[Long-term care facilities (LTCF) for the elderly: the surveillance of communicable diseases as part of health care and protection.] / Centros residenciales de mayores: la vigilancia de las enfermedades transmisibles como parte del cuidado y la protección de la salud.

During the last decades, healthcare has undergone important changes. Increased life expectancy has given rise to an aging population that, according to the United Nations, is about to become one of the most important social transformations of the 21st century. Globally, there were 727 million people aged 65 or over in 2020 (9.3% of the total population) and this is estimated to increase to 16% by 2050 . In the European Union (EU), the percentage of the population aged 65 or over has increased from 9.6% in 1960 to 20.3% in 2019 and is projected to increase to 31.3% by 2100. We are also witnessing a process of aging of the elderly population, with a proportion of very old people (those aged 80 and over) in the total population of the European Union of 5.8% in 2019 . Spain is one of the countries with the highest proportion of older people, with a percentage of citizens aged 65 or over in 2020 of 19.6% of the total population, and with a projection of 26.5% for 2035. Almost a third of this population (6%) are 80 years or older.

Durante las últimas décadas la asistencia sanitaria ha sufrido importantes cambios. La mayor esperanza de vida ha dado lugar a un envejecimiento de la población que, según las Naciones Unidas, está a punto de convertirse en una de las más importantes transformaciones sociales del siglo XXI. A nivel mundial, había 727 millones de personas de 65 años o más en 2020 (un 9,3% de la población total) y se estima que aumente al 16% en 2050 . En la Unión Europea (UE), el porcentaje de población de 65 años o más se ha incrementado de un 9,6% en 1960 a un 20,3% en 2019 y se proyecta que aumente a un 31,3% para 2100. Asistimos además a un proceso de envejecimiento de la población mayor, con una proporción de personas muy mayores (aquellas de 80 años y más) en la población total de la Unión Europea del 5,8% en 2019 . España es uno de los países con una mayor proporción de personas mayores, con un porcentaje de ciudadanos de 65 años o más en 2020 del 19,6% del total de la población, y con una proyección del 26,5% para 2035. Casi un tercio de esta población (6%) tienen 80 años o más.

Tools for Assessment of Country Preparedness for Public Health Emergencies: A Critical Review.

Recent international communicable disease crises have highlighted the need for countries to assure their preparedness to respond effectively to public health emergencies. The objective of this study was to critically review existing tools to support a country's assessment of its health emergency preparedness. We developed a framework to analyze the expected effectiveness and utility of these tools. Through mixed search strategies, we identified 12 tools with relevance to public health emergencies. There was considerable consensus concerning the critical preparedness system elements to be assessed, although their relative emphasis and means of assessment and measurement varied considerably. Several tools identified appeared to have reporting requirements as their primary aim, rather than primary utility for system self-assessment of the countries and states using the tool. Few tools attempted to give an account of their underlying evidence base. Only some tools were available in a user-friendly electronic modality or included quantitative measures to support the monitoring of system preparedness over time. We conclude there is still a need for improvement in tools available for assessment of country preparedness for public health emergencies, and for applied research to increase identification of system measures that are valid indicators of system response capability.

[Toxoplasmosis in Spain, analysis of hospitalizations during the period 1997-2018.] / Toxoplasmosis en España, aná-lisis de las hospitalizaciones en el periodo 1997-2018.

OBJECTIVE: Toxoplasmosis is a systemic infectious disease. Infection is acquired by ingestion of Toxoplasma gondii cysts or by vertical transmission mother-to-child during pregnancy (congenital toxoplasmosis). In Spain, the prevalence shows wide variability depending on the region and the study. The incidence in other European countries evidences a decline in recent years. The aim of this study was to characterize the presence and the epidemiological patterns of the disease in the Spanish population with information obtained of hospitalized cases with a diagnosis of toxoplasmosis at discharge. METHODS: The interactive platform of the Specialized Registry (RAE-MBD) of the Ministry of Health was used to obtain data on hospital discharges with "toxoplasmosis" diagnosis. Frequencies and rates of hospital discharges were calculated according to sex, age groups, region and diagnosis at discharge. Sequence graphs were generated to analysed the temporal evolution of the number of hospitalizations. The trends and slopes of the RHs were analyzed using "joinpoint" regression models, estimating the mean annual percentage change (PCAM) in the RHs and its 95% confidence interval. RESULTS: There were 13,704 cases with toxoplasmosis diagnosis at discharge, (58%) were men. The highest hospitalization rate (RH) was in the 15-44-year-old men group (5,804 discharges and HT=2.52). During the period studied a decrease in the number of discharges was observed, it was progressive and affected all the autonomous regions, being more pronounced in men (81.9% vs 63.9%). CONCLUSIONS: The number of hospitalizations in Spain decreased substantially during the studied period (1997-2018), similar to other European studies reported. The decrease was progressive and mainly affected men between 15-44 years.

OBJETIVO: La toxoplasmosis es una enfermedad infecciosa sistémica. Se contrae principalmente por ingestión de quistes y ooquistes de Toxoplasma gondii o por afectación fetal tras la primoinfección de la madre embarazada (toxoplasmosis congénita). La prevalencia en España presenta una gran variabilidad, dependiendo de la región y el estudio. La incidencia en otros países europeos refleja un descenso en los últimos años. El objetivo de este estudio fue caracterizar la presencia y el patrón epidemiológico de la enfermedad en la población española a partir de los casos hospitalizados con un diagnóstico de toxoplasmosis al alta. METODOS: A través de la plataforma interactiva del Registro de Atención Sanitaria Especializada (RAE-CMBD) del Ministerio de Sanidad se obtuvieron los datos de altas hospitalarias con diagnóstico "toxoplasmosis". Se calcularon frecuencias y tasas de altas hospitalarias (TH) según sexo, grupos de edad, comunidad autónoma y diagnóstico al alta. Se analizó la evolución temporal del número de hospitalizaciones a través de gráficos de secuencia. Las tendencias y las pendientes de las TH se analizaron mediante modelos de regresión "joinpoint", estimándose el porcentaje de cambio anual medio (PCAM) en las TH y su intervalo de confianza al 95%. RESULTADOS: Se contabilizaron 13.704 casos con diagnóstico toxoplasmosis al alta, el 58% hombres. La tasa de hospitalización (TH) más elevada se dio en hombres, en el grupo de 15-44 años (5.804 altas y TH=2,52). Se observa un descenso del 76,8% en el número de altas a lo largo del periodo estudiado, éste fue progresivo y afectó a todas las comunidades autónomas; siendo más acusado en hombres (81,9% vs 63,9%). CONCLUSIONES: El número de hospitalizaciones por toxoplasmosis en España se redujo notablemente a lo largo del periodo estudiado (1997-2018), mostrando una tendencia similar a la referida en otros estudios europeos. El descenso en los ingresos fue progresivo y afectó fundamentalmente a hombres de 15 a 44 años.

Management of a COVID-19 outbreak in a hotel in Tenerife, Spain.

Since the first accounts of SARS-CoV-2, authorities have encountered numerous unprecedented situations threatening public health. This rapid communication addresses events that led to the quarantining of a hotel in Tenerife, Spain and the effectiveness of the rapidly implemented control measures. In total, eight cases have been associated with the hotel. Due to the international nature of the guests, had these timely precautions not been in place, a multinational cluster might have formed.

Zika virus disease in Spain. Surveillance results and epidemiology on reported cases, 2015-2017. / La enfermedad por virus Zika en España. Resultados de la vigilancia y epidemiología de los casos notificados en 2015-2017.

INTRODUCTION AND OBJECTIVE: Zika virus disease is a challenge for public health due to its rapid spread and potential foetal complications. Although it is imported in Spain, there is a risk of autochthonous transmission due to Aedes albopictus presence. Zika disease and congenital cases have been under surveillance since 2016. The objective of this study is to explore the epidemiology of disease and pregnancies result. MATERIAL AND METHODS: A descriptive study was carried out into cases reported to the National Surveillance Network (RENAVE) during the 30/11/2015 to 31/12/2017 period. The case definition and the survey are included in the RENAVE protocol. The variables were: date; notifying region (Autonomous Community (AC)); pregnancy and its evolution; case classification; mode of transmission; country or region of infection; socio-demographical, clinical and microbiological data. A descriptive analysis of the cases and their distribution according to the other variables was carried out. RESULTS: A total of 512 cases were reported by 17 ACs. 507 were non-congenital, of which 327 (64.5%) were women (52.5% of childbearing age). 403 cases (79.5%) corresponded to 2016 and 193 (38.1%) resided in regions with A. albopictus presence between May and October. 96.1% of imported cases were infected in America (51.7% while visiting relatives). Three cases (3.9%) of congenital Zika virus infection were detected among 77 pregnant women. CONCLUSIONS: The evolution of reported cases was in accordance with that of the epidemic in America. The largest group of travellers was young women who travelled to Latin America on family visits. Pregnancy monitoring resulted in the identification of Zika related foetal complications.

Epidemiology of tuberculosis in Spain. Results obtained by the National Epidemiological Surveillance Network in 2015. / Epidemiología de la tuberculosis en España. Resultados obtenidos por la Red Nacional de Vigilancia Epidemiológica en el año 2015.

The epidemiological surveillance data for tuberculosis in Spain in 2015 is analysed in this report. This information was gathered through cases reported to the Red Nacional de Vigilancia Epidemiológica [National Epidemiological Surveillance Network]. In addition, the update of the treatment of the cases reported in 2014 is included. The incidence rate of tuberculosis in 2015 was 10.59 cases per 100,000 inhabitants, 10% less than in 2014. This decrease was mainly due to the sustained decreased trend of pulmonary tuberculosis rates, from other locations and in adults, while for cases of tuberculous meningitis and in children the decrease is less marked, with a tendency to stabilization. The percentage of cases born in other countries remains stable (approximately 30% of the total). Information on HIV status is available in 63% of cases, of which 7% were HIV-positive. Regarding the treatment results, 77% of the new lung cases confirmed by culture reported in 2014 had a satisfactory result, 6% died, and 11% did not have this information.

[Chronic diseases as a priority for the public health surveillance system in Spain]. / Las enfermedades crónicas como prioridad de la vigilancia de la salud pública en España.

At present, epidemiological surveillance in Spain remains focused on the communicable diseases included in the list of notifiable diseases. However, there has been a change in epidemiological pattern that predominated until the last few decades of the twentieth century. Infectious diseases, which used to be the leading causes of morbidity and mortality, have given way to a predominance of chronic diseases. In this regard, progress has been made in the drafting and adoption of specific legal regulations on public health monitoring. However, Spain has yet to develop this legislation which, among other elements, includes the mandate to organize the surveillance of non-communicable diseases in Spain. This article aims to describe some points that should be considered in the development of a national surveillance system linked to existing strategies for the prevention and control of chronic diseases.

[Epidemiological surveillance of sexually-transmitted diseases. Spain 1995-2003]. / Vigilancia epidemiológica de las infecciones de transmisión sexual. España, 1995-2003.

BACKGROUND AND OBJECTIVE: Sexually transmitted infections (STIs) are a major public health problem due to their morbidity, complications and sequels, and also by their relationships with human immunodeficiency virus infection. Several countries have been described a resurgence of STIs since the mid-1990's. MATERIAL AND METHOD: Descriptive study of the STIs monitored by epidemiological surveillance, using as source of information the Spanish National Network of Epidemiological Surveillance data, from 1995 to 2003. RESULTS: In 2003, 1069 new cases of gonorrhoea (rate: 2.55 per 100,000 population) and 917 new cases of syphilis (rate: 2.19 per 100,000 population) were notified to the Spanish Compulsory Disease Reporting System. Between 1995 and 2003, gonorrhoea incidence rates decreased in a 78% and syphilis rates diminish in a 15%. Nevertheless, between 2001 and 2003, both gonorrhoea and syphilis incidence rates have increased in a 29% and 27% respectively. CONCLUSIONS: The data analyzed in this period show an evident change in the trend of the incidence of these STIs. This fact has to be confirmed in the future.