Browsing by Author "Perret, Cecilia"
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Item Brotes de salmonelosis y el tamaño y rol del Estado en Chile(Sociedad Chilena de Infectología, 2012) Fica, Alberto; Acosta-Jamett, Gerardo; Dabanch, Jeannette; Perret, Cecilia; Torres, Marisa; Lopez, Javier; Jofre, Leonor; Weitzel, Thomas; Comité de Infecciones Emergentes de la Sociedad Chilena de InfectologíaDuring year 2011 two outbreaks of Salmonella infection captured media attention in the Metropolitan Area (MA) in Chile: one of typhoid fever associated to Salmonella serotype Typhi, and the other, of gastroenteritis related to Salmonella serotype Enteritidis, both with decreasing or stable rates in the previous years. The aim of this work is to analyze probable causes of their reemergence. Methods: Several government websites were searched looking for epidemiological data. Results: Typhoid fever rates have declined to current values of 1 case per 100.000 habitants, a decreased associated to improvements in the human development index. The typhoid outbreak was associated to a predominant clone within the MA. The only risk factor identified was consumption of raw vegetables acquired in open fairs, but without identifying a common source. Despite improvements in disease notification and molecular epidemiology capabilities, this outbreak is coincidental with a reduced number of food inspection visits in the MA, probably explained by the limited personnel available for this task. In the case of Salmonella Enteritidis, rates have increased twice since 1998 (5.3 to 10.7 per 100.000 habitants) with an important increase in the number of outbreaks linked to this agent (7 to 31 annual outbreaks) since year 2005. Persistence of this problem is probably associated to the low surveillance of poultry farms made by the Chilean state, to the absence of a cold chain during collection, distribution and selling of eggs, and to the lack of an educational program directed to the population. The recent regulation that bans home-made mayonnaise in restaurant or fast food stores is an important advance that requires further evaluation. Conclusions: The persistence and reemergence of different kind of Salmonellosis in Chile suggests chronic problems on the size and role of the Chilean state regarding food safety.Item Chikungunya, enfermedad emergente en América Latina. Descripción de los primeros casos en Chile(2018) Perret, Cecilia; Vizcaya, Cecilia; Weitzel, Thomas; Rosas, Reinaldo; Dabanch, Jeannette; Martínez, ConstanzaBackground: Chikungunya (CHIK) was introduced in The Americas in 2013, spreading rapidly. In 2014, the first imported case was diagnosed in Chile. Aim: To identify patients with clinical suspicion of CHIK and describe their clinical and laboratory characteristics. Patients and Methods: Patients with suspected CHIK were enrolled. All were confirmed by PCR, IgM or IgG CHIK. A structured survey was applied, which included demographic questions, travel characteristics, clinical manifestations, and laboratory results. Results: 21 patients were enrolled and CHIK was confirmed in 16, who were further analyzed; 12 were female (75%), average age 39 years (27-52). The Caribbean and South Americawere the most frequent sites of exposure. In 63%, the initial symptom was arthralgia. Most frequent symptoms were myalgias, malaise (both 100%), fever, and polyarthralgia (both 94%). The median duration of arthralgias was 90 days (3-262); in 53% arthralgias lasted ≥ 3 months. Main joints involved were ankles, hands, and wrists; 87% reported invalidating pain. Arthritis lasted longer in men than in women (p < 0.001). 38% of patients presented lymphopenia and one patient mild thrombocytopenia. Two patients required hospitalization, one with severe headaches, the other with acute pyelonephritis. Conclusions: Chikungunya should be suspected in returning travelers presenting with fever and severe polyarthralgia. Travelers to endemic areas should apply prevention measures to avoid mosquito bites.Item Cluster of imported vivax malaria in travelers returning from Peru.(International Society of Travel Medicine., 2015) Weitzel, Thomas; Labarca, Jaime; Cortés, Claudia; Rosas, Reinaldo; Balcells, Elvira; Perret, CeciliaWe report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis.Publication Different Safety Pattern of an Inactivated SARS-CoV-2 Vaccine (CoronaVac®) According to Age Group in a Pediatric Population from 3 to 17 Years Old, in an Open-Label Study in Chile(2023) Le Corre, Nicole; Abarca, Katia; Astudillo, Patricio; Potin, Marcela; López, Sofía; Goldsack, Macarena; Valenzuela, Vania; Schilling Redlich, Andrea; Gaete, Victoria; Rubio, Lilian; Calvo, Mario; Twele, Loreto; González, Marcela; Fuentes, Daniela; Gutiérrez, Valentina; Reyes, Felipe; Tapia, Lorena I.; Villena, Rodolfo; Retamal-Díaz, Angello; Cárdenas, Antonio; Alarcón-Bustamante, Eduardo; Meng, Xing; Xin, Qianqian; González-Aramundiz, José V.; Alvarez-Figueroa, María Javiera; González, Pablo A.; Bueno, Susan M.; Soto, Jorge A.; on behalf of the PedCoronaVac03CL Study Group; Perret, Cecilia; Kalergis, Alexis M.During the COVID-19 pandemic, the importance of vaccinating children against SARS-CoV-2 was rapidly established. This study describes the safety of CoronaVac® in children and adolescents between 3- and 17-years-old in a multicenter study in Chile with two vaccine doses in a 4-week interval. For all participants, immediate adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were registered throughout the study. In the safety subgroup, AEs were recorded 28 days after each dose. COVID-19 surveillance was performed throughout the study. A total of 1139 individuals received the first and 1102 the second dose of CoronaVac®; 835 were in the safety subgroup. The first dose showed the highest number of AEs: up to 22.2% of participants reported any local and 17.1% systemic AE. AEs were more frequent in adolescents after the first dose, were transient, and mainly mild. Pain at the inoculation site was the most frequent AE for all ages. Fever was the most frequent systemic AE for 3–5 years old and headache in 6–17 years old. No SAEs or AESIs related to vaccination occurred. Most of the COVID-19 cases were mild and managed as outpatients. CoronaVac® was safe and well tolerated in children and adolescents, with different safety patterns according to age.Publication Inactivated Vaccine-Induced SARS-CoV-2 Variant-Specific Immunity in Children(2022) Soto, Jorge; Melo, Felipe; Gutierrez, Cristián; Schultz, Bárbara; Berríos, Roslye; Rivera, Daniela; Piña, Alejandro; Hoppe, Guillermo; Duarte, Luisa; Vázquez, Yaneisi; Moreno, Daniela; Ríos, Mariana; Palacios, Pablo; Garcia, Richard; Santibañez, Álvaro; Pacheco, Gaspar; Mendez, Constanza; Andrade, Catalina; Silva, Pedro; Diethelm, Benjamín; Astudillo, Patricio; Calvo, Mario; Cárdenas, Antonio; González, Marcela; Goldsack, Macarena; Gutiérrez, Valentina; Potin, Marcela; Schilling, Andrea; Tapia, Lorena; Twele, Loreto; Villena, Rodolfo; Grifoni, Alba; Sette, Alessandro; Weiskopf, Daniela; Fasce, Rodrigo; Fernández, Jorge; Mora, Judith; Ramírez, Eugenio; Gaete, Aracelly; Acevedo, Mónica; Valiente, Fernando; Soto, Ricardo; Retamal, Angello; Muñoz, Nathalia; PedCoronaVac03CL Study Group; Meng, Xing; Xin, Qianqian; Alarcón, Eduardo; González, José; Le Corre, Nicole; Álvarez, María; González, Pablo; Abarca, Katia; Perret, Cecilia; Carreño, Leandro; Bueno, Susan; Kalergisa, AlexisMultiple vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been evaluated in clinical trials. However, trials addressing the immune response in the pediatric population are scarce. The inactivated vaccine CoronaVac has been shown to be safe and immunogenic in a phase 1/2 clinical trial in a pediatric cohort in China. Here, we report interim safety and immunogenicity results of a phase 3 clinical trial for CoronaVac in healthy children and adolescents in Chile. Participants 3 to 17 years old received two doses of CoronaVac in a 4-week interval until 31 December 2021. Local and systemic adverse reactions were registered for volunteers who received one or two doses of CoronaVac. Whole-blood samples were collected from a subgroup of 148 participants for humoral and cellular immunity analyses. The main adverse reaction reported after the first and second doses was pain at the injection site. Four weeks after the second dose, an increase in neutralizing antibody titer was observed in subjects relative to their baseline visit. Similar results were found for activation of specific CD4+ T cells. Neutralizing antibodies were identified against the Delta and Omicron variants. However, these titers were lower than those for the D614G strain. Importantly, comparable CD4+ T cell responses were detected against these variants of concern. Therefore, CoronaVac is safe and immunogenic in subjects 3 to 17 years old, inducing neutralizing antibody secretion and activating CD4+ T cells against SARS-CoV-2 and its variants. (This study has been registered at ClinicalTrials.gov under no. NCT04992260.) IMPORTANCE This work evaluated the immune response induced by two doses of CoronaVac separated by 4 weeks in healthy children and adolescents in Chile. To date, few studies have described the effects of CoronaVac in the pediatric population. Therefore, it is essential to generate knowledge regarding the protection of vaccines in this population. Along these lines, we reported the anti-S humoral response and cellular immune response to several SARS-CoV-2 proteins that have been published and recently studied. Here, we show that a vaccination schedule consisting of two doses separated by 4 weeks induces the secretion of neutralizing antibodies against SARS-CoV-2. Furthermore, CoronaVac induces the activation of CD4+ T cells upon stimulation with peptides from the proteome of SARS-CoV-2. These results indicate that, even though the neutralizing antibody response induced by vaccination decreases against the Delta and Omicron variants, the cellular response against these variants is comparable to the response against the ancestral strain D614G, even being significantly higher against Omicron.Item Modelo computacional interactivo, semi-automatizado y de código abierto aplicado a la vigilancia de virus respiratorios(2020) Reyes, Felipe; Ferrés, Marcela; Vial, Pablo; Vollrath, Valeska; Camponovo, Rossanna; Montecinos, Luisa; Hirsch, Tamara; Valenzuela, Patricia; Perret, CeciliaLas infecciones respiratorias agudas (IRA) causadas por virus son una importante causa de morbilidad y mortalidad en el mundo, afectando principalmente a niños y adultos mayores. Se asocian a un alto número de consultas y hospitalizaciones, a una significativa sobrecarga del sistema de salud y a un alto costo económico. La vigilancia de virus respiratorios tiene el potencial de ayudar a optimizar la respuesta sanitaria, garantizar la disponibilidad de recursos humanos, racionalizar los recursos y disminuir los costos asociados a la atención en salud. Con el objetivo de optimizar la recolección y visualización de los datos de nuestro actual sistema de vigilancia de virus respiratorios, se diseñó una plataforma basada en R y sus paquetes Shiny, que permite la creación de una interfase web interactiva y amigable para la recolección, análisis y publicación de los datos. Se ingresaron a esta plataforma los datos de la red de vigilancia metropolitana de virus respiratorios disponibles desde 2006. En esta plataforma, el investigador demora menos de un minuto en registrar los datos. El análisis y publicación es inmediato, llegando a cualquier usuario con un dispositivo conectado a Internet, quien puede elegir las variables a consultar. Con un costo muy bajo, en poco tiempo y utilizando el lenguaje de programación R, se logró crear un sistema simple e interactivo, disminuyendo el tiempo de carga y análisis de datos de forma considerable, posiblemente aumentando el impacto y la disponibilidad de esta vigilanciaItem Recomendaciones para viajeros chilenos a la Copa Mundial de la FIFA 2014 en Brasil(2014) Perret, Cecilia; TWeitzel, ThomasEste artículo proporciona una serie de precauciones a observar y vacunas recomendadas para viajeros chile-nos que asistirán a la Copa Mundial de Fútbol 2014 en Brasil. Su propósito es ayudar a los médicos a preparar a los visitantes a este masivo evento y resume las recomendaciones útiles para evitar enfermedades infecciosas, teniendo en consideración las circunstancias y disponibilidad en Chile.Item Shortage of yellow fever vaccination: A travel medicine emergency for Chilean travellers(Elsevier Ltd., 2019-03) Weitzel, Thomas; Vial, Pablo; Perret, Cecilia; Aguilera, XimenaIn recent years, yellow fever (YF) outbreaks have struck various African and South American countries, a scenario, which led to the creation of the “Eliminate Yellow fever Epidemics” initiative by the WHO [1]. The current Brazilian outbreak is the largest, both in human and epizootic cases in decades in South America, expanding from the historical endemic areas towards the crowded coastal region [2]. This outbreak poses a unique challenge for national authorities and global response [3], but also Travel Medicine.