RESUMEN
BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4-7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9-4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms.
Asunto(s)
Infecciones por Caliciviridae/epidemiología , Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos/epidemiología , Gastroenteritis/epidemiología , Norovirus , Psoriasis/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Islas del Atlántico/epidemiología , Infecciones por Caliciviridae/diagnóstico , Infecciones por Caliciviridae/etiología , Estudios de Cohortes , Diarrea , Femenino , Enfermedades Transmitidas por los Alimentos/etiología , Gastroenteritis/diagnóstico , Gastroenteritis/etiología , Instituciones de Salud , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/terapia , Estudios Retrospectivos , Países Escandinavos y Nórdicos/etnología , España/epidemiología , Encuestas y Cuestionarios , VómitosRESUMEN
Una de las lesiones mas frecuentes de la mucosa oral son las ulceraciones recurrentes orales (U.R.O.). La causa específica de la U.R.O. permanece aún icierta. En la literatura se citan diversos factores asociados como el stress, alergia, alimentos, etc. El objetivo de este estudio fue comprobar la relación existente entre el stress y las U.R.O. Se estudiaron 50 personas que presentaban úlceras recurrentes de la mucosa oral y comogrupo control, 50 personas, tomadas al azar, libres de estas lesiones en el transcurso de su vida. El grupo de estudio, así como el control fueron sometidos a 6 tests diseñados para conocer el grado de estres que cada sujeto padece (Test de Experiencia Reciente, Test para medir Signos de Stress, Test para medir Síntomas de Stress, Test de Apoyo Social, Test de Apoyo Laboral y Test de Apoyo Familiar). Se concluyó que las personas que hacen U.R.O., presentan mayor grado de stress que los individuos que no padecen de estas lesiones
