RESUMO
Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).
Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia , Colo/patologia , Busca de Comunicante , Evolução Fatal , Feminino , Vírus da Febre Hemorrágica da Crimeia-Congo/classificação , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Febre Hemorrágica da Crimeia/patologia , Febre Hemorrágica da Crimeia/transmissão , Febre Hemorrágica da Crimeia/virologia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Necrose , Reação em Cadeia da Polimerase , EspanhaRESUMO
BackgroundA large outbreak of leishmaniasis with 758 cutaneous and visceral leishmaniasis cases occurred in 2009 in Fuenlabrada, in the south-west of the Madrid region of Spain.AimWe aimed to determine the prevalence of asymptomatic Leishmania infection after this outbreak, and its associated risk factors.MethodsA cross-sectional study of 804 healthy individuals living in Fuenlabrada who had no history of leishmaniasis, was conducted between January and July 2015. Asymptomatic infections were sought by either a combination of PCR, immunofluorescent antibody titre, and direct agglutination tests, or by whole blood stimulation assay (WBA) with interleukin-2 (IL-2) quantification.ResultsUsing the first approach, prevalence of asymptomatic individuals was 1.1% (9/804), while the second returned a value of 20.7% (143/804). Older age, being male, proximity to the park where the focus of infection was identified, and living in a detached house, were all strongly associated with the prevalence of asymptomatic infection.ConclusionsThe true number of infected individuals may be underestimated if only serological methods are used. The combination of WBA with IL-2 quantification may allow to better determine the prevalence of asymptomatic Leishmania infection, which would be useful in establishing control measures and in quantifying their impact. In our study, the use of WBA with IL-2 quantification also helped establish the risk factors that influence exposure to and infection by Leishmania.
Assuntos
Infecções Assintomáticas/epidemiologia , Surtos de Doenças , Leishmaniose Cutânea/epidemiologia , Leishmaniose Visceral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Estudos Transversais , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Lactente , Leishmaniose Cutânea/sangue , Leishmaniose Cutânea/diagnóstico , Leishmaniose Visceral/sangue , Leishmaniose Visceral/diagnóstico , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Varicella vaccine was recommended in the Community of Madrid (CM) at 15months of age between November 2006 and December 2013. The objective was to describe the impact of vaccination on the incidence of varicella in the CM during the period 2001-2015. DESIGN: A descriptive study of cases of varicella reported to the Sentinel Physician Network of the CM and the cases recorded in the Minimum Basic Data Set at hospital discharge was carried out. Total incidence of cases and of hospital admissions were calculated, as well as specific incidence by age and sex. RESULTS: The incidence was 94.0% lower between 2012 and 2013 than between 2001 and 2003. Between 2014 and 2015 the incidence was 61.8% higher than between 2012 and 2013. The highest incidence was observed in children aged 0 to 4years except for 2010-2014, which was exceeded by the incidence in children aged 5 to 9. The trend in hospital admissions was also decreasing, with the highest incidence in children aged 0 to 1year, followed by 1-4years. CONCLUSIONS: There has been a significant decrease in the incidence of cases and of hospital admissions by varicella in all age groups after the recommendation to vaccinate at 15months of age, which is compatible with the effectiveness of a dose and its ability to produce immunity group. The withdrawal of this recommendation between 2014 and 2015 has led to an increase in the incidence.
Assuntos
Varicela/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Varicela/prevenção & controle , Vacina contra Varicela , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Espanha/epidemiologia , Fatores de Tempo , Saúde da População UrbanaRESUMO
INTRODUCTION: Seroprevalence surveys enable the level of endemicity of hepatitis A (HAV) to be assessed. The aim of this study was to estimate the seroprevalence (SP) antibody against HAV by age group, and compare it with those obtained in previous surveys. METHODS: Observational cross-sectional study. The target population consists of residents from 2 to 60 years old in the Community of Madrid. Two-stage cluster sampling was performed with stratification of first stage units. After signing the informed consent, a serum sample was extracted from each participant and sociodemographic data were collected by a questionnaire. RESULTS: SP antibodies to hepatitis A is 46.8% (95% CI 44.6 to 49.0). The SP increases with age. It is higher in the population from more endemic countries and people with less education and lower social class. In relation to the previous survey, SP increased in the population under 30 years old, and a decline after that age is observed. If only the autochthonous population and from countries with very low endemicity is observed, the increase is statistically significant in the 2-5 years age group. CONCLUSIONS: Our region has a very low level of endemicity thus, following the recommendations of WHO, vaccination should be targeted at specific risk groups.
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Anticorpos Anti-Hepatite A/sangue , Hepatite A/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Vírus da Hepatite A , Humanos , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Espanha/epidemiologia , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. MATERIAL AND METHOD: A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. RESULTS: A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. DISCUSSION: Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months.
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Anticorpos Antivirais/sangue , Vacina contra Varicela/imunologia , Herpesvirus Humano 3/imunologia , Adolescente , Adulto , Vacina contra Varicela/administração & dosagem , Criança , Pré-Escolar , Estudos Transversais , Humanos , Esquemas de Imunização , Lactente , Pessoa de Meia-Idade , Estudos SoroepidemiológicosRESUMO
Together with AIDS, the burden of hepatitis C virus (HCV) in Spain heads the list of communicable diseases in terms of impact on public health. The aim of this study was to estimate the prevalence of HCV antibodies in the Community of Madrid, assess changes in recent years and analyse associated risk factors. Descriptive cross-sectional study of a target population consisting of Community of Madrid residents aged 16-80 years old. Two-stage cluster sampling was performed, with stratification by socioeconomic status and percentage immigrant population. The sampling frame consisted of public blood extraction centers attached to the Madrid Health Service. Seroprevalence of HCV antibodies, prevalence ratios by age groups in comparison with 1999 survey data and prevalence association with risk factors were assessed using a logistic regression model. Prevalence of HCV antibodies for the age group 16-80 years was 1.8% (95% CI: 1.3-2.5). The age group with the highest prevalence was 41-60 years. In comparison with the 1999 survey, prevalence fell for the age groups 21-30 and 31-40 years and increased for the age group 41-60. Statistically significant associations were found for age, education, history of hepatitis C and consultation regarding liver problems. Seroprevalence of HCV antibodies in the Community of Madrid is similar to that shown in other regions of Spain. It is increasing in older age groups as the population at risk ages. Incidence of hepatitis C may be decreasing considering the decrease in the seroprevalence in the population younger than 40 related to the previous serosurvey.
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Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Hepatite C/imunologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Espanha/epidemiologia , Adulto JovemRESUMO
Mumps is a vaccine-preventable disease caused by the mumps virus (MuV). However, MuV has re-emerged in many countries with high vaccine coverage. The World Health Organization (WHO) recommends molecular surveillance based on sequencing of the small hydrophobic (SH) gene. Additionally, the combined use of SH and non-coding regions (NCR) has been described in different studies, proving to be a useful complement marker to discriminate general patterns of circulation at national and international levels. The aim of this work is to test local-level usefulness of the combination of SH and MF-NCR sequencing in tracing hidden transmission clusters and chains during the last epidemic wave (2015-2020) in Spain. A database with 903 cases from the Autonomous Community of Madrid was generated by the integration of microbiological and epidemiological data. Of these, 453 representative cases were genotyped. Eight different SH variants and thirty-four SH haplotypes were detected. Local MuV circulation showed the same temporal pattern previously described at a national level. Only two of the thirteen previously identified outbreaks were caused by more than one variant/haplotype. Geographical representation of SH variants allowed the identification of several previously undetected clusters, which were analysed phylogenetically by the combination of SH and MF-NCR, in a total of 90 cases. MF-NCR was not able to improve the discrimination of geographical clusters based on SH sequencing, showing limited resolution for outbreak investigations.
Assuntos
Vírus da Caxumba , Caxumba , Humanos , Vírus da Caxumba/genética , Filogenia , Caxumba/epidemiologia , Surtos de Doenças , GenótipoRESUMO
OBJECTIVES: To study the spatio-temporal distribution of cases of invasive pneumococcal disease (IPD) due to serotypes resistant to erythromycin and its relationship with community consumption of macrolides and childhood vaccination coverage. METHODS: We selected IPD cases in adults over 59 years old, residents in the Community of Madrid (MC), notified in the period 2007-2016. The variables studied were obtained from the Vaccination Information Systems and the Pharmaceutical Service. The cut-off point (minimum inhibitory erythromycin concentration > 0.5 mg/L) of the EUCAST classification was used to define erythromycin resistant serotypes. We used JointPoint to estimate the incidence trends by erythromycin resistant serotypes included in the 13-valent vaccine (STPCV13) and not included in it (STnoPCV13). The association of these incidences with the community consumption of macrolides and vaccination coverage was made using Poisson models. Statistical scanning was used for the detection of temporal-spaces clusters of cases. RESULTS: 1936 cases were identified, of which 427 erythromycin resistant serotypes were identified. The incidence of all cases due to resistant serotypes was decreasing (AAPC: -5,40%). During the period studied, the incidence of cases due to erythromycin resistant STPCV13 was decreasing with an annual percentage change (APC): -13.8 and was inversely associated with childhood vaccination coverage (IRR 0.641), while that of cases due to erythromycin resistant STnoPCV13 was ascending (APC): 4.5; and was not associated with coverage. 1 cluster was detected by STnoPCV13 and none by STPCV13 after the date of inclusion of the 13-valent in the childhood vaccination calendar. CONCLUSIONS: The decrease in IPD due to resistant STPCV13 was associated with an increase in childhood vaccination coverage. The presence of clusters due to STnoPCV13 after the date of inclusion of the 13-valent vaccine in the childhood vaccination calendar indicates serotypes replacement. The increase in cases of resistant STnoPCV13 could be related to the replacement of vaccine serotypes in nasopharyngeal colonization, facilitated by the consumption of macrolides still at high levels in MC.
Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Adulto , Humanos , Pessoa de Meia-Idade , Sorogrupo , Vacinas Pneumocócicas , Vacina Pneumocócica Conjugada Heptavalente , Sorotipagem , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Antibacterianos/farmacologia , Eritromicina/farmacologia , Macrolídeos/farmacologiaRESUMO
INTRODUCTION: The aim of this study was to describe the distribution of Streptococcus pneumoniae serotypes in isolates from pleural fluid in the Madrid Autonomous Community between the years 2007-2018. METHODS: Invasive pneumococcal disease strains isolated during the period 2007-2018 were studied. The frequency of serotypes from pleural fluid was compared with that observed in other samples. RESULTS: A total of 6,115 pneumococcal invasive isolates were processed. Of them, 182 (3%) were isolated from pleural fluid. A total of 70.9% of isolates belonged to some of the following 6serotypes: 1, 3, 19A, 8, 7F and 5. The serotypes 3 and 8 increased significantly from 9.6% to 30.8%, and from 5.3% to 20.5%, respectively, over the periods 2007-2010 to 2015-2018. CONCLUSIONS: Pneumococcal serotypes 3 and 8 are currently significant causes of infection of pleural fluid in our region.
Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Humanos , Infecções Pneumocócicas/epidemiologia , SorogrupoRESUMO
INTRODUCTION: This work evaluates the burden and trends of hepatitis C virus (HCV)-associated hospitalisations in Spain before and after the implementation of the Strategic Plan for Tackling Hepatitis C in the National Health System in 2015. METHODS: HCV-related hospitalisation discharges from 2005 to 2017 were obtained from the National Registry of Hospitalisations. A descriptive analysis of the hospitalisations was performed. RESULTS: From 2005 to 2017, there were 674 067 HCV-related hospitalisations: 1.2%, 29.9%, 63.9% and 5% of them due to acute, carriers, chronic and unspecified hepatitis C. Average age of the patients was 57.7 years (SD: 16.4), average hospital stay was 9.1 days (SD: 12.2) and intra-hospital case-fatality rate was 6.5%. Hospitalisation rates decreased notably (P < 0.05) in 2016-2017 compared to 2005-2015 for all [hospitalisation rate ratio (HRR): 0.77], males (HRR: 0.80), females (HRR: 0.74), chronic hepatitis C (HRR: 0.84), non-advanced liver disease (N-AdLD) (HRR: 0.80) and AdLD (HRR: 0.73). Acute HCV (HRR: 0.54) and carriers (HRR: 0.49) show decreases in 2016-2017 vs. 2005-2015, although their rates started to decrease in 2008/2009. Unspecified HCV hospitalisation rates increased (P < 0.05) in 2016-2017 (HRR: 2.02) vs. 2005-2015. From 2015 to 2017, cost per patient increased from 5981 euros to 6349 euros, but overall cost decreased, as hospitalisations rates decreased from 302 to 264 million euros. DISCUSSION: HCV-related hospitalisation rates decreased notably in 2016 and 2017 after the strategic plan for tackling hepatitis C was launched. Although cost per AdLD patient increased in 2016 and 2017, globally costs were reduced around 35 million euros per year.
Assuntos
Hepatite C Crônica , Hepatite C , Feminino , Hepacivirus , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/terapia , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/terapia , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: It is important to know the impact of public financing on routine vaccination on compliance with the vaccination regimen. Few studies have been carried out on this topic. The objective of this study was to describe the effect of public financing of pneumococcal vaccine on vaccination coverage and the degree of compliance with the vaccination regimen in the child population of the Community of Madrid (CM). METHODS: A descriptive observational study was carried out. The study population were children vaccinated in the period of public (2008 and 2010) and private (2012 and 2013) funding. Data source was the vaccination information system. We estimated the coverage of "full inmunization" at 24 months and the coverage of "vaccination on time" of the primary vaccination and the complete schedule. Comparison according to the type of financing was made using the prevalence ratio (PR) and the relative percentage of change. The delay between vaccine doses was calculated at 24 months of age. RESULTS: On-time vaccination coverage was 72% when public financing of the vaccine and 64% when private financing (PR= 1.12). The delay between doses was greater than 10% when funding was private. CONCLUSIONS: Public financing of the vaccine improves compliance with the vaccine regimen.
OBJETIVO: Es importante conocer el impacto de la financiación pública de la vacunación sistemática sobre el cumplimiento de la pauta vacunal. Se han realizado pocos estudios sobre este tema. El objetivo de este estudio fue describir el efecto de la financiación pública de la vacuna antineumocócica sobre la cobertura de vacunación y el grado de cumplimiento de la pauta vacunal en la población infantil de la Comunidad de Madrid (CM). METODOS: Se realizó un estudio observacional descriptivo. La población de estudio fueron niños residentes en la Comunidad de Madrid que alcanzaron la edad de vacunación en los períodos de financiación pública (2008 y 2010) y privada (2012 y 2013). La fuente de datos fue el sistema de información vacunal de la CM. Se estimó la cobertura de "vacunación completa" a los 24 meses y la cobertura de "vacunación a tiempo" de la primovacunación y de la pauta completa. La comparación según el tipo de financiación se efectuó mediante la razón de prevalencias (RP) y el porcentaje relativo del cambio. Se calculó el retraso entre dosis vacunales a los veinticuatro meses de edad. RESULTADOS: La cobertura de vacunación a tiempo fue del 72% cuando la financiación de la vacuna fue pública y del 64% cuando fue privada (RP=1,12). El retraso entre dosis fue mayor del 10% cuando la financiación fue privada. CONCLUSIONES: La financiación pública de la vacuna mejora el cumplimiento de la pauta vacunal.
Assuntos
Financiamento Governamental/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/economia , Vacinação/estatística & dados numéricos , Pré-Escolar , Humanos , Esquemas de Imunização , Lactente , Infecções Pneumocócicas/prevenção & controle , EspanhaRESUMO
OBJECTIVES: To study the spatio-temporal distribution of cases of invasive pneumococcal disease (IPD) due to serotypes resistant to erythromycin and its relationship with community consumption of macrolides and childhood vaccination coverage. METHODS: We selected IPD cases in adults over 59 years old, residents in the Community of Madrid (MC), notified in the period 2007-2016. The variables studied were obtained from the Vaccination Information Systems and the Pharmaceutical Service. The cut-off point (minimum inhibitory erythromycin concentration > 0.5 mg/L) of the EUCAST classification was used to define erythromycin resistant serotypes. We used JointPoint to estimate the incidence trends by erythromycin resistant serotypes included in the 13-valent vaccine (STPCV13) and not included in it (STnoPCV13). The association of these incidences with the community consumption of macrolides and vaccination coverage was made using Poisson models. Statistical scanning was used for the detection of temporal-spaces clusters of cases. RESULTS: 1936 cases were identified, of which 427 erythromycin resistant serotypes were identified. The incidence of all cases due to resistant serotypes was decreasing (AAPC: -5,40%). During the period studied, the incidence of cases due to erythromycin resistant STPCV13 was decreasing with an annual percentage change (APC): -13.8 and was inversely associated with childhood vaccination coverage (IRR 0.641), while that of cases due to erythromycin resistant STnoPCV13 was ascending (APC): 4.5; and was not associated with coverage. 1 cluster was detected by STnoPCV13 and none by STPCV13 after the date of inclusion of the 13-valent in the childhood vaccination calendar. CONCLUSIONS: The decrease in IPD due to resistant STPCV13 was associated with an increase in childhood vaccination coverage. The presence of clusters due to STnoPCV13 after the date of inclusion of the 13-valent vaccine in the childhood vaccination calendar indicates serotypes replacement. The increase in cases of resistant STnoPCV13 could be related to the replacement of vaccine serotypes in nasopharyngeal colonization, facilitated by the consumption of macrolides still at high levels in MC.
RESUMO
INTRODUCTION: In recent years, Streptococcus pneumoniae serotype 8 has become the most prevalent cause of invasive pneumococcal disease (IPD) in Madrid, Spain. The objective of this study was to characterize the invasive clones of S. pneumoniae serotype 8 in Madrid over the 2012-2015 period. METHODS: From January 2012 to December 2015, a total of 1543 invasive isolates were studied. Serotyping was carried out by Pneumotest-Latex agglutination and Quellung reaction. Susceptibilities to penicillin, erythromycin and levofloxacin were determined by the Etest®. All serotype 8 strains were typed by multilocus sequence typing (MLST) and by pulsed-field gel electrophoresis (PFGE). RESULTS: Two hundred and forty-eight (248) serotype 8 strains were detected (16.1%) and 243 of them were available for molecular typing. Nine sequence types (STs) by MLST (8-ST53, 8-ST63, 8-ST404, 8-ST1107, 8-ST989, 8-ST1110, 8-ST2231, 8-ST3544 and 8-ST4301), and nine PFGE profiles were identified (one corresponding to each ST). The 8-ST53 clone was the most widespread, and increased from 53.8% among all serotype 8 isolates in 2012, to 90.1% in 2015. In contrast, the 8-ST63 clone, resistant to levofloxacin and erythromycin, decreased from 30.8%, among all serotype 8 strains in 2012, to 5.0% in 2015. CONCLUSIONS: The increase in our region of S. pneumoniae serotype 8, not included in conjugated vaccines, occurred at the expense of the 8-ST53 clone. On the contrary, the 8-ST63 clone decreased. Since clone 8-ST63 has the theoretical advantage of its levofloxacin-erythromycin resistance in comparison to 8-ST53, the predominance of 8-ST53 over 8-ST63 is striking.
Assuntos
Antibacterianos , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae , Antibacterianos/farmacologia , Células Clonais , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Infecções Pneumocócicas/epidemiologia , Sorogrupo , Espanha/epidemiologia , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
INTRODUCTION: To describe the distribution of Streptococcus pneumoniae serotypes isolated in cerebrospinal fluid (CSF) between 2007-2018 in the Community of Madrid (CM) and to identify those with higher meningeal tropism. METHODS: Strains isolated from invasive pneumococcal disease were sent to the Regional Laboratory of Public Health by Microbiology laboratories of public and private hospitals of the CM. The frequency of serotypes from CSF was compared with that observed in other samples. RESULTS: A total of 6,115 strains were processed and 5% (n=304) were isolated from CSF. Seven serotypes (11A, 19F, 23B, 10A, 24F, 23A and 35F) showed a frequency significantly higher in CSF than in other usually sterile samples. Serotypes 24F, 11A and 23B showed high penicillin-resistance. CONCLUSION: The frequency and resistance of certain pneumococcal serotypes with high meningeal tropism could compromise the treatment of central nervous system infections.
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Meninges/microbiologia , Meningites Bacterianas , Infecções Pneumocócicas , Streptococcus pneumoniae , Humanos , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/epidemiologia , Meningites Bacterianas/microbiologia , Resistência às Penicilinas , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Sorogrupo , Espanha/epidemiologia , Streptococcus pneumoniae/classificação , TropismoRESUMO
In this study results against measles, rubella and mumps obtained in the III Sero-epidemiological Survey of the Autonomous Region of Madrid, performed in 1999-2000, were related to the posterior evolution of these diseases in this Region. The prevalence of antibodies against measles, rubella and mumps was >90%, >95% and <90 %, respectively. Despite of the good results obtained for rubella and measles, in 2005 and 2006 two important outbreaks of these diseases occurred in Madrid. The rubella outbreak in 2005 (450 cases) affected especially to immigrants of both sexes (mainly from Central and South America) and Spanish adults males. The 2006 measles outbreak (174 cases) was imported, a high proportion of cases were adults and most of the patients were unvaccinated. No differences according to sex were observed. In Madrid mumps virus circulation has continued from 1999 to present. Two epidemic waves in the periods 2000-2001 and 2006-2007 have been detected. During 2006-2007, an important proportion of cases showed antecedents of vaccination. Each one of these three diseases has typical characteristics. However, the three has in common the change in the age of apparition, with a growing frequency of cases among young adults.
Assuntos
Anticorpos Antivirais/sangue , Sarampo/sangue , Sarampo/epidemiologia , Caxumba/sangue , Caxumba/epidemiologia , Rubéola (Sarampo Alemão)/sangue , Rubéola (Sarampo Alemão)/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Estudos Soroepidemiológicos , Espanha , Saúde da População Urbana , Adulto JovemRESUMO
INTRODUCTION: Mumps is characterised by parotid inflammation and fever and is preventable by vaccination with MMR vaccine. The objective of the study is to assess the impact and effectiveness of the vaccine. MATERIAL AND METHODS: Cases notified to the Notifiable Disease System between 1998 and 2016 were used for the study. The vaccine effectiveness (VE) was calculated in cohorts vaccinated with two doses of Jeryl-Lynn, and the impact was calculated by comparing incidences by age and by Rubini (1995-1998) and Jeryl-Lynn (1999-2002) cohorts during the periods 1998-2004, 2005-2009 and 2010-2015. The incidences for age group and period were compared with the previous period and the incidences for cohorts were compared within a period with incidence ratios (IR) using Poisson models. The VE was estimated using the screening method using logistic regression models. RESULTS: 13,816 cases were reported. The incidence in 2005-2009 was higher than in 1998-2004 (IR: 1.46, 95% CI: 1.40-1.53), and it remained stable in 2010-2015 (IR: 0.99, 95% CI: 0.95-1.03). The average incidence rate of the Rubini cohort was 69.43 and the Jeryl-Lynn cohort was 32.24. The IR was 0.25 (95% CI: 0.22-0.29), 0.55 (95% CI: 0.49-0.61) and 0.88 (95% CI: 0.76-1.00) for each period respectively. 2,574 cases were included in the VE study. EV decreased over time reaching not significant values after seven years of follow-up (VE: 55%, 95% CI: 82 to -12%). CONCLUSIONS: Parotiditis behavior is characterised by fluctuations, changes in presentation and a decrease in VE.
Assuntos
Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Caxumba/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Surtos de Doenças/estatística & dados numéricos , Humanos , Esquemas de Imunização , Incidência , Lactente , Modelos Logísticos , Pessoa de Meia-Idade , Caxumba/prevenção & controle , Vírus da Caxumba/imunologia , Distribuição de Poisson , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: The availability of antipneumococcal vaccines makes it necessary to go deeply into the knowledge of pneumococcal disease. This study aims at describing the magnitude and incidence of pneumococcal disease in the Region of Madrid from 1998 to 2006. MATERIAL AND METHOD: Retrospective study of Computerized Hospital Discharge Data registered from 1998 to 2006. Incidence per 100,000 inhabitants and lethality were calculated. Temporal evolution was analyzed. RESULTS: 20,813 cases of pneumococcal disease were registered (annual average incidence 41.87/100,000 inhabitants). Incidence was 40.65 for pneumoniae and 0.77 for meningitis. People over 64 years old (185.04) and under 1 year of age (67.22) showed the highest incidence. Lethality was 10.1% (15.8% for meningitis). Incidence in 2004--2006 was lower than 1998--2000 (before the introduction of conjugate vaccine). Incidence trend has declined slightly. CONCLUSIONS: The incidence is higher than that shown by other studies. Selected source of data can explain this difference, since our data included suspected cases. However, pneumococcal meningitis incidence is similar to that described by others.
Assuntos
Infecções Pneumocócicas/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Meningite Pneumocócica/epidemiologia , Pessoa de Meia-Idade , Infecções Pneumocócicas/mortalidade , Pneumonia Pneumocócica/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Espanha/epidemiologiaRESUMO
OBJECTIVE: to ascertain the seroprevalence of antibodies to varicella-zoster virus in the Madrid population prior to the introduction of vaccination. STUDY DESIGN: Cross-sectional antibody seroprevalence study. POPULATION: persons aged 2 to 40 years in Madrid. Field work: September 1999 to April 2000. Data were collected on demographic and socio-economic variables and on a number of exposures. IgG antibodies were determined using Enzyme Linked ImmunoSorbent Assay (ELISA), and antibody prevalence broken down by age group. Logistic regression was used to analyse the association between the presence of antibodies and the respective study variables. The results were compared against those of an earlier seroprevalence survey in Madrid (1993). RESULTS: A total of 2,131 subjects were included, with a non-response rate of 20.4%. Antibody prevalence was estimated at 90.2%; the 90% mark was reached at 11 years of age and almost 100% of adults presented with antibodies. In the case of children, school attendance associated with the presence of antibodies. No significant differences were observed vis-à-vis the results of the earlier survey. CONCLUSIONS: The seroprevalence profile coincides with those of other Spanish regions and European countries, and remains stable over time. Antibody presence rises sharply in children from aged 2 years to adolescence. Further seroprevalence studies are called for to study the disease trend and assess preventive measures.
Assuntos
Varicela/epidemiologia , Herpes Zoster/epidemiologia , Herpesvirus Humano 3/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Análise de Variância , Anticorpos Antivirais/sangue , Varicela/sangue , Criança , Pré-Escolar , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Herpes Zoster/sangue , Herpesvirus Humano 3/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Espanha/epidemiologiaRESUMO
INTRODUCTION: The aim of this study was to evaluate a cut-off point of the titration of IgG by ELISA in the diagnosis of mumps. METHODS: A study was made of serum samples from 85 mumps cases (confirmed by PCR in saliva) and 2,351 controls of the general population of the Region of Madrid. RESULTS: The IgM detection was positive in 21 cases (sensitivity of 24.7%). The best cut-off point corresponded to IgG titres ≥4,900 (sensitivity of 64.7% and specificity of 86.1%). Among 42 patients immunised with at least one dose of measles mumps, rubella vaccine IgM was detected in 4 cases. However, the detection of IgG ≥4,900 was positive in 29 (sensitivity of 69.0%). CONCLUSIONS: An IgG result of ≥4.900 was almost 5 times more probable in a patient with mumps than in a non-infected patient. The detection of high titres of IgG against mumps could improve the IgM results in vaccinated people.
Assuntos
Imunoglobulina G/sangue , Caxumba/sangue , Caxumba/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Sorológicos , Adulto JovemRESUMO
BACKGROUND: Chickenpox is a contagious airborne disease. Immunization by varicella vaccine is an effective preventive measure. The objective of this study is to evaluate the impact and effectiveness of a single-dose vaccination against chickenpox at 15 months of age. METHODS: Observational study based on data from the Epidemiological Surveillance System of the Autonomous Community of Madrid from 2001 to 2015. The years were grouped into 4 periods according to epidemic cycles and vaccination schedule: 2001-06, 2007-10, 2011-13 and 2014-15. The impact was calculated as Relative Risk (RR) between the incidence of chickenpox in children between 15 months and 13 years of age between 2011-13 and 2001-06 through Poisson regression using notifications made to the Diseases of Compulsory Declaration (DCD) system, the Sentinel Physicians Network (SPN) and hospital discharge records noted as Minimum Basic Data Set (MBDS). The vaccine effectiveness (VE) was calculated using the screening method and a 1:2 case-control study paired by age and paediatrician in population from 15 months to 13 years and between 2007 and 2015 using SPN source data. RESULTS: The RR2011-13/2001-06 using data from the DCD was 0.14 (95% CI: 0.14 to 0.15), 0.07 (95% CI: 0.06 to 0.08) from SPN and 0.17 (95% CI: 0.15 to 0.20) from MBDS. A total of 338 cases were included in the VE screening obtaining an overall of 76.7% (IC 95%: 71.9 to 80.7%). For a case-control study, 120 cases and 247 controls were recruited obtaining a VE of 92.4% (IC 95%: 80.8 to 97.0%). CONCLUSIONS: The single-dose vaccination against chickenpox at 15 months of age has high impact and effectiveness.