Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022.

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18-67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

[Characteristics of COVID-19 cases and contacts reported in an area of Madrid during beginning of de-escalation.] / Características de los casos y contactos de COVID-19 identificados en un área de Madrid durante el inicio de la desescalada.

OBJECTIVE: Deescalation began in May 2020 increases social interaction, which has an influence on COVID-19 epidemiological surveillance. The aim of this study was the characterization of COVID-19 cases detected during this period. METHODS: We analyzed certain variables of interest coming from the epidemiological surveys carried out in an area of Madrid during May 2020, and stratified the results depending on its temporal relation with the deescalation. Prevalence for each category of response and average duration in minutes of the telephonic call were calculated. Confidence intervals were estimated at 95%. RESULTS: We included 167 cases, being 30.5% of them incident and 49.1% prevalent. The main source of infection was home (38.0%; CI 95% 31.4-46.2). Regarding healthcare and social care workers, the main source of infection was workplace (93.0%; 85.4-100). Average number of close contacts per case was 2.0 (1.8-2.2), being 1.5 (1.0-2.0) among pre-deescalation incident cases and 2.4 (1.8-3.0) among those post-deescalation. Average duration of each survey was 35.9 minutes (32.2-38.9), being 32.1 (24.4-39.8) among pre-deescalation incident cases and 37.0 (29.6-44.4) among those post-deescalation. Most of the contacts were household, both before and after beginning of deescalation. CONCLUSIONS: Home is the most prevalent place for the acquisition of the infection among general population, while workplace is the most prevalent among healthcare and social care workers. The initial phase of deescalation do not represents a change regarding sources of infection, but it may increase the number of close contacts.

OBJETIVO: La desescalada iniciada en mayo de 2020 aumenta las interacciones sociales, lo que influye en la vigilancia epidemiológica de la COVID-19. Este estudio tuvo como objetivo caracterizar los casos identificados durante este periodo. METODOS: Se analizaron parámetros de interés de las encuestas epidemiológicas realizadas en un área de Madrid durante mayo de 2020, estratificando los resultados según su relación temporal con la desescalada. Para las distintas opciones de respuesta, se calculó la prevalencia, y para la duración de la encuesta, la media en minutos. Los intervalos de confianza se estimaron al 95%. RESULTADOS: Se incluyeron 167 casos, siendo un 30,5% incidentes y un 49,1% prevalentes. El principal lugar de contagio fue el domicilio (38,8%; IC 95% 31,4-46,2). En el caso de los trabajadores sanitarios y sociosanitarios fue el centro de trabajo (93,0%; 85,4-100). El número medio de contactos por caso fue 2,0 (1,8-2,2), siendo 1,5 (1,0-2,0) en los casos incidentes predesescalada y 2,4 (1,8-3,0) en los postdesescalada. El tiempo medio por encuesta fue de 35,9 minutos (32,2-38,9), siendo 32,1 (24,4-39,8) en los incidentes predesescalada y 37,0 (29,6-44,4) en los postdesescalada. El principal ámbito de contacto fue el domicilio, tanto antes como después del inicio de la desescalada. CONCLUSIONES: Los contagios se producen principalmente en el domicilio en el caso de la población general y en el centro de trabajo en cuanto a los profesionales sanitarios y sociosanitarios. La fase inicial de la desescalada no supone un cambio en las fuentes de exposición, pero sí podría haber aumentado el número de contactos a investigar.

[Tuberculosis trend in Madrid region in native and foreign population (2009-2018).] / Tendencia de la tuberculosis en la Comunidad de Madrid en población autóctona y extranjera (2009-2018).

OBJECTIVE: Tuberculosis is a major public health problem and most cases are concentrated in vulnerable populations. The objective was to describe the incidence rates trend in native and foreign population (2009-2018) in Madrid Region. METHODS: Retrospective analysis of cases from the Tuberculosis Regional Registry of cases of Madrid Region 2009-2018. Annual incidence rates were calculated by country of birth (Spain, other), sex and age group (<15, 15-34, 35-44, 45-64, >64), using the annual January 1st continuous register population. The infection rate trend and the annual percentage change (APC) were calculated, along with the best jointpoint adjustment using Jointpoint regression. RESULTS: 7,696 cases were analyzed, 48.2% were foreign-born individuals. Average age in native population was 50 years old (SD: 23.96) and 35 (DS: 36.64) in foreign-born individuals (p<0.001). The overall incidence rate decreased from 17.30 in 2009 to 9.00 per 100,000 in 2018 and was higher in men. Pulmonary tuberculosis reduced from 11.90 to 6.55. Among native population, the incidence of TB fell from 10.29 to 5.24 with an APC of -7.3% (95%IC: -8.9; -5.7) (p<0.05), no jointpoint was identified. Among foreign-born individuals the incidence of tuberculosis declined from 46.54 to 25.49, a joint point was identified in 2013, observing an incidence decrease for the period 2009-2013 and APC of -13.8% (IC95%: -17.5; -10.0). CONCLUSIONS: The global incidence rate in this period has decreased by approximately 7% per year. However, this reduction occurred mainly in native population. In foreign-born individuals the incidence decreased by approximately 14% during the 2009-2013 period, after this period there have been no significant incidence changes.

OBJETIVO: La tuberculosis (TB) continúa siendo un problema importante de salud pública, debido a que la mayoría de los casos se concentran en población vulnerable. El objetivo de este trabajo fue describir la tendencia de las tasas de incidencia en población autóctona y extranjera (2009-2018) en la Comunidad de Madrid (CM). METODOS: Se realizó un análisis retrospectivo de casos del Registro Regional de casos de Tuberculosis de la CM en el período 2009-2018. Se calcularon tasas de incidencia anual por cada 100.000 habitantes, por país de nacimiento (España, fuera de España), sexo y grupo de edad (<15, 15-34, 35-44, 45-64, >64), utilizando las poblaciones de padrón continuo a 1 de enero de cada año. Se calculó la tendencia de las tasas de incidencia y el porcentaje anual de cambio (APC), así como el mejor ajuste del punto de inflexión utilizando la regresión de Jointpoint. RESULTADOS: Se analizaron 7.696 casos, siendo el 48,2% en personas nacidas fuera de España. La edad media en población autóctona fue de 50 años (DS: 23,96) y 35 (DS: 36,64) en inmigrante (p<0,001). La tasa de incidencia global pasó de 17,30 por cada 100.000 habitantes en 2009 a 9 en 2018, siendo superior en hombres. La incidencia de tuberculosis pulmonar pasó de 11,90 a 6,55. En población autóctona, la incidencia de TB pasó de 10,29 a 5,24, con un APC de -7,3% (IC95%: -8,9; -5,7; p<0,05), y no se identificó ningún punto de inflexión. En población extranjera la incidencia de tuberculosis pasó de 46,54 a 25,49, identificándose un punto de inflexión en 2013, con una disminución más acusada de la incidencia para el periodo 2009-2013 debido a un APC de -13,8% (IC95%: -17,5; -10,0). CONCLUSIONES: La tasa de incidencia global en este periodo disminuye cerca de un 7% anual; sin embargo, esta disminución de la incidencia se produce fundamentalmente en población autóctona. En población extranjera la incidencia desciende cerca de un 14% durante el periodo 2009-2013. Tras este periodo no hay cambios significativos en la incidencia.

Women's response to intimate partner violence.

The responses of women to a situation of abuse by their partner has hardly been addressed in the literature. Using a self-administered, anonymous questionnaire, 400 women attending three practices in a primary health care center in Granada (Spain) were studied. The women's response to abuse was used as a dependent variable. Sociodemographics, intensity, duration, and combination of the types of abuse were used as independent variables. Lifetime prevalence of any type of partner abuse was 22.8%. Of abused women, 68% showed an active response, attempting to resolve the situation mainly through separation (58.2%). The factors independently associated with a woman's active response were being separated, widowed, or divorced; reporting a greater intensity of abuse; and being younger than age 35 years. The results of this study show that a large majority of abused women in Spain try to resolve their situation, and that they are not passive victims.