"We must rule out that we are facing a hantavirus epidemic"



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that the situation at Epuyén because of the hantavirus outbreak, even though it is "not controlled, it will enter the control channel", said Secretary of the Nation's Health, Adolfo Rubinstein. In an exclusive interview with Los Andes, the head of the national health department said that there are 36 total cases in this country: 28 in Epuyén and eight in Salta, Jujuy, Entre Ríos and Buenos Aires provinces.

– Is the situation in Epuyén under control?

– The situation remains the same, we continue with 28 reported positive cases and 10 deaths, epidemiological panoramas have not changed, and the number of people in selective respiratory isolation in Epuyén and in two or three neighboring areas has declined, as some are currently depleted

The situation is out of control, but we are quite optimistic that the situation will enter the control channel. I say naturally because I cannot convince you: between the first week, that is when the patient first appears, the index case, and the first infected with Epuyén, when we determined that the transmission was inhuman, some contacts could have leaked. He left the area and finally cases that we have not yet identified.

What we can say is that a complete search has been carried out and the criteria for isolating the house are very broad. So far, 28 cases of Epuyén have been referenced and refer to the index case, Mr. Lumberjack with symptoms to the party, in early November. In addition, several days have passed without new cases, and the last are people who are in selective isolation, so we know that there is no transmission. This is a good scenario, but we can't guarantee anything.

– There are also cases in Entre Ríos and in Buenos Aires. Are you afraid of the plague?

-No, it must be removed because it's something else. The Epuyen outbreak has nothing to do with endemic cases that are now reported in Salta, Jujuy, Entre Ríos and the province of Buenos Aires. Different, this happens every year; What's more, there are more than a hundred annual cases that are always reported. In 2018, for example, the provinces that contribute the most are Buenos Aires, Salta and Jujuy.

This is an endemic case of environmental transmission that occurs in rural areas where hanta are: in the north, in Salta and Jujuy; in the middle, Entre Ríos, Buenos Aires and Santa Fe; and in Patagonia. And they are different strains. The current tensions in the Epuyen outbreak and those in the El Bolsón outbreak in 1996 were the stock of the South Andes. On the other hand, circulating in the north or in the province of Buenos Aires is endemic, different.

-How many cases have been counted throughout the country so far?

– The report arrived fifteen minutes ago (the interview was at sunset yesterday). Taking the Chubut case, we have confirmed eight cases of endemic hanta. In the province of Buenos Aires there are five; in Entre Ríos, one; in Jujuy, one and in Salta, one. That's all we have reported so far in 2019. If we compare it with different eneros in the past few years, we are in the same amount as usual.

– Why do you think the Epuyén case multiplied so quickly?

-Who is in Epuyén is the plague. There was in 1996 the famous epidemic in El Bolsón, which was far worse than this, reaching almost 60% of deaths. Then it is not known that there may be inhumane ways, respiratory infections, it is estimated that transmission of hanta is an environment, by inhaling the secretions of infected mice, in rural areas, weeds, confined spaces, and so on. There is no specific treatment for hantavirus, but at the moment we are designing experimental protocols for certain treatments.

– Are there other countries with this problem?

-Yes, there are lots of blows, with different clinical manifestations. This South Andean stock is also in Chile's Patagonia. But there are signs in the United States, in Africa, with various complications.

– Is the game assigned to Chubut to control endemic diseases eliminated?

Not. That is sanitary sovereignty. It has nothing to do with anything. The entire vector program budget is increasing rapidly. Nothing can be seen Not only there is no decrease, but there is an increase. They were Chicanas politicians who had to degrade the ministry to the secretariat, they said that the prevention program was disarmed, but without evidence. Forget it, that's not true. The fact is that this was an outbreak similar to 1996, with the difference that the route of human transmission was unknown at that time. 28 cases reported so far in Epuyén are referred to in this index case. This is a book outbreak.

– Hantavirus left the sequel?

– No, there are patients who start with clinical symptoms, flu syndrome, abdominal pain, diarrhea, headaches, congestion, muscle aches and nothing happens to them. The most feared complication is pulmonary syndrome, which is very serious and affects the heart, and this results in a very high mortality rate.

-Do you plan all kinds of budget allocations to service these people, if they cannot attend your work?

– At Epuyén we currently have more than one hundred people in compulsory housing isolation. Everyone who has contact with patients who have positive cases is in isolation homes. And that is mandatory. Chubut provides food and assistance, of course. In addition, the Ministry of National Health provides Chubut with a lot of assistance in supplies, equipment, human resources.

In fact, I returned yesterday from Epuyén and Esquel and we worked with our team from the Directorate of Epidemiology, Deputy Minister of Communicable Diseases, Malbrán Institute, and intensive therapy at the Del Cruce Hospital, Florencio Varela, to evaluate intensive therapy at Esquel Hospital; besides, the Argentine Society of Infectology. We do very intense, very productive work.

– Floods can complicate the situation with dengue fever and other diseases?

– Today I was in the Chaco and Corrientes to see a bit of the flood area and the needs and panorama there. The problem is that when the water drops, that's when you have to start responding, because someone is evacuated, and always increases the risk of diseases, especially gastrointestinal, diarrhea, more mosquitoes.

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