RESUMEN
A cluster of three cases of food-borne botulism due to Clostridium baratii type F occurred in France in August 2015. All cases required respiratory assistance. Consumption of a Bolognese sauce at the same restaurant was the likely source of contamination. Clostridium baratii was isolated both from stool specimens from the three patients and ground meat used to prepare the sauce. This is the second episode reported in France caused by this rare pathogen.
Asunto(s)
Proteínas Bacterianas/toxicidad , Toxinas Botulínicas , Botulismo/diagnóstico , Clostridium/aislamiento & purificación , Neurotoxinas/toxicidad , Adulto , Proteínas Bacterianas/metabolismo , Antitoxina Botulínica/uso terapéutico , Botulismo/etiología , Botulismo/microbiología , Clostridium/clasificación , Clostridium/metabolismo , Análisis por Conglomerados , Heces/microbiología , Femenino , Microbiología de Alimentos , Francia , Hospitalización , Humanos , Masculino , Carne/microbiología , Persona de Mediana Edad , Neurotoxinas/análisis , Neurotoxinas/metabolismo , Cuadriplejía/microbiología , Respiración Artificial , Insuficiencia Respiratoria/microbiología , Insuficiencia Respiratoria/terapia , Resultado del TratamientoRESUMEN
In 2013, 15 clusters of mumps were notified in France; 72% (82/114) of the cases had been vaccinated twice with measles-mumps-rubella vaccine. To determine whether the risk of mumps increased with time since the last vaccination, we conducted a case-control study among clusters in universities and military barracks. A confirmed case had an inflammation of a salivary gland plus laboratory confirmation in 2013. A probable case presented with inflammation of a salivary gland in 2013 either lasting for > 2 days or with epidemiological link to a confirmed case. Controls had no mumps symptoms and attended the same university course, student party or military barracks. We collected clinical and vaccination data via web questionnaire and medical records. We calculated adjusted odds ratios (aOR) using logistic regression. 59% (50/85) of cases and 62% (199/321) of controls had been vaccinated twice. The odds of mumps increased for twice-vaccinated individuals by 10% for every year that had passed since the second dose (aOR 1.10; 95% confidence interval (CI): 1.02-1.19; p = 0.02). Mumps immunity waned with increasing time since vaccination. Our findings contributed to the French High Council of Public Health's decision to recommend a third MMR dose during outbreaks for individuals whose second dose dates > 10 years.
Asunto(s)
Notificación de Enfermedades/estadística & datos numéricos , Brotes de Enfermedades , Vacuna contra la Parotiditis/administración & dosificación , Vacuna contra la Parotiditis/inmunología , Paperas/epidemiología , Paperas/inmunología , Adolescente , Estudios de Casos y Controles , Femenino , Francia , Humanos , Masculino , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Vacuna contra el Sarampión-Parotiditis-Rubéola/inmunología , Paperas/prevención & control , Virus de la Parotiditis/genética , Virus de la Parotiditis/aislamiento & purificación , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Vacunación/estadística & datos numéricos , Adulto JovenRESUMEN
Lower respiratory tract infections (LRTI) are the leading cause of infectious deaths in nursing homes. An early reporting procedure of LRTI outbreaks to local public health authorities was set up in France in 2006 in order to reduce the morbidity and the mortality related to these events. Local public health authorities reported these outbreaks to the French institute for Public Health Surveillance through a web application allowing a real-time exchange of information. Between August 2006 and July 2007, 64 outbreaks were reported. In more than 30% of the episodes, influenza virus was detected. On average, attacks rates were 22% for the residents and 7% for the staff. Staff members were affected in at least 56% of outbreaks. Average influenza vaccine uptake was 91% for the residents and 38% for the staff. The time for control measures implementation was 6.7 days on average and control measures were implemented after reporting in 36% of outbreaks. When control measures were implemented more than 2 days after the onset of the first case, the duration of outbreaks was longer (16.4 days vs. 8.3 days, P < 0.005) and residents had an increased rate of LRTI (P < 0.001) than when these measures were implemented earlier. These data show that the influenza immunization coverage for staff working in nursing homes is limited. The implementation of control measures is often delayed, although recommendations stress that they should start upon diagnosis of the first case. Reporting creates a dialog between nursing homes and public health professionals which facilitates outbreak management.