RESUMO
During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.
Assuntos
Mpox , Surtos de Doenças , Humanos , Mpox/epidemiologia , Monkeypox virus , Espanha/epidemiologiaRESUMO
BACKGROUND: In 2021-2022, influenza A viruses dominated in Europe. The I-MOVE primary care network conducted a multicentre test-negative study to measure influenza vaccine effectiveness (VE). METHODS: Primary care practitioners collected information on patients presenting with acute respiratory infection. Cases were influenza A(H3N2) or A(H1N1)pdm09 RT-PCR positive, and controls were influenza virus negative. We calculated VE using logistic regression, adjusting for study site, age, sex, onset date, and presence of chronic conditions. RESULTS: Between week 40 2021 and week 20 2022, we included over 11 000 patients of whom 253 and 1595 were positive for influenza A(H1N1)pdm09 and A(H3N2), respectively. Overall VE against influenza A(H1N1)pdm09 was 75% (95% CI: 43-89) and 81% (95% CI: 45-93) among those aged 15-64 years. Overall VE against influenza A(H3N2) was 29% (95% CI: 12-42) and 25% (95% CI: -41 to 61), 33% (95% CI: 14-49), and 26% (95% CI: -22 to 55) among those aged 0-14, 15-64, and over 65 years, respectively. The A(H3N2) VE among the influenza vaccination target group was 20% (95% CI: -6 to 39). All 53 sequenced A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.1. Among 410 sequenced influenza A(H3N2) viruses, all but eight belonged to clade 3C.2a1b.2a.2. DISCUSSION: Despite antigenic mismatch between vaccine and circulating strains for influenza A(H3N2) and A(H1N1)pdm09, 2021-2022 VE estimates against circulating influenza A(H1N1)pdm09 were the highest within the I-MOVE network since the 2009 influenza pandemic. VE against A(H3N2) was lower than A(H1N1)pdm09, but at least one in five individuals vaccinated against influenza were protected against presentation to primary care with laboratory-confirmed influenza.
Assuntos
Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Humanos , Estudos de Casos e Controles , Europa (Continente)/epidemiologia , Vírus da Influenza A Subtipo H3N2/genética , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Atenção Primária à Saúde , Vacinação , Eficácia de Vacinas , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , IdosoRESUMO
OBJECTIVE: To improve and adapt training rotation periods following the training program (POE) of the Badajoz Family and Community Medicine (MFyC) Training Unit (UDOCBA). DESIGN: Mixed qualitative (brainstorming and nominal technical group), and quantitative (cross-sectional descriptive), study in 2006 and 2007. SETTING: UDOCBA. PARTICIPANTS: The participants include 50 Residents, 31 accredited tutors, a health technician and a UDOCBA coordinator, as well as 93 MFyC Teaching Units in Spain (UUDD). INTERVENTIONS AND MEASUREMENTS: A rotations working group was formed in UDOCBA, which met on two occasions to make substantial modifications to adapt the POE. The first meeting was a brainstorming session, and the second using a nominal technical group, whose results were submitted to an Advisory Committee. MATERIALS: Questionnaire aimed at tutors, analysis of residents self-assessment files, a questionnaire delivered to all the UUDD (via e-mail) and nominal resident groups. Descriptive and bivariate statistics on the variables using the SPSS 15 program. RESULTS: The consensus of the second meeting of the UDOCBA rotations group on evaluating the results obtained with the rest of the tools used, were: to shorten the initial rotation of the C.S. to 5 months, increase the cardiology rotation to 3 months, shorten the rural rotation to 2 months and opt out of the elective 1 month stay in palliatives and radiology. CONCLUSIONS: Theoretically well prepared and easily to put into practice. All the consensus results of the UDOCBA were accepted by the Advisory Committee, followed by POE directives. Homogeneity was seen in the UUDD rotations. Unanimity of initial and final rotation by the C.S., and less in rural.