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INS refuerza vigilancia ante incremento de casos en enfermedad de mano, pies y boca en Colombia
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El Instituto Nacional de Salud (INS) informó sobre un incremento de casos de la enfermedad manos, pies y boca (EMPB) en varios departamentos de Colombia, especialmente en población infantil. La entidad descartó cualquier relación con sarampión y anunció medidas de aislamiento y limpieza en instituciones educativas, alineadas con las recomendaciones de la OPS, para contener la propagación del virus.
Origen y características de la EMPB
La enfermedad manos, pies y boca (EMPB) es una infección viral frecuente, principalmente en niños menores de cinco años, aunque puede presentarse en adolescentes y adultos. Está causada por enterovirus, siendo los más comunes el Coxsackievirus A16 y, con menor frecuencia, el Enterovirus A71, este último asociado a complicaciones del sistema nervioso central en contextos de brotes severos.
Clínicamente, se manifiesta con fiebre breve, erupciones papulovesiculares en palmas y plantas, y úlceras dolorosas en la cavidad oral, que suelen cicatrizar de forma espontánea entre 3 y 5 días tras el inicio de los síntomas.
La transmisión es predominantemente por contacto directo con secreciones respiratorias, vesiculares y fecales, así como por fomites contaminados, con alta contagiosidad durante la primera semana de la enfermedad.
Distribución geográfica y cifras clave
Desde finales de mayo de 2025 se ha observado un repunte de la EMPB en varias regiones:
- Valle del Cauca: En municipios como Yumbo y Tuluá se han reportado más de 170 casos positivos en instituciones educativas, lo que motivó cierres temporales de aulas y jornadas de desinfección intensivas. En Cali, la Secretaría de Salud Distrito confirmó 32 casos en menores en un periodo reciente, atribuible a una vigilancia epidemiológica más rigurosa.
- Caldas: La Dirección Territorial de Salud reportó 390 casos acumulados a la semana epidemiológica 20 (11 de mayo de 2025), con concentración del 60 % de los casos en Manizales (226), seguido por Viterbo (65), San José (32) y Villamaría (27).
- Otras regiones: El INS confirmó un incremento en varios departamentos sin precisar cifras totales, pero aseguró que la situación está siendo monitoreada de manera constante.
Estos datos reflejan un comportamiento estacional que, aunque habitual en climas tropicales, ha superado los niveles registrados en años anteriores, lo que ha llevado a reforzar la vigilancia en guarderías, colegios y hogares con niños pequeños.
Medidas de control y recomendaciones
Frente a este aumento, el INS y las entidades territoriales han adoptado las siguientes acciones, en concordancia con las directrices de la Organización Panamericana de la Salud (OPS) emitidas el 26 de marzo de 2025:
- Aislamiento preventivo: Separación de casos sospechosos y confirmados por al menos 7 días o hasta la resolución de síntomas, para evitar la cadena de transmisión.
- Jornadas de limpieza y desinfección: Empleo de soluciones de hipoclorito de sodio (1:20) con un tiempo de contacto mínimo de 5 minutos en superficies, juguetes y baños de instituciones educativas.
- Higiene rigurosa de manos: Promoción del lavado frecuente con agua y jabón y uso de guantes y mascarilla en la atención de secreciones y lesiones cutáneas.
- Comunicación de riesgos: Campañas educativas dirigidas a padres, cuidadores y docentes para identificar signos de alarma (vómitos persistentes, somnolencia, rechazo al alimento y deshidratación) y consultar oportunamente al servicio de salud.
El INS también recomendó mantener a los niños afectados en sus hogares hasta la desaparición total de los síntomas y reforzar la ventilación natural en salones de clase, así como la supervisión de reportes semanales de casos según boletines epidemiológicos locales.
Retos y perspectivas de vigilancia epidemiológica
A pesar de las medidas implementadas, la EMPB no es enfermedad de notificación obligatoria en todos los países, lo que limita la detección temprana de brotes y el análisis comparativo interanual.
En Colombia, el INS considera evaluar la inclusión de la EMPB en el sistema de notificación obligatoria (Sivigila) y fortalecer la vigilancia sindrómica en centros de cuidado infantil. Asimismo, la diversidad de serotipos de enterovirus y la reactividad cruzada en pruebas serológicas dificultan la tipificación precisa, por lo que se promueven métodos de RT-PCR en laboratorios de referencia nacional.
Mirando hacia adelante, la coordinación entre el INS, las secretarías de salud departamentales y municipales, y el sector educativo será clave para consolidar protocolos de respuesta rápida y estandarizar la comunicación de datos, garantizando así una mejor respuesta ante futuros repuntes de la EMPB.
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