IV^th Meeting of the Southern Cone Surveillance Network for Emerging/ Reemerging Infectious Diseases

(Santiago, Chile, 14–16 April 2003)

Final Report (in Spanish, 101 pp, PDF, 2551 KB; links in the Table of Contents to chapters listed below; titles translated for user orientation)

Executive Summary
(in Spanish and English, with recommendations)

1. Opening Session
- Proposals to Integrate Different Subregional Surveillance Networks and International Health Security Activities
- Integration of Subregional Networks
- World Health Security

3. Surveillance of Specific Diseases
- West Nile Virus (WNV): Pilot Surveillance Plan in Brazil
- Surveillance of Diarrheas Associated with Shigatoxin-producingEscherichia coli (STEC) y Hemolytic Uremic Syndrome (HUS)
- Preparedness Plan for an Influenza Pandemic
- Evaluation of Serological Diagnosis of Emerging/Reemerging Diseases
- Laboratory Accreditation: The Chilean Case

4. Status of Emerging Diseases in 2002: Country Reports

5. Compliance with Recommendations of Meeting in Atlanta, USA, 2002

6. Recommedations for 2003–2004 Period
- General Network Activities
- Laboratory Performance Evaluation
- Antimicrobial Resistance
- Hemolytic Uremic Syndrome
- Hantavirus
- Influenza
- Dengue and Yellow Fever
- Syndromic Surveillance

7. List of Participants

The IV^th Meeting of the Surveillance Network for Emerging/Reemerging Infectious Diseases (EIDs) in the Southern Cone Region took place in Santiago, Chile, 14–16 April 2003. The participants included officials from the Ministries of Health and academic institutions of Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay, as well as from the US Department of Defense and PAHO.

The objective of the meeting was to present and discuss topics of special interest in EID surveillance in the subregion. The participants evaluated the following areas:

1. The degree to which the commitments made at the network's meeting in Atlanta, Georgia, USA, in 2002 were met.
2. Proposals for integrating various subregional surveillance networks and global health security activities.
3. The surveillance of specific diseases.
4. The ability of the Southern Cone's national reference laboratories to diagnose EIDs and the accreditation of laboratories.
Country reports.

Integration of Subregional Networks

Since those responsible for epidemiological surveillance in the MERCOSUR countries hold regular semiannual meetings to standardize definitions and procedures for epidemiological surveillance (including laboratory procedures) and the prevention and control measures to be adopted, the possibility of integrating the activities of the Epidemiological Surveillance Network for EIDs in the Southern Cone Region with those of MERCOSUR was discussed, given that the same countries are involved.

Global Health Security

The impact of EIDs on global health security was discussed. Many factors are involved in turning these infections into a transnational problem, among them tourism and business travel, international agriculture and the livestock trade, the international spread of drug-resistant organisms, the movement of mosquito vectors across borders, the displacement of infected persons, and the failure of society to set up prevention and control measures. Furthermore, these infections pose a potential threat as agents of bioterrorism. The U.S. government was especially interested in this issue and has pledged US$ 19.5 million for 2003 to improve Global Health Security in this area. WHO and PAHO will each receive US$ 6 million of these funds, and US$ 7.5 million will be used for bilateral agreements between the United States and specific countries.

Country Reports

All of the countries made a great effort to strengthen their surveillance activities. The activity reports described the situation of several emerging/reemerging infectious diseases in 2002 and the beginning of 2003. Staffs are already trained in the diagnosis of West Nile fever in one of the six countries, but it was still believed that the training should be expanded. Multicenter research on STEC and HUS is still under way in every country. Five of the six countries are monitoring various enteropathogens (Salmonella, Shigella and Vibrio cholerae), as well as other species found in the community and hospitals. Each of the participating countries has a national reference center that compiles information on the identification of the species isolated and their sensitivity to antibiotics. In addition, the centers supervise adherence to the principles of quality control in each of the network laboratories and are responsible for evaluating their performance. Sentinel sites in the six countries numbered 97 in 2000 and 98 in 2001.

Prior to 1999, Bolivia and Paraguay did not monitor resistance to antibiotics as a systematic, routine activity promoted by the Ministries of Health.

Concern was expressed about foodborne diseases (FBDs), the need to strengthen influenza epidemiology, and the establishment of emergency plans to deal with a pandemic.

Subregional Surveillance Networks   | Emerging/Reemerging Diseases