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In Chile, the Immunization Department of the Ministry of Health has carried out the seasonal influenza vaccination campaign annually since 1982 in collaboration with the national health services, regional health offices, and primary health care centres. With the aim of preventing deaths and serious morbidity in high-risk groups and preserving the integrity of health services, the seasonal influenza campaign had been the largest implemented in Chile until 2020, since in 2021 the vaccination campaign against SARS-CoV-2 is expected to become the largest ever implemented. In response to local demographic and epidemiological changes, and taking into account the new scientific evidence on the safety and immunogenicity of vaccines, the influenza vaccines available in Chile would increase annually as a result of campaign planning. In 2020, the influenza campaign had to be re-planned while in progress due to the addition of new high-risk groups to be vaccinated in accordance with the SARS-CoV-2 pandemic health alert modification of March 6th, 2020. Over the course of three weeks, the Immunization Department managed to increase the doses of available influenza vaccines from 6,799,800 previously agreed upon to 8,480,325 and thus serve high-risk groups, guaranteeing their access to state funded influenza vaccination.

In this work, we present the maximum daily values of solar ultraviolet A radiation (UV-A) as a function of time. The results indicated that such values reached a maximum of 93.9 W/m 2 in 2010 and a minimum of 16.5 W/m 2 in 2012. The annual averages of both UV-A and solar ultraviolet B radiation (UV-B) from 2007 to 2013 were recorded. UV-A was always higher than UV-B. However, UV-B is more energetic due to its intrinsic wavelength. The nonmelanoma skin cancer mortality incidences per 100,000 inhabitants in Arica and in Chile as a function of time between 2007 and 2013 indicated that these mortality rates varied from 3.12 (Arica) to 0.88 (Chile) in 2007 and 2.71 (Arica) to 0.88 (Chile) in 2013. The nonmelanoma skin cancer prevalence rates per 100,000 inhabitants in Arica were 22.2 in 2007 and 19.5 in 2013. The relationship between NMSC and exposure to UV-A is given. In Arica, we report high levels of UV-A and the highest NMSC rates compared with other regions in our country., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Caligus rogercresseyi is the dominant sea louse parasite affecting the salmon and trout industry in southern Chile. This parasite has a wide range of native and endemic fish hosts. The Patagonian blenny Eleginops maclovinus, which is parasitized mostly by the caligid species Lepeophtheirus spp. and C. rogercresseyi, is presumably responsible for the transmission of C. rogercresseyi to salmonids. The aim of this study was to characterize the transmission of parasites between different fish species and parasite cohort development under laboratory conditions. Parasite abundances and intensities were quantified. Transmission of parasites from Patagonian blenny to Atlantic salmon Salmo salar was lower (~9%, mainly corresponding to C. rogercresseyi) than from salmon to Patagonian blenny (14.7-26.9%, where only C. rogercresseyi were observed). This suggests that the transmission of C. rogercresseyi from salmon individuals is higher than the transmission from a native fish. Parasite cohorts developed successfully on both fish species, but apparently under different developmental rates. Water temperature, oxygen, and juvenile abundances were the variables that better explained cohort development success and variation in C. rogercresseyi adult abundances over time.

Objective: To describe potential regional variations in therapies for severe asthma exacerbations in Chilean children and estimate the associated health expenditures., Methods: Observational prospective cohort study in 14 hospitals over a one-year period. Children five years of age or older were eligible for inclusion. Days with oxygen supply and pharmacological treatments received were recorded from the clinical chart. A basic asthma hospitalization basket was defined in order to estimate the average hospitalization cost for a single patient. Six months after discharge, new visits to the Emergency Room (ER), use of systemic corticosteroids and adherence to the controller treatment were evaluated., Results: 396 patients were enrolled. Patients from the public health system and from the north zone received significantly more days of oxygen, systemic corticosteroids and antibiotics. Great heterogeneity in antibiotic use among the participating hospitals was found, from 0 to 92.3% (ICC 0.34, 95% CI 0.16-0.52). The use of aminophylline, magnesium sulfate and ketamine varied from 0 to 36.4% between the different Pediatric Intensive Care Units (ICC 0.353, 95% CI 0.010-0.608). The average cost per inpatient was of $1910 USD. 290 patients (73.2%) completed the follow-up six months after discharge. 76 patients (26.2%) were not receiving any controller treatment and nearly a fourth had new ER visits and use of systemic corticosteroids due to new asthma exacerbations., Conclusions: Considerable practice variation in asthma exacerbations treatment was found among the participating hospitals, highlighting the poor outcome of many patients after hospital discharge, with an important health cost., (Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Asthma hospitalization rates in Chilean children have increased in the last 14 years, but little is known about the factors associated with this., Objective: Describe clinical characteristics of children hospitalized for asthma exacerbation., Methods: Observational prospective cohort study in 14 hospitals. Over a one-year period, children five years of age or older hospitalized with asthma exacerbation were eligible for inclusion. Parents completed an online questionnaire with questions on demographic information, about asthma, indoor environmental contaminant exposure, comorbidities and beliefs about disease and treatment. Disease control was assessed by the Asthma Control Test. Inhalation technique was observed using a checklist., Results: 396 patients were enrolled. 168 children did not have an established diagnosis of asthma. Only 188 used at least one controller treatment at the time of hospitalization. 208 parents said they believed their child had asthma only when they had an exacerbation and 97 correctly identified inhaled corticosteroids as anti-inflammatory treatment. 342 patients used the wrong spacer and 73 correctly performed all steps of the checklist., Conclusions: Almost half of the patients were not diagnosed with asthma at the time of hospitalization despite having a medical history suggestive of the disease. In the remaining patients with an established diagnosis of asthma potentially modifiable factors like bad adherence to treatment and poor inhalation technique were found. Implementing a nationwide asthma program including continued medical education for the correct diagnosis and follow up of these patients and asthma education for patients and caregivers is needed to reduce asthma hospitalization rates in Chilean children., (Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)

The increase in the amount of solar ultraviolet (UV) light that reaches the earth is considered to be responsible for the worldwide increase in skin cancer. It has been reported that excessive levels of UVA and UVB light have multiple effects, which can be harmful to humans. Experimental measurements were obtained using wide-band solar light YES biometers from 2006 to 2009 in Arica, Chile and from 2003 to 2006 in Valdivia, Chile, both instruments having been calibrated according to the World Health Organization (WHO) criteria and integrated into the Chilean Meteorological Organization network. To explain the possible effect of radiation on skin cancer, revised pathological reports in Arica and Valdivia were analyzed. In Arica, data on men and women were collected between 1997 and 1998-2002, and in Valdivia, between 1997-2000 and 2001-2007. In this study, comparative values of ultraviolet index (UVI) from the above datasets, were analyzed. Arica is a city located in the subtropical zone of northern Chile, 25 meters above sea level, with a latitude of 18˚49'S and a longitude of 70˚19'W. It has a microclimate characterized by stable meteorological conditions throughout the year, including low precipitation (<5 mm per decade), predictable winds, a high percentage of clear sky days and high ground reflectivity due to the presence of light sand. Due to its location near sea level, the population performs a great number of outdoor activities. Valdivia is a city located in the southern part of Chile, 19 meters above sea level with a latitude of 39˚38'S and a longitude of 73˚5'W. The aim of the present study was to determine the relationship between latitude and the risk of skin cancer in two cities with different latitudes. The incidence of skin cancer per 100,000 persons significantly (P<0.05) increased in both genders between the periods 1997-2000 and 2001-2007 in Arica. However, it decreased in men between the periods 1993-1997 and 1998-2002 in Valdivia. The results of this study indicate a steady increase in the incidence of skin cancer in Arica, most probably due to the high levels of UV light and the latitude to which individuals are exposed throughout the year, as well as the accumulative effect of this type of radiation on the skin. It can be concluded that Arica presented a greater UVI than Valdivia, which can explain the high prevalence of skin cancer in this population according to the pathological reports.

Enterohemorrhagic Escherichia coli (EHEC), have been associated with pathogenesis of hemolytic uremic syndrome (HUS) worldwide. Our aim was to determine the association of EHEC infection and HUS in Chilean children. During may 1991 and october 1993, 34 children with HUS and 33 age matched controls (children with diarrhea that did not develop HUS) were enrolled in a case/control study. For each child a stool and serum sample were obtained at admission. Stools were processed for common enteropathogens and for EHEC identification. EHEC were identified in stools by gene probes for different virulence factors (EHEC plasmid-associated fimbria, Shiga-like toxin I, Shiga-like toxin II and eae adherence factor) and by detection of free fecal toxin by a neutralization assay in Vero cells. Sera were processed for anti-cytotoxin antibodies also by an assay in Vero cells. Enteropathogens were isolated in 20.6% and 15.5% of HUS and control children respectively (p = NS). 91% of the HUS children and 73% of the control children were EHEC positive by one or more of the techniques used (p = 0.05). Of the three detection methods used for EHEC, only free fecal cytotoxin was significantly more common in HUS children than controls (45.5% vs 9% p = 0.007). Genotype patterns of HUS and controls strains were similar except for a trend towards a higher frequency of non-toxigenic strains in the control group. Serogroup O157 was more common in HUS children than in controls (9% vs 0% p = 0.036). In Chile as in other countries, EHEC infection is common and significantly associated with occurrence of HUS. Infection with EHEC strain O157 seems to be an important risk factor for HUS.