Executive Summary
List of Participants

Full Text & Country Reports
(83 pages, PDF: see report in Spanish for links to chapter headings translated below)

Cover and Contents
Executive Summary

I-II. Inaugural Session, Election of the President and Rapporteur

III. Introduction and Objectives

IV. Regional Focus on Emerging Disease Surveillance

V. Working Groups

VI. y VII. Need to Strengthen the Network, 2001 Activities (by country)

VIII. Recommendations

IX. List of Participants

4th Meeting of the Emerging Disease Surveillance Network of the Southern Cone (Asunción, Paraguay, 30 May—1 June 2001)

Recommendations

Influenza

To the Countries

Surveillance

Verify case definition based on WHO.

Increase sentinel surveillance via physician systems.

Implement sentinel units for obtaining morbidity data.

Increase the number of isolated and characterized viruses.

Transporting Samples

Carry out annually at least one shipment of strains to the CDC and ideally three corresponding shipments at the beginning, peak and the end of the season.

Establish mechanisms that facilitate virus transportation. Opening an account is proposed for the use of the Southern Cone countries.

Communication

Enter surveillance data to the FluNet Weekly.

Establish an information system at the national level (Web page, bulletins, etc.)

Improve access of peripheral sentinel units to communication systems.

Pandemic

Prepare national pandemic plan.

Research

Evaluate the possibility of developing vaccine production at the national level.

Develop techniques for diagnostic tables.

Begin serological studies for workers who come into contact with birds and Avian viruses.

Carry out cost-effective studies on vaccination.

To PAHO

Support the sending of samples to WHO Collaborating Center.

Hemolytic Uremic Syndrome (HUS)

To the Countries

Estimate the incidence rate for HUS in children under five years of age at the national and regional levels in the Southern Cone countries, controlled by place of residence.

Establish surveillance strategies for children with HUS and bloody diarrhea at the country level, in such a way as to reintegrate data.

Propose standard procedures for laboratories in all the countries of the region.

Suggest the Physiopathogenic Service Fisiopatogenia of the INEI / ANLIS "Dr. C. G. Malbrán" as a Regional Reference Center.

Analyze risk factors of HUS infections, particularly from each country or region.

Define strategies and prevention and promotion measures to be utilized at the regional level.

Evaluate the potential impact of implementing these prevention and promotion strategies.

Evaluate the economic impact of the disease in the health system.

Form interinstitutional commissions to address the problem and how to control it.

To the CDC and PAHO

Support the implementation of these recommendations.

Other Emerging and Reemerging Diseases

Aedes aegypti/dengue

To the countries

Promote the need to educate the younger population on behaviors for vector control.

Seek strategies of long-term control to achieve a substantial change of attitude among the population.

Carry out resistance surveillance on Aedes aegypti larvicides and adulticides.

Make recommendations to the Services Network concerning sampling for laboratory diagnosis.

Send information to the countries on laws or regulations for dengue control.

Disseminate information on yellow fever among health workers.

To PAHO

Strengthen training on yellow fever diagnosis for those countries that lack the technology (Chile and Uruguay) and promote the exchange of diagnostic reagents among the Southern Cone countries.

Hantavirus

To the countries

Carry out epidemiological analysis of cases of Hantavirus Pulmonary Syndrome (HPS) according to level of seriousness of the clinical presentation.

Reinforce quality control system via the regional reference laboratory at the "Carlos G. Malbrán" Institute.

Carry out controlled studies aimed at clarifying the magnitude of person-to-person transmission in the Region.

Produce a pathogens panel for laboratory diagnosis and syndromic surveillance of respiratory distress.

Form a clinical definition for mild cases of HPS.

Inform health workers on the activities carried out for promoting the interests of the physician in the detection of emerging diseases.

To PAHO

Facilitate the shipment of samples and panels of sera controls among the countries and the regional reference laboratory at the "Carlos G. Malbrán Institute.

Strengthen the dissemination among health workers of syndromic algorithms, information on sample shipment, and its corresponding confirmation.

Resistance to Antibiotics

To the Countries

Carry out species-isolated surveillance in the community and for hospital infections, according to standards of quality control.

Analyze and periodically disseminate the results of that surveillance.

To PAHO

Strengthen the training of medical and laboratory staff on the above.

Discuss country surveillance activities on resistance to antibiotics at upcoming Network meetings.