RESUMEN
The coronavirus disease 2019 (COVID-19) pandemic has affected the world radically since 2020. Spain was one of the European countries with the highest incidence during the first wave. As a part of a consortium to monitor and study the evolution of the epidemic, we sequenced 2,170 samples, diagnosed mostly before lockdown measures. Here, we identified at least 500 introductions from multiple international sources and documented the early rise of two dominant Spanish epidemic clades (SECs), probably amplified by superspreading events. Both SECs were related closely to the initial Asian variants of SARS-CoV-2 and spread widely across Spain. We inferred a substantial reduction in the effective reproductive number of both SECs due to public-health interventions (Re < 1), also reflected in the replacement of SECs by a new variant over the summer of 2020. In summary, we reveal a notable difference in the initial genetic makeup of SARS-CoV-2 in Spain compared with other European countries and show evidence to support the effectiveness of lockdown measures in controlling virus spread, even for the most successful genetic variants.
Asunto(s)
COVID-19/epidemiología , COVID-19/transmisión , Control de Enfermedades Transmisibles/organización & administración , Modelos Estadísticos , SARS-CoV-2/genética , COVID-19/virología , Control de Enfermedades Transmisibles/métodos , Humanos , Incidencia , Filogenia , Distanciamiento Físico , Cuarentena/métodos , Cuarentena/organización & administración , SARS-CoV-2/clasificación , SARS-CoV-2/patogenicidad , Índice de Severidad de la Enfermedad , España/epidemiologíaRESUMEN
INTRODUCTION: Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE: To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS: A retrospective review of serology registries and clinical registries, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA ≥1/256). RESULTS: Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION: Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.
Asunto(s)
Bartonella henselae , Enfermedad por Rasguño de Gato , Coriorretinitis , Retinitis , Enfermedad por Rasguño de Gato/diagnóstico , Humanos , Retinitis/diagnóstico , Estudios RetrospectivosRESUMEN
INTRODUCTION: Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE: To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS: A retrospective review of serology and clinical records, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA≥1/256). RESULTS: Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION: Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.
