Early intervention in pertussis outbreak with high attack rate in cohort of adolescents with complete acellular pertussis vaccination in Valencia, Spain, April to May 2015.

Forty-three pertussis cases reported in May 2015 in Valencia were linked to a school outbreak where 90% of the students had been vaccinated. Cases were diagnosed upon paediatrician consultation and in hospital emergency units. Approximately half of the cases were students born in 2002, the first age cohort with complete shift to acellular pertussis vaccine. Public health intervention, visiting school premises to conduct interviews, sample collection and early antibiotic prophylaxis stopped further spread in the community.

[Infectious acute gastroenteritis in the emergency department of an urban hospital]. / Gastroenteritis aguda infecciosa en urgencias de un hospital urbano.

OBJECTIVES: To examine the etiology, clinical, analytical and evolutionary characteristics of gastroenteritis in the pediatric population in the Emergency Department of Dr. Peset University Hospital in Health Care Area 10 in Valencia, Spain, over a 1-year period (2005). PATIENTS AND METHODS: Children < 15 years of age with acute diarrhea were prospectively enrolled in the Emergency Department. Data were collected through information sheets. Their stools were examined for diarrheagenic bacteria and viruses (rotavirus and adenovirus). RESULTS: 794 episodes of gastroenteritis were recorded. The incidence of rotavirus was 22 %, adenovirus 8 %, Campylobacter jejuni 7 % and Salmonella spp. 4 %. Socioeconomic characteristics were not helpful in differentiating disease due to specific enteropathogens. Ninety per cent cases caused by viruses only affected children under three years of age. Rotavirus gastroenteritis had a marked seasonal pattern (90 % cases in December-February). Among infants < or = 6 months of age rotavirus was less frequent as cause of diarrhea in breast-fed infants than in bottle-fed. Macroscopic blood in stools was reported almost exclusively among patients with a bacterial infection. In 96 % of all cases of diarrhea there was no dehydration, in 2 % it was mild, in 2 % moderate and none severe. Ten of the seventeen cases (59 %) of moderate dehydration were caused by rotavirus. Six percent of all children were hospitalised. CONCLUSIONS: Rotavirus was significantly more associated with the need for intravenous fluid therapy and hospitalisation than episodes negative for rotavirus. Rotavirus accounted for 3 % of hospitalisations in infants aged 1 month-2 years.

[Can we improve the prevention of tuberculosis? Analysis of the application of chemoprophylaxis]. / Podemos mejorar la prevención de la tuberculosis? Análisis de la aplicación de la quimioprofilaxis.

To analyze the situations that make chemoprophylaxis for tuberculosis difficult. One hundred twenty-eight patients consecutive (106 HIV negative and 22 HIV positive) diagnosed of tuberculosis (TB) were studied. The patients were interviewed and a questionnaire was filled out in order to identify risk groups and determine what steps had been taken to prevent TB. In the HIV negative group, 63 (57.8%) had at least one risk factor. The most common were contact with persons with active TB (31.1%), former TB (15.1%), rapid weight loss or chronic malnutrition (13.2%) and residence in closed institutions (5.6%). Of the 51 (48.1%) for whom evaluation of chemoprophylaxis was indicated, 43 (84.3%) had been examined by a physician within the past five years; only 10 (23.3%) of them, however, had been checked for TB and isoniazide had been prescribed for only 4 (9.3%). In the HIV positive group, 13 (72.2%) of those for whom evaluation of chemoprophylaxis was indicated had been seen by a physician; 12 (97.7%) of them were given tuberculin tests checked for TB and isoniazide was prescribed for 4 (30.7%). None of the patients in either group who were prescribed a full course of prophylaxis actually took the drug enough. Most HIV negative patients for whom evaluation of chemoprophylaxis was indicated had been examined by a physician in the five years before disease was detected; less than a quarter of them were checked for TB, however. This situation is probably a consequence of the structure of health care in Spain as it affects TB control. Nearly all the HIV positive patients were checked for the disease, as they benefited from protocolized health care.

[Ureaplasma urealyticum and Mycoplasma hominis: incidence and clinical significance of their isolation in the perinatal period]. / Ureaplasma urealyticum y Mycoplasma hominis: frecuencia y significado clínico de su aislamiento en el período perinatal.

In order to known the clinical significance of the colonization of the maternal genitalia and infant with genital mycoplasmas, we studied prospectively 219 pairs of mothers and newborns admitted for delivery to a general public hospital. U. urealyticum and M. hominis were isolated from 72 (32.9%) and 10 (4.6%) of the mothers, respectively. During the first 4 days of life. U. urealyticum and M. hominis were isolated from 23 (10.5%) and 1 (0.5%), of the newborn infants respectively. Maternal colonization by genital mycoplasmas was not associated with a longer duration of membrane rupture, nor with a shorter gestational age, nor with smaller neonatal weight and length. Neonatal colonization by U. urealyticum was not associated with shorter gestational age, nor with smaller birth weight and length, nor with the appearance of any disease during the first 3 months of life.