[Travelers attending an international vaccine center. Is the risk for the pediatric traveler increasing?]. / Viajeros atendidos en un centro de vacunación internacional. ¿Está aumentando el riesgo en el viajero pediátrico?

INTRODUCTION: There is a perception that the number of pediatric travelers is increasing, mainly due to the so-called visiting friends and relatives (VFRs) group. Both the demographic and trips characteristics in this group may lead to an increased risk and a greater complexity in vaccinations and other preventive recommendations. OBJECTIVE: To analyze the outcomes of different groups of pediatric travelers. To describe the demographic and travel characteristics within the pediatric population, and to analyze whether the VFRs differ from non-VFRs with regards to the factors that may contribute to a greater risk. METHODOLOGY: A cross sectional descriptive study of the characteristics of pediatric travelers treated in the International Pre-travel Consultation Unit of the University Hospital Vall d'Hebron, from July 2002 to January 2009. RESULTS: Of the 692 children analyzed, with a mean age of 8 years (SD 5.4), an increase in the overall number of travelers was identified, along with an initial increase in the number of VFR children in the early years of the study, although later on, the numbers of this group stabilized. The mean age of the VFR travelers was also found to be lower. A lack of planning prior to the start of the travel was also noted in the VFRs group, as well as longer trip durations. A routine vaccine was administered to 29.2% of children, and malaria prophylaxis was recommended for 52% of travelers. CONCLUSION: Despite the progressive increase in international travel and the initial increase in VFR travelers, the percentage of this group has remained stable in recent years. However, the perception of a low risk among the immigrant population suggests the need to encourage an adequate pre-travel consultation within this group.

[MMR vaccine and egg allergy. Experience in a hospital immunization unit]. / Vacuna triple vírica y alergia al huevo. Experiencia en una unidad de vacunación hospitalaria.

INTRODUCTION: We review the scientific evidence on the safety of the measles, mumps, and rubella (MMR) vaccine (produced in chicken embryo cell culture) in children with egg allergy. Data on the reactogenicity observed with this vaccine in a large series of children with this type of allergy immunized in an hospital immunization unit are presented. MATERIAL AND METHODS: An observational prospective study was performed in the International Immunization Unit of the Epidemiology and Preventive Medicine Service of the Vall d'Hebron University Hospital from March 2004 to December 2005. Demographic variables, clinical history of allergy, and the adverse reactions observed 30 minutes after vaccine administration were analyzed. RESULT: A total of 140 patients (106 referred for the first MMR vaccine dose, and 34 for the second) were evaluated. Of these, 75.7 % showed clinical signs after egg ingestion (severe reactions were described in only seven patients: respiratory distress in six and systemic anaphylaxis in one). The MMR vaccine was administered to 121 children. No significant adverse reactions were observed (17.8 % of the vaccinated children developed mild local symptoms). CONCLUSIONS: According to current scientific evidence and the data obtained in this study, the MMR vaccine is safe in patients with egg allergy.

[Evaluation of Spanish websites useful for the primary care physicians]. / Evaluación de las páginas web en lengua española útiles para el médico de atención primaria.

OBJECTIVE: To assess the usefulness of medical websites in spanish for the primary care physicians using quality criteria chosen by themselves. DESIGN: Observational, descriptive, cross-sectional study. SETTING: Internet. PARTICIPANTS: The search was performed in Google and Yahoo using as key words the name of Spanish National Health Service medical specialities, primary care and synonyms. The first one hundred links in spanish for every keyword were included in the study. EXCLUSION CRITERIA: paysites, commercial sites, non-clinical content, link sites, patient oriented sites and on-line editions of printed issues. METHODS: A survey was carried out asking the primary care physicians of area IV in Asturias which were the most important criteria that a medical website should fulfil. The results of this survey were used to make an assessment questionnaire. Every site was analysed randomizedly by two researchers and was classified as excelent, good, medium or bad. RESULTS: 2.095 medical websites in spanish were found, being repeated 1.218 (58.14%). From the 877 analysed websites, 597 (68.07%) were excluded. The Intraclass Correlation Coefficient (ICC) was 0.73 (95% CI, 0.66%-0.785%). 5 websites (1.8%) were rated as excelent and the 77.2% as medium or bad. The sites with better ratings were those oriented to the primary care professionals. CONCLUSIONS: The most websites were rated as medium or bad. The evaluation questionnaire is useful for futures studies.