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Meningococcal disease is mostly endemic in Latin America, with periodic occurrences of outbreaks and epidemics over the last few decades. This literature review summarizes the available epidemiological data for this region between 1945 and 2010. Incidence rates and serogroup distribution differ from country to country and over time. Serogroups A, B, and C have all been major causes of meningococcal disease since the 1970s. In the last decade serogroups W135 and Y may now be emerging in certain countries, with serogroup A virtually disappearing. Although progress has been made in improving and coordinating the surveillance of invasive disease, the uniformity and quality of reported data reflect the fact that the current surveillance systems focus on passive rather than active reporting, hence the reliability of data may vary between countries. Consideration of vaccination policies to control meningococcal disease can only be made with a sufficient understanding of the changing epidemiology in the region.

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INTRODUCCIÓN La leptospirosis es considerada por la Organización Mundial de la Salud como la zoonosis de mayor distribución mundial. Es una enfermedad desatendida, con un impacto en salud pública poco conocido en países en desarrollo. OBJETIVOS Conocer la epidemiología de la leptospirosis en la comunidad de Olavarría, y específicamente: a) estimar la prevalencia de anticuerpos contra Leptospira; b) describir los signos y síntomas, la distribución de serovares y los factores de riesgo conocidos en los pacientes positivos. MÉTODOS Entre mayo de 2013 y enero de 2014, se incluyó a 456 pacientes de uno a 94 años que asistían a centros públicos de salud de la localidad de Olavarría y tenían indicación de toma de muestra de sangre. Previo consentimiento, se realizó una encuesta y se tomó una alícuota de suero. El análisis serológico se efectuó en el Departamento de Zoonosis Rurales (Ministerio de Salud de la Provincia de Buenos Aires). El análisis de los datos incluyó estadísticas descriptivas y de comparación. RESULTADOS La seroprevalencia global fue del 2% (1,1% en mujeres y 3,3% en varones). Algunos pacientes positivos refirieron haber presentado un síndrome gripal la semana previa. Se observó reactividad (títulos 1/50 a 1/100) para los serovares Ballum, Tarassovi e Icterohaemmorrhagiae. Los factores y actividades de riesgo referidos por los pacientes positivos fueron variados. El 88,8% no pudo describir la enfermedad, ni conocía sus medidas de prevención. Se detectaron agrupamientos espaciales, con una zona delimitada de mayor riesgo de exposición. DISCUSIÓN La prevalencia encontrada es baja y similar a la informada en otros países de América del Sur. Aunque en la provincia de Buenos Aires el serovar Canicola es el más prevalente en los casos humanos, la reacción al serovar Tarassovi coincide con lo observado en 2010-2013. La información suministrada a la autoridad sanitaria local debería redundar en acciones conjuntas, dirigidas a disminuir el riesgo de infección.

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BACKGROUND: Invasive meningococcal infections remain an important cause of death in children. In addition, malnutrition has been classically associated with increased severity of infectious diseases. However, in our experience lethal meningococcaemia in clinically malnourished children is extremely rare. Our purpose was to determine whether there is an association between nutritional status and outcome in children with invasive meningococcal infection. METHODS: We carried out an observational study and prospectively determined anthropometrical parameters in 127 children aged 1 month to 4 years with invasive meningococcal infection seen in our inpatient facilities from August 1999 to May 2004. Severity and survival were the clinical end points analysed. RESULTS: Children with severe disease had higher weight for age (1.02 vs -0.19) and height for age (1.12 vs -0.58) z scores than those with non-severe disease. Non-survivors had higher weight for age (0.90 vs -0.16) and height for age (0.73 vs -0.57) z scores than survivors. Clinical and biological variables usually accepted as predictors of high mortality or severity in patients with meningococcal infection were not significantly associated with weight for age and height for age z scores. CONCLUSION: In the present prospective series of children with invasive meningococcal disease, severity and death were linked to anthropometrical parameters and seemed to be associated with a very good nutritional status, which confirmed our previous uncontrolled observations.

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Haemophilus influenzae (Hi) is the causative agent of several human diseases such as sepsis, meningitis, celulitis, and osteoarthritis. We investigated the isolation of Hi serotypes from sterile sites in sick children. One hundred and seventy nine strains from 146 patients were studied, period 1996-2002, at the Microbiology Laboratory, Hospital de Niños Superiora Sor María Ludovica, Argentina. The serotype distribution was:1 a, 112 b,1 c,1 d, 4 e, 3 f y 24 no typable. Since the beginning of universal Hi b vaccination in 1998, we have observed the fast decrease of serotype b and a relative increase of other serotypes.

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Haemophilus influenzae (Hi) es responsable de diversas enfermedades humanas como sepsis, meningitis, celulitis y osteoartritis. En este trabajo se investigó la recuperación de distintos serotipos de Hi en muestras profundas de pacientes pediátricos. Se estudiaron 179 aislamientos de 146 niños durante el periodo 1996-2002 en el Laboratorio de Microbiología del Hospital de Niños Superiora Sor María Ludovica, Argentina. La distribución de los serotipos fue la siguiente: 1 a, 112 b, 1 c,1 d, 4 e, 3 f y 24 no tipificables. A partir del establecimiento de la estrategia de vacunación universal anti Hi b en 1998 se observa una disminución notable del serotipo b y un aumento relativo de otros y no tipificables.

Haemophilus influenzae (Hi) is the causative agent of several human diseases such as sepsis, meningitis, celulitis, and osteoarthritis. We investigated the isolation of Hi serotypes from sterile sites in sick children. One hundred and seventy nine strains from 146 patients were studied, period 1996-2002, at the Microbiology Laboratory, Hospital de Niños Superiora Sor María Ludovica, Argentina. The serotype distribution was:1 a, 112 b,1 c,1 d, 4 e, 3 f y 24 no typable. Since the beginning of universal Hi b vaccination in 1998, we have observed the fast decrease of serotype b and a relative increase of other serotypes.

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Haemophilus influenzae (Hi) is the causative agent of several human diseases such as sepsis, meningitis, celulitis, and osteoarthritis. We investigated the isolation of Hi serotypes from sterile sites in sick children. One hundred and seventy nine strains from 146 patients were studied, period 1996-2002, at the Microbiology Laboratory, Hospital de Niños Superiora Sor María Ludovica, Argentina. The serotype distribution was:1 a, 112 b,1 c,1 d, 4 e, 3 f y 24 no typable. Since the beginning of universal Hi b vaccination in 1998, we have observed the fast decrease of serotype b and a relative increase of other serotypes.

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