Progressive Invasion of Aedes albopictus in Northern Spain in The Period 2013-2018 and A Possible Association with the Increase in Insect Bites.

1) Background: Aedes albopictus has rapidly expanded throughout Europe, becoming a public health concern in the Mediterranean Basin. 2) Methods: Following the detection of Ae. albopictus in the southwestern French region of Aquitaine in 2012, an entomological surveillance programme was implemented in the Basque Country (Northern Spain) in 2013. 3) Results: Ae. albopictus eggs were first detected in 2014 in a transited parking area in the northeastern sampling point, 22 km away from the nearest French site with recorded presence of tiger mosquito. At this site, eggs were found throughout the study (2014-2018). Other western and southern municipalities became positive in 2017 and 2018. Ae. albopictus adults were first captured in 2018 by aspiration of the vegetation in an area where eggs had been detected since 2015, suggesting a progressive establishment of a self-sustained population. Incidence of insect bites in humans was roughly constant over the study period except for a significant increase in 2018 in the Health County where eggs had been detected since 2014. Densities of Ae. albopictus eggs in positive areas remained at similar levels over the years. 4) Conclusion: Multiple approaches and standardized methods are necessary to successfully control this vector.

Brote de hepatitis A asociado a un manipulador de alimentos en Bizkaia, 2017 / Hepatitis A outbreak associated with a food handler in Bizkaia, 2017

INTRODUCCIÓN: La notificación de un caso de hepatitis A en un manipulador de alimentos de una pastelería y de 5 casos en trabajadores de una empresa tras consumir productos de la misma dio lugar a una investigación de brote. MÉTODOS: Se definieron como casos las personas con infección por el virus de la hepatitis A (VHA) confirmada por el laboratorio, con comienzo de síntomas en junio y que, durante el periodo de incubación, trabajaron con el manipulador y/o tuvieron contacto estrecho con él y/o consumieron productos de la pastelería. Se realizó una encuesta epidemiológica y se tomaron muestras de sangre para analizar la presencia de anticuerpos anti-hepatitis A. Se realizó la caracterización molecular por PCR, secuenciación de la región VP1/2A y análisis filogenético con el método de máxima verosimilitud, bootstrap 1000 (software MEGA 7.0). RESULTADOS: Se identificaron 14 casos primarios: 11 relacionados con el consumo de productos de la pastelería, 2 compañeros de trabajo del manipulador y un contacto familiar. Los 12 virus secuenciados eran genotipo IA, coincidiendo con una de las cepas (RIVM-HAV16-090) responsable de los brotes producidos en ese momento en Europa y que afectaban fundamentalmente a hombres que tienen sexo con hombres. CONCLUSIONES: Se debería reforzar la vacunación frente al VHA de grupos de riesgo para prevenir brotes futuros. La implementación del uso del tipado molecular en casos de hepatitis A podría mejorar la investigación de brotes, que se puede esperar que aumenten en el futuro debido al descenso de inmunidad en la población

INTRODUCTION: The reporting of one case of hepatitis A in a food handler at a bakery and five cases in employees of a company after consuming products from the same bakery prompted an outbreak investigation. METHODS: Outbreak cases were defined as individuals with laboratory-confirmed hepatitis A (HAV) infection, with symptoms which started in June and who, during the incubation period, worked with the food handler and/or had close contact with him and/or consumed products from the bakery. Epidemiologic questionnaires were performed and blood samples were obtained to be tested for the presence of anti-hepatitis A antibodies. Molecular characterisation was carried out by PCR, sequencing of the VP1/2A region and phylogenetic analysis with the maximum likelihood estimation method, bootstrap 1000 (MEGA 7.0 software). RESULTS: A total of 14 primary hepatitis A cases were identified: eleven cases related to the consumption of products from the bakery, two cases among co-workers of the food handler, and one case was a household contact. All 12 sequenced viruses were genotype IA, matching one of the strains (RIVM-HAV16-090) responsible for the outbreaks occurring at that time in Europe, mostly affecting men who have sex with men. CONCLUSIONS: HAV vaccination of at-risk groups should be reinforced in order to prevent future outbreaks. Increasing the use of molecular typing in hepatitis A cases could improve the investigation of outbreaks, which can be expected to increase in the future because of decreasing immunity in the population

Epidemiología de los accidentes en una cohorte de adultos mayores de 64 años de la Comunidad Autónoma del País Vasco / Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country

Introducción. Los accidentes son un problema importante de salud para las personas mayores. El objetivo de este estudio ha sido valorar la incidencia de accidentes en la población mayor de 64 años y describir las características que se asocian a la accidentalidad. Material y métodos. Estudio descriptivo de una cohorte de 15.192 personas mayores de 64 años, no institucionalizadas, realizado a través de Red Vigía de la CAPV y durante el periodo de un año. Por cada accidente se realizó una encuesta. Se calcularon las tasas de accidentalidad y los riesgos por grupos de edad y sexo. Resultados. La tasa de accidentalidad fue 46,52 y 81,87 por 1.000 hombres y mujeres, respectivamente. El tipo de accidente más frecuente fue la caída (92%), la lesión más severa la fractura (17%) con un riesgo significativamente superior para las mujeres y los mayores de 75 años. Conclusiones. Los datos presentados confirman la importante dimensión de los accidentes no intencionados en la población mayor de 64 años en la CAPV. El accidente más frecuente ha sido la caída, que constituye un fenómeno de gran transcendencia en los adultos mayores ya que son una de las principales causas de lesiones, incapacidad e institucionalización (AU)

Introduction. Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. Material and methods. This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. Results. The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. Conclusions. These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group (AU)