Postcard from Latin America #2

More from Dr. Wenzel as he visits several countries in Latin America:

Had dinner with former fellows- Claudio Pannuti and Sergio Wey- and their colleagues in Brazil. There is an upsurge in influenza thought to correlate with vacationers returning from Argentina and Chile. Pregnancy is the risk factor for severity of illness in cases that they have seen. What is unusual is how the government is managing the outbreak. Ill patients with ILI can be screened in this megacity of approximately 15 million by law only at 7 hospital ERs. The screen is with an immunoblot with a sensitivity of 70 percent. If and only if a patient with a positive screen also has some defined high risk elements will oseltamivir be given. A confirmatory PCR test is then done and sent to a single lab. The results of the PCR are available only after 10 or more days. The important point is that ID specialists cannot write a prescription for oseltamivir or screen for flu; this is controlled by law by the physicians at the 7 EDs.