Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities.

BACKGROUND: Older adults living in long-term care facilities (LTCFs) are at increased risk for severe outcomes from COVID-19 and were identified as a priority group in COVID-19 vaccination strategies. Emerging evidence suggests vaccine effectiveness in LTCF populations, but data about median and long-term durability of immune response after vaccination are still limited. OBJECTIVES: In this study, we assessed the humoral response to BNT162b2 mRNA COVID-19 vaccine 3 months after the second dose, in a cohort of 495 residents aged ≥65 years from 11 LTCF in Granada, Spain. METHOD: Between April 19 and April 30, 2021, we measured anti-SARS-CoV-2 Spike IgG to evaluate the humoral vaccination response. Antibody titers were reported in binding antibody units (BAU/mL). Bivariate and multivariate logistic regression models were performed to investigate the impact of age, sex, underlying health conditions, and prior COVID-19 infection on the antibody levels. RESULTS: Over 96% of the participants developed an adequate humoral response. We detected higher antibody titers in previously infected individuals, compared with those previously uninfected (B: 1,150.059 BAU/mL, p < 0.001). Moreover, we found a significant inverse association between age and antibody levels (B: -7.943 BAU/mL, p < 0.05). This negative age-dependent response was more noticeable among residents over 85 years old. In contrast, baseline health conditions and cognitive status were not associated with different antibody levels. CONCLUSIONS: These findings support monitoring COVID-19 vaccination response trend in older adults, in order to optimize future disease prevention and control strategies in this vulnerable population.

Characterization of the first autochthonous dengue outbreak in Spain (August-September 2018).

On October 3rd 2018, dengue virus (DENV) infection was confirmed in three family members (symptoms onset between August 18th and 27th) without travel history outside of Spain. They had been together in the Autonomous Communities (AC) of Murcia and Andalusia. By the end of October, a second cluster of two dengue cases (symptoms onset on September 27th and 30th) was confirmed in the AC of Murcia. DENV type 1 sequence was identical to the first cluster, and the epidemiological link was a visit from a case of the first cluster to a fruit-farm neighboring the small village of residence of the second cluster. The entomological investigation found Aedes albopictus activity in this area although all mosquitoes were PCR-negative for DENV. This is the first autochthonous dengue outbreak identified in Spain. This outbreak highlights challenges to timely detect and respond to DENV transmission and opens questions on dengue dynamics in a non-endemic context.

Consumo de psicofármacos y exposición a toxinas bacterianas vehiculizadas por alimentos: una asociación peligrosa / Consumption of psychoactive drugs and exposure to bacterial toxins carried by food: a dangerous association

Objetivo: Describir y analizar desde el punto de vista clínico y epidemiológico un brote de toxiinfección alimentaria en una institución de enfermos psiquiátricos de Granada, en 2015, y examinar si el tratamiento con psicofármacos constituye un factor de riesgo para desarrollar una toxiinfección alimentaria, analizando los grados de susceptibilidad según el grupo terapéutico consumido. Método: Estudio ambispectivo de cohortes. La unidad de análisis fueron los residentes. Se realizó búsqueda activa de casos, encuesta alimentaria y búsqueda de otros riesgos, e inspección alimentaria. Se estudiaron variables de persona, lugar y tiempo. Análisis descriptivo (frecuencias absolutas y relativas), cálculo de las tasas de ataque por pabellón y por menú. Análisis bivariado (ji al cuadrado, t de Student) y riesgo relativo como medida de la fuerza de asociación. Análisis multivariado mediante regresión logística para el análisis de riesgos de la medicación. Resultados: Se contabilizaron 18 casos con diarrea sin fiebre (periodo de incubación de 6-16 horas), de carácter leve y autolimitado. Las manifestaciones clínicas, la agrupación temporal de casos y las características de los alimentos ingeridos centraron la sospecha en una toxina bacteriana. A igualdad en el resto de variables, los grupos terapéuticos N03AF y N03AG confirieron mayor riesgo de enfermar (odds ratio [OR]: 8,626; intervalo de confianza del 95% [IC95%]: 2,050-36,308; p=0,003; y OR: 14,516; IC95%: 3,155-66,784; p=0,001, respectivamente). Conclusión: La disminución del tránsito intestinal causada por la administración de antiepilépticos puede aumentar el tiempo de exposición de la mucosa intestinal a la toxina, aumentando el riesgo de enfermar y de padecer complicaciones. Debe realizarse un esfuerzo higiénico suplementario en este tipo de instituciones para prevenir estas afecciones

Objective: To describe and analyse from a clinical and epidemiological point of view, a food borne outbreak in a psychiatric institution in Granada, in 2015, and to examine whether treatment with psychoactive drugs constitutes a risk factor for the development of a food borne disease, analysing the degree of susceptibility according to the therapeutic group consumed. Method: Ambispective cohort study. Residents were the unit of analysis. Our group carried out an active case search and a food survey. A search for other risks was developed as well as a food inspection. Location, time and individual variables were studied. A descriptive analysis was conducted (absolute and relative frequencies). Calculation of attack rates by building and by menu was made. Bi-variant analysis (Chi-square test, t-Student test) and relative risk were used as a measure of strength of association. For risk analysis of medication, a multivariate analysis using logistic regression was carried out. Results: 18 cases with diarrhoea without fever were found (incubation period from 6 to 16hours). Cases were mild and self-limiting. The clinical manifestations, the temporal grouping of cases and the characteristics of the ingested foods, focussed suspicion on a bacterial toxin. Being equal in the rest of variables, the N03AF, and N03AG therapeutic groups confer greater risk of disease (odds ratio [OR]: 8.626; 95% confidence interval [95%CI]: 2.050-36.308; p=0.003; and OR: 14.516; 95%CI: 3.155-66.784; p=0.001, respectively). Conclusion: Decreased intestinal transit, caused by the administration of anticonvulsants, may increase exposure time of the intestinal mucosa to the toxin, increasing the risk of disease and suffering from complications. An additional hygienic effort should be made in this type of institution to prevent these pathologies

[Consumption of psychoactive drugs and exposure to bacterial toxins carried by food: a dangerous association]. / Consumo de psicofármacos y exposición a toxinas bacterianas vehiculizadas por alimentos: una asociación peligrosa.

OBJECTIVE: To describe and analyse from a clinical and epidemiological point of view, a food borne outbreak in a psychiatric institution in Granada, in 2015, and to examine whether treatment with psychoactive drugs constitutes a risk factor for the development of a food borne disease, analysing the degree of susceptibility according to the therapeutic group consumed. METHOD: Ambispective cohort study. Residents were the unit of analysis. Our group carried out an active case search and a food survey. A search for other risks was developed as well as a food inspection. Location, time and individual variables were studied. A descriptive analysis was conducted (absolute and relative frequencies). Calculation of attack rates by building and by menu was made. Bi-variant analysis (Chi-square test, t-Student test) and relative risk were used as a measure of strength of association. For risk analysis of medication, a multivariate analysis using logistic regression was carried out. RESULTS: 18 cases with diarrhoea without fever were found (incubation period from 6 to 16hours). Cases were mild and self-limiting. The clinical manifestations, the temporal grouping of cases and the characteristics of the ingested foods, focussed suspicion on a bacterial toxin. Being equal in the rest of variables, the N03AF, and N03AG therapeutic groups confer greater risk of disease (odds ratio [OR]: 8.626; 95% confidence interval [95%CI]: 2.050-36.308; p=0.003; and OR: 14.516; 95%CI: 3.155-66.784; p=0.001, respectively). CONCLUSION: Decreased intestinal transit, caused by the administration of anticonvulsants, may increase exposure time of the intestinal mucosa to the toxin, increasing the risk of disease and suffering from complications. An additional hygienic effort should be made in this type of institution to prevent these pathologies.

[Changes in Hepatitis A epidemiological pattern in Andalucía: 2007-2017]. / Cambios en el patrón epidemiológico de la Hepatitis A en Andalucía: 2007-2017.

OBJECTIVE: Sexual transmission of hepatitis A (HAV) is documented, mainly by risk behaviors in men who have sex with men (MSM). There have been HAV outbreaks in MSM in countries of the European Union in the last years. The aim of this work was to study HAV epidemiology in Andalusia in the last 10 years (2007-2017) and the outbreaks among MSM in this period. METHODS: Retrospective descriptive study of HAV cases reported in the Andalusia Epidemiological Surveillance System between January 2007 and May 2017. We calculated the annual incidence rate per 100000 habitants. We studied case distribution for gender and age. We used the male-female ratio as an indirect marker for MSM. RESULTS: The mean annual incidence rate in the study period was 4.09 cases per 100000 habitants, with a difference by sex: 4.7 per 100000 men and 2.53 per 100000 women. Two large outbreaks were detected in this period: one in 2008-2009 and another in 2016-2017. The epidemiological characteristics of these outbreaks differ from the classical pattern of the disease, affecting young MSM with associated sexual risk behaviors. CONCLUSIONS: MSM play a fundamental role in recent outbreaks of HAV. For disease control we must carry out a different strategy, assessing the introduction of systematic vaccination.

OBJETIVO: La trasmisión sexual de la hepatitis A (VHA) está documentada, principalmente en conduc- tas de riesgo en hombres que tienen sexo con hombres (HSH). En los últimos años están apareciendo brotes de VHA en HSH en países de la Unión Europea. El objetivo del trabajo fue estudiar la epidemiología del VHA en Andalucía en los últimos 10 años (2007-2017) y la de los brotes ocurridos en HSH en dicho periodo. METODOS: Estudio descriptivo retrospectivo de los casos de VHA declarados en el Sistema de Vigilancia Epidemiológica de Andalucía (SVEA) entre enero de 2007 y mayo de 2017. Se calculó la tasa de incidencia anual por 100.000 habitantes. Se estudió la distribución de los casos por grupo de edad y sexo. Se usó la razón hombre-mujer, como marcador indirecto de los HSH. RESULTADOS: La tasa de incidencia media anual en el periodo de estudio fue 4,09 casos por 100.000 habitantes, con una diferencia según sexo: 4,7 por 100.000 hombres y 2,53 por 100.000 mujeres. Aparecieron dos grandes brotes en este periodo: uno en 2008-2009 y otro en 2016-2017. Las características epidemiológicas de estos brotes difirieron del patrón clásico de la enfermedad, afectando a HSH jóvenes, colectivo que se asocia con conductas sexuales de riesgo. CONCLUSIONES: Los HSH tienen un papel fundamental en los brotes de VHA aparecidos recientemente. Para el control de la enfermedad debemos realizar una estrategia diferente, valorando la introducción de la vacunación sistemática.

Cambios en el patrón epidemiológico de la Hepatitis A en Andalucía: 2007-2017 / Changes in Hepatitis A epidemiological pattern in Andalucía: 2007-2017

Fundamentos: La trasmisión sexual de la hepatitis A (VHA) está documentada, principalmente en conductas de riesgo en hombres que tienen sexo con hombres (HSH). En los últimos años están apareciendo brotes de VHA en HSH en países de la Unión Europea. El objetivo del trabajo fue estudiar la epidemiología del VHA en Andalucía en los últimos 10 años (2007-2017) y la de los brotes ocurridos en HSH en dicho periodo. Métodos: Estudio descriptivo retrospectivo de los casos de VHA declarados en el Sistema de Vigilancia Epidemiológica de Andalucía (SVEA) entre enero de 2007 y mayo de 2017. Se calculó la tasa de incidencia anual por 100.000 habitantes. Se estudió la distribución de los casos por grupo de edad y sexo. Se usó la razón hombre-mujer, como marcador indirecto de los HSH. Resultados: La tasa de incidencia media anual en el periodo de estudio fue 4,09 casos por 100.000 habitantes, con una diferencia según sexo: 4,7 por 100.000 hombres y 2,53 por 100.000 mujeres. Aparecieron dos grandes brotes en este periodo: uno en 2008-2009 y otro en 2016-2017. Las características epidemiológicas de estos brotes difirieron del patrón clásico de la enfermedad, afectando a HSH jóvenes, colectivo que se asocia con conductas sexuales de riesgo. Conclusiones: Los HSH tienen un papel fundamental en los brotes de VHA aparecidos recientemente. Para el control de la enfermedad debemos realizar una estrategia diferente, valorando la introducción de la vacunación sistemática

Background: Sexual transmission of hepatitis A (HAV) is documented, mainly by risk behaviors in men who have sex with men (MSM). There have been HAV outbreaks in MSM in countries of the European Union in the last years. The aim of this work was to study HAV epidemiology in Andalusia in the last 10 years (2007-2017) and the outbreaks among MSM in this period. Methods: Retrospective descriptive study of HAV cases reported in the Andalusia Epidemiological Surveillance System between January 2007 and May 2017. We calculated the annual incidence rate per 100000 habitants. We studied case distribution for gender and age. We used the male-female ratio as an indirect marker for MSM. Results: The mean annual incidence rate in the study period was 4.09 cases per 100000 habitants, with a difference by sex: 4.7 per 100000 men and 2.53 per 100000 women. Two large outbreaks were detected in this period: one in 2008-2009 and another in 2016-2017. The epidemiological characteristics of these outbreaks differ from the classical pattern of the disease, affecting young MSM with associated sexual risk behaviors. Conclusions: MSM play a fundamental role in recent outbreaks of HAV. For disease control we must carry out a different strategy, assessing the introduction of systematic vaccination

[Contribution of Electronic Health Record in Surveillance of Notifiable Diseases]. / Aportación de la historia clínica digital a la vigilancia de enfermedades de declaración obligatoria.

BACKGROUND: In 2009 a system was introduced for the automatic import (AI) of cases with suspected notifiable diseases (ND) from electronic medical record (EMR) to RedAlerta, an application for surveillance in Andalusia. At present, the contribution of this system to classical active statement has not been determined enough. The main objective of this study is to evaluate the usefulness of IA in the province of Granada, between 2009 and 2014. METHODS: During the study period (2009-2014), an epidemiologist assessed whether AI met declaration criteria or not. We calculate the contribution of AI to RedAlerta and the percentage of validation of AI, estimating 95% CI. RESULTS: The contribution of AI was 17.3% (95% CI 16.1 to 18.5); and type of statement, 5.2% (95% CI 4.1 to 6.5) for urgent and 24.4% (95% CI 22.7 to 26.2) for ordinary. The contribution was higher (more than 45%) in Lyme disease, congenital hypothyroidism, genital herpes, hepatitis C and other viral hepatitis. 30% (95% CI 28.1 to 32) of AI were validated; 39.9% (95% CI 33 to 47.2) urgent and 29.1% (95% CI 27.2 to 31.2%) ordinary. The percentage of validation was higher than 45% (between 47.5 and 100%) in vaccine-preventable diseases, sexually transmitted infections and low incidence. CONCLUSIONS: Although not replace manual reporting and requires verification, the AI system is useful and increases the completeness of the epidemiological surveillance system.

Aportación de la historia clínica digital a la vigilancia de enfermedades de declaración obligatoria / Contribution of electronic health record in surveillance of notifiable diseases

Fundamentos: En 2009 se implantó el sistema para la importación automática (IA) de casos con sospecha de enfermedad de declaración obligatoria (EDO) desde la historia clínica digital (HCD) a la RedAlerta, aplicación informática para la vigilancia epidemiológica en Andalucía. Hasta ahora, la contribución de este sistema a la clásica declaración activa no se ha determinado suficientemente. El principal objetivo de este estudio es evaluar la utilidad de IA en la provincia de Granada, entre 2009 y 2014. Métodos: Durante el periodo de estudio (2009-2014), un epidemiólogo validó si las EDO importadas satisfacían el criterio de declaración o no. Se halló la contribución de la IA a la RedAlerta y el porcentaje de validación de IA, estimando su IC 95%.Resultados: La contribución de la IA fue del 17,3% (IC95%: 16,1-18,5). Por tipo de declaración el 5,2% (IC95%:4,1-6,5) fueron las urgentes y 24,4% (IC95%: 22,7-26,2) fueron ordinarias. La contribución fue superior al 45% en la enfermedad de Lyme, hipotiroidismo congénito, herpes genital, hepatitis C y otras hepatitis víricas. El 30% (IC95%:28,1-32) de las IA fueron validadas de las cuales el 39,9% (IC95%:33–47,2) fueron urgentes y el 29,1% (IC95%:27,2–31,2%) ordinarias. El porcentaje de validación fue superior al 45% (entre el 47,5 y el 100%) en enfermedades vacunables, en las de transmisión sexual y en las de baja incidencia. Conclusiones: Si bien no sustituye la declaración manual y requiere de un proceso de verificación, el sistema de incorporación automática es útil e incrementa la exhaustividad del sistema de vigilancia epidemiológica (AU)

Background: In 2009 a system was introduced for the automatic import (AI) of cases with suspected notifiable diseases (ND) from electronic medical record (EMR) to RedAlerta, an application for surveillance in Andalusia. At present, the contribution of this system to classical active statement has not been determined enough. The main objective of this study is to evaluate the usefulness of IA in the province of Granada, between 2009 and 2014. Methods: During the study period (2009-2014), an epidemiologist assessed whether AI met declaration criteria or not. We calculate the contribution of AI to RedAlerta and the percentage of validation of AI, estimating 95% CI. Results: The contribution of AI was 17.3% (95% CI 16.1 to 18.5); and type of statement, 5.2% (95% CI 4.1 to 6.5) for urgent and 24.4% (95% CI 22.7 to 26.2) for ordinary. The contribution was higher (more than 45%) in Lyme disease, congenital hypothyroidism, genital herpes, hepatitis C and other viral hepatitis. 30% (95% CI 28.1 to 32) of AI were validated; 39.9% (95% CI 33 to 47.2) urgent and 29.1% (95% CI 27.2 to 31.2%) ordinary. The percentage of validation was higher than 45 % (between 47.5 and 100%) in vaccine-preventable diseases, sexually transmitted infections and low incidence. Conclusions: Although not replace manual reporting and requires verification, the AI system is useful and increases the completeness of the epidemiological surveillance system (AU)

Historia de salud digital (Diraya): un recurso en la vigilancia epidemiológica / The electronic health record (Diraya): a resource in epidemiological surveillance

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[Referrals and sex of physicians and patients: a gender analysis, Andalussia, Spain]. / Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes: un análisis de género.

BACKGROUND: It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. OBJECTIVES: To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. METHODS: Observational, cross-sectional, and multicenter study. POPULATION: 4 health districts in Andalucía and their physicians. SAMPLE: 382 physicians. MEASUREMENTS: referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. SOURCES: databases of health districts. PERIOD OF STUDY: 2010. ANALYSIS: Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. RESULTS: In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. CONCLUSION: There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.

Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes. Un análisis de género / Referrals and sex of physicians and patients. A gender analysis, Andalussia, Spain

Fundamento: En atención primaria se han identificado diferencias de práctica según sexo del profesional y, simultáneamente, existen des- igualdades de género en la asignación de recursos sanitarios, aspectos ambos que suscitan un interés creciente en la gestión y provisión de servicios de salud. El objetivo del estudio es conocer si existen diferencias de práctica en las derivaciones sanitarias realizadas por médicas y médicos de familia (MF) de centros de salud de Andalucía, si existen desigualdades en las derivaciones recibidas por hombres y mujeres, y si existe inter- acción sexo de profesional sexo de paciente. Métodos: Estudio transversal y multicéntrico. Población: MF de 4 distritos sanitarios (DDSS). Muestra: 382 MF. Variables: tasa de derivaciones por visita (TDxV), tasa de derivaciones por cupo (TDxC), sexo de paciente; sexo, edad, y formación postgraduada en medicina familiar de MF, tamaño del cupo por sexo, media de visitas /paciente por sexo, edad media del cupo por sexo, y proporción de hombres en el cupo; centro de salud urbano/rural, tamaño del equipo, población adscrita y acreditación docente. Fuentes: bases de datos de los DDSS. Análisis estadístico: descriptivo. Bivariante y multivariante mediante análisis multinivel de la TDxV con modelo mixto de Poisson. Resultados: En 2010 los/as 382 MF realizaron 129.161 derivaciones a especialistas. La TDxC fue 23,47 y la TDxV es 4,92. Las TDxC de las médicas fue 27,23 en mujeres y 19,78 en hombres y las de los médicos 27,37 en mujeres y 19,51 en hombres. La TDxV de las médicas fueron 4,92 en mujeres y 5,48 en hombres y para los médicos 4,54 y 4,93 respectivamente. Conclusiones: No existen diferencias en las derivaciones según sexo de las mujeres son menos derivadas. No existe interacción sexo profesional-sexo paciente (AU)

Background: It has been identified differences of medical care practice in primary care related to physician’s sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provi- sion of health services. Objectives: To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction bet- ween patient’s sex and physician’s sex. Methods: Observational, cross-sectional, and multicenter study. Population: 4 health districts in Andalucía and their physicians. Sample: 382 physicians. Measurements: referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. Sources: databases of health districts. Period of study: 2010. Analysis: Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. Results: In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. Conclusion: There are no differences in referral according to physician´s sex. However, there are signs that might indicate the existence of men patient received less referrals. There are no physician-patient's sex interaction (AU)

Brote de psitacosis en Granada / Psittacosis outbreak in Granada, Spain

Fundamento: La psitacosis se puede transmitir de pájaros infectadosa seres humanos, siendo causa de neumonía atípica. El objetivode este trabajo es determinar origen de un brote de psitacosis, lascaracterísticas de los sujetos expuestos, y describir las medidas paracontrolarlo.Métodos: Estudio descriptivo. Comunicación al Sistema deVigilancia Epidemiológica y Delegación de Agricultura, realizándoselas actuaciones pertinentes (inspección, toma de muestras, desinfeccióne inmovilización cautelar de aves), clausura del establecimiento;definición de caso y encuesta epidemiológica. Análisis defrecuencias.Resultados: 17 personas tuvieron contacto con animales sospechosos(53% varones/47% mujeres), de ellos 9 (edad media: 30) presentaronsíntomas (100% fiebre, cuadro pseudogripal 44,4%). Serealizó serología para C. psitacci a 11 de los 17 sujetos expuestos(68,75%), resultando positiva en dos de ellos (18,18%). En el estudiode tejido pulmonar del fallecido se comprobó la presencia de DNAde C. psitacci. La confirmación diagnóstica entre personas sintomáticasfue del 33% (3/9). La Delegación de Agricultura impuso cuarentenaa 22 núcleos zoológicos. De las 70 muestras tomadas (60:cloacas de animales y 10 aves), presentaron antígeno positivo 7(10%), siendo la detección de ácidos nucleicos por PCR positiva enuna de ellas.Conclusiones: La exposición a aves enfermas en los establecimientosimplicados originó el brote, siendo el foco común de contagiode carácter laboral. La adecuada coordinación/colaboraciónentre las Delegaciones de Salud y Agricultura permitió evitar la apariciónde casos nuevos

Background: Psittacosis can be transmitted to humans frominfected birds, being the cause of atypical pneumonia. This work isaimed at determining the source of a psittacosis outbreak, the characteristicsof the subjects exposed and describing the measures tocontrol the outbreak.Methods: Descriptive study. Notification to the EpidemiologicalMonitoring System and Autonomic Agriculture authorities, takingthe pertinent measures (inspection, sampling, disinfecting and precautionaryquarantine of birds), closing the establishment. Case definitionand epidemiological survey. Frequency analysis.Results: Seventeen (17) individuals (one of whom died) cameinto contact with suspicious animals (53% males/47% females),nine of whom (mean age: 30) showed symptoms (100% fever, flulikesymptoms 44.4%). A serology was performed for C. psitaccion 11 of the 17 subjects exposed (68.75%), two of whom (18.18%)tested positive. The presence of C. psittaci DNA was detected inthe pulmonary tissue study conducted on the deceased individual.A total of 33% (3/9) of those showing symptoms were confirmedby diagnosis. The Autonomic Agriculture authorities placed 22animal compounds under quarantine. A total of seven (10%) of the70 samples taken (60: animal cloacas and 10 birds) revealed a positiveantigen, the PCR nucleic acid test being positive in one thereof.Conclusions: The exposure to diseased animals at the establishmentsinvolved caused the outbreak, the common source of contagionbeing of an occupational nature. The appropriate coordination/collaboration between the local Health and Agriculture authoritiesmade it possible to prevent any further cases from arising

[Psittacosis outbreak in Granada, Spain]. / Brote de psitacosis en Granada.

BACKGROUND: Psittacosis can be transmitted to humans from infected birds, being the cause of atypical pneumonia. This work is aimed at determining the source of a psittacosis outbreak, the characteristics of the subjects exposed and describing the measures to control the outbreak. METHODS: Descriptive study. Notification to the Epidemiological Monitoring System and Autonomic Agriculture authorities, taking the pertinent measures (inspection, sampling, disinfecting and precautionary quarantine of birds), closing the establishment. Case definition and epidemiological survey. Frequency analysis. RESULTS: Seventeen (17) individuals (one of whom died) came into contact with suspicious animals (53% males/47% females), nine of whom (mean age: 30) showed symptoms (100% fever, flu-like symptoms 44.4%). A serology was performed for C. psitacci on 11 of the 17 subjects exposed (68.75%), two of whom (18.18%) tested positive. The presence of C. psittaci DNA was detected in the pulmonary tissue study conducted on the deceased individual. A total of 33% (3/9) of those showing symptoms were confirmed by diagnosis. The Autonomic Agriculture authorities placed 22 animal compounds under quarantine. A total of seven (10%) of the 70 samples taken (60: animal cloacas and 10 birds) revealed a positive antigen, the PCR nucleic acid test being positive in one there-of. CONCLUSIONS: The exposure to diseased animals at the establishments involved caused the outbreak, the common source of contagion being of an occupational nature. The appropriate coordination/collaboration between the local Health and Agriculture authorities made it possible to prevent any further cases from arising.

Carcinoma basocelular en usuarias de salones de bronceado: riesgos deluso de lámparas de ultravioleta / Basal cell carcinoma in tannig salons users: ultraviolet devices use reisk

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