Posted by: calloftheandes | January 14, 2011

Hospitals Mount Effort to Confront Ecuador Flu Epidemic

A flu outbreak in Ecuador’s highlands and coastal region is taxing capacities at hospitals, including the HCJB Global Hands health facility in the nation’s capital, Quito. The Health Ministry’s National Director of Epidemiology, Juan Moreira, reported that of 900 tests of respiratory patients, 61 showed positive for H1N1 strain of influenza A. H1N1 is the influenza strain that reached global pandemic proportion in 2009.

“The first cases (in December) showed in a ‘rapid test’ as positive for Influenza A,” said Dr. Richard Douce, an infectious diseases specialist. Douce serves as the medical director at Hospital Vozandes Quito (HVQ).

Negative pressure isolation exam rooms. Surgical masks are also part of the Hospital Vozandes emergency room procedures.

He said that tests at Ecuador’s national laboratory, Izquieta Pérez, also revealed influenza A, but not H1N1. Then on Tuesday, January 11, HVQ received confirmation that HVQ had in fact treated one case of pandemic H1N1. Douce believes the predominant strain of influenza shifted to H1N1 in the third week of December.

“The hospital has been full, with no available beds for the last three weeks and lots of action in the intensive care unit,” Douce summarized, “I understand that for some weeks, beds have not been available in any intensive care units in Quito and we have had to turn patients away from our emergency room due to no available beds.”

Three people have died of proven influenza A, while another 12 have died with a clinical syndrome suggestive of influenza, but without laboratory confirmation. Under a triage system, patients suspected of influenza are issued masks or confined to a negative pressure isolation chamber to curtail transmission of flu in the HVQ emergency room.

Hospital Vozandes-Quito continues to serve as a sentinel site in Ecuador for the detection of the H1N1 virus as well as other emerging strains of influenza. During the last several years this surveillance has confirmed both H1N1 and an influenza A sub-type H3N2 at HVQ. The data collection is done in collaboration with the U.S. Navy Tropical Disease Research Laboratory in Lima, Peru, during the last several years. “So surely we have H1N1 circulating now,” Douce said. As many as four different flu viruses may be circulating simultaneously.

A Quito newspaper, El Comercio, reported earlier this week that the Hospital Enrique Garcés in south Quito, has indeed treated five patients for influenza A (H1N1), the pandemic strain of mid 2009. Hospital staff at that state-run facility are testing as many as 120 patients per day for influenza. Director Marco Ochoa said his staff have isolated a 14-bed area for those who require hospitalization.

Dr. Richard Douce

Douce said that several neighborhood clinics operated by Hospital Vozandes are also swamped with flu cases. Staff at Clinica La Y were vaccinating 200 patients per day against influenza until the vaccine supply ran out. In fact, Douce asserted, vaccine in the capital city may have dried up. “I was awaiting another supply of flu vaccine just this morning, but I´m not certain that it arrived,” he said.

In the midst of Ecuador’s flu epidemic, President Rafael Correa declared a healthcare state of emergency and allocated an additional $400 million dollars to the $1.2 billion dollar Health Ministry budget. In a regular Saturday broadcast, the president did not point to the epidemic as factoring into the appropriation, but pointed to increased use of government health centers after out-patient visits were made free. In this country of 12 million inhabitants, 30 million out-patient visits were done in 2010, according to Correa. His administration has since announced plans to strengthen the infrastructure by intervention in 32 of the country’s 127 state-run hospitals. The state of emergency is to last 60 days.

Sources: HCJB Global, EFE, El Comercio, El Telégrafo



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