Brote de gripe pandémica (H1N1) 2009 en una academia militar: inicio de la circulación comunitaria en España / Pandemic influenza (H1N1) 2009 outbreak in a military academy: start of community circulation in Spain

Fundamento: El 19 de mayo de 2009 se declararon 21 casos de soldados con síntomas de infección respiratoria aguda en la Academia Militar de Ingenieros (ACING) en Hoyo de Manzanares, España. En el contexto de una alerta mundial por gripe A(H1N1) 2009, se decide investigar la posible aparición de un brote por este virus. El objetivo es describir un posible brote de gripe (H1N1) 2009 en un Centro de Formación Militar y describir las medidas adoptadas, en la fase de contención, para evitar su transmisión. Métodos: Se administró un cuestionario específico y se recogieron muestras biológicas a todos los casos en investigación. Se recomendaron aislamiento y cuarentena, respectivamente de los casos y contactos. Resultados: Se confirmaron 81 casos de infección por virus de la gripe A (H1N1)2009. De las 52 muestras procesadas 31 fueron positivas para virus influenza A/California/7/2009. La edad media de los casos fue 22,0 años (rango, 18-31). El 84% eran varones. Los síntomas más comunes fueron tos y fiebre. Todos los casos permanecieron aislados y fueron tratados con oseltamivir, con buena evolución. La tasa de ataque global fue 12,42%. Ningún caso tenía antecedentes de viaje a zonas de riesgo o vinculo epidemiológico con un caso diagnosticado previamente fuera de la ACING. Se identificaron 31 casos relacionados con este brote fuera de la ACING, 24 casos eran contactos familiares y amigos. Conclusiones: Este brote alertó del inicio de la circulación comunitaria del virus pandémico en España. La detección precoz del mismo favoreció la puesta en marcha de medidas para la contención de su trasmisión(AU)

Background: On May 19, 2009, 21 cases of influenza-like illness were reported among soldiers from an Engineering Military Academy (ACING) in Hoyo de Manzanares, Spain. In the context of an influenza A (H1N1)2009 global alert, it was decided to investigate a possible pandemic influenza outbreak. To describe a possible outbreak of influenza A (H1N1)2009 in a Military Training Centre and to describe the measures adopted for transmission control of this new infection. Methods: A specific questionnaire was administered and biological samples were collected from all cases under investigation. Isolation and quarantine were recommended for cases and contacts, respectively. Results: Eighty-one cases were confirmed. Among 52 samples tested, 31 were positive for influenza virus A/California/7/2009. The average age of the cases was 22.0 years (range 18-31 years) and 84% were men. Most common reported symptoms were cough and fever. All cases were isolated and treated with oseltamivir, with full recovery. The total attack rate was 12.42%. None of the cases had history of travel to risk areas or contact with previously diagnosed cases outside the academy. Thirty-one confirmed cases related to this outbreak were identified outside the academy, 24 cases were family contacts and friends. Conclusions: This outbreak was the first evidence of community transmission of pandemic influenza H1N1 in Spain. The rapid detection of this outbreak enhanced an early implementation of measures aiming at the containment of its transmission(AU)

[Pandemic influenza (H1N1) 2009 Outbreak in a Military Academy: start of community circulation in Spain]. / Brote de gripe pandémica (H1N1) 2009 en una academia militar: inicio de la circulación comunitaria en España.

BACKGROUND: On May 19, 2009, 21 cases of influenza-like illness were reported among soldiers from an Engineering Military Academy (ACING) in Hoyo de Manzanares, Spain. In the context of an influenza A (H1N1)2009 global alert, it was decided to investigate a possible pandemic influenza outbreak. To describe a possible outbreak of influenza A (H1N1)2009 in a Military Training Centre and to describe the measures adopted for transmission control of this new infection. METHODS: A specific questionnaire was administered and biological samples were collected from all cases under investigation. Isolation and quarantine were recommended for cases and contacts, respectively. RESULTS: Eighty-one cases were confirmed. Among 52 samples tested, 31 were positive for influenza virus A/California/7/2009. The average age of the cases was 22.0 years (range 18-31 years) and 84% were men. Most common reported symptoms were cough and fever. All cases were isolated and treated with oseltamivir, with full recovery. The total attack rate was 12.42%. None of the cases had history of travel to risk areas or contact with previously diagnosed cases outside the academy. Thirty-one confirmed cases related to this outbreak were identified outside the academy, 24 cases were family contacts and friends. CONCLUSIONS: This outbreak was the first evidence of community transmission of pandemic influenza H1N1 in Spain. The rapid detection of this outbreak enhanced an early implementation of measures aiming at the containment of its transmission.

Septic arthritis of the knee due to Prevotella loescheii following tooth extraction.

This is a case report of septic arthritis of the knee due to Prevotella loescheii, in a patient with advanced arthrosis. Two weeks beforehand he had undergone a dental root extraction without antibiotic prophylaxis. His knee had become inflamed 48 hours after extraction and he was started on ibuprofen and steroid treatment (prescribed by his primary health care doctor). With a provisional diagnosis of septic arthritis, synovial fluid was taken for study. Antimicrobial therapy was commenced with amoxicillin/clavulanic acid and the patient progressed satisfactorily. Prevotella loescheii was identified by anaerobic culture. A site of origin for the infection was never found. Joint infection is generally secondary to haematogenous dissemination of bacteria from habitual sites such as odontogenic locations. We suggest that patients with inflammatory arthropathies should be considered as candidates for antibiotic prophylaxis in oral surgery and invasive dental procedures. We suggest, in these cases, the use of antibiotic with spectrum against aerobic and anaerobic bacteria.

Septic arthritis of the knee due to Prevotella loescheii following tooth extraction

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This is a case report of septic arthritis of the knee due to Prevotella loescheii, in a patient with advanced arthrosis. Two weeks beforehand he had undergone a dental root extraction without antibiotic prophylaxis. His knee had become inflamed 48 hours after extraction and he was started on ibuprofen and steroid treatment (prescribed by his primary health care doctor). With a provisional diagnosis of septic arthritis, synovial fluid was taken for study. Antimicrobial therapy was commenced with amoxicillin/clavulanic acid and the patient progressed satisfactorily.Prevotella loescheii was identified by anaerobic culture. A site of origin for the infection was never found. Joint infection is generally secondary to haematogenous dissemination of bacteria from habitual sites such as odontogenic locations. We suggest that patients with inflammatory arthropathies should be considered as candidates for antibiotic prophylaxis in oral surgery and invasive dental procedures. We suggest, in these cases, the use of antibiotic with spectrum against aerobic and anaerobic bacteria (AU)

Piomiositis lumbar por Finegoldia magna (Peptostreptococcus magnus) en paciente con hepatitis C / Lumbar pyomiositis caused by Finegoldia magna (Peptostreptococcus magnus) in a patient with hepatitis C virus infection

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Sultamicilina: estudio de las complicaciones infecciosas en la exodoncia de terceros molares / Sultamicillin: Study of infectious complications in third molar removal

Introducción: La infección postoperatoria es una posible complicación tras la exodoncia quirúrgica de los terceros molares. Se trata generalmente de infecciones de origen mixto, que pueden aparecer precoz o tardíamente, aumentando la morbilidad y retrasando la recuperación del paciente. Objetivo: Comprobar la eficacia de un antibiótico derivado de la penicilina, resistente a las betalactamasas; la sultamicilina (Sulbactam-Ampicilina), en la prevención de infecciones postoperatorias. Método: Se han extraído 476 terceros molares en 238 pacientes, administrándoles a todos ellos Sultamicilina antes y después de la intervención, evaluando y analizando estadísticamente diversas variables, durante un período de seguimiento de tres meses. Resultados: Hemos obtenido un índice de 0,63 por ciento de alveolitis, frente a índices, publicados por otros autores, que oscilan entre 0,5 por ciento a 30 por ciento. En las infecciones secundarias hallamos 0,42 por ciento, la incidencia más baja en la bibliografía revisada, que recoge unos índices comprendidos entre 1,5 por ciento a 5,8 por ciento. Conclusiones: Los excelentes resultados obtenidos, con uno de los índices más bajos publicados de alveolitis y el índice más bajo que hemos encontrado de infecciones secundarias, demuestran la eficacia de la Sultamicilina en la prevención de la aparición de complicaciones infecciosas tras la exodoncia de terceros molares incluidos. (AU)