RESUMO
BackgroundBy mid-September 2023, several event notifications related to cryptosporidiosis had been identified from different regions in Spain. Therefore, a request for urgent notification of cryptosporidiosis cases to the National Surveillance Network was launched.AimWe aimed at assessing the extent of the increase in cases, the epidemiological characteristics and the transmission modes and compared to previous years.MethodsWe analysed data on case notifications, outbreak reports and genotypes focusing on June-October 2023 and compared the results to 2016-2022.ResultsIn 2023, 4,061 cryptosporidiosis cases were notified in Spain, which is an increase compared to 2016-2022. The cumulative incidence was 8.3 cases per 100,000 inhabitants in 2023, sixfold higher than the median of 1.4 cases per 100,000 inhabitants 2016-2022. Almost 80% of the cases were notified between June and October. The largest outbreaks were related to contaminated drinking water or swimming pools. Cryptosporidium hominis was the most common species in the characterised samples (115/122), and the C. hominis IfA12G1R5 subtype, previously unusual in Spain, was detected from 76 (62.3%) of the 122 characterised samples.ConclusionsA substantial increase in cryptosporidiosis cases was observed in 2023. Strengthening surveillance of Cryptosporidium is essential for prevention of cases, to better understand trends and subtypes circulating and the impact of adverse meteorological events.
Assuntos
Criptosporidiose , Cryptosporidium , Surtos de Doenças , Criptosporidiose/epidemiologia , Humanos , Espanha/epidemiologia , Cryptosporidium/isolamento & purificação , Cryptosporidium/genética , Masculino , Incidência , Adulto , Feminino , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Adolescente , Pessoa de Meia-Idade , Criança , Lactente , Idoso , Adulto Jovem , Genótipo , Vigilância da População , Água Potável/parasitologia , Piscinas , Notificação de Doenças/estatística & dados numéricos , Recém-Nascido , Fezes/parasitologiaRESUMO
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.
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Mpox , Surtos de Doenças , Humanos , Mpox/epidemiologia , Monkeypox virus , Espanha/epidemiologiaRESUMO
Over 79,000 confirmed cases of mpox were notified worldwide between May and November 2022, most of them in men who have sex with men. Cases in women, for whom mpox might pose different risks, are rare, and Spain has reported more than one third of those in Europe. Using surveillance data, our study found similar time trends, but differences in delay of diagnosis, sexual transmission and signs and symptoms between men and women.
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Mpox , Minorias Sexuais e de Gênero , Masculino , Feminino , Humanos , Espanha/epidemiologia , Homossexualidade Masculina , Mpox/diagnóstico , Mpox/epidemiologia , Europa (Continente)RESUMO
Following the report of a non-travel-associated cluster of monkeypox cases by the United Kingdom in May 2022, 41 countries across the WHO European Region have reported 21,098 cases and two deaths by 23 August 2022. Nowcasting suggests a plateauing in case notifications. Most cases (97%) are MSM, with atypical rash-illness presentation. Spread is mainly through close contact during sexual activities. Few cases are reported among women and children. Targeted interventions of at-risk groups are needed to stop further transmission.
Assuntos
Exantema , Mpox , Animais , Criança , Surtos de Doenças , Feminino , Humanos , Mpox/diagnóstico , Mpox/epidemiologia , Monkeypox virus , Organização Mundial da SaúdeRESUMO
The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.
Assuntos
Poliomielite , Poliovirus , Criança , Humanos , Paralisia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral/efeitos adversos , Vigilância da População , Saúde Pública , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
Aims: This study aimed to describe the demographic and geographic patterns of campylobacteriosis in Denmark, Finland, Norway and Sweden during 2000-2015. Methods: All Campylobacter infections notified to national authorities in the four countries during the study period were included. Background data for each notification consisted of patient age, sex, geographical location, presumed origin of infection and date of sample taken or date of sample received in the laboratory. These data were analysed in order to investigate annual trends, age group and sex patterns, as well as variations in the geographical and seasonal distribution of infections. Results: During the study period, a total of 164,001 Campylobacter infections, excluding travel-related cases, were registered, representing a mean annual incidence of 42.3 cases/100,000 population (ranging from 28.5 in Norway to 60.4 in Denmark). The incidence increased significantly from 2004 onwards in all countries, apart from Denmark. Males had higher infection rates in general. The highest incidences were observed in 0-4 year olds and those aged 20-29 years, apart from in Finland where there was no peak of infections in children aged 0-4 years. Seasonality of disease was distinct in all four countries, showing peaks of infection between July and August. In Sweden and Norway, incidences of campylobacteriosis were significantly higher in municipalities with high degrees of coastline or inland water. Conclusions: Campylobacter in the Nordic countries mostly follows known patterns with respect to demography and seasonality. Our study demonstrates new insights concerning geographical patterns of disease, highlighting possible future vulnerable population groups and locations.
Assuntos
Infecções por Campylobacter/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Cidades/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Países Escandinavos e Nórdicos/epidemiologia , Estações do Ano , Distribuição por Sexo , Adulto JovemRESUMO
Despite concerns about infection risks of floating tanks, outbreaks have rarely been reported. In May 2017, an outbreak of skin rash occurred among visitors of a floating tank open for the public in Norway. We assessed the extent and cause of the outbreak and the risk factors for infection in a retrospective cohort study among the visitors of the floating tank using a standardized web-based questionnaire. An environmental investigation was conducted including microbiological analysis of the floating tank water. Of the 46 respondents to the questionnaire (61 distributed), 22 reported symptoms, most commonly palmar and plantar rash, swollen lymph nodes, ear canal pain and itching. None of the investigated risk factors, such as sex, age, duration of bathing or use of the shower after bathing, were significantly associated with illness. The results of the environmental investigation indicated that the water was heavily contaminated by P. aeruginosa and heterotrophic bacteria. The outbreak investigation highlights the need to ensure adequate hygienic operation of floating tanks. Awareness about responsibilities should be raised among the operators of floating tanks and relevant operational parameters for floating tanks should be made available for local health authorities.
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Exposição Ambiental/estatística & dados numéricos , Exantema/microbiologia , Infecções por Pseudomonas/epidemiologia , Pseudomonas/isolamento & purificação , Piscinas , Microbiologia da Água , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Estudos Retrospectivos , Medição de Risco , Adulto JovemRESUMO
BACKGROUND: Hospital-acquired pneumonia (HP) is the most common infection in adult intensive care units (ICUs). To develop effective strategies to prevent it, we identified factors that independently increased the risk of contracting HP while admitted at an ICU. METHODS: We performed a prospective cohort study during 4 years in which we included all patients who had been admitted for at least 24 h to the ICU at a university reference hospital in Spain. We conducted a multivariable Cox regression analysis to obtain adjusted hazard ratios (HR). The dependent variable for patients with HP was duration of ICU stay prior to the onset of HP. For those without HP, the dependent variable was duration of stay between admission and discharge from the ICU. The independent variables were intrinsic characteristics of the patients already present at admission to the ICU and diagnostic or therapeutic procedures performed during admission. RESULTS: We studied 4427 patients, of which 233 (5.3%) developed HP while admitted to the ICU. The strongest independent risk factors associated with the occurrence of HP were mechanical ventilation (HR = 8.2; 95% CI = 3.6-18.9) and the use of a nasogastric tube (HR = 2.3; 95% CI = 1.6-3.3). The intrinsic risk factors that were part of the model were the presence of decreased level of consciousness upon admission (HR = 2.0; 95% CI = 1.5-2.7) and the APACHE II index (HR = 1.018; 95% CI = 1.002-1.035). CONCLUSIONS: Although severity of illness upon admission (APACHE II index) and decreased level of consciousness were relevant predisposing factors to contract HP in the ICU, the strongest association corresponded to extrinsic factors such as mechanical ventilation and use of a nasogastric tube. The fact that these are therapeutic interventions facilitates developing prevention and control measures that can contribute to reduce the risk for HP.
Assuntos
Infecção Hospitalar , Pneumonia/epidemiologia , Pneumonia/etiologia , APACHE , Adulto , Idoso , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Infecção Hospitalar/microbiologia , Feminino , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Intubação Gastrointestinal/efeitos adversos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Ventiladores Mecânicos/microbiologiaRESUMO
We conducted a matched case-control study to examine the association between heavy precipitation events and waterborne outbreaks (WBOs) by linking epidemiological registries and meteorological data between 1992 and 2012 in four Nordic countries. Heavy precipitation events were defined by above average (exceedance) daily rainfall during the preceding weeks using local references. We performed conditional logistic regression using the four previous years as the controls. Among WBOs with known onset date (n = 89), exceedance rainfall on two or more days was associated with occurrence of outbreak, OR = 3.06 (95% CI 1.38-6.78), compared to zero exceedance days. Stratified analyses revealed a significant association with single household water supplies, ground water as source and for outbreaks occurring during spring and summer. These findings were reproduced in analyses including all WBOs with known outbreak month (n = 186). The vulnerability of single households to WBOs associated with heavy precipitation events should be communicated to homeowners and implemented into future policy planning to reduce the risk of waterborne illness.
Assuntos
Surtos de Doenças , Chuva , Neve , Doenças Transmitidas pela Água/epidemiologia , Estudos de Casos e Controles , Humanos , Países Escandinavos e Nórdicos/epidemiologiaRESUMO
In May 2014, a cluster of Yersinia enterocolitica (YE) O9 infections was reported from a military base in northern Norway. Concurrently, an increase in YE infections in civilians was observed in the Norwegian Surveillance System for Communicable Diseases. We investigated to ascertain the extent of the outbreak and identify the source in order to implement control measures. A case was defined as a person with laboratory-confirmed YE O9 infection with the outbreak multilocus variable-number tandem repeat analysis (MLVA)-profile (5-6-9-8-9-9). We conducted a case-control study in the military setting and calculated odds ratios (OR) using logistic regression. Traceback investigations were conducted to identify common suppliers and products in commercial kitchens frequented by cases. By 28 May, we identified 133 cases, of which 117 were linked to four military bases and 16 were civilians from geographically dispersed counties. Among foods consumed by cases, multivariable analysis pointed to mixed salad as a potential source of illness (OR 10.26; 95% confidence interval (CI): 0.85-123.57). The four military bases and cafeterias visited by 14/16 civilian cases received iceberg lettuce or radicchio rosso from the same supplier. Secondary transmission cannot be eliminated as a source of infection in the military camps. The most likely source of the outbreak was salad mix containing imported radicchio rosso, due to its long shelf life. This outbreak is a reminder that fresh produce should not be discounted as a vehicle in prolonged outbreaks and that improvements are still required in the production and processing of fresh salad products.
Assuntos
Diarreia/epidemiologia , Surtos de Doenças , Contaminação de Alimentos/análise , Verduras/microbiologia , Yersiniose/diagnóstico , Yersinia enterocolitica/isolamento & purificação , Estudos de Casos e Controles , Busca de Comunicante , Diarreia/microbiologia , Notificação de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Modelos Logísticos , Masculino , Militares , Repetições Minissatélites , Análise Multivariada , Noruega/epidemiologia , Razão de Chances , Vigilância da População , Yersiniose/epidemiologia , Yersinia enterocolitica/classificação , Yersinia enterocolitica/genéticaRESUMO
BACKGROUND: We describe the status of waterborne outbreaks notified in Norway and discuss this in the context of outbreaks recorded in previous years, to gain a better understanding of their development in Norway in recent years. MATERIAL AND METHOD: We have collected information on all outbreaks notified to the Norwegian Institute of Public Health via the surveillance system for communicable diseases in the ten-year period from 2003-2012 for which drinking water was given as the suspected cause. RESULTS: Altogether 28 waterborne outbreaks with a total of 8,060 persons reported as ill were notified in the period. The majority of outbreaks resulted in fewer than 100 cases of illness. There were two outbreaks with more than 1,000 cases of illness: an oubreak of campylobacteriosis in Røros and an oubreak of giardiasis in Bergen. In more than half of the outbreaks, water was supplied from public water distribution systems (16/28 outbreaks, 57%). In addition, a large proportion was linked to individual households with their own water supply (12/28 outbreaks, 43%). INTERPRETATION: Most of the outbreaks in the ten-year period were linked to public water distribution systems, while almost half were linked to non-disinfected water supplies to individual households. Although most of the outbreaks were small, two extensive outbreaks were also registered in the period, resulting in more than one thousand cases of illness. This underscores the need for good contingency planning and surveillance, so that suspicion of waterborne outbreaks is rapidly notified to the responsible authorities, and the importance of good protection of water sources, as well as proper maintenance of water treatment plants and distribution systems.
Assuntos
Surtos de Doenças , Microbiologia da Água , Doenças Transmitidas pela Água/epidemiologia , Infecções por Campylobacter/epidemiologia , Água Potável , Monitoramento Epidemiológico , Giardíase/epidemiologia , Humanos , Noruega/epidemiologia , Vigilância em Saúde Pública , Abastecimento de Água/normasRESUMO
In March 2014, after an increase of notifications of domestically acquired hepatitis A virus infections, an outbreak investigation was launched in Norway. Sequenced-based typing results showed that these cases were associated with a strain that was identical to one causing an ongoing multinational outbreak in Europe linked to frozen mixed berries. Thirty-three confirmed cases with the outbreak strain were notified in Norway from November 2013 to June 2014. Epidemiological evidence and trace-back investigations linked the outbreak to the consumption of a berry mix cake. Identification of the hepatitis A virus outbreak strain in berries from one of the implicated cakes confirmed the cake to be the source. Subsequently, a cluster in Germany linked to the cake was also identified.
Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/virologia , Surtos de Doenças , Contaminação de Alimentos/análise , Frutas/virologia , Alemanha/epidemiologia , Hepatite A/epidemiologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Humanos , Tipagem Molecular , Noruega/epidemiologiaRESUMO
Determining the role of weather in waterborne infections is a priority public health research issue as climate change is predicted to increase the frequency of extreme precipitation and temperature events. To document the current knowledge on this topic, we performed a literature review of analytical research studies that have combined epidemiological and meteorological data in order to analyze associations between extreme precipitation or temperature and waterborne disease.A search of the databases Ovid MEDLINE, EMBASE, SCOPUS and Web of Science was conducted, using search terms related to waterborne infections and precipitation or temperature. Results were limited to studies published in English between January 2001 and December 2013.Twenty-four articles were included in this review, predominantly from Asia and North-America. Four articles used waterborne outbreaks as study units, while the remaining articles used number of cases of waterborne infections. Results presented in the different articles were heterogeneous. Although most of the studies identified a positive association between increased precipitation or temperature and infection, there were several in which this association was not evidenced. A number of articles also identified an association between decreased precipitation and infections. This highlights the complex relationship between precipitation or temperature driven transmission and waterborne disease. We encourage researchers to conduct studies examining potential effect modifiers, such as the specific type of microorganism, geographical region, season, type of water supply, water source or water treatment, in order to assess how they modulate the relationship between heavy rain events or temperature and waterborne disease. Addressing these gaps is of primary importance in order to identify the areas where action is needed to minimize negative impact of climate change on health in the future.
Assuntos
Água Potável/microbiologia , Água Potável/parasitologia , Calor Extremo , Chuva , Doenças Transmitidas pela Água/epidemiologia , Mudança Climática , Água Potável/virologia , Humanos , Doenças Transmitidas pela Água/microbiologia , Doenças Transmitidas pela Água/parasitologia , Doenças Transmitidas pela Água/virologiaRESUMO
BACKGROUND: Approximately 90% of new tuberculosis (TB) cases notified in Norway are asylum seekers and other immigrants from high-incidence countries. Asylum seekers are screened upon arrival at the National Immigration Centre. Other immigrants receive a letter from the Municipal Health Services requesting that they present for screening in their municipality of residence. In order to identify potential areas where the TB control programme could be better adapted for these groups, we studied the largest cluster of TB cases ("cluster X") notified in Norway until 2011. METHODS: Cases were defined as TB notifications reported to MSIS between January 1997 and December 2011 with identical IS6110 RFLP assigned to cluster X. We described the cases in cluster X by using data from the Norwegian Surveillance System for Communicable Diseases (MSIS). Missing or incomplete information in MSIS was obtained from the National Reception Centre, Oslo University Hospital and Municipal Health services. RESULTS: Of a total of 44 individuals meeting the case definition, 36 originated from Somalia and eight from other high-incidence countries. Twenty nine were asylum seekers and 15 were other immigrants. Upon arrival, 18/44 had been diagnosed with latent TB infection (LTBI), 9/44 tested negative for LTBI and 4/44 had been diagnosed with active TB. Results of TB-screening upon arrival were not available for the remaining 13/44 (one asylum seeker and 12 other immigrants). Five of the 12 other immigrants had still not been screened for TB after staying one year or longer in Norway. CONCLUSIONS: Most cases in cluster X with available results of TB-screening were already infected at arrival, indicating that their disease could be due to endogenous reactivation, rather than recent transmission after arrival to Norway. TB-status upon arrival was unknown for many of the other immigrants due to lack of initial screening. The reasons why conduction of the initial screening among other immigrants is failing should be explored and methods to simplify the TB screening at arrival should be implemented.
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Emigrantes e Imigrantes/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Vigilância de Evento Sentinela , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Noruega/epidemiologia , Fatores de Risco , Somália/etnologia , Adulto JovemRESUMO
BACKGROUND: During the 2009-2010 pandemic in Norway, 12 513 laboratory-confirmed cases of pandemic influenza A(H1N1)pdm09, were reported to the Norwegian Surveillance System for Communicable Diseases (MSIS). 2.2 million persons (45% of the population) were vaccinated with an AS03-adjuvanted monovalent vaccine during the pandemic. Most of them were registered in the Norwegian Immunisation Registry (SYSVAK). Based on these registries, we aimed at estimating the vaccine effectiveness (VE) and describing vaccine failures during the pandemic in Norway, in order to evaluate the role of the vaccine as a preventive measure during the pandemic. METHODS: We conducted a population-based retrospective cohort study, linking MSIS and SYSVAK with pandemic influenza vaccination as exposure and laboratory-confirmed pandemic influenza as outcome. We measured VE by week and defined two thresholds for immunity; eight and 15 days after vaccination. RESULTS: The weekly VE ranged from 77% to 96% when considering 15 days or more after vaccination as the threshold of immunity and from 73% to 94% when considering eight days or more. Overall, 157 individuals contracted pandemic influenza eight or more days after vaccination (8.4/100,000 vaccinated), of these 58 had onset 15 days or more after vaccination (3.0/100,000 vaccinated). Most of the vaccine failures occurred during the first weeks of the vaccination campaign. More than 30% of the vaccine failures were found in people below 10 years of age. CONCLUSIONS: Having available health registries with data regarding cases of specific disease and vaccination makes it feasible to estimate VE in a simple and rapid way. VE was high regardless the immunity threshold chosen. We encourage public health authorities in other countries to set up such registries. It is also important to consider including information on underlying diseases in registries already existing, in order to make it feasible to conduct more complete VE estimations.
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Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Sistema de Registros/estatística & dados numéricos , Adjuvantes Imunológicos/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Combinação de Medicamentos , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Polissorbatos/administração & dosagem , Estudos Retrospectivos , Esqualeno/administração & dosagem , Resultado do Tratamento , Adulto Jovem , alfa-Tocoferol/administração & dosagemRESUMO
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are microorganisms that have acquired resistance to extended-spectrum antibacterials and constitute an emerging threat to public health. Although carriers are an important source of transmission in healthcare settings, data about risk factors for MDR-GNB carriage are limited. Therefore, we aimed to identify risk factors for MDR-GNB carriage upon intensive care unit (ICU) admission and to optimise screening strategies. We conducted a case-control study. Admissions of adult patients to the ICU of a 1000-bed hospital during a year were included. We collected sociodemographic, clinical and microbiological data and performed a multivariate logistic regression model. A total of 1342 patients resulted in 1476 episodes of ICU admission, 91 (6.2%) of whom harboured MDR-GNB (38.5% women; median age 63.9 years). The most frequently isolated pathogens were Escherichia coli (57%) and Klebsiella pneumoniae (16%). The most frequent resistance mechanism was production of extended-spectrum beta lactamases. MDR-GNB carriage was associated to liver cirrhosis (OR 6.54, 95% CI 2.17-19.17), previous MDR-GNB carriage (OR 5.34, 1.55-16.60), digestive surgery (OR 2.83, 1.29-5.89) and length of hospital stay (OR 1.01 per day, 1.00-1.03). Several risk factors for MDR-GNB carriage upon admission to a high-risk setting were identified; the main comorbidity was liver cirrhosis.
Assuntos
Infecção Hospitalar , Infecções por Bactérias Gram-Negativas , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Feminino , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
COVID-19 outbreak surveillance in Spain was established with the main objective of characterizing outbreaks and the settings in which they occurred, in order to identify those population groups at highest risk to support them with the implementation of preventive and control measures. Between June 2020 and June 2021, 55,824 outbreaks were reported, with 414,882 cases in all settings. About 12.5% were reported in an occupational setting and within this, most of them were identified in the industry and building sectors. The outbreaks that had a greater impact were those that took place both in agriculture and in the meat industry, where there is a higher risk of exposure due to living and working conditions. Outbreaks in the catering and home care sectors were also frequent. Since the beginning, there was coordination between all stakeholders involved in the management of the pandemic, in order to implement prevention and control measures, as well as social protection measures. In addition, special actions were implemented in the most vulnerable sectors. Despite the work carried out, the presence of outbreaks in these sectors continues, although they are smaller than the previous pandemic phase. Due to this, there is needed to continue strengthening the inter-sectoral coordination structures and mechanisms to ensure the implementation of those measures that contribute to the containment of the pandemic.
La vigilancia de brotes COVID-19 en España se estableció con el objetivo de caracterizar los brotes y los ámbitos en los que ocurrían, con el propósito de identificar aquellos grupos de población con mayor riesgo para apoyar la toma de medidas de prevención y control. Entre junio de 2020 y junio de 2021 se comunicaron 55.824 brotes con 414.882 casos en todos los ámbitos. Alrededor del 12,5% de brotes y casos asociados fueron comunicados en el ámbito laboral y dentro de éste, la mayoría se identificó en los sectores de la industria y construcción, si bien, entre los brotes que han tenido un mayor impacto se encuentran aquellos producidos en el sector agrícola y en la industria de la carne, donde existe un mayor riesgo de exposición debido a las condiciones de vida y trabajo. También destacaron los brotes en el sector de la restauración y hostelería, y cuidados a domicilio. Desde el inicio hubo una coordinación entre las administraciones implicadas en la gestión de la pandemia para poner en marcha las medidas de prevención y control, así como las de protección social. Además, se llevaron a cabo medidas especiales en sectores de mayor vulnerabilidad. A pesar del trabajo realizado, los brotes en estos sectores continúan ocurriendo, si bien son de menor tamaño, por lo que se deben continuar fortaleciendo las estructuras y mecanismos de coordinación intersectoriales para la aplicación de las medidas que contribuyen además de la contención de la pandemia, a mantener activo el tejido productivo.
Assuntos
COVID-19 , Surtos de Doenças , Seguimentos , Humanos , SARS-CoV-2 , Espanha/epidemiologiaRESUMO
INTRODUCTION: Bexsero® (4CMenB), meningococcal B vaccine, was licensed in Europe in 2013. In Spain, despite MenB being the most frequent cause of invasive meningococcal disease (IMD), Bexsero® is recommended and financed for patients at increased risk of IMD but is not financed by the NHS in the routine vaccination schedule. OBJECTIVE: to evaluate the cost-utility, epidemiological impact, and total costs of the introduction of 4CMenB into the vaccination schedule to help inform vaccine policy in Spain. METHOD: We adapted a cost-utility analysis, a probabilistic decision-tree, to Spain. A cohort of new-born infants in 2015 was modelled with two dosages, using two different strategies: routine vaccination schedule with 4CMenB and non-vaccination. Costs were measured from a payer perspective and benefits were calculated in quality-adjusted life years (QALYs). A Monte Carlo analysis and 32 scenarios were performed to assess the robustness and the uncertainty of our results. RESULTS: With the 3+1 dosage, routine vaccination prevented 54% of cases and deaths and an incremental cost-utility ratio (ICUR) of 351.389 /QALY (95% confidence interval [95%CI]: 265,193-538,428) was estimated. The 2+1 dosage prevented 50% of cases and deaths, with an ICUR of 278.556 /QALY (95%CI: 210,285-430,122). CONCLUSIONS: Given the current incidence of invasive meningococcal disease in Spain and the information available from 4CMenB, our model shows that routine vaccination is not cost-effective at the current price. Only with a vaccine price of 1.45 for the 3+1 schedule or 3.37 for the 2+1 schedule could it be recommended based on efficiency criteria.
Assuntos
Infecções Meningocócicas , Vacinas Meningocócicas , Análise Custo-Benefício , Humanos , Lactente , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/prevenção & controle , Espanha/epidemiologiaRESUMO
Global climate change is predicted to alter precipitation and temperature patterns across the world, affecting a range of infectious diseases and particularly foodborne infections such as Campylobacter. In this study, we used national surveillance data to analyse the relationship between climate and campylobacteriosis in Denmark, Finland, Norway and Sweden and estimate the impact of climate changes on future disease patterns. We show that Campylobacter incidences are linked to increases in temperature and especially precipitation in the week before illness, suggesting a non-food transmission route. These four countries may experience a doubling of Campylobacter cases by the end of the 2080s, corresponding to around 6,000 excess cases per year caused only by climate changes. Considering the strong worldwide burden of campylobacteriosis, it is important to assess local and regional impacts of climate change in order to initiate timely public health management and adaptation strategies.
Assuntos
Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/etiologia , Mudança Climática , Doenças Transmitidas por Alimentos/epidemiologia , Infecções por Campylobacter/prevenção & controle , Análise de Dados , Monitoramento Epidemiológico , Europa (Continente)/epidemiologia , Feminino , Doenças Transmitidas por Alimentos/etiologia , Humanos , Incidência , Masculino , Temperatura , Estados Unidos , United States Public Health ServiceRESUMO
Протокол по проблемам воды и здоровья к Конвенции по охране и использованию трансграничных водотоков и международных озер 1992 г. направлен на защиту здоровья и благополучия людей путем связи устойчивого управления водными ресурсами с деятельностью по предотвращению, ограничению и сокращению степени распространения заболеваний, связанных с водой. Предотвращение заболеваний, связанных с водой, и сокращение их числа является одним из приоритетов программы работы в рамках Протокола на 2014-2016 гг. В результате обзора имеющихся фактических данных было обнаружено существенное занижение сведений и недооценка реального масштаба распространенности заболеваний, связанных с водой, в Общеевропейском регионе, что указывает на необходимость укрепить национальные возможности в области надзора за этими заболеваниями. К наиболее часто регистрируемым желудочно-кишечным инфекционным заболеваниям, которые могут быть связаны с водой, относятся кампилобациллярный энтерит, лямблиоз, гепатит А и шигеллез. Ограниченные опубликованные данные указывают на то, что примерно 18% расследованных вспышек заболеваний в Европейском регионе ВОЗ могут быть связаны с этим источником. Делаются определенные успехи по установке конкретных целевых показателей по предотвращению и сокращению случаев заболеваний, связанных с водой, и укреплению систем надзора и раннего предупреждения в соответствии с основными положениями Протокола.