Browsing by Author "Perret Pérez, Cecilia"

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    A cluster randomized trial of interferon ß-1a for the reduction of transmission of SARS-Cov-2: protocol for the Containing Coronavirus Disease 19 trial (ConCorD-19)
    (2021) Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás
    Abstract Background SARS-CoV-2 infection rapidly spreads in populations due to the high rates of community transmission. Interrupting the shedding of SARS-CoV-2 may reduce the incidence of Coronavirus Disease 19 (COVID-19). Herein we provide a protocol for a cluster randomized trial that will examine the effectiveness of treatment with interferon (IFN) ß-1a compared to standard of care in limiting the transmission of SARS-CoV-2. Co-primary objectives are to determine whether IFN therapy reduces (a) the proportion of infected cases shedding SARS-CoV-2 at day 11 post randomization and (b) the incidence of transmission of SARS-CoV-2 infection from index cases to treatment-eligible household post-exposure contacts at day 11 after randomization. Secondary objectives include assessing the impact of IFN treatment on duration of viral clearance, hospitalizations and fatalities, and evaluating the safety of IFN treatment. Methods Three hundred and ten households, each including an index case with a recent COVID-19 diagnosis and at least one asymptomatic treatment-eligible household contact, will be randomized to receive 3 doses of 125 μg IFN ß-1a by subcutaneous administration (days 1, 6, and 11), or standard of care. All participants will be followed until day 29. Discussion The results from this trial will identify whether IFN ß treatment of mild or moderate COVID-19 cases accelerates viral clearance and prevents disease progression and whether IFN ß treatment of post-exposure contacts of COVID-19 cases reduces transmission of infection. Trial Registration: This trial is registered at ClinicalTrials.gov NCT04552379; date of registration September 17, 2020.
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    Aporte de la biología molecular en el diagnóstico de infecciones respiratorias agudas
    (2016) Budnik Ojeda, Isolda Cecilia; Ferres Garrido, Marcela Viviana; Pardo Tarrago, Trinidad; Edwards Tagle, Javiera; Labarca Trucios, Gonzalo Patricio; Reyes Zaldivar, Felipe Tomas; Martínez Valdebenito, Constanza Pamela; Montecinos Perret, Luisa Paola; Perret Pérez, Cecilia
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    Chikungunya, enfermedad emergente en América Latina. Descripción de los primeros casos en Chile
    (2018) Perret Pérez, Cecilia; Vizcaya Altamirano, María Cecilia; Weitzel, Thomas; Rosas, Reinaldo; Dabanch, Jeannette; Martínez, Constanza
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    Clinical and epidemiological characteristics of SARS-CoV-2 virus in ambulatory children under 2 years old
    (2022) Pérez, Carolina A.; Ormazábal, Ivana; Pérez Valenzuela, Javier; Araya del Pino, Andrea Paz; Medina, Rafael; Perret Pérez, Cecilia
    Background: SARS-CoV-2 is an emerging virus that has mainly affected adults; hence, most clinical information has been derived from that population. Most pediatric cases are mild and with nonspecific symptoms requiring outpatient management. Children are a major source of spread for most traditional respiratory viruses. Their role in SARS-CoV-2 transmission was thought to be relevant. Children under the age of two comprise a group that is more susceptible to infection since vaccines have not been approved for them until recently. The knowledge of clinical manifestation of COVID-19 in young children is scarce. Objectives: To describe the clinical, epidemiological, and demographic characteristics of children under 2 years old with confirmed COVID-19, who did not require hospitalization. Methods: This descriptive study was performed from May, 2020 to June, 2021. Children ages 0-2 years with COVID-19, confirmed by transcriptase-polymerase chain reaction assay that were performed in laboratories of the Red de Salud UC CHRISTUS Health Network, were selected to be contacted. If the parents accepted participating and their children were not hospitalized, a survey was sent to the patients' caregivers. Results: Of the 242 cases, 159 caregivers answered the survey (65.7%). The median age of the subjects was 14 months, and 53.5% were males. Fifty percent had comorbidities, of which one third corresponded to atopy. Ninety eight percent were secondary cases. Most of them were infected within their households (81%). The most frequent sources were their parents, followed by their grandparents. The most common symptom was fever (78%) followed by irritability (67.3%), rhinorrhea (66%), and fatigue (64.8%). Infants less than 6 months old more often presented with conjunctival congestion and less loss of appetite compared to older children (p < 0.05). Conclusions: This study provides valuable insights regarding COVID-19 in ambulatory young children. Most cases of SARS-CoV-2 infection in children under 2 years old do not require hospitalization. There was a slight male predominance, and the majority had been infected within their households. SARS-CoV-2 infection should be suspected in children under 2 years old presenting with fever, irritability, fatigue, and rhinorrhea. Children with positive household contacts and fever should also be tested for COVID-19.
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    Cluster of imported vivax malaria in travelers returning from Peru
    (2015) Weitzel, Thomas; Labarca L., Jaime; Cortes, Claudia P.; Rosas, Reinaldo; Balcells Marty, María Elvira; Perret Pérez, Cecilia
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    Different Safety Pattern of an Inactivated SARS-CoV-2 Vaccine (CoronaVac®) According to Age Group in a Pediatric Population from 3 to 17 Years Old, in an Open-Label Study in Chile
    (2023) Le Corre, Nicole; Abarca Villaseca, Katia; Astudillo, Patricio André; Potin Santander, Marcela Patricia; López, Sofía; Goldsack, Macarena; Valenzuela Guerrero, Vania; Schilling Redlich, Andrea; Gaete, Victoria; Rubio, Lilian; Calvo, Mario; Twele, Loreto; González, Marcela; Fuentes, Daniela; Gutiérrez Muñoz, Valentina José; Reyes Zaldivar, Felipe Tomás; Tapia, Lorena I.; Villena, Rodolfo; Retamal Díaz, Angello; Cárdenas, Antonio; Alarcón Bustamante, Eduardo; Xin, Qianqian; González Aramundiz, José Vicente; Álvarez Figueroa, María Javiera; González Muñoz, Pablo Alberto; Bueno Ramírez, Susan; Soto Ramírez, Jorge Andrés; Perret Pérez, Cecilia; Meng, Xing; Kalergis Parra, Alexis Mikes
    During the COVID-19 pandemic, the importance of vaccinating children against SARS-CoV-2 was rapidly established. This study describes the safety of CoronaVac® in children and adolescents between 3- and 17-years-old in a multicenter study in Chile with two vaccine doses in a 4-week interval. For all participants, immediate adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were registered throughout the study. In the safety subgroup, AEs were recorded 28 days after each dose. COVID-19 surveillance was performed throughout the study. A total of 1139 individuals received the first and 1102 the second dose of CoronaVac®; 835 were in the safety subgroup. The first dose showed the highest number of AEs: up to 22.2% of participants reported any local and 17.1% systemic AE. AEs were more frequent in adolescents after the first dose, were transient, and mainly mild. Pain at the inoculation site was the most frequent AE for all ages. Fever was the most frequent systemic AE for 3–5 years old and headache in 6–17 years old. No SAEs or AESIs related to vaccination occurred. Most of the COVID-19 cases were mild and managed as outpatients. CoronaVac® was safe and well tolerated in children and adolescents, with different safety patterns according to age.
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    Disseminated and fatal adenovirus infection in an immunocompromised child,Infección diseminada por adenovirus de curso fatal en un niño inmunocomprometido
    (2008) Abarca Villaseca, K.; Le Corre P., N.; Perret Pérez, Cecilia; Wietstruck P., A.; Oddó B., D.; Barriga C., F.
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    Emergent Pneumonia in Children
    (2021) Perret Pérez, Cecilia; Le Corre Pérez, Monique Nicole; Castro Rodríguez, Jose A.
    In recent decades there have been multiple pathogens, viruses and bacteria, which have emerged as causal agents of pneumonia affecting adults, albeit less frequently, to children. For the purposes of this article we have classified emerging pathogens as follows: True emerging, to pathogens identified for the very first time affecting human population (SARS-CoV-1, SARS-CoV-2, MERS-CoV, avian influenza, and hantavirus); Re-emerging, to known pathogens which circulation was controlled once, but they have reappeared (measles, tuberculosis, antimicrobial resistant bacteria such as CA-MRSA, Mycoplasma pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and new serotypes of post-vaccine pneumococcal); and finally, those that we have called old known with new presentations, including common pathogens that, in particular condition, have changed their form of presentation (rhinovirus, and non-SARS coronavirus). We will review for each of them their epidemiology, forms of presentation, therapy, and prognosis in children compared to the adult with the aim of being able to recognize them to establish appropriate therapy, prognostics, and effective control measures.
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    Emerging infections in children
    (2023) Perret Pérez, Cecilia
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    ¿En qué consiste la infección humana por virus Zika?
    (2016) Acuña, L. G.; Perret Pérez, Cecilia
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    Endocarditis por Streptococcus pneumoniae en niños. Presentación de un caso clínico y revisión de la literatura
    (2005) Le Corre Pérez, Monique Nicole; Viviani Salgado, Tamara Nieves; Perret Pérez, Cecilia; Prado Sanhueza, Maria Alejandra
    La endocarditis causada por Streptococcus pneumoniae es una patología muy poco frecuente en niños, correspondiendo sólo a 3 - 7% de los casos. Sin embargo, su importancia radica en que se puede presentar de forma muy agresiva, con complicaciones como destrucción valvular y abscesos, y con una mortalidad reportada hasta 61%, de no mediar tratamiento antimicrobiano precoz y muchas veces cardiocirugía. En más del 50% se puede asociar a otros focos infecciosos, como meningitis, neumonía, sinusitis o mastoiditis. Se describe el caso de una lactante de 10 meses que presentó una meningitis asociada a endocarditis debidas a S. pneumoniae, con grave compromiso cardíaco, y que requirió reemplazo valvular. Se realizó una revisión de la literatura médica acerca de endocarditis por S. pneumoniae en niños.
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    Evidencia seroepidemiológica de exposición humana a Anaplasma sp en Santiago, Chile
    (2008) Abarca Villaseca, Katia; López del P., Javier; González A.,Patricia; Dabanch P., Jeannette; Torres Hidalgo, Marisa; Solari G., Verónica; Perret Pérez, Cecilia
    Objetivos y Método: Con el propósito de buscar mayor evidencia de exposición humana a Anaplasma sp en Chile, se estudiaron 108 personas en contacto con perros con ehrlichiosis canina (EC) (grupo de riesgo) y 61 personas sin antecedente de contacto con garrapatas ni con perros con EC (grupo control). Se aplicó encuesta sobre factores de riesgo e historia de cuadros sugerentes de ehrlichiosis/anaplasmosis al grupo de riesgo. En ambos grupos se determinó presencia de IgG anti-Anaplasma sp. Resultados: Se encontró significativa mayor prevalencia de anticuerpos anti-Anaplasma sp en el grupo de riesgo que en el grupo control (18,5 versus 3,3%), p < 0,005. No se encontraron factores de riesgo asociados a sero-positividad, ni personas con historia sugerente de ehrlichiosis/anaplasmosis clínica. Noventa y cuatro por ciento de las viviendas del grupo de riesgo presentaba infestación por garrapatas. Discusión: Se evidencia mayor riesgo de exposición humana a Anaplasma sp en personas en contacto cercano con perros con EC y que habitan viviendas con infestación por garrapatas.
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    GeoSentinel Surveillance of Illness in Returned Travelers 2007-2011
    (2013) Leder, Karin; Torresi, Joseph; Libman, Michael; Cramer, Jakob; Castelli, Francesco; Schlangenhaus, Patricia; Wilder Smith, Annelies; Wilson, Mary E.; Keystone, Jay S.; Perret Pérez, Cecilia; Schwartz, Eli; Barnett, Elizabeth; Von Sonnenburg, Frank; Brownstein, John S.; Cheng, Allen C.; Sotir, Mark J.; Esposito, Douglas; Freedman, David O.; GeoSentinel Surveillance Network
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    Human metapneumovirus as hospitalization cause in children under 3 years old with acute respiratory infections during 2004
    (2007) Prado Sanhueza, Maria Alejandra; Perret Pérez, Cecilia; Montecinos Perret, Luisa Paola; Veloz B., A.; Le Corre Pérez, Monique Nicole; Habash A., L.; Potin Santander, Marcela Patricia; Abarca Villaseca, Katia; Ferres Garrido, Marcela Viviana
    Metapneumovirus humano (MPVh) fue detectado entre julio y noviembre en 15 de 123 niños bajo 3 años de edad hospitalizados por infección respiratoria aguda (12%). Las muestras fueron estudiadas mediante técnicas de biología molecular (RPC-TR de muestra de hisopado nasofaríngeo y/o de sobrenadante de cultivo). El 67% de los niños hospitalizados con MPVh tenían menos de 1 año de edad, todos ellos presentaron tos y fiebre y el principal motivo de hospitalización fue el requerimiento de oxígeno en 73% de los casos. Si bien un tercio de los pacientes tenía patología previa, su evolución clínica no fue diferente respecto de los niños previamente sanos. El patrón radiológico mostró aumento de la trama intersticial, con focos de consolidación en 6 casos (40%). El diagnóstico más frecuente fue síndrome bronquial obstructivo o bronquiolitis, asociado o no a neumonía. Destaca la necesidad de un método de diagnóstico rápido para optimizar el diagnóstico diferencial, manejo y control de infecciones en estos pacientes.
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    Immune responses during COVID-19 breakthrough cases in vaccinated children and adolescents
    (Frontiers Media SA, 2024) Rivera Pérez, Daniela; Méndez Vejar, Constanza Soledad; Diethelm Varela, Benjamín Manuel; Melo González, Felipe Andrés; Vázquez Hernández, Yaneisi; Meng, Xing; Xin, Qianqian; Fasce, Rodrigo A.; Fernández, Jorge; Mora, Judith; Ramírez, Eugenio; Acevedo, Mónica L.; Valiente Echeverria, Fernando; Soto Rifo, Ricardo; Grifoni, Alba; Weiskopf, Daniela; Sette, Alessandro; Astudillo Paredes, Patricio Andrés; Le Corre Pérez, Monique Nicole; Abarca Villaseca, Katia; Perret Pérez, Cecilia; González Muñoz, Pablo Alberto; Soto Ramírez, Jorge Andrés; Bueno Ramírez, Susan; Kalergis, Alexis M.
    Background: Vaccine effectiveness against SARS-CoV-2 infection has been somewhat limited due to the widespread dissemination of the Omicron variant, its subvariants, and the immune response dynamics of the naturally infected with the virus. Methods: Twelve subjects between 3-17 years old (yo), vaccinated with two doses of CoronaVac®, were followed and diagnosed as breakthrough cases starting 14 days after receiving the second dose. Total IgGs against different SARS-CoV-2 proteins and the neutralizing capacity of these antibodies after infection were measured in plasma. The activation of CD4+ and CD8+ T cells was evaluated in peripheral blood mononuclear cells stimulated with peptides derived from the proteins from the wild-type (WT) virus and Omicron subvariants by flow cytometry, as well as different cytokines secretion by a Multiplex assay. Results: 2 to 8 weeks post-infection, compared to 4 weeks after 2nd dose of vaccine, there was a 146.5-fold increase in neutralizing antibody titers against Omicron and a 38.7-fold increase against WT SARS-CoV-2. Subjects showed an increase in total IgG levels against the S1, N, M, and NSP8 proteins of the WT virus. Activated CD4+ T cells showed a significant increase in response to the BA.2 subvariant (p<0.001). Finally, the secretion of IL-2 and IFN-γ cytokines showed a discreet decrease trend after infection in some subjects. Conclusion: SARS-CoV-2 infection in the pediatric population vaccinated with an inactivated SARS-CoV-2 vaccine produced an increase in neutralizing antibodies against Omicron and increased specific IgG antibodies for different SARS-CoV-2 proteins. CD4+ T cell activation was also increased, suggesting a conserved cellular response against the Omicron subvariants, whereas Th1-type cytokine secretion tended to decrease. Clinical Trial Registration: clinicaltrials.gov #NCT04992260
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    Immunogenicity, safety, and interchangeability of two inactivated hepatitis A vaccines in Chilean children
    (2008) Abarca, K.; Ibánez, I.; Perret Pérez, Cecilia; Vial, P.; Zinsou, J. A.
    Objectives: To compare the immunogenicity, safety, and interchangeability of two pediatric hepatitis A vaccines, Avaxim 80U-Pediatric® and Havrix 720®, in Chilean children. Methods: In this randomized trial, 332 hepatitis A virus (HAV) seronegative children from 1 to 15 years of age received two doses of Avaxim, two doses of Havrix, or Havrix followed by Avaxim, 6 months apart. Anti-HAV antibody titers were measured before and 14 days after the first dose of vaccine, and before and 28 days after the second dose of vaccine. Immediate reactions were monitored; reactogenicity was evaluated from parental reports. Results: Seroconversion rates after the first vaccination were 99.4% and 100% for Avaxim and Havrix, respectively. Anti-HAV geometric mean concentrations (GMCs) were 138 mIU/ml for Havrix (95% confidence interval (CI): 120; 159) and 311 mIU/ml for Avaxim (95% CI: 274; 353). GMCs increased to 4008 mIU/ml after two doses of Havrix, 8537 mIU/ml following two doses of Avaxim, and 7144 mIU/ml in children who received Havrix with Avaxim as the second dose. Following the first injection, 36% of subjects given Avaxim and 44% given Havrix reported local reactions; 38% of subjects in the Avaxim group and 40% in the Havrix group reported systemic reactions related to vaccination. Solicited reactions were less frequent after the second dose of Avaxim or Havrix, occurring in 27% to 37% of subjects. Conclusions: No significant difference in seroconversion rates was seen 14 days after a single dose of vaccine. A two-dose schedule with either vaccine or with Havrix/Avaxim provided a strong booster response. Both vaccines were well tolerated and can be recommended for routine vaccination of Chilean children. Avaxim 80 may be used to complete a vaccine schedule begun with Havrix 720. © 2007 International Society for Infectious Diseases.
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    Infección atípica y neurorretinitis por Bartonella henselae en una unidad de hospitalización pediátrica: comunicación de tres casos
    (2020) Pérez Pérez, Regina Elizabeth; Fischman, Alexandra; Poblete, María José; Vizcaya Altamirano, María Cecilia; Perret Pérez, Cecilia; García, Cristián; Muñoz, Aldo; Le Corre Pérez, Monique Nicol
    Bartonella henselae es el agente etiológico de la enfermedad por arañazo de gato (EAG), infección endémica en Chile. Típicamente se presenta como una linfadenopatía regional autolimitada y menos frecuentemente con compromiso sistémico y manifestaciones extraganglionares: en hígado, bazo, hueso, ojo, entre otros. Se presentan tres casos de infección atípica por Bartonella henselae en las que se evidenció compromiso ocular, manifestado como una neurorretinitis. Esta revisión destaca la importancia de la búsqueda activa de complicaciones oculares en pacientes con compromiso sistémico por Bartonella henselae, implicando un cambio en el tratamiento y pronóstico de la enfermedad.
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    Infecciones en viajeros internacionales
    (2014) Perret Pérez, Cecilia
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    Influenza Aviar y Riesgo de Pandemia
    (2008) Perret Pérez, Cecilia; Dabanch P., Jeanette
    Influenza es una enfermedad común que se presenta en Chile en forma estacional. Ocasionalmente ocurren pandemias las que se generan cuando aparece un nuevo subtipo de virus influenza A en la humanidad producto de la recombinación de genomas de virus de influenza humano con virus de influenza de otras especies. En los últimos años la humanidad se encuentra en una situación de alerta de una nueva pandemia dada la existencia de la más grande epizootia por influenza A, subtipo H5N1 en aves que se extiende desde el Sudeste Asiático a Europa Oriental, Occidental y África. Se han documentado casos esporádicos en humanos por contacto cercano con aves infectadas. El presente artículo revisa las características virológicas del virus de influenza A, la situación actual de la epizootia por H5N1, las características de esta infección en humanos y el estado de preparación que se encuentra Chile frente a una eventual pandemia.