Influenza-Like Illness Sentinel Surveillance in Peru
Laguna-Torres VA1, Gómez J, Ocaña V, Aguilar P, Saldarriaga
T, Chavez E, Perez J, Zamalloa H, Forshey B, Paz I, Gomez E, Ore R, Chauca G,
Ortiz E, Villaran M, Vilcarromero S, Rocha C, Chincha O, Jiménez G, Villanueva
M, Pozo E, Aspajo J, Kochel T.
1US Naval Medical Research Center Detachment, Lima, Peru. alberto.laguna@med.navy.mil
Abstract
BACKGROUND:
Acute respiratory illnesses and influenza-like
illnesses (ILI) are a significant source of morbidity and mortality
worldwide. Despite the public health importance, little is known about
the etiology of these acute respiratory illnesses in many regions of
South America. In 2006, the Peruvian Ministry of Health (MoH) and the US
Naval Medical Research Center Detachment (NMRCD) initiated a
collaboration to characterize the viral agents associated with ILI and
to describe the clinical and epidemiological presentation of the
affected population.
METHODOLOGY/PRINCIPAL FINDINGS:
Patients
with ILI (fever > or =38 degrees C and cough or sore throat) were
evaluated in clinics and hospitals in 13 Peruvian cities representative
of the four main regions of the country. Nasal and oropharyngeal swabs,
as well as epidemiological and demographic data, were collected from
each patient. During the two years of this study (June 2006 through May
2008), a total of 6,835 patients, with a median age of 13 years, were
recruited from 31 clinics and hospitals; 6,308 were enrolled by regular
passive surveillance
and 527 were enrolled as part of outbreak investigations. At least one
respiratory virus was isolated from the specimens of 2,688 (42.6%)
patients, with etiologies varying by age and geographical region.
Overall the most common viral agents isolated were influenza A virus
(25.1%), influenza B virus (9.7%), parainfluenza viruses 1, 2, and 3,
(HPIV-1,-2,-3; 3.2%), herpes simplex virus (HSV; 2.6%), and adenoviruses
(1.8%). Genetic analyses of influenza virus isolates demonstrated that
three lineages of influenza A H1N1, one lineage of influenza A H3N2, and
two lineages of influenza B were circulating in Peru during the course of this study.
CONCLUSIONS:
To our knowledge this is the most comprehensive study to date of the etiologic agents associated with ILI in Peru. These results demonstrate that a wide range of respiratory pathogens are circulating in Peru
and this fact needs to be considered by clinicians when treating
patients reporting with ILI. Furthermore, these data have implications
for influenza vaccine design and implementation in South America.
PLoS One. 2009 Jul 1;4(7):e6118. doi: 10.1371/journal.pone.0006118.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0006118
Md. Irmia Paz. Tutora del GII
