#16,978
We've more details - posted on the Tucumán MOH website within the past hour - on the outbreak of an unidentified pneumonia at a hospital in San Miguel de Tucumán (see my earlier report: Argentine MOH Statement On Investigation Into A Hospital Outbreak Of A Pneumonia Outbreak of Unknown Origin).
As alluded to in earlier press accounts, the MOH confirms a 3rd death and 3 additional `suspected' cases.
According to this report, tests for COVID, Legionella, and Hantavirus (see 2019's WHO Update & Risk Assessment: Hantavirus Pulmonary Syndrome – Argentine Republic) have come back negative.
(translated)
PUBLIC HEALTH September 1, 2022
The Ministry of Public Health reported on the health situation of the bilateral pneumonia outbreak
In a new press conference, the head of the Health Portfolio, Dr. Luis Medina Ruiz, reported the death of a 70-year-old patient and the identification of 3 employees of the sanatorium experiencing the same outbreak.
In this regard, the minister announced: “The sanatorium informed us of the death of a 70-year-old patient who was hospitalized there, we needed the family to know first to be able to communicate it. In addition, we identified 3 more employees of the private agent who began with symptoms around August 20 to 23 (that is, they correspond to the same outbreak and place of contagion in principle). That is why at this moment 3 more people are added to the 6 initial patients”.
Regarding the 70-year-old patient who died on that date, the minister stated: “She was hospitalized and underwent surgery for a gallbladder problem. She was re-operated twice. From then on, an infectious pulmonary disease took place, the date of which coincides with the onset of symptoms in the other patients, around August 20. Although it is not yet clear which came first, at first she was considered patient zero, but she is under study based on the deepening of the analyzes that are being carried out”.
At the same time he added: “We reported on the 3 identified employees, one of them is a 40-year-old pharmacy assistant and has been hospitalized a few days ago in a public hospital with a fever. In the active search that we are carrying out, especially in health personnel, we detected that it is a person who has non-severe bilateral pneumonia with an oxygen requirement under study. The other person is a 44-year-old nurse, she is at her home and we are following her evolution, since her clinic does not warrant hospitalization. The third case is a 30-year-old nurse with comorbidities, who was recently admitted to hospital this morning, symptoms began around the same days and on the date he was present to be evaluated, at which time we decided to hospitalize him.
Following this line, the official explained that these three people have bilateral pneumonia as a clinical characteristic and in common the origin of the focus, the epidemiological link with the 6 initial patients. The criterion of incorporating them as suspected patients to the outbreak in principle is based on the employment relationship with the sanatorium, bilateral pneumonia and that with all the study panels its etiology has not yet been found.
“Last night and this morning we had information from the Malbrán Institute and so far all the studies that we had as negative -for Covid, Hantavirus and some strains of Legionella- are also giving negative results there. We continue to carry out the research protocol for blood cultures, sputum cultures, urine cultures and all the viruses and bacteria that we have available in the province. We are in direct communication with Minister Carla Vizzotti, who is available, as well as all the epidemiology and infectology teams of the Nation, we are working as a large medical board in which we all participate with the information we have, there are hypotheses of the etiology that are being put on the table, although what we have specifically is the common origin and evolution of the disease, "he added.In the same way Medina Ruiz stressed that Sanitary Control is doing an exhaustive analysis in the sanatorium and so far nothing has been found that gives suspicion of being the origin of the problem.
“We are all on alert about this issue, that is why it is essential to inform ourselves through official means, we are issuing communications to the guards and public and private intensive therapies, due to the possible appearance of a patient who has these characteristics, especially to make an adequate diagnosis. with all the necessary protocols and PPE, as recommended with all patients with respiratory conditions. If the patient had a work history from the private sanatorium, they should receive a different protocol regarding the taking of samples before starting the antibiotic scheme, so that the bacteria or germ that is causing this health problem can eventually be found” he warned.
And he continued: “We are still in the middle of the days determined for the restriction of the clinic, whether it is extended or not will depend on the epidemic situation and whether new cases appear. Isolation is complied with and from the Ministry we issue recommendations from the first moment, which are still in force, we are still in the midst of a pandemic, we continue to have patients with respiratory symptoms and what is usually done when a patient is hospitalized is to investigate it , Covid, flu etiology is ruled out, based on that it is determined where the patient is hospitalized and in these cases there is a third differential isolation, with a differential human resource ”.Continuing Medina Ruiz explained that all possible etiologies are being evaluated and even capturing DNA samples to eventually make a genomic identification of any virus or viral particle that can be found. At the toxicological level, in addition, samples are being studied since they do not want to leave any hypothesis out.
“Our teams are going to the clinic offering support to do an examination of the patients identified according to the pathology and treatment. Although the private clinic has its autonomy and responsibility carried out by its management, we have offered to support it with resources and advice, ”he explained.
Likewise, the official emphasized that there is no patient who has an epidemiological link with the sick. In any case, he advises the population to continue with the care. “The most important thing is that if someone had a working relationship during those days with these patients and presents any symptoms, they present themselves at our on-call services and report it. This situation is unpredictable, in principle more than eleven days have passed, each patient has a different evolution, for example, one of them presents a bilateral pneumonia with an important compromise from the tomographic point of view, but we have to wait for the evolution that it is a disease whose origin is still unknown, therefore, the evolution is also unpredictable”, he stated.
“Regarding the close contact group, the personnel who were sharing work space, which were around twenty people, are being closely followed. In principle, all patients have some type of comorbidity, such as smoking, COPD, a history of respiratory symptoms, obesity, diabetes, and high blood pressure. We do not leave any hypotheses closed, we have more than thirty possible germs with the ability to detect them and they are giving negative results, but we must also take into account that many times there may be a previous intake of antibiotics that can hide the etiology, "he said.It should be noted that first a meeting was held in the Ministry's office with the committee of experts and managers, infectologists and epidemiologists from the Centro de Salud, Eva Perón and Ángel C. Padilla hospitals. “The committee of experts with whom we are working and concluding that it is an outbreak that has to do with the sanatorium, that in one or two moments he was exposed to the germ or bacteria, and that from that the infections began since after the first exposure around August 20, there were no new infections either in the family or with work contacts,” he concluded.
The Medical Executive Secretary of Siprosa, Dr. Miguel Ferre Contreras , the Director of Health Management, Dr. Alejandra Mattiacci , the Director of Epidemiology of the Provincial Health System, Dr. Rogelio Calli , were present .
