RESUMO
Following the outbreak of haemolytic uraemic syndrome (HUS) on June 2011 in south-western France, household transmission due to Escherichia coli O104:H4 was suspected for two cases who developed symptoms 9 and 10 days after onset of symptoms of the index case. The analysis of exposures and of the incubation period is in favour of a secondary transmission within the family. Recommendations should be reinforced to prevent person-to-person transmission within households.
Assuntos
Infecções por Escherichia coli/transmissão , Escherichia coli/isolamento & purificação , Síndrome Hemolítico-Urêmica/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Dor Abdominal/etiologia , Adulto , Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Pré-Escolar , Busca de Comunicante , Diarreia/complicações , Diarreia/epidemiologia , Surtos de Doenças , Escherichia coli/classificação , Escherichia coli/genética , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Características da Família , Fezes/microbiologia , França/epidemiologia , Síndrome Hemolítico-Urêmica/complicações , Síndrome Hemolítico-Urêmica/tratamento farmacológico , Síndrome Hemolítico-Urêmica/epidemiologia , Humanos , Masculino , Escherichia coli Shiga Toxigênica/efeitos dos fármacos , Escherichia coli Shiga Toxigênica/genética , Resultado do TratamentoAssuntos
Diarreia/epidemiologia , Surtos de Doenças , Infecções por Escherichia coli/complicações , Escherichia coli/isolamento & purificação , Doenças Transmitidas por Alimentos/etiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Adulto , Idoso , Toxinas Bacterianas/isolamento & purificação , Diarreia/microbiologia , Resistência Microbiana a Medicamentos , Escherichia coli/classificação , Escherichia coli/genética , Infecções por Escherichia coli/diagnóstico , Feminino , França/epidemiologia , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/microbiologia , Síndrome Hemolítico-Urêmica/diagnóstico , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To analyse the associations between socio-economic status (SES), measured using occupation, and self-reported health, and to examine the contribution of various material, occupational and psychosocial factors to social inequalities in health in Europe. METHODS: This study was based on data from the European Quality of Life Survey (EQLS) carried out in 2003. The total sample consisted of 6038 and 6383 working men and women in 28 countries in Europe (response rates: 30.3-91.2%). Each set of potential material, occupational and psychosocial mediators included between eight and 11 variables. Statistical analysis was performed using multilevel logistic regression analysis. RESULTS: Significant social differences were observed for self-reported health, manual workers being more likely to be in poor health (OR=1.89, 95% CI 1.46 to 2.46 for men, OR=2.18, 95% CI 1.71 to 2.77 for women). Strong social gradients were found for almost all potential mediating factors, and almost all displayed significant associations with self-reported health. Social differences in health were substantially reduced after adjustment for material, occupational and psychosocial factors, with material factors playing a major role. The four strongest contributions to reducing these differences were found for material deprivation, social exclusion, financial problems and job reward. Taking all mediators into account led to an explanation of the social differences in health by 78-100% for men and women. CONCLUSION: The association between SES and poor health may be attributed to differential distributions of several dimensions of material, occupational and psychosocial conditions across occupational groups. Interventions targeting different dimensions might result in a reduction in social inequalities in health.