ABSTRACT The Ebola virus is a pathogen that causes high morbidity and mortality in epidemic events during which health personnel are frequently infected. Such an epidemic occurred in West Africa, prompting WHO to issue a call in 2014 for health personnel to be dispatched to affected countries. Cuba responded and signed an assistance agreement under which 265 Cuban health professionals, members of the Henry Reeve Emergency Medical Contingent, volunteered their services in the Republic of Guinea, Sierra Leone and Liberia. This article presents Cuba’s strategy of medical aid and organization of the three medical teams formed; refers to the teams’ contribution to epidemic control in treatment centers where they worked alongside other personnel; and describes measures taken in Cuba to prevent the virus from entering the country through returning volunteers or other means. In the centers where Cuban medical teams worked with other health professionals in West Africa, case fatality decreased from 80%–90% to 24%, contributing to control of the epidemic; no Ebola outbreaks occurred in Cuba. During the epidemic, two Cuban health professionals died of malaria and one physician fell ill with Ebola. This paper includes an overview of the treatment and evolution of the latter case, a doctor who contracted the disease in Sierra Leone and was treated in Geneva and Havana.

Introduction: hemophilia is an inherited bleeding disorder; its incidence is almost constant in different populations. Since the 80th decade a multidisciplinary group for the care of patients with hemophilia was created at the Instituto de Hematología e Inmunología. Nowadays a national comprehensive care program allows patients to receive a continuous monitoring and an effective treatment. Objective: to know prevalence of patients with hemophilia in Cuba. Results: data of 229 patients from 5 provinces and the special municipality Isla de la Juventud were included, which covered 58,71% of the total patients registered in Cuba. The information included demographic data, severity of hemophilia, presence of inhibitors and infection status for viral diseases. Hemophilia A patients were 188 (82.10%) and 41 (17.90%) with hemophilia B. The disease was severe in 56.33 % of patients, moderate in 24 %, and mild in 19.70 %. Inhibitors were present in 17.03 % of the patients. Human immunodeficiency virus infection was present only in 0.87 % of patients and hepatitis C virus infection in 39.03 %. The mean age at diagnosis was 2.15 years. Conclusions: the general age-adjusted prevalence was 9.63 cases of hemophilia per 100 000 male and the main prevalence of patients was found in ages between 20 and 59 years.

Introducción:la hemofilia es una enfermedad hemorrágica con una incidencia casi constante para diferentes poblaciones. Desde la década del 80 del pasado siglo, en el Instituto de Hematología e Inmunología se creó un grupo multidisciplinario de especialistas para la atención del paciente con hemofilia. En la actualidad existe un programa nacional de atención integral al hemofílico que permite el monitoreo continuo y el tratamiento adecuado. Objetivo: conocerla prevalencia de la hemofilia en Cuba. Métodos:se incluyeron los datos de 229 pacientes procedentes de 5 provincias cubanas y el municipio especial Isla de la Juventud (según la división política-administrativa previa), que representan el 58,1 % de los pacientes registrados. Los datos incluyeron aspectos demográficos, gravedad de la enfermedad, presencia de inhibidores y de infecciones transmitidas por las transfusiones. Resultados: los pacientes con hemofilia A fueron 188 (82,10 %) y 41 (17,90 %) con hemofilia B. El 56,33 % de los pacientes presentaron la enfermedad en forma severa, 24 % moderada y 19,7 % leve. Los inhibidores se encontraron en el 17,03 % de los casos. La infección por el virus de inmunodeficiencia humana estuvo presente solamente e el 0,87 % de los pacientes, y la hepatitis C en el 39,03 %. La edad media al diagnóstico fue de 2.15 años. Conclusiones: la prevalencia general ajustada a la edad fue de 9,63 casos de hemofilia por 100 000 varones y la mayor prevalencia de pacientes se encontró en las edades entre 20 y 59 años.

INTRODUCTION: live attenuated oral Vibrio cholerae O1 El Tor, Ogawa strain 638 has demonstrated to be well tolerated and immunogenic when administrated orally in studies carried out in healthy volunteers. OBJECTIVE: to evaluate the protection against cholera infection in a challenge clinical trial, for the technological and pharmaceutical scale-up of this vaccinal candidate as active ingredient at industrial level. METHOD: a total of 21 healthy volunteers were involved in this trial; the vaccine candidate was administered to 12 of them and the remaining nine were given the placebo. Twenty eight days later, all of them received an infective dose of a V. cholerae virulent strain. RESULTS: diarrheas were observed in 7 out of 9 placebos whereas not a single vaccinated volunteer showed diarrheas. More frequent and intense loose stools were found in the placebo volunteers with O-blood group. All volunteers in he placebo group excreted V. cholerae, but only three (25%) out of the 12 vaccinated volunteers did so. CONCLUSION: in this challenge clinical trial model, the 638 strain proved to protect people against the diarrhea caused by a virulent V. cholerae strain.

INTRODUCCIÓN: la cepa atenuada 638 Vibrio cholerae O1 El Tor, Ogawa, ha demostrado ser bien tolerada e inmunogénica por vía oral en estudios realizados en voluntarios sanos. OBJETIVO: se evaluó la protección conferida contra el cólera, en un ensayo clínico de reto, para el escalado tecnológico y farmacéutico de este candidato vacunal como ingrediente activo a escala industrial. MÉTODOS: en el estudio participaron 21 voluntarios sanos, 12 de ellos recibieron el candidato vacunal, y 9 ingirieron un placebo; 28 d después, todos recibieron una dosis infectante de una cepa virulenta de V.cholerae. RESULTADOS: la diarrea se registró en 7 de los 9 placebos, mientras que ninguno de los voluntarios vacunados presentó diarrea. Los voluntarios placebos del grupo sanguíneo O, tuvieron diarreas con mayor frecuencia e intensidad. Todos los voluntarios en el grupo placebo excretaron V. cholerae mientras que solo 3 (25 %) de los 12 vacunados la excretaron. CONCLUSIONES: en este modelo de ensayo de reto, la cepa 638 demostró proteger contra la diarrea producida por una cepa virulenta de V. cholerae.

AIM: To assess the considerations for the implementation of a national system for taking and sending biological samples. DEVELOPMENT: We made a general assessment on the conditions existing in the country in relation to the transportation of biological samples, common practice among laboratories with different purposes, on the antecedents connected with the topic in the world and in Cuba, as well as on the present state of the sending of samples, and its characteristics in the national health system. CONCLUSIONS: The authors highlight the advantage of having an organized and functional national health system within the structure of the socialist State to achieve in a near future the implementation of a national system for taking and sending biological samples.

OBJETIVO: valorar consideraciones para la implementación de un sistema nacional de toma y envío de muestras biológicas. DESARROLLO: se hizo una valoración general sobre las condiciones existentes en el país relacionadas con la transportación de muestras biológicas, práctica común entre laboratorios con propósitos diversos, sobre los antecedentes relacionados con el tema en el mundo y en Cuba, así como sobre el estado actual del envío de muestras y sus características en el sistema nacional de salud. CONCLUSIONES: se destaca la ventaja que representa contar con un sistema nacional de salud organizado y funcional dentro de la estructura del Estado socialista, para lograr en un futuro no muy lejano la implementación de un sistema nacional de toma y envío de muestras biológicas.