Rotavirus vaccination effectiveness: a case-case study in the EDICS project, Castellón (Spain).

In Spain, in 2006, two oral live-attenuated vaccines against rotavirus disease were licensed for infants up to 6 months. Recent data suggest that vaccine efficacy may vary by region. This makes the real-life postmarketing monitoring of rotavirus vaccination effectiveness an important aspect of rotavirus epidemiologic surveillance. We carried out a case-case study to assess the rotavirus vaccination effectiveness in children from 2 to 35 months of age during the year 2009 in Castellón. As a second- and counterfactual objective to evaluate the possible selection bias and the specificity of the association, we evaluated the "effectiveness" of pneumococcal vaccination against rotavirus diarrhea. Cases were 71 children with confirmed rotavirus gastroenteritis, and controls were 261 children with positive results to any other organism that was not rotavirus. The immunization status of each child, the number of doses and dates of vaccination were assessed by consulting the Regional Immunization Registry. The lowest proportion of vaccinated cases was observed among rotavirus diarrhea (2.8%). The proportion of vaccinated children among the control group was 21.8%. The effectiveness of vaccination with at least one dose of vaccine against rotavirus was 87.7% (45.5-99.7%). If we restrict the analysis to non-hospitalized children, this figure was slightly lower, 83.5% (25.4-96.3%). As expected, pneumococcal vaccination was not protective against rotavirus infection showing the specificity of the association found. The immunization information systems in combination with population-based studies of the incidence of infectious gastroenteritis, such as EDICS offer appropriate conditions for postmarketing monitoring of vaccine effectiveness.

[Aggregation of cases of legionella pneumonia in workers related to the ceramic industry in Castellon, Spain, 2006]. / Agregación de casos de neumonía por Legionella en trabajadores relacionados con la industria de la cerámica en Castellón en 2006.

BACKGROUND: Cases of legionellosis sometimes arise in the form of aggregations which are difficult to interpret. This study provides an analysis of these groupings having arisen one summer in Castellon. METHODS: Microbiological, clinical and epidemiological field methods were employed. RESULTS: Within a few days, there were five (5) cases of legionella pneumonia in workers related to various ceramic industries within an area where a large number of these plants are located. Two constituted a minor outbreak. By means of molecular biology techniques performed on the strains, the common origins of three of the cases were ruled out. CONCLUSIONS: It is debated whether this episode of an outbreak having arisen within the context of a broader-ranging cluster of cases of a multi-focal origin was a chance event or whether it was the manifestation of a risk related to this industrial activity which might repeat itself.

Agregación de casos de neumonía por Legionella en trabajadores relacionados con la industria de la cerámica en Castellón en 2006 / Aggregation of caes of Legionalla pneumonia in workers related to the ceramic industry in Castellon, Spain, 2006

Fundamento. Los casos de la legionelosis en ocasiones se presentan en forma de agregaciones que son difíciles de interpretar. Analizamos aquí una de estas agrupaciones ocurrida durante un verano en Castellón. Métodos. Se aplicaron métodos microbiologicos, clínicos y de epidemiología de campo. Resultados. En pocos días hubo 5 casos de neumonía por Legionella en trabajadores relacionados con varias industrias de la cerámica, en un área donde existe una alta concentración de estas fábricas. Dos de ellos, constituyeron un pequeño brote. Mediante técnicas de biología molecular de las cepas se descartó el origen común de tres de los casos. Conclusiones. Se discute si este episodio de un brote surgido en el contexto de un cluster más amplio de casos de origen multifocal fue un hecho casual o fue la expresión de un riesgo relacionado con esa actividad industrial que pudiera repetirse (AU)

Background. Cases of legionellosis sometimes arise in the form of aggregations which are difficult to interpret. This study provides an analysis of these groupings having arisen one summer in Castellon. Methods. Microbiological, clinical and epidemiological field methods were employed. Results. Within a few days, there were five (5) cases of legionella pneumonia in workers related to various ceramic industries within an area where a large number of these plants are located. Two constituted a minor outbreak. By means of molecular biology techniques performed on the strains, the common origins of three of the cases were ruled out. Conclusions. It is debated whether this episode of an outbreak having arisen within the context of a broader-ranging cluster of cases of a multi-focal origin was a chance event or whether it was the manifestation of a risk related to this industrial activity which might repeat itself (AU)