation we want to rule out a screenshot of a laboratory request, the image was spread and caused a lot of concern in the population and in the media about the diagnosis of leptospirosis, that is not true information, "he explained.

Likewise, the official explained that yesterday he was in telephone communication with Minister Carla Vizzotti , who is aware of what is happening and offered her support in terms of teams of experts if required, and that for the moment It is not the case. "We have direct and fluid communication with the Ministry of Health of the Nation, which is always present," she added.
“The samples were sent to Malbrán and we are waiting for the results, it is very likely that before the weekend we will have some answer and if they are before we will inform you. We continue to investigate in terms of the environment since we do not want to rule out any etiology, among the possible causes are of course the infectious ones and others that are toxic or environmental, that is why we are analyzing the water, air conditioning discharges, that is, other situations that generate similar episodes, what these patients have in common is the severe respiratory condition with bilateral pneumonia and compromise in images very similar to covid, but that is ruled out, ”he said.

In the same way, Medina Ruiz emphasized: “We want to make it clear that as soon as we have any news, whether due to the result of an investigation, the aggravation of a patient or new infections, we are going to communicate it, our way is going to be this, the official and when there is important information that warrants, it will be communicated to you.”

“We want to reassure the population since the situation is under control, the patients are hospitalized, isolated and there is strict monitoring by our teams in coordination with the hospitals and sanatoriums where they are hospitalized. We have to wait for the good evolution of the patients, mainly the four who are seriously ill with mechanical ventilation, their condition is of a reserved nature.

Continuing with what was said, the minister reminded the population that they must follow the same recommendations as always, the use of a mask and hand hygiene, consumption of drinking water, food hygiene and the washing of cans or containers. And that, if there is a relative of any of the patients who are hospitalized or in a sick condition, they must communicate immediately.

“The epidemiological situation indicates that they are patients who have a respiratory condition in mechanical respiratory assistance, the etiological origin is not determined and is under study. It is known that in every study there are tests of less complexity and some of greater sensitivity and complexity, which are those carried out by institutes such as Malbrán, to investigate other causes”, he added.

At the same time he detailed: “We began to investigate when two patients who have an employment relationship with the private sanatorium coincided in the manifestation of bilateral pneumonia, for which we did not find the cause. When we began to look for other patients, it coincided with the communication from the sanatorium to epidemiology, then we found the other four patients who have in common that work relationship or proximity to the sanatorium. This is why we speak of a localized and focused outbreak, with patients who are isolated.

The official pointed out that the days that the results will take are variable, since there are serological studies that are carried out with reactive strips, and others that depend on cultures. "When we talk about Legionella and Leptospira, they are bacteria that need a culture that takes days, for which we will surely have preliminary results this week, hopefully before the weekend, since we are in permanent communication with Malbrán, but certainties just starting next week. What we really have to hope for is that new patients do not appear, that the evolution of those who are hospitalized is good, ”he remarked.

“We want to give the certainty that communication will be fluid between us and towards the community, to whom we will inform everything that happens. The way to control an outbreak or any situation that carries a risk of contagion is fundamentally direct, real and timely communication, this is the way we always work and for that we thank the media for their presence, because this frontal communication is the that brings peace of mind to homes,” he added.

Regarding the messages that were disseminated, the minister said: "We ask society to always look for the official versions and information, which will always be the truth, we will be predisposed and willing to report what is happening, if there is any news, the we will communicate This situation affects us because messages continually arrive from all sides, even last night a screenshot was released where the patient's name was seen and it gave the impression that the diagnosis had already been determined, when in reality what was being displayed was the laboratory request. In this line, the official urged society as a whole not to viralize those contents about which they have doubts, since that only generates concern, "he concluded.

https://msptucuman.gov.ar/queremos-...edimos-que-sigan-con-los-cuidados-habituales/
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August 31, 2022

OFFICIAL COMMUNICATION

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The Ministry of Health regrets to report the death of one of the patients linked to the pneumonia outbreak, whose etiology is under study.

This is a 45-year-old male patient with comorbidities and who was hospitalized at the Eva Perón hospital since the 21st of the current.

https://msptucuman.gov.ar/comunicado-oficial-19/
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ANLIS-MALBRÁN August 31, 2022

They analyze the samples of the cases of pneumonia of unknown cause in Tucumán
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The National Administration of Laboratories and Health Institutes (ANLIS) “Dr. Carlos Malbrán” received the samples from Tucumán to carry out a diagnostic extension of the six cases of pneumonia of unknown origin.

The registered cases correspond to five health workers and a patient from a private sanatorium who started symptoms between August 18 and 22.

In addition, the health authorities are working to carry out the investigation of the outbreak, which includes the follow-up of the contacts of the cases and specific control actions in the health center where the outbreak arose.

The registered cases correspond to five health workers and a patient from the intensive care unit of a private sanatorium in San Miguel de Tucumán who started symptoms between the 18th and 22nd of this month. The six cases presented bilateral pneumonia, two of them died, three are hospitalized and the remaining one is in good health in home isolation. Since August 22, no new cases have been detected.

https://msptucuman.gov.ar/analizan-...-de-neumonia-de-causa-desconocida-en-tucuman/

 

[sharon sanders]

Deaths from bilateral pneumonia in Tucumán: they request reports on health inspections at the clinic where the outbreak occurred





This is how legislators did it to the provincial Minister of Health; They also demanded that it be investigated how the contagion occurred

September 1, 2022
20:10
Fabian Lopez
FOR THE NATION

SAN MIGUEL DE TUCUMÁN.- Pending the results of the studies that will allow the identification of the disease causing the outbreak of bilateral pneumonia that has already claimed three lives and produced at least six other infections in a private sanatorium in the capital of Tucumán, the local health authorities suspect that legionella bacteria could be responsible . It is a microscopic agent that proliferates in contaminated water sources and poorly maintained artificial water systems, especially cooling towers or steam condensers used in the installation of air conditioning and refrigeration systems, and in water pipes. in buildings.


According to a report from the Centers for Disease Control and Prevention (CDC) of the United States Department of Health, outbreaks of "legionnaire's disease", as the pathology caused by this bacterium is called and which, among other symptoms , causes bilateral pneumonia such as those recorded in Tucuman patients, "they are associated with large or complex water systems, such as those found in hospitals, hotels and cruise ships." This disease is not spread from person to person and is spread by inhalation of infected water vapor or through tiny water droplets in the air.


Suspecting that the outbreak is related to this bacterium, the authorities set their sights on the Luz Médica Sanatorium in this capital, where the nine infections confirmed so far occurred . In addition to ordering preventive isolation for seven days pending the epidemiological evolution, from the provincial Ministry of Health they took samples of the water deposited in the storage tanks of the medical center and inspections were carried out in the air conditioning duct to confirm or rule out the presence of germs that could be the cause of contagion.​

more....

https://www.lanacion.com.ar/sociedad...a-nid01092022/

 

[Mary Wilson]

Tucuman: third reported death from bilateral pneumonia of unknown origin

01/09/2022 Updated: 10 hours ago
ByNation World News Desk

... Summarizing the situation, the minister explained: “Therefore, we added 3 patients to the 6 patients who were already informed. The three new cases are suspected cases.” commented. The minister acknowledged some panic at the moment, because “so far we have not found anything to give us an idea of ​​what caused the outbreak,” he said. Therefore, “since this is a disease that we do not know what is involved, we do not know its development very well,” he said.

“Most patients started with vomiting, high fever, diarrhea, and body aches,With the development that in some patients it was more complicated. Out of the initial 6 patients, two are still in critical condition and are getting help in breathing.

Consulted by experts in Infectology and Pulmonology infobae suspect the presence of bacteria legionellaBut they insist that the results of the ongoing studies should be awaited.

According to the provincial public health ministry, It is being investigated whether the pipes that provide water and air-conditioning in the sanatorium could have been the cause of the pneumonia outbreak.

... The private clinic has autonomy. We have offered them support with resources and advice”, the minister said. “With a health team we have approached the sanatorium” in order to preserve the measures of isolation. If we find any risk to the hospitalized population, we will consider it. This It is an outgrowth and belongs to the sanatorium (Lus Medica). There was a moment or two of exposure to germs. everything spins 20 August”Told.

... For its part, the ANLIS-Malbran Institute reported yesterday afternoon that it “analyses samples from cases of pneumonia of unknown cause in Tucumán” and that the results will be known in the next few hours. ANLIS-Malbrán “received samples from Tucumán For clinical extension of six cases of pneumonia of unknown origin”, Told.

“So we added 3 patients to the 6 patients who had already been notified. The three new cases are suspected cases,” said the minister (ISToc)
The nation’s health ministry assured that “in addition, there are national and provincial health authorities”. work together To investigate the outbreak, including follow-up of contacts of cases and specific containment action at the health center where the outbreak originated.

https://nationworldnews.com/tucuman-third-reported-death-from-bilateral-pneumonia-of-unknown-origin/

 

[sharon sanders]

Informative Note: Cases of pneumonia of unknown cause Tucumán Argentina



On August 30, 2022, the Ministry of Health of Argentina informed the Pan American Health Organization / World Health Organization (PAHO/WHO) of the notification by the Ministry of Public Health of the province of Tucumán, about the detection from a conglomerate of 6 cases of bilateral pneumonia with no etiological identification to date. PAHO/WHO is monitoring this event together with the Argentine health authorities.





https://www.paho.org/es/documentos/n...uman-argentina

 

[Pathfinder]

Translation Google

OFFICIAL COMMUNICATION 2 September, 2022
Current situation of the Bilateral Pneumonia outbreak in the province

listen to this note

During the morning of today, the head of the health portfolio, Dr. Luis Medina Ruiz, together with the Medical Executive Secretary, Dr. Miguel Ferre Contreras, gave a press conference from Government House to update the population on this problem.

"We want to announce that, regarding the cases of bilateral pneumonia with unknown etiology and under investigation, we continue with nine patients, there are no more people added to the list", assured the minister.
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[TD]And he continued: ¨The novelty is that we have a patient who, yesterday, at night, was discharged, hospitalized and continues to be observed at home due to her clinical condition. At this time we have three patients who are still hospitalized, of which two are on mechanical ventilation and one on non-invasive ventilation; All three in serious condition. The other three patients are in an outpatient condition with less serious follow-up and, unfortunately, three have died¨.[/TD]
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In this sense, Medina Ruiz assured: ¨We continue to investigate the etiology of this health problem, we have an alert activated in both public and private services, where any patient who has an epidemiological link, such as a health worker from this private sanatorium that presents a respiratory condition, enters a suspicion protocol where a follow-up with tomography and laboratory will be carried out, to confirm or rule out that it can enter this group¨.
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[TR]
[TD]Within the framework of the intense investigation that the Ministry of Public Health is carrying out, the minister had a virtual meeting last night with the Minister of Health of the Nation, Dr. Carla Vizzotti , references with vast experience in this type of problems and authorities of the Malbrán Institute, with whom they are constantly in communication to provide a prompt solution to the case.[/TD]
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¨We received information that the studies that are being done so far are negative for bacteria and viruses that are being investigated. In any case, there are studies that require cultures, so they require a little more time¨, explained the official. Meanwhile, he added that when the results are negative, another study is sought that is more sensitive and complex, which sometimes takes longer to perform.
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[TD]"Surely in the course of the day we will have other results, the idea is to continue working on the investigation of the cause and we will continue looking for epidemiological links," said the official.[/TD]
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On the other hand, the minister confirmed that at the moment there are nineteen hospitalized patients in the private clinic, some in intensive care and others in common rooms: "We from the Ministry of Public Health have formed teams that are going to support and evaluate the epidemic situation of the patients. They are working on the control of internees, they are analyzing the epidemiological links and they are analyzing everything related to environmental health; We do not leave any edge uncovered.

He also added that, so far, they have not found any pathogens in the water and the results of chemical tests are pending.​

Regarding the time in which new patients can present some symptomatology, the head of the health portfolio said that, whenever it is a viral or bacterial disease, the process time can last between seven and fourteen days, a time that Health it will take to wait if any new patients show up.
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[TD]¨All this began around August 20 and during all this time no person with a direct work relationship with the sanatorium appeared, but, since we do not know the precise etiology, we must wait a little longer, at least seven more days. ¨, asserted the minister.[/TD]
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¨What we are doing with all patients is supportive treatment, regardless of the etiology, through a basic protocol that includes maintaining oxygenation and blood pressure stable enough so that the heart, brain and all organs remain preserved. ¨, he continued.
Regarding how the isolation of the private center will be acted upon, Medina Ruiz said that this will depend on the patients that may arise today and over the weekend: ¨The determination will be made based on what is happening until now. Tuesday.
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[TD]¨The fact that there are no more infected encourages us to think that it is an infectious agent that does not have a great power of contagion. Usually all viruses, bacteria and fungi have the ability to spread through a medium; This, apparently, is a case that does not produce significant contagion, or the other possibility is that it is a contagious germ with a longer incubation period, he extended.[/TD]
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For this reason, the minister asserted: ¨We are constantly having meetings at the national level and we have the full support of institutions of national and international prestige to reach the result of the etiology. It is essential that the information on this topic is carried out in an official and formal manner. The greatest risk occurs when there is too much misinformation and it creates panic in society.

Finally, Medina Ruiz assured that the health control carried out by Siprosa at the level of the personnel, as well as the health of the place, will be reinforced in this situation.​

...
https://msptucuman.gov.ar/situacion-actual-del-brote-de-neumonia-bilateral-en-la-provincia/

 

[Pathfinder]

Translation Google


PUBLIC HEALTH 2 September, 2022
OFFICIAL COMMUNICATION

listen to this note

The Ministry of Health reports that a new patient linked to the conglomerate of cases of pneumonia of unknown origin has been detected.

Case number 10 is an 81-year-old male patient with comorbidities hospitalized in serious condition, with ARM, in the public sector.


https://msptucuman.gov.ar/comunicado-oficial-20/

 

[alert]

Legionella suspected:

https://www.lanacion.com.ar/sociedad...s-nid02092022/

(I do note that the rapid tests of Legionella only detect the most common strains and the full culture must be done to confirm some of the others. There was a mystery pneumonia outbreak in Ontario, Canada a few years ago that was initially reported to be ruled out for Legionella because of those tests that was later confirmed by culture. The presence of cases lined to the medical facility itself and not to the activities of patients outside that facility also suggests an environmental exposure like Legionella.

While the article reports that the drinking water tanks were negative for all bacteria, having been sufficiently chlorinated, other water sources such as heaters, air conditioners, or humidifiers/dehumidifiers have been implicated in Legionella outbreaks elsewhere. -

The article also increases the number of patients that have been discharged to three. - alert)

 

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Home » News » Featured News » OFFICIAL COMMUNICATION

PUBLIC HEALTHSeptember 3, 2022
OFFICIAL ANNOUNCEMENT

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The Ministry of Public Health reports that a new patient linked to the conglomerate of cases of pneumonia of unknown origin has been detected.

Case number 11 is a 64-year-old male patient with comorbidities, hospitalized in serious condition with mechanical ventilation, in the private sector.


https://msptucuman.gov.ar/comunicado-oficial-21/

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PUBLIC HEALTHSeptember 3, 2022
OFFICIAL COMMUNICATION

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The Ministry of Public Health reports the death of a patient linked to the conglomerate of cases of pneumonia of unknown origin.

This is a 48-year-old male patient with comorbidities, who was hospitalized in serious condition in the public sector.



https://msptucuman.gov.ar/comunicado-oficial-22/

 

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BALBRÁN DATA

Outbreak of pneumonia in Tucumán: studies indicate that it was caused by a bacterium
...
3.09.2022 | 11:06

The first data sent by the laboratories of the National Institute of Microbiology Dr. Malbrán indicate that the samples taken from patients affected by the outbreak of pneumonia in Tucumán tested positive for legionella, sources from the institution unofficially anticipated.

Formal confirmation in this regard will be made in the next few hours. Even the Minister of Health of the Nation, Carla Vizzotti, boarded a plane bound for this province together with her team to make this announcement.
...
https://www.labrujula24.com/notas/2...-indican-que-lo-origino-una-bacteria-n239625/

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Bilateral pneumonia in Tucumán: data from Malbrán point to legionella and there are already 11 cases

Editorial LAVOZ
Saturday, September 3, 202211:27 hs

The Ministry of Health of Tucumán confirmed in the last hours a new case of bilateral pneumonia , with which there are already 11 detected in recent weeks, including three deaths.

Meanwhile, the tests carried out by the Malbrán Institute indicate that the samples taken from patients affected by the pneumonia outbreak in Tucumán tested positive for legionella.

WHAT DID THE MALBRÁN DETECT?

The Gazette anticipated that the analyzes detected from the samples a condition caused by the bacterium Legionella pneumophila, which fundamentally presents two totally differentiated clinical forms: on the one hand, pulmonary infection or "legionnaire's disease", which is characterized by generating a pneumonia with high fever; on the other, the form known as "Pontiac fever", which manifests as an acute febrile syndrome.
...
https://www.lavoz.com.ar/ciudadanos...ran-apuntan-a-legionella-y-ya-suman-11-casos/

 

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EPIDEMIOLOGICAL SITUATION September 3, 2022
Vizzotti confirmed that the outbreak of pneumonia in Tucumán was due to legionella

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From Government House, the Minister of Health of the Nation, together with her counterpart from the province, Dr. Luis Medina Ruiz, confirmed that it is an outbreak of legionella, possibly pneumophila.

With the presence of the Minister of Health of the Nation, Carla Vizzotti , and the representative in Argentina of the Pan American Health Organization (PAHO), Eva Jané Llopis, this Saturday from the province's health portfolio confirmed that the samples taken from patients affected by bilateral pneumonia tested positive for legionella bacteria.

Vizzotti explained at a press conference that, until now, they have preliminary information and progress remains to be made in the final diagnosis, which is with serological pairs, however "in four samples (three respiratory and a puncture biopsy of one of the deceased) it is being isolated in the PCR a bacterium called legionella and its last name is being typified and will be there today," he said, adding: "The suspicion is that it is an outbreak of legionella pneumophila."

The Minister of Health commented that it is a bacterium that is transmitted by inhalation through water or air conditioning. It has an antibiotic treatment and a significant impact on people at risk, older than 50 years, smokers, diabetics and people with immunocompromise or respiratory diseases.

All the actions are being generated and the recommendation that we agree with the provincial team is that, having the diagnosis and that it is safe to transfer these patients to another hospital to follow their evolution, to be able to generate an exhaustive study of the health center and thus carry out the actions in the building both in the water and in the air conditioning system so that it is completely safe to return to work in such a health center”, said Vizzotti.

For his part, the Minister of Public Health, Dr. Luis Medina Ruiz , highlighted the joint work with the Nation and contextualized stating that since last Saturday, when they became aware of two patients with bilateral pneumonia who were not with a known etiology of the 30 studies that can be developed in Tucumán and that they came from the same place of work, "it caught our attention and we began to work in the active search for patients who meet the same conditions and we found six".

"So it was that on Monday we checked that it was neither Covid-19 nor flu nor hantavirus, and on Tuesday we made the decision to make this new epidemic situation known and we generated a contingency plan together with the Nation to evaluate the etiology," he explained.

Along these lines, he continued: “We developed a patient control strategy, we decided on the sanitary isolation of the private sanatorium and we sent samples to the National Institute of Microbiology Dr. Malbrán and the National Institute of Human Viral Diseases «Dr. Julio I. Maiztegui».
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Finally, the representative of the Pan American Health Organization, Dr. Eva Jane Llopis , valued the speed and efficiency with which these cases were worked on both in the province and in the Nation. “This demonstrates an optimal way to identify the problem and respond, in addition to notifying the world in a timely manner, through the mechanism of international health regulations. There you can see the commitment of Tucumán and Argentina to global public health and I think this is very important”, she emphasized.

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https://msptucuman.gov.ar/vizzotti-confirmo-que-el-brote-de-neumonia-en-tucuman-fue-por-legionella/

 

[Mary Wilson]

Mystery cluster of pneumonia cases in Argentina being monitored by World Health Organisation

Saturday 3 September 2022 18:37, UK

The World Health Organisation is monitoring a cluster of pneumonia cases from an unknown cause in Argentina, in an outbreak that so far has included three deaths.

The 10 cases are linked to a single private clinic in the city of San Miguel de Tucuman in the country's northwest, according to the Pan American Health Organisation (PAHO), the regional office of the WHO.

... Biological samples have been sent to Argentina's National Administration of Laboratories and Health Institutes for additional testing, which will include an analysis for the presence of toxins.

Dr Michael Osterholm, an infectious disease expert at the University of Minnesota, said given that the lungs are heavily involved, the cause is likely something the patients inhaled.

He first suspected Legionnaires' disease, which is caused by inhaling droplets of water containing Legionella bacteria, but tests have ruled that out.

Dr Osterholm said "mystery illnesses" do sometimes happen, and most often they can be explained by some local outbreak that does not have pandemic implications.

He said he expects more definitive information from Argentine health officials in the next five to seven days.

https://news.sky.com/story/mystery-...lth-organisation-12689136?dcmp=snt-sf-twitter

 

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DERIVATIONSeptember 3, 2022
Completed the transfer of 12 patients to the public sector

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After the meeting led by the Minister of Health of the Nation, Dr. Carla Vizzotti, her counterpart from the province of Tucumán, Dr. Luis Medina Ruiz, and the PAHO representative in Argentina, Dr. Eva Llopis, the health portfolios agreed on the transfer of patients who remained hospitalized in the private sanatorium for various pathologies.

These are 12 people housed in intensive care and other hospital rooms who were referred to the Centro de Salud hospital as part of the contingency health plan, following the outbreak of legionella detected in that institution.

The purpose of the transfer responds to the continuity of the evolution of these patients and to various monitoring and environmental control actions. The operation was carried out by the Directorate of Health Emergencies 107 and had the collaboration of the Tucumán Police.

To date, the infectious outbreak of bilateral pneumonia already identified by the Legionella bacterium amounts to eleven cases, of which four died; four are hospitalized (three in MRA and one with non-invasive ventilation); and three persist under outpatient treatment with home monitoring.


https://msptucuman.gov.ar/culmino-el...ector-publico/

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EPIDEMIOLOGICAL SITUATIONSeptember 4, 2022
OFFICIAL COMMUNICATION

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The Ministry of Public Health reports the death of a patient linked to the cluster of pneumonia cases

This is a 64-year-old male patient with comorbidities, who was hospitalized in serious condition, in the public sector.


https://msptucuman.gov.ar/comunicado-oficial-23/

 

[Shiloh]

Source: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON407


Legionellosis - Argentina

5 September 2022


Outbreak at a glance
As of 3 September 2022, a cluster of 11 cases of severe pneumonia,including four deaths, have been reported in San Miguel de Tucumán city, Tucuman Province, Argentina. Legionella spp. was isolated in the samples from four cases. Legionellosis is a pneumonia-like illness that varies in severity from mild febrile illness to a serious and sometimes fatal form of pneumonia. Cases were initially reported as being pneumonia of unknown cause. Legionella bacteria was identified as the causative organism on 3 September.
All cases presented with bilateral pneumonia, fever, myalgia, abdominal pain, and dyspnea between 18 and 25 August 2022 and are epidemiologically linked to one health facility. Of the 11 cases, eight are health workers of the facility; three are patients of the health facility. Three of the four deaths were among health workers.
Health authorities are coordinating cluster investigation activities, active case finding to identify additional cases, contact tracing and public health activities to limit further spread.
Outbreak overview
On 29 August 2022, WHO was notified by the Ministry of Health of Argentina of a report from the Ministry of Public Health of Tucumán Province, of a cluster of six cases of bilateral pneumonia without an etiological cause identified in San Miguel de Tucumán city, Tucuman Province, Argentina [SUP]1[/SUP]. All six cases were linked to one private health facility in the city of San Miguel de Tucumán, with the onset of symptoms between 18 and 22 August 2022. The six cases included five health workers and one patient who was admitted to the clinic for an unrelated condition and then subsequently to the intensive care unit after developing pneumonia. In addition to bilateral pneumonia, all cases presented with fever, myalgia, abdominal pain, and dyspnea.
On 1 September, three additional cases were identified through active case finding - all health workers from the same private health facility, aged 30 to 44 years - with similar signs and symptoms to the initial six cases identified [SUP]2[/SUP]. The onset of symptoms for these cases was between 20 and 25 August 2022.

Between 2 and 3 September, two additional cases were identified, an 81-year-old male and a 64-year-old male, both with comorbidities, who were hospitalized and presented similar clinical presentation as the previous cases [SUP]3[/SUP].
As of 3 September 2022, 11 cases have been identified, four of whom have died (three health workers). Eight of the 11 reported cases are health workers of the same health facility. The median age of the cases is 45 years; seven are male. Ten cases had underlying conditions and/or risk factors for severe disease, including the four reported deaths. Four cases are still hospitalized as of 3 September. Contacts of the cases are under follow-up and, to date, none have developed symptoms.
Laboratory results
Blood, respiratory and tissues samples were obtained from the 11 cases. Preliminary tests conducted at the local Public Health Laboratory were negative for respiratory viruses, and other viral, bacterial, and fungal agents. On 31 August, samples from the initial six cases were sent to the National Reference Laboratory - the Administration of National Laboratories and Health Institutes (Administración Nacional de Laboratorios e Institutos de Salud - ANLIS per its acronym in Spanish) - for additional testing [SUP]4[/SUP] . As of 3 September 2022, negative results have been obtained for COVID-19 (RT-PCR), Influenza, detection of antibodies for Coxiella, urinary antigen for Legionella spp., panel of 12 respiratory viruses, hantavirus (Elisa IgM), histoplasma (RT-PCR), Yersinia pestis (PCR) and micro agglutination for leptospirosis.
Further analyses of two bronchoalveolar lavage samples by highly sensitive total DNA sequencing (metagenomics) found readings compatible with Legionella spp. On 3 September 2022, ANLIS reported that amplification products of the 16S ribosomal gene for Legionella spp. from the two samples of bronchoalveolar lavage sequenced by metagenomics and analyzed by four different bioinformatic methods, produced results compatible with Legionella pneumophila. Confirmation of these results is expected upon completion of the sequencing processes. This laboratory result supports evidence compatible with Legionnaires’ disease. Blood culture and seroconversion tests continue to be conducted to complement the diagnosis of Legionella infection.
Epidemiology of Legionellosis
Legionellosis is a generic term describing the pneumonic and non-pneumonic forms of infection with the Legionella species of bacteria.Legionellosis varies in severity from mild to serious and can sometimes be fatal.
Legionnaires’ disease, the pneumonic form, has an incubation period of 2 to 10 days (but up to 16 days have been recorded in some outbreaks). It is an important cause of community- and hospital-acquired pneumonia; and although uncommon, Legionnaires may cause outbreaks of public health significance. Initially, symptoms are fever, mild cough, loss of appetite, headache, malaise and lethargy, with some patients also experiencing muscle pain, diarrhoea and confusion. The severity of Legionnaires’ disease ranges from a mild cough to rapidly fatal pneumonia. Untreated Legionnaires’ disease usually worsens during the first week.
Mortality from Legionnaires’ disease depends on the severity of the disease, the use of antibiotic treatment, the setting where Legionella was acquired, and whether the patient has underlying conditions, including immunosuppression. The death rate may be as high as 40–80% in untreated immunosuppressed patients and can be reduced to 5–30% through appropriate case management, depending on the severity of the clinical signs and symptoms. Overall, the death rate is usually between 5–10%.




Public health response

In response to the detection of the cluster of bilateral pneumonia, health authorities in Tucuman Province coordinated cluster investigation activities including the follow-up of cases, search for the source(s) of infection, active case finding to identify additional cases, and contact tracing. Preliminary investigations indicated no secondary cases were identified.
As Legionella spp. has been identified as the etiology of this outbreak, the following public health measures were implemented:

• Risk assessment and suspension of healthcare activities in the health facility.
• Enhanced surveillance including active and passive case finding.
• Biological and environmental sampling, and laboratory testing, including bacteria isolation, and metagenomics.
• Case isolation and clinical care of patients.
• Contact identification, support and monitoring.
• Risk communication

With the support of national health authorities, environmental samples are being collected to define the source of contamination and urgently implement prevention and control measures. The health authorities are also implementing internal and external communication strategies for health professionals and the community.
The Pan American Health Organization (PAHO)/WHO is providing technical support for the outbreak investigation, including advice on sampling, environmental assessment, clinical management, and Infection and Prevention Control (IPC) measures.


WHO risk assessment

Legionellosis varies in severity from a mild febrile illness to a serious and sometimes fatal form of pneumonia and is caused by exposure to Legionella species found in contaminated water and potting mixes. The most common form of transmission of Legionellosis is inhalation of contaminated aerosols from contaminated water sources. Sources that have been linked to both the transmission of Legionella via aerosols and outbreaks of Legionellosis include air conditioning cooling towers or evaporative condensers associated with air conditioning and industrial cooling, hot and cold water systems, humidifiers, and whirlpool spas. Infection can also occur by aspiration of contaminated water or ice, particularly in susceptible hospital patients. To date, there is no reported direct human-to-human transmission.
Sporadic outbreaks of legionellosis pneumonia have been reported in Argentina before. There are robust surveillance activities being implemented in the affected health facility. Nonetheless, in the absence of an identified source of Legionella bacteria, the risk of developing Legionellosis for people working or hospitalized at the same health facility is currently moderate.
Countries with cases of Legionellosis reported after travel to Argentina should notify their regional IHR focal point.


WHO advice

WHO recommends the continuation of laboratory analyses, case identification and clinical care, contact tracing, outbreak investigation to identify the source(s), implementation of measures to prevent further infections and enhancement of Infection Prevention and Control (IPC) measures. IPC measures in health facilities have been enhanced during the COVID-19 pandemic and should be reinforced to prevent healthcare-associated transmission. Precautions that are recommended for COVID-19 should continue to be followed.
WHO does not recommend any specific different measures for travelers. In case of symptoms suggestive of respiratory illness either during or after travel, travelers are encouraged to seek medical attention and share their travel history with their healthcare provider.
WHO advises against the application of any travel or trade restrictions on Argentina based on the current information available on this event.

Further information

• Pan American Health Organization / World Health Organization. Informative Note: Update cases of pneumonia due to Legionella – Tucumán, Argentina. 3 September 2022, Washington, D.C.: PAHO/WHO; 2022. Available at: https://bit.ly/3AN00e9
• Infection prevention and control of epidemic-and pandemic prone acute respiratory infections in health care, WHO guidelines: https://bit.ly/3AMk14G
• Ministry of Public Health of the Government of Tucumán Official Communication. Available at: https://bit.ly/3TJaHac
• Ministry of Public Health of the Government of Tucumán Official Communication. Available at: https://bit.ly/3cOjKWT
• Argentina Ministry of Health press release, “ANLIS-MALBRÁN analyzes samples from cases of pneumonia of unknown cause in Tucumán”. Available at: https://bit.ly/3cLPqw0
• Ministry of Public Health of the Government of Tucumán Official Communication. The Minister of Public Health led a virtual meeting with Carla Vizzotti to analyze the situation of pneumonia of unknown origin. Available at: https://bit.ly/3RC3XZS
• Ministry of Public Health of the Government of Tucumán Official Communication, “Vizzotti confirmed that the outbreak of pneumonia in Tucumán was due to Legionella”. Available at: https://bit.ly/3cJhxvV
• World Health Organization. Legionellosis fact sheet. Available at: https://bit.ly/3KMmZL9
• World Health Organization. Legionellosis Outbreak Toolbox. Available at: https://bit.ly/3KMIdZd

[SUP][SUP][1][/SUP][/SUP] Ministry of Public Health of the Government of Tucumán Official Communication. Available at: https://msptucuman.gov.ar/comunicado-oficial-18/

[SUP][SUP][2][/SUP][/SUP] Ministry of Public Health of the Government of Tucumán Official Communication. Available at: https://msptucuman.gov.ar/el-ministe...nia-bilateral/

[SUP][SUP][3][/SUP][/SUP] Ministry of Public Health of the Government of Tucumán Official Communication. Available at: https://msptucuman.gov.ar/comunicado-oficial-21/

[SUP][SUP][4][/SUP][/SUP] Argentina Ministry of Health press release, “ANLIS-MALBRÁN analyzes samples from cases of pneumonia of unknown cause in Tucumán”. Available at: [url]https://www.argentina.gob.ar/noticias/anlis-malbran-analiza-las-muestras-de-los-casos-de-neumonia-de-causa-desconocida-en-tucuman[/URL]


Citable reference: World Health Organization (5 September 2022). Disease Outbreak News;Legionellosis in Argentina . Available at: https://www.who.int/emergencies/dise...em/2022-DON407

 

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EPIDEMIOLOGICAL SITUATIONSeptember 4, 2022
OFFICIAL COMMUNICATION

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The Ministry of Public Health reports the death of an 81-year-old male patient, with comorbidities, who was hospitalized in serious condition, in the public sector. It is linked to the cluster of pneumonia cases.


https://msptucuman.gov.ar/comunicado-oficial-24/

 

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PUBLIC HEALTH 5 September, 2022
The Minister announced the new inclusion criteria for the detection of the outbreak of legionella pneumophila

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Within the framework of a new press conference, the person in charge of the Sanitary portfolio, Dr. Luis Medina Ruiz, explained that the change in the criteria includes patients, health personnel, and caregivers who have been in the sanatorium in August private, or has received a surgical intervention and has some compatible symptom such as fever or respiratory symptoms.

"We want to report that, having a known etiology of this outbreak linked to the private sanatorium, we have considered together with the Minister of the Nation, Dr. Carla Vizzotti, a change in the inclusion criteria within this outbreak. Initially, when we detected two patients with bilateral pneumonia that coincided with the common workplace and that we also could not find its etiology, that was what we had as inclusion criteria. Today, knowing that it is a bacterium that does not always cause bilateral pneumonia, we are including any health personnel, patient or family caregiver who has been in the month of August or has received a surgical intervention in the selection criteria for patients. in this private sanatorium and who has some compatible symptom such as fever or respiratory symptoms, not necessarily bilateral pneumonia, "he reported. [TABLE="width: 713, height: 24"]
[TR]
[TD]“That is why today we are including at least 8 new patients, of which 1 is a patient, 2 are health personnel and 5 are caregivers of patients who were hospitalized, post-surgical or with neurological problems. Of these 8 patients, there is one who has severe comorbidity, due to a cerebrovascular accident and is also suffering from pneumonia, he is the only one who is serious. We are very sorry for the death of the two patients yesterday, who were on mechanical respiratory assistance for their bilateral pneumonia, and very seriously ill with severe comorbidities. One of them was 81 years old and the other 64, in summary today we have 6 deceased, 9 patients who are at home with outpatient medical follow-up, since the clinic they present is of moderate or mild severity,[/TD]
[/TR]
[/TABLE]
Likewise, the official stressed that it is a bacterium that is not transmitted from person to person and the fact of having found the cause gives them great certainty about the measures to be taken. “Initially we had taken the measure of isolating the sanatorium without removing the patients, since not knowing the etiology it could have been a virus or a battery that could have spread in the community. Knowing today that it is a bacterium, has allowed us to take other measures regarding this outbreak.”

Regarding the private sanatorium, the Minister stressed: "First of all we have to analyze responsibility, today we are with the sanatorium closed, patients cannot enter, neither outpatients nor inpatients, and as of today or tomorrow a team of experts will come since Legionella is not an easy-to-find bacterium, a special technique is needed”.​

[TABLE="width: 713, height: 24"]
[TR]
[TD]At the same time, Medina Ruiz clarified that the Ministry carries out tests on the condition of the water, if it is drinkable, if it has residual chlorine, if it has germs and that has not been found; since the conditions were within the adequate. “The public sector has a permanent epidemiological surveillance, in case of seriously ill patients, the cause is sought, that does not happen everywhere. Here we saw patients who came from the private sector, we took action on the matter and we have thoroughly investigated what the cause is. And not finding it is when all this is triggered. I think the next steps will depend on the findings in the coming weeks."[/TD]
[/TR]
[/TABLE]
At the same time he added: “There are no patients who are not related to the private sanatorium in the month of August, and that is the situation where the limits are. Today we have a little more certainty. This disease has the characteristic that it is self-limited; it is very different from COVID that one does not know when it ends. With this bacterium no, most people can have an asymptomatic or mild symptomatic picture, and it is self-limited. That means that when the disease begins, the body itself limits it and cures it. He will not have relapses because he has no new contact with the germ, ”he detailed.

In the same way, he remarked: “Anyone who begins with symptoms such as fever, symptoms compatible with the flu: body aches, headache, cough, cold, dyspnea. In some patients diarrheal pictures. We are going to control them for at least two weeks, from the closure of the sanatorium and that there is no other person working inside, until we are certain that there are no more patients.​

Medina Ruiz, remarked that the patients who are hospitalized are receiving a specific treatment. Pneumonia is a very frequent cause of death in older people and with comorbidities, the cause is not always known and that is every year and winter. Pneumonia is usually fatal, due to the Influenza virus. [TABLE="width: 713, height: 24"]
[TR]
[TD]“Today all the patients who are compromised are under strict surveillance, in therapy with professionals with a lot of experience and of course we are going to have a very fluid communication with the family. It will be opportune, we are going to have a press conference once a day, and then with official communications when some relevant information appears, ”she warned.[/TD]
[/TR]
[/TABLE]
Finally, the official explained: “The way this disease is spread is through water vapor, air conditioning, the shower when it disperses the water, when it is breathed. The bacteria do not enter through the mouth when one touches the water, it has a special way of contagion and entry into the body. In a certain way, it generates outbreaks and this way of contagion does not give rise to interhuman contagion, that is, for the person next to me to become infected, they need a cloud of particles that enter the lung.”


...
https://msptucuman.gov.ar/el-ministr...a-pneumophila/