Brote de toxiinfección alimentaria por Norovirus: estudio epidemiológico y medidas sanitarias aplicadas para evitar su recurrencia / Foodborne outbreak of norovirus: Epidemiologycal study and Health measures implemented to prevent recurrence

Objetivo: Debido a que las Toxiinfecciones alimentarias (TIA) originan daños para la salud, pérdidas económicas y requieren la intervención directa sobre la fuente de contaminación, el objetivo fue realizar un estudio clínico, epidemiológico e higiénico sanitario de un brote de TIA, sin posibilidad de análisis microbiológico. Diseño: Estudio descriptivo y de casos-controles. Emplazamiento: Comunidad de Munera. Albacete (España). Participantes: Población compuesta por las personas asistentes a tres comidas de celebración de comunión. Mediciones Principales: Se realizó una encuesta telefónica epidemiológica y se calcularon odds ratio (OR) crudas y ajustadas con intervalos de confianza al 95 %. Se realizó un modelo de regresión logística multivariante e inspección sanitaria del restaurante. Resultados: Se expusieron 204 personas y fueron encuestadas 62 (32 afectados y 30 sanos). La tasa global de ataque fue de 51,6 % y el periodo de incubación de 33 horas. Los síntomas principales: dolor abdominal, vómitos y diarreas. El tiempo de duración de la enfermedad fue 38 horas. Se observó asociación con la "Ensalada" (OR-cruda: 7,5; IC95: 1,48-37,91), resultando al borde de la significación estadística la relación con "Sepia" (ORc: 4,15; IC95: 1,00-17.18) y "Marisco" (ORc: 4,57; IC95: 0,87-24,08). La OR-ajustada para la "Ensalada" fue 5,41 (IC95: 1,00-29,23). La inspección sanitaria comprobó la existencia de deficiencias de estructura, limpieza, desinfección y formación de manipuladores. Conclusiones: La Ensalada fue el único alimento asociado estadísticamente, pero no podemos descartar la Sepia y Mariscos; mediante la inspección sanitaria y los criterios de Kaplan, es posible clasificarla como una infección por Norovirus. Se aplicaron medidas especiales de funcionamiento en el restaurante para evitar reincidencia del brote (AU)

Objective: Because Foodborne diseases (FBD) cause health damage, financial losses, and require direct intervention at the source of contamination, our aim was to carry out a clinical, epidemiological, and hygienic study of an outbreak of FBD, without the possibility of conducting a microbiological analysis. Design: A descriptive and case-control study. Location: Community of Munera, Albacete (Spain). Participants: Population composed of the attendees to three first communion celebrations. Main measurements: An epidemiological telephone survey was made, and crude and adjusted odds ratios (OR) were calculated with confidence intervals of 95%. A multivariate logistic regression model, and restaurant health inspection were also performed. Results: 204 people exposed, 62 respondents (32 affected and 30 healthy); global infection rate: 51.6%, and incubation period: 33 hours; main symptoms: abdominal pain, vomiting, and diarrhea; duration of disease: 38 hours. Statistical analysis showed associations with the consumption of three foodstuff. "Salad" crude OR 7.5 IC95(1.48-37.91), "Cuttlefish" crude OR 4.15 IC95(1,00-17.18) and "Seafood" crude OR 4.57 IC95(0.87-24.08). The adjusted-OR for the "Salad" is 5.41 IC95(1.00-29.23). The health inspection found the existence of deficiencies in structure, cleaning, disinfection and food handling training. Conclusions: The Salad was the only food statistically associated with the infection, but Cuttlefish and Seafood cannot be ruled out. Through sanitary inspection and Kaplan’s criteria, this can be classified as a Norovirus infection. Special performance measures were applied in the restaurant to prevent recurrence of the outbreak (AU)

Estudio de un brote poblacional de hepatitis A. Efectividad de la vacunación como medida de control / Study of a population outbreak of hepatitis A. Effectiveness of vaccination as a control measure

ObjetivoDescribir un brote de hepatitis A en la ciudad de Albacete y valorar la efectividad de las medidas de control adoptadas.MétodosConstatada la existencia del brote, se establecieron las definiciones de caso. Se recogieron los datos clínicos y epidemiológicos de los casos mediante encuesta. Se describió la distribución temporoespacial, mediante la localización de los casos y la curva epidémica. Se pusieron en marcha, como medidas de control y prevención inmediatas, la administración de inmunoglobulina (IG) y educación sanitaria a la población en riesgo.ResultadosDesde enero de 2005 a enero de 2006 se declararon 62 casos. Los grupos de edad más afectados fueron los escolares y los adultos jóvenes. El mecanismo de transmisión fue de persona a persona. La curva epidémica presenta dos periodos. Las medidas de control iniciales fueron higiénicas y administración de IG a los contactos; en el segundo periodo se complementaron con la vacunación contra la hepatitis A, administrada a los alumnos de los centros de enseñanza de los dos barrios inicialmente implicados. La extensión del brote a los barrios colindantes y la alarma social que ocasionó hicieron que se ampliara la vacunación a los centros de enseñanza próximos a aquellos en que se habían detectado casos. Después de la última vacunación, en enero de 2006, no se notificó ningún caso.ConclusionesEl uso de la vacuna postexposición frente al virus de la hepatitis A en la población escolar y los adultos jóvenes parece ser una medida efectiva para el control de un brote (AU)

ObjectiveTo describe an outbreak of hepatitis A in the city of Albacete (Spain) and to assess the effectiveness of the control measures implemented.MethodsWhen the outbreak was noted, definitions of a case were established. Clinical and epidemiological data were collected through a survey. The temporal-spatial distribution was identified through mapping and the epidemic curve. Health education and immunoglobulin (IG) administration were conducted as immediate prevention and control measures in the population at risk.ResultsFrom January 2005 to January 2006, 62 cases were reported. The most affected age groups were school children and young adults. Transmission was person to person. The epidemic curve was divided into two periods. Initial control measures consisted of hygiene measures and IG administration to contacts. In the second period, these measures were complemented with vaccination against hepatitis A in students of the school centers of the two neighborhoods initially involved. Due to public alarm and spread of the outbreak to adjacent neighborhoods, vaccination was extended to schools close to those where cases had been detected. No cases were notified after the last vaccination in January 2006.ConclusionsThe use of vaccination after exposure to the hepatitis A virus in young adults and the school population seems to be an effective outbreak control measure (AU)

[Study of a population outbreak of hepatitis A. Effectiveness of vaccination as a control measure]. / Estudio de un brote poblacional de hepatitis A. Efectividad de la vacunación como medida de control.

OBJECTIVE: To describe an outbreak of hepatitis A in the city of Albacete (Spain) and to assess the effectiveness of the control measures implemented. METHODS: When the outbreak was noted, definitions of a case were established. Clinical and epidemiological data were collected through a survey. The temporal-spatial distribution was identified through mapping and the epidemic curve. Health education and immunoglobulin (IG) administration were conducted as immediate prevention and control measures in the population at risk. RESULTS: From January 2005 to January 2006, 62 cases were reported. The most affected age groups were school children and young adults. Transmission was person to person. The epidemic curve was divided into two periods. Initial control measures consisted of hygiene measures and IG administration to contacts. In the second period, these measures were complemented with vaccination against hepatitis A in students of the school centers of the two neighborhoods initially involved. Due to public alarm and spread of the outbreak to adjacent neighborhoods, vaccination was extended to schools close to those where cases had been detected. No cases were notified after the last vaccination in January 2006. CONCLUSIONS: The use of vaccination after exposure to the hepatitis A virus in young adults and the school population seems to be an effective outbreak control measure.

Efectividad de un programa de educación sexual en adolescentes acerca de la adquisición de conocimientos y cambios de actitud ante el empleo de métodos anticonceptivos / Effectiveness of a sexual education program in teenagers in knowledge acquisition and changes in attitude to the use of contraceptive methods

Objetivo. Evaluar la efectividad de un programa de educación sexual en la adquisición de conocimientos acerca de métodos anticonceptivos y anticoncepción de urgencia, así como el cambio de actitud ante el uso del preservativo. Material y métodos. Estudio cuasi experimental, controlado, realizado con 481 alumnos de primero de bachillerato que pertenecían a centros educativos donde no había ningún programa de educación sexual. La intervención consistió en 5 sesiones teoricopracticas de 50 min acerca del empleo de métodos anticonceptivos y anticoncepción de emergencia. La evaluación se realizó por medio de un cuestionario autoadministrable de preguntas cerradas que se pasó 3 veces (antes de la intervención, al mes y a los 6 meses tras ésta). El análisis estadístico se realizó por intención de tratar. Resultados. La edad media de los participantes fue de 16,85 años (intervalo de confianza del 95%, 16,77-16,93), el 29,1% (140) ya había mantenido relaciones sexuales. Se observó una distribución homogénea de las variables de control y asociación estadísticamente significativa entre la intervención y aumento de los conocimientos acerca de métodos anticonceptivos, especialmente de la píldora poscoital. También se halló una asociación estadística en el cambio de actitud y el empleo del preservativo y píldora poscoital a favor del grupo intervención. Conclusiones. La intervención educativa es efectiva para el aumento de conocimientos acerca de métodos anticonceptivos y empleo de la píldora poscoital; asimismo, mejora en general la actitud para el fomento del preservativo y el uso racional de la píldora poscoital, tanto al mes como a los 6 meses postintervención(AU)

Objective. To evaluate the effectiveness of a sex education program in the acquisition of knowledge about contraceptive methods and emergency contraception, as well as in changing attitudes to condom use. Material and methods. A quasi-experimental controlled study was conducted in 481 students in the first year of higher secondary education in centers with no sex education programs. The intervention was based on five theoretical and practical 50-minute lectures on the use of contraceptive methods and emergency contraception. The assessment was conducted through a self-administered questionnaire with closed questions, administered on three separate occasions (before the intervention, at 1 month and 6 months later). The statistical analysis was performed by intention-to-treat. Results. The mean age of the participants was 16.85 years (95% CI: 16.77-16.93), and 29.1% (140) had maintained sexual relations. A homogeneous distribution was observed in the control variables and a statistically significant association was found between the intervention and increased knowledge about contraceptive methods, especially in knowledge about the post-coital pill (PCP). A statistically significant improvement was also found in changes in attitudes to the use of condoms and PCP in favor of the intervention group. Conclusions. The educational intervention was effective in increasing knowledge about contraceptive methods and the use of the PCP. Attitudes to condom use and rational use of the PCP also improved, both the first month and at 6 months after the intervention(AU)

[Effectiveness of a sexual education program in teenagers in knowledge acquisition and changes in attitude to the use of contraceptive methods]. / Efectividad de un programa de educación sexual en adolescentes acerca de la adquisición de conocimientos y cambios de actitud ante el empleo de métodos anticonceptivos.

OBJECTIVE: To evaluate the effectiveness of a sex education program in the acquisition of knowledge about contraceptive methods and emergency contraception, as well as in changing attitudes to condom use. MATERIAL AND METHODS: A quasi-experimental controlled study was conducted in 481 students in the first year of higher secondary education in centers with no sex education programs. The intervention was based on five theoretical and practical 50-minute lectures on the use of contraceptive methods and emergency contraception. The assessment was conducted through a self-administered questionnaire with closed questions, administered on three separate occasions (before the intervention, at 1 month and 6 months later). The statistical analysis was performed by intention-to-treat. RESULTS: The mean age of the participants was 16.85 years (95% CI: 16.77-16.93), and 29.1% (140) had maintained sexual relations. A homogeneous distribution was observed in the control variables and a statistically significant association was found between the intervention and increased knowledge about contraceptive methods, especially in knowledge about the post-coital pill (PCP). A statistically significant improvement was also found in changes in attitudes to the use of condoms and PCP in favor of the intervention group. CONCLUSIONS: The educational intervention was effective in increasing knowledge about contraceptive methods and the use of the PCP. Attitudes to condom use and rational use of the PCP also improved, both the first month and at 6 months after the intervention.

Representaciones socio-culturales sobre la menopausia. Vivencias del proceso en mujeres residentes en Albacete (España) / Socio-cultural representations about menopause: Experiences of the process in resident women in Albacete, Spain

Objetivo: Acercamiento a las representaciones sociales constitutivas de un fenómeno biológico-biográfico denominado climaterio, mediante los significados atribuidos por medio de los saberes, actitudes y comportamientos socioculturales de las mujeres en este periodo de su vida. Metodología: Estudio cualitativo mediante siete grupos focales (37 mujeres). Población de estudio: mujeres entre 45-55 años, residentes en la ciudad de Albacete. Resultados: proceso identificado con la edad biológica de las mujeres, con atributos negativos por su relación con el envejecimiento. Se relaciona también con la imagen social de la mujer y los roles socioculturales asignados clásicamente a este colectivo. Esta combinación de factores las conduce hacia un periodo de su vida tildado como "edad crítica", construcción en la que priman elementos biográficos sobre biológicos. Conclusión: Reconocer la "Variabilidad" de la vivencia del proceso. Esto entraría en conflicto con la actual tendencia biomédica, de protocolizar ciertas etapas relacionadas con el ciclo vital de las personas, intentando generar adscripciones unitarias basadas en entidades médicas construidas con fines operativos e instrumentales. Reconocer la "Vulnerabilidad" que supone la confluencia de diversas circunstancias, que las conducen, no sólo a enfrentarse con cambios físicos, emocionales y socioculturales, propios de esta etapa, sino a la realización de una evaluación retrospectiva crítica y profunda de la experiencia de vida, de la autobiografía (AU)

Objective: Approach to the social representations constituent of a biological-biographical phenomenon denominated climacteric, by means of the meanings attributed through socio-cultural knowledge, attitudes and behaviours of the woman in this period of their life. Methodology: Qualitative study by means of seven focal groups (37 women). Population of study: women between 45-55 years, residents in the city of Albacete. Results: Process identified with the biological age of the women, with negative attributes by its relation with the ageing. It is also related to the social image of the woman and the socio-cultural roles assigned classically to this group. This combination of factors leads them towards a period of their life labelled like "critical age", construction in which biographical elements prioritizes on biological. Conclusion: To recognize the "Variability" of the experience of the process. This would come into conflict with the present biomedical trend, of drawing up certain stages related to the vital cycle of people, trying to generate unitary ascriptions based on medical entities constructed with operative and instrumental aims. To recognize the "Vulnerability" that supposes the confluence between diverse circumstances, which lead them, not only to face physical, emotional and socio-cultural changes, peculiar of this stage, but to the accomplishment of a critical and deep retrospective evaluation of the life experience, of the autobiography (AU)