RESUMO
BACKGROUND: The objective of this study was to assess the incidence of nosocomial rotavirus gastroenteritis among children <2 years of age. METHODS: We conducted a prospective active surveillance for acute gastroenteritis (AGE) in the pediatric wards of 3 representative hospitals in Valencia (Spain) from October 2006 to March 2007, among children between 1 and 23 months of age with acute diarrhea. Children were followed up for 3 days after discharge. We obtained clinical and demographic information from participants and tested their stool specimens for rotavirus. RESULTS: A total of 1576 children were hospitalized at the 3 hospitals and 1300 (82.5%) were followed up as the study cohort. In 69 children, AGE started 48 hours after admission and were considered nosocomial infections. In 35 of the 59 cases where stool samples were obtained, rotavirus (RV) was present (59%), and in 12 of them symptoms started after discharge. The accumulated incidence of nosocomial rotavirus disease during the study period was 2.8 cases per 100 inpatients (95% CI: 1.9-3.8), and the incidence rate was 4.8 cases per 1000 hospital days (95% CI: 3.2-6.5). The most commonly found genotype in nosocomial infection was G9P[8], in 23 cases (66%), followed by G1P[8] in 4 cases (11%). The total economic cost was 883 euro per case. CONCLUSION: Active surveillance demonstrated that the burden of nosocomial rotavirus disease is substantial, and G9P [8] was the genotype found most frequently. Following up children after discharge from hospital allowed the discovery of cases of nosocomial RVAGE which are missed in most other studies.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/virologia , Gastroenterite/epidemiologia , Gastroenterite/virologia , Infecções por Rotavirus/epidemiologia , Rotavirus/isolamento & purificação , Animais , Diarreia/epidemiologia , Diarreia/virologia , Fezes/virologia , Feminino , Genótipo , Humanos , Incidência , Lactente , Masculino , Estudos Prospectivos , Rotavirus/classificação , Rotavirus/genética , Espanha/epidemiologiaRESUMO
Seis años después de Jenner descubriera la vacuna antivariólica, el rey Carlos IV dispuso emprender campañas vacunales en todos sus reinos. La campaña ultramarina fue dirigida por el médico militar valenciano Xavier de Balmis ayudado por el catalán Josep Salvany. El trasporte de la vacuna a América se realizó 'in vivo' en 22 niños. La expedición partió de A Coruña en noviembre de 1806 y llegó al puerto venezolano de La Guayra donde se dividió en dos: Una, al mando de Josep Salvany, siguió por tierra a Colombia, Ecuador, Perú y Bolivia. Salvany falleció en la ciudad boliviana de Cochabamba. La otra, al mando del propio Balmis, siguió por mar a Cuba y México. Desde Acapulco llegó a Manila y de allí a Macau desde donde se adentró en las zonas chinas adyacentes introduciendo así la vacuna en el continente asiático.
