Detection and diversity of gastrointestinal viruses in wastewater from Caracas, Venezuela, 2021-2022

Gastrointestinal viruses (GIV) are an important cause of childhood morbidity and mortality, particularly in developing countries. Their epidemiological impact in Venezuela during the COVID-19 pandemic remains unclear. GIV can also be detected in domestic sewage. Ninety-one wastewater samples from urban areas of Caracas collected over 12 months and concentrated by polyethylene-glycol-precipitation, were analyzed by multiplex reverse-transcription-PCR for rotavirus/calicivirus/astrovirus and enterovirus/klassevirus/cosavirus, and monoplex-PCR for adenovirus and Aichi virus. The overall frequency of virus detection was 46.2%, fluctuating over months, and peaking in the rainy season. Adenoviruses circulated throughout the year, especially type F41, and predominated (52.7%) over caliciviruses (29.1%) that peaked in the rainy months, rotaviruses (9.1%), cosaviruses (5.5%), astroviruses and enteroviruses (1.8%). Aichi-virus and klassevirus were absent. Rotavirus G9/G12, and P[4]/P[8]/P[14] predominated. The occurrence of GIV in wastewater reflects transmission within the population of Caracas and the persistence of a potential public health risk that needs to be adequately monitored.

[Severity evaluation of ventilated patients at a respiratory intensive care unit with the APACHE II system]

APACHE II system, is a simple and inexpensive method to evaluate severity of Intensive Care Patients. In a 2 years period (between 1988 and 1990), grading severity using APACHE II system, was performed on 498 consecutive mechanical Ventilated Patients in a Respiratory Intensive Care Unit. APACHE II was higher in COPD patients, but patients with Pneumonia and Organophosphate Poisoning had higher mortality. Correlating the different components of APACHE II with the results, we verified that Prognosis was not influenced by the Previous Health Status. Mortality was higher with increasing age, in patients with COPD and Organophosphate Poisoning. APS was the most important index for prognosis. Patients with Pneumonia and Organophosphate Poisoning had the highest APS. The Authors conclude that APACHE II is an objective and not time consuming method to evaluate severity in ICU Patients. However indexes measured on the first 24 hours of ICU staying are a result of severity of illness, treatment performed and time elapsed before ICU admission, and, this may be a possible source of bias when comparing different Unit results.