Cases - Semana Binacional de Salud

Binational Health week
Public Health Priority Issues
Dr. Jesús Felipe González Roldán
Director General
Centro Nacional de Programas Preventivos y
Control de Enfermedades.
October 6, 2014
Risk Transition
Stress
Smoking
Gender Behavior
Sedentary
life style
Unemployment
Education,
Poverty and
Migration
Inadequate Diet
At Work
At Home
In the air
Sexual Behavior
On the Street
Food
Inadequate
Sanitation
Alcoholism and
other Addictions
Non-Communicable Diseases
In 2012, 25% of the 6.6 million Mexican adults
known with diabetes, was in metabolic control.
Previous
diagnosis
with
complications
Adequate
metabolic control.
Regarding diabetes, 6.4 million Mexican adults who have been diagnosed
by a doctor and receive treatment, 25% showed evidence of adequate
metabolic control.
This figure indicates a major challenge for the health sector, while
showing the progress between 2006 and 2012: in 2006, only 5.3% of
individuals with diabetes showed evidence of adequate metabolic control.
If trend had maintained, today 5.4 million
more people would be overweight or have
obesity.
There are 22.4 million Mexican adults with
hypertension and 5.7 million are controlled.
National Strategy for Prevention and Control of
Overweight, Obesity and Diabetes
•
•
•
In October 31, 2013, the President of the Republic announced the
launch of the National Strategy for Prevention and Control of
Overweight, Obesity and Diabetes.
To meet the presidential statement, the SSA designed a
comprehensive strategy based on three pillars: (1) Public Health, (2)
Health Care and (3) Health Regulation.
The aim of the Strategy is to improve the welfare levels of the
Mexican population, stabilize and reduce the incidence of obesity in
order to reverse the epidemic of Noncommunicable diseases,
particularly cardiovascular diseases, diabetes and related diseases.
National Strategy
Pillars and Strategic Axes
Public Health
Health Care
Quality and Effective Access
3
Health Regulatory and Fiscal
Policy
Labelling
Evaluation
public accountability
2
intersectoral
Prevention
Mainstreaming
Health Promotion and Educational
Communication
Increase public and
individual awareness of
obesity and its association
with the NCDs
Stewardship
Epidemiological Surveillance
AxesEvidence
and Scientific
ResearchGuide
1
Advertising
Direct the National Health
System towards early
detection
Solve and control at first
contact
Slowing the increase in the
prevalence of overweight,
obesity and NCDs
Fiscal actions
Health in All Policies
Social Determinants of Health
Regulatory Actions
• As part of this strategy, COFEPRIS participated in the design of the
third pillar: Health Legislation.
• In this regard, it was proposed to update our regulations according to
international best practices in food advertising and labeling:
1
Advertising
Standards for advertising
child audience
2
Food labelling
Inclusion of Nutritional
Labelling
3
Taxes.- Beverages and
food
Higher callories
Advances in Health Care
Medical Specialities Unit for Chronic Diseases
(UNEME EC)
Medical Specialties units that offer an outpatient health care quality model,
comprehensive and interdisciplinary based on scientific evidence and best clinical
practice, focus in Chronic Non Communicable Diseases: Obesity, Diabetes,
Hypertension and Cardiovascular Disease.
Aim:
•
•
•
•
Improve control of these diseases.
Prevent and reduce complications.
Promoting and maintaining adherence to long-term treatment.
Educating patients relatives and people at risk.
Currently in operation 101 UNEMES EC, in 29 federal states of
Mexico
Advances in Health Care
Mutual Aid Groups of
Chronic Disease (GAM EC)
Educational strategy which includes the organization of the patients by
themselves with health services staff support, developing their potential to acquire
knowledge of their diseases and abilities to improve their control.
In July 2014 the GAM-EC network consists of 6,792 groups, serving a total of
159,605 patients.
Advances in Health Care
Chronic disease information system (SIC)
The National Health Council, determined the creation of the Chronic
disease information system (SIC).
Electronic platform that will replace the Chronic Diseases card used in
first contact medical units over the country.
Aim:
•
•
•
•
Develop a nominal census record.
Develop a technological tool that optimizes first contact health
services performance.
Valuable health information source on the control and treatment
of patients.
Simplifying processes for planning and timely drugs supply.
Advances in Health Care
Excellence Networks in Obesity and Diabetes
12
60
339
11
1,764
entities
First contact
health centers
Medical offices
UNEMES
health Personnel
In the
geographic
area of
influence of
the 60 health
centers:
Strengthening the referral
and counter-referral of
patients
Total resident
population:
Total resident
3,874,316
Population 20 years
population
Source: http://www.tableroredesdiabetes.com/
affiliated to Seguro
Popular :
1,380,186
and over affiliated to
Seguro Popular
554,350
Advances in Health Care
Access and care quality of patients with NCDs in health services.
Comprehensive
detections
Training health
personnel serving
NCDs
Drug Supply
•
•
•
Compliance in 65% of the target detection of
chronic diseases like diabetes, hypertension,
dyslipidemia, overweight and obesity.
Training on Chronic Diseases to health care
givers by 75.9%
Drug Supply in 81% of the health units.
Souce: http://www.tableroredesdiabetes.com/
Following Steps
Sectoral Specific Action Programs
• Extending
the Excellence Networks in Obesity and
Diabetes to all states.
• Continue
training medical and paramedical first contact
staff on chronic diseases issues.
• Improving
adequate drug supply in health units.
• Implementation of SIC.
Influenza Prevention and Control
Introduction
Underministry of Health Prevention and Promotion
Influenza Prevention and Control
General Direction of
Epidemiology
National Center for
Preventive Programs
and Diseases Control
Network of Highly
Specialized Hospitals
General Direction of
Health Promotion
Objectives of the Especific Action
Program 2013-2018
1.- Implementation of the Respiratory Diseases and Influenza
National Program.
2.- Evaluation of the infrastructure of health services to suit the
program needs.
3.- Development of the Official Mexican Normativity Standard for
Influenza and Respiratory Diseases Control and Prevention .
Objectives of the Especific Action
Program 2013-2018
4.- Promotion and training focused on prevention and control
of influenza.
5.-Strengthen the information system for epidemiological
surveillance of influenza (SISVEFLU).
6.- Strengthen operational research as the main tool for
continuous quality improvement program.
Action lines for influenza prevention
and control
• To develop a standardized policy, giving priority to influenza
prevention and control in the first and second level of health
attention.
• To increase influenza vaccination coverage, focused on risk groups.
• To develop promotional and educational materials for influenza
prevention and control, according to the cultural and educational
environment of the population.
• To continue updating health staff on influenza prevention and control.
Binational collaboration
CENAPRECE – CDC
To implement a binational
coordination on
epidemiological
surveillance and influenza
laboratory in the region.
To strength the influenza
surveillance system for
increasing response
efficiency to any
eventuality that may arise
during the season of
disease onset.
Tb control
Tuberculosis on the border states of
Mexico and the USA, 2013
USA (2012):
Total Cases: 9,945
Borderline cases : 3,675
Cases 2191
Rate: 5.8
22.%.
Cases: 211
Rate: 3.2
2.12%
36,8%
Cases: 40
Rate: 1,9
0,4
Cases 1233
Rate: 4.7
from the National
total
Source: MMWR CDC
12.3 %
Cases:1839
Rate: 54.4
9.3%
Cases:854
Rate: 29.9
Mexico (2013):
Cases: 19,703
4.3 %
Cases: 696
Rate:19.1
3.5%.
Cases:609
Rate:21.1
3.1%
Borderline cases:
6,339
32% from the National
Cases:1233
Rate:24.9
* Rate per 100,000
6.3%
Cases:,1108
Rate:32
Total
5.6%
Source: DGE/SS
Migratory Routes
Migration patrons
in Mexico
Kind of Migration
Regional
Swallow
Grand scale
Intl from Center
-South Am-Mex to USA
Migration patrons in México and USA
.
.
• Migration in Mexico is quite complex
• Mexico is the only country in the region
that is origin, transit and destiny of
migrants
Honduras
Nicaragua
Guatemala
El Salvador
Costa Rica
Source: PNT-Mexico, MMWR-CDC, DGE-SSa.
*
Panama
Outbreaks and Epidemiological
Emergencies Attention
Threats
Mexico, is not only one of the countries with the greatest risks of
suffering a disaster caused by a natural phenomena, but also its social
and economical conditions favour the presence of diseases outbreaks
such as chickenpox, hepatitis A, poisoning food, dengue and diarrhea,
among other ailments.
Health Emergencies
All extraordinary event that constitutes a health harm and/or risk and
requieres immediate and coordinated response.
Epidemiological emergency
Disaster
Health damages caused by the
presence
of
microbiological,
chemical or toxic agents, that bring
about
outbreaks
or
epidemies,
including emerging and reemerging
diseases.
“Any event, caused by natural
phenomena or produce by man, that
causes damage, ecological disruption,
loss of human life, deterioration of
health and health services, on a scale
sufficient to require and extraordinary
response from outside assistance”.
Source: PAHO/WHO
Coordination
Scientific Advisory Committee
UNAM, IPN, PAHO/WHO, CDC,
Academies
• SCT
DGP
DGMM
•SECTUR
SEGOB
•CENAPRECE
•COFEPRIS
•DGE
•DGCS
•IMSS
•ISSSTE
•PC
•CISEN
•PFP
•SER
•PGR
• SEMARNAT•SAGARPA
•Civil Aviation
•SEDENA
•SEMAR
National Comittee for Health
Security
National Council for
Civil Protection
State Committee for Health
Security
State Council for Civil
Protection
Jurisdictional Committee for
Health Security
Municipal Council for
Civil Protection
SSA, SEP, CFE, SCT, PFP, SEDENA,
SEMAR,
SEDESOL,
CONAGUA,
TELMEX, RED CROSS, MUNICIPAL
SERVICES, ETC.
•
•
•
•
SSA
IMSS
ISSSTE
SEDENA
•
•
•
•
SEMAR
PEMEX
DIF
CR
Operative Command for Health
Security (OCHS)
Affected Area
Action Component for
Emergencies Attention
1. Coordination
2. Medical Attention
3. Psychological Attention
4. Epidemiological Surveillance
5. Health Risks Control (food and water)
6. Basic Sanitation
7. Health Promotion
8. Laboratory
9. Vector Control
10. Public Health Actions (if applicable)
•
•
Vaccination
Condom Distribution
11. Social Communication
•
•
•
•
Health Units
Modules
Temporary Shelters
Community
Lines of action of the different
phases
Before
During
After
Develop Program and Intervention Plans.
 Set the Coalition and Coordination intra and extraInstitutions
Assignment of responsibilities
Training Institutional Staff
Activate present intervention plans
Medical Attention
Evaluation of damage to health infastructure
Epidemiological Surveillance
Health Surveillance
Supervision of assigned duties
Compilation, tabulation and analysis of information
Information to the public and media
Events
Hospital
Outbreaks
Community Outbreaks
Bioterrorism
Disasters
Accident or radiological, chemical and
nuclear attacks
Response to outbreaks
Outbreaks Investigation and Control
Evaluation of the previous epidemic
activity in the risk area.
Evaluation of the endemic level of
major diseases under surveillance in
risk areas.
Evaluation of quality of life
conditions after emergency
(shelter, access to clean
water,
proper
sewage
disposal,
mosquito
protection)
Outbreak Detection
Selection of diseases
subject to surveillance
(tracers)
Evaluation of risk factors for preexisting conditions in risk areas
Arising Risks
Diseases Prevention and
Control
Sentinel surveillance
Epidemiological Surveillance
BEFORE
Disaster
Epidemiological surveillance after
disaster
Dengue: Integrated
Strategy
IVM (Integrated Vector Management)
Surveillance, diagnosis, and case management
•
•
•
•
•
Entomological and mosquitoes viral infection surveillance
Epidemiological and virological surveillance
Early diagnosis and circulating serotypes
Hospital Case Management
Enabling
Integrated
Vector
Management
(IVM)
from
the
entomological risk or as an immediate response to the
appearance of cases
IVM (Integrated Vector Management)
•
Management
of
personal
and
environmental
risks
(integrated approach with intersectoral and community
participation)
•
Larviciding
•
Space sprays
•
Indoor fast residual spraying with residual insecticide
National Dengue 2013 - 2014*
2013
2014
FHD confirmed
9,264
21,515
30,779
2.2:1
57
49
40
0.43
4,055
9,866
13,921
2.4:1
64
33
22
0.54
FD confirmed
Confirmed
Ratio FD:FHD
% Sampling
% Positivity
Deaths
Lethality
• Decrease
12.7
-32.2
-45
25.7
in the total number of
Suspects y Confirmed
11250
9000
Cases
DATA
% of
variation
-56.2
-54.1
-54.8
6750
4500
2250
0
Week
Probables 2013
Probables 2014
Confirmados 2013
Confirmados 2014
confirmed cases Dengue (-54.8%) from
baseline dengue 2013.
• Transmission is concentrated in the Southeast region states (55%). The state of
Veracruz recorded 12.7% and 8.9% Sinaloa.
• Deaths occur in the states: (5) Veracruz (3) Chiapas, (3) Guerrero, (2) Sinaloa,
(2) Yucatan (2) Oaxaca (1) Campeche (1) Nuevo Leon (1) Quintana Roo (1) and
Tabasco (1) Sonora.
• Circulation of the four serotypes in the country is reported.
•Updated to September 14, 2014. Source: Plataforma Única SINAVE Módulo Dengue, DGE
Incidence, test positivity and circulating
denguevirus serotypes isolated by state,
Mexico 2014 *
DIAGNOSIS TEST
NS1
IgM
IgG
RAPID
TEST
AIS
PCR**
TOTAL
POSITIVE
3,752
6,910
3,422
0
0
1,055
14,084
NEGATIVE
27,753
19,275
28,184
0
0
414
75,212
TOTAL
31,505
26,185
31,606
0
0
1,469
89,296
% OF POSITIVE
26.64
49.06
24.30
0
0
0.00
100
STATE
BAJA CALIFORNIA SUR
CAMPECHE
COAHUILA
COLIMA
CHIAPAS
GUANAJUATO
DURANGO
GUERRERO
HIDALGO
JALISCO
MEXICO
MICHOACAN
MORELOS
NAYARIT
NUEVO LEON
OAXACA
PUEBLA
QUERETARO
QUINTANA ROO
SAN LUIS POTOSI
SINALOA
SONORA
TABASCO
TAMAULIPAS
TLAXCALA
VERACRUZ
YUCATAN
TOTAL
1
31
1
3
20
10
0
0
57
0
19
0
116
20
0
1
127
22
0
39
6
23
13
4
11
0
8
61
592
Circulating Serotypes 2014
2
3
4
3
0
0
8
0
7
0
0
0
24
0
2
86
42
1
0
0
0
5
0
0
26
0
5
0
0
0
62
0
1
0
0
0
6
0
2
4
0
0
10
0
0
0
0
0
4
1
8
22
0
0
0
0
0
5
1
1
0
0
0
35
0
0
7
0
0
4
0
0
24
9
0
0
0
0
35
0
0
11
0
4
381
53
31
1,2
1,2
1
TOTAL
34
16
3
46
139
0
5
88
0
82
0
124
24
10
1
140
44
0
46
6
58
20
8
44
0
43
76
1,057
1,2
1
2
1,2,3
0.01
- 59.08
59.09 - 118.16
118.17 - 177.23
177.24 - 236.31
1
2
1,2,4
1,2,4
1,2,4 1,2,4
1,2
1,2,3,4
1,2
1,2
1,2 1,2,4
1,2,4
1,2,3,4
1,2,3,4
• BCS reported the highest incidence rate of
confirmed cases 179.8 X 100,000.
• Serotypes DNV1 (56%) and DNV2 (36.1%)
predominate in relation to serotypes DENV3
(5%) and DNV4 (2.9%).
• Veracruz has reported the highest number of
cases so far.
•Updated to September 14, 2014. Source : Plataforma Única SINAVE Módulo Dengue, DGE
Spatial distribution of reported cases of
Dengue, Mexico 2014 *
• In 2014, transmission of dengue in the first weeks has been concentrated in the south-southeast (> 54%).
• Updated to Week No. 37-2014. Source: Panorama Epidemiological Dengue, DGE
Strategy to define the incorporation of
dengue vaccine in Mexico
Main Objective:
•
Create
a
proposal
supported
by
scientific
evidence and field experience for the application
of dengue vaccine (to the Mexican population)
when available.
•
For this a group of experts were integrated.
Dengue Expert Group
v
v
Chikungunya,
Surveillance, Prevention and
Control
Geographical distribution in
the world
Countries and territories have been reported Chikungunya indigenous
cases (September 16, 2014)
http://www.cdc.gov/chikungunya/images/maps/CHIKWorldMap-current.jpg
Geographical distribution
in America
Countries and territories have been reported Chikungunya indigenous
cases (September 16, 2014)
http://www.cdc.gov/chikungunya/images/maps/CHIKWorldMap-current.jpg
Epidemiological situation in
America
Domestic and imported cases to Epidemiological Week
36 (September 12, 2014)
Domestic cases
Number
Confirmed cases
8,651
Deaths
Imported cases
113
Number
United States
926
Venezuela
70
Brazil
12
Mexico
3
Source: OPS/OMS
* Note: July, 17, United States reported the first two cases of indigenous transmission in Florida state
Operational Definitions
Suspect Case:
Any person with fever and arthritis of acute onset or severe arthralgia,
resident or visiting areas with transmission of Chikungunya virus during
the two weeks preceding the onset of symptoms, or contact of a confirmed
case or that any epidemiological link is found with transmission areas.
Operational Definitions
Confirmed case
Every suspected case with a positive result to chikungunya virus by any of
the following specific laboratory tests:
Detection of viral RNA by RT-PCR in serum samples taken in the first
five days of onset of fever.
Serum IgM from 6th day the onset of fever.
Detection of IgG antibodies in paired serum samples, with a difference
of at least a week in the making. Increase of at least 4-fold antibody
titer CHIKV.
Algorithm key actions for
suspected cases
Patient with fever,
arthritis or arthralgia
with visiting or
resident in area
transmisison
Serum sampling
Entomological
risk assessment
Immediate
reporting to
Jurisdiction
Sending sample
LESP
Vector Control
Capture
Database
Immediate reporting
to state
Sending sample
InDRE
* En las primeras 24 horas de conocimiento por los servicios de salud
Immediate
reporting to DGE
Analytical framework for
CHIKV in InDRE
Mexico has installed capacity for laboratoryconfirmed cases of CHIKV
Virological
VIRAL INSULATION
C6 / 36 cells
BHK21
Vero
MOLECULAR
Real-time RT-PCR
(Strains African and Asian
strains)
sequencing
Serologic
MAC-ELISA
GAC-ELISA
microneutralisation
Commercial kits (SD
Health Promotion
http://www.todosobrefiebredelchikungunya.mx
CHIKV and Dengue Vectors
Aedes aegypti
Aedes albopictus
Entomological surveillance
ovitraps
•
•
•
•
•
Identify the presence, distribution and density vector
(Aedes aegypti and Aedes albopictus)
Entomovirológica surveillance to identify the presence of
CHIKV and Dengue virus
Uniform sampling in the
whole town (cover)
Weekly
readings
throughout the year, over
85%
Seasonal fixed observation
sites
National Meeting of
Chikungunya
Brucellosis
Situation
5000
CASOS DE BRUCELA POR ENTIDAD
00-13
•
3750
2500
Reporte de casos en SUIVE/SSA de enero a
julio 2013
N°
N°
JURISDICCI UNIDADES
TOTAL DE
ESTADO ONES DE
DE
CASOS
OCURREN OCURREN
CIA
CIA
1250
0
AGUASCALIENTES
•
In XXI century, 35,700 cases
accumulate, 51.5% in the states
of Coahuila, Guanajuato, Jalisco,
Michoacán, Nuevo León and
Sinaloa
CHIHUAHUA
MEXICO
QUERETARO
TLAXCALA
Six states have reported
cases of brucellosis in
2013 and 2014.
Guanajuat
o
Michoacá
n
Reporte de casos en SUIVE/SSA de enero a
julio 2014
N°
N°
JURISDICCI UNIDADES
TOTAL D
ESTADO ONES DE
DE
CASOS
OCURREN OCURREN
CIA
CIA
7
141
194
Puebla
9
49
207
8
27
125
Sinaloa
3
25
170
Puebla
7
31
122
8
23
146
Sinaloa
3
14
72
Michoacán
Guanajuat
o
8
40
120
Zacatecas
6
18
53
Coahuila
6
10
105
Sonora
5
18
45
Zacatecas
6
28
104
Morelos
3
18
28
13
31
53
Tlaxcala
3
11
26
México
Nuevo
León
8
19
53
Brucellosis Programme of Action
2013-2018
Challenges
•
•
•
Promote the nominal registry of case at State Health Services
that have a higher incidence.
Corroborate laboratory studies establishing regulations in
patients suspected brucellosis.
Ensure that the State Health Services to provide treatment
confirmed by SAT / 2ME patients. And to follow up on the health
sector institutions to patients treated brucellosis.
Brucellosis Programme of Action
2013-2018
Objectives, strategies, action lines and indicators
•
Objective: To improve the care of patients with brucellosis in health
sector institutions to provide early diagnosis and treatment.
•
Strategy: To verify compliance with standards in reported cases of
these zoonoses.
•
•
Action Line: To apply current regulations in patients with brucellosis
Indicator: To apply appropriate treatment to 100% of confirmed
patients with brucellosis.
Brucellosis Programme of Action
2013-2018
Nominal Registration Cases
•
In the process of programming the "Collaborative Communication
Network" (RCC) platform eColls admistrada by the company.
•
Each SESA has a username and password to feed the platform with
information on diagnosis, treatment and monitoring of patients with
brucellosis to their high health.
•
It will be in September all states register their cases of brucellosis in
that platform.
New tests for
the diagnosis of brucellosis
Research collaboration with the CDC
•Participation CENAPRECE: promote the identification of patients and
sampling.
•Contemplate realize two states Michoacan and Nuevo Leon (200
patients and 200 control patients).
•Medical personnel (3) and laboratory (1) was hired to implement the
study.
•Objective: To compare the results of conventional tests with new tests
(rapid assay life, Brucellacapt and Elisa) for InDRE.
•Preview: medical staff in outpatient tested methodology, CS La Piedad
Michoacan and Nuevo León.
•InDRE indications are expected to start taking samples.
Rickettsiosis
Rickettsiosis:
•
•
•
They are zoonosis caused by obligate intracellular gram-negative bacteria, transmitted
by ticks
and other ectoparasites such as lice and fleas to wild or domestic animals and man
accidentally.
In Mexico the most comun cases presented are result of Rickettsia rickettsii, Rickettsia
prowazekii y Rickettsia typhi.
R. rickettsii
.
R. prowazekii
R. typhi
The most common is the spotted fever of the Rocky Mountains, althought 16.0% are mixed
infections.
Mexico Background
Evolution and current
situation
They are existing Rickettsiosis records
since 1920; by 1940´s, the cases where
reported in several states in Mexico.
In the 90´s, they where Spotted Fever
cases registered in Mexico City and
Yucatan.
In late 2008 and early 2009 Mexico
reported
the
biggest
outbreak
of
Rockettsiosi in Los Santorales, located in
the metropolitan area of Mexicali, Baja
California.
Mapa 1. Prevalencia de casos confirmados de rickettsiosis por Laboratorio, InDRE, México 2012
Prevalencia Nacional 2012
0.40/100,00 habitantes
Prevalencia/100,000
habitantes
< 0.01
Since
2010,
the
epidemiological
surveillance reported cases in Baja
California Sur, Coahuila, Sonora, Durango
and Nuevo León.
0.01 a 0.49
0.5 a 0.99
1.0 a 2.9
3.0 a 4.9
According to InDRE in 2012, positive
serology to Rickettsia rickettsii was
registered in 28 states of Mexico.
Fuente: Secretaría de Salud/DGE/InDRE/Deptos. Virología y Bacteriología/Base de datos Rick 2012. fecha de corte
29 de abril de 2013 de las 10:58 hrs
In 2014 there has been 199 registered Rickettsiosis cases. Coahuila accounts for 36 % of cases in the
country until epidemiological week 36.
Cases
Rickettsiosis cases
Mexico 2005 2014*
2000
1800
1600
1400
1200
1000
800
600
400
200
0
1971
1836
1480
1273 1256
24
331
208
373
543
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014*
From 2005 to 2014 a total of 9,295 cases where registered in
Mexico
Source: SUIVE/DGE/ SS/Vigilancia Epidemiológica de Rickettsiosis.*Al corte de la semana epidemiológica 28
Cases per Rickettsiosis type
México 2005 - 2014*
Year
Spotted
Fever
2005
8
2006
3
2007
1
2008
2
2009
948
2010
527
2011
545
2012
677
2013
1032
2014* week 123
*At 28th epidemiological
Other types
Recurrent
of
Epidemic
Fever*** Rickettsiosis*
Tifo
*
16
316
203
367
995
659
515
698
711
sd
** The notifications began in 2014
*** The notifications stopped in 2014
Source: SUIVE/DGE/Secretaría de Salud/Estados Unidos Mexicanos
sd
sd
sd
sd
sd
sd
sd
sd
sd
362
0
12
0
0
0
27
99
31
44
17
Murine
Tifo
0
0
4
4
28
60
97
74
49
41
Vector integral Management
Simultaneous actions;
Entomológical
Surveillance
Enviromental
Control
Ecto canine
Deworming
Rickettsiosis
prevention
and control
program
Vector Program
Zoonosis
program
Ebola
Filoviridae RNA. There are five different subtypes: Bundibugyo, Côte d'Ivoire,
Reston, Sudan and Zaire. Reston has not caused disease in humans.
•It was first detected in 1976 in two simultaneous outbreaks occurred in Nzara,
Yambuku Sudan and Democratic Republic of Congo.
• The village where the second outbreak occurred is located near the Ebola
River, which gives its name to the virus.
• It has been found that the natural hosts of the virus are fruit bats.
• Before this outbreak (2014), outbreaks were recorded in the year 2012 in
Uganda and Democratic Republic of Congo.
• Collaboration Between Countries.
• Need to Identify new cases in time
GRACIAS
Dr. Jesús Felipe González Roldán
CENAPRECE
jesus.gonzalez@salud.gob.mx
jfgonzalezroldan@yahoo.com.mx