A Questionnaire Survey of Personal and Occupational Variables Associated With SARS-COV-2 Infection in Health Care Personnel of the Spanish Central Military Hospital.

INTRODUCTION: Spain is the country with the highest number of health care workers affected by coronavirus disease 2019 (COVID-19) in the world. The aim of this study was to describe the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection in health care worker (HCW) at the Gómez Ulla Military Hospital (HCDGU). MATERIALS AND METHODS: A case-control study was conducted during the first outbreak of COVID 19 at GUMH. The study was extended to the total number of HCW in the hospital who met the inclusion criteria. Health care worker of the HCDGU were civilian and military personnel that included nursing and medicine students of Spanish Military Academy, medicine specialty residents, and nursing residents of Medical Surgical Specialty in Operations (EMQO). A questionnaire of 33 items was prepared. The questionnaire was sent by e-mail to the entire population of study. With this questionnaire personnel were classified into sick (cases) or healthy. RESULTS AND CONCLUSIONS: One hundred fifty professionals answered the questionnaire. Cases were defined as those who tested positive in the diagnostic tests (n = 28, 20.7%) and no cases were those who tested negative (n = 107, 79.3%). Therefore, the percentage of SARS-CoV-2 in the GUMH was 20.7%. Of the total number of cases, 64.3% were men (P < .05), with a mean age of 47.1 years (SD 13.3), a mean BMI of 25.3 (SD 3.8), and 48.2% being overweight. Of the total cases, 59.3% had "A" blood group type and 69.2% were Rh positive. 50% were physicians, 32.1% were nurses, and 17.9% were auxiliary nurses (P < .05). Cases and controls with vitamin D deficiency and who took supplements had a lower risk of suffering COVID-19, with significant differences. Fever, cough, and diarrhea were found in at least 50% of the samples with significant differences.

Pandemia de gripe A (H1N1): estrategia de vigilancia y vacunación en las Fuerzas Armadas / Pandemic of swine flu (H1N1): strategies for surveillance and immunization in the Armed Forces

Las Fuerzas Armadas constituyen un colectivo de interés especial en cuanto a la vigilancia y prevención de la gripe. El objetivo de este trabajo es describir las medidas de Salud Pública adoptadas frente a la pandemia de gripe A (H1N1). Se elaboraron protocolos de actuación específicos, tanto en vigilancia epidemiológica como en vacunación, en territorio nacional y en zona de operaciones. El número de casos notificados de gripe A fue de 1223 (el 57,5% en el Ejército de Tierra), 10 necesitaron hospitalización, y no se produjo ninguna defunción. Se distribuyeron 67.800 vacunas pandémicas y la cobertura fue del 9,7%, la Unidad Militar de Emergencias fue donde se conseguieron coberturas más altas (45,9%). Se notificaron 613 efectos adversos a la vacunación, todos ellos fueron leves (AU)

The Armed Forces constitute a group of special interest for the surveillance and the prevention of influenza. The aim of this paper is to describe the public health measures taken in response to pandemic of Influenza A (H1N1). Specific protocols of action were designed for the epidemiological surveillance and the vaccination, for national territory and operation areas. The reported cases of Influenza A were 1223 (57,5% in the Army), 10 have required hospitalization, and no death has taken place. 67800 pandemic vaccines have been distributed and the coverage reached 9,7 %, the highest coverage of vaccination (45,9%) was obtained in the UME (Emergencies Military Unit). 613 adverse effects to the vaccination were reported, but all of them were slight (AU)

Primer brote de nueva gripe A(H1N1) en las Fuerzas Armadas españolas. Forma de presentación y medidas adoptadas / First outbreak of the new influenza A (H1N1) in the spanish Armed Forces. Form of presentation and measures adopted

Objetivos: Describir la forma de presentación de los primeros casos de nueva gripe A(H1N1) en la Academia de Ingenieros de Hoyo de Manzanares. Describir las medidas adoptadas durante el brote. Analizar críticamente la actuación de la Sanidad Militar, tanto en lo referente a la rapidez como a la eficacia. Material y Métodos: Se describe la situación de partida y la evolución cronológica inicial de las actuaciones. Se utiliza para el estudio del brote una encuesta epidemiológica. Se describen las diferentes actuaciones, reuniones institucionales, actividades médicas, etc, llevadas a cabo. Se analiza la concordancia de las mismas con la normativa e instrucciones oficiales, así como la eficacia/ineficacia de las mismas. Resultados: El brote se detectó el día 19 de Mayo y se dio por finalizado el día 1 de Junio. La sintomatología predominante en los 16 casos que fueron motivo de estudio, entre los 21 que motivaron la alerta, fue malestar general, tos, cefalea y dolor faríngeo. Sólo un tercio de estos primeros pacientes del brote presentaron fiebre. Las Autoridades sanitarias del Ministerio de Defensa realizaron varias reuniones y actividades conjuntas con diferentes organismos dependientes del Ministerio de Sanidad y Política Social, con conocimiento y colaboración de la Consejería de Sanidad de la Comunidad Autónoma de Madrid. Se realizaron encuestas epidemiológicas y reconocimientos conjuntos sobre el terreno. Se trató con oseltamivir a todos lo casos, estableciendo medidas de cuarentena sobre los contactos próximos, sin aplicar quimioprofilaxis. Los pacientes hospitalizados no reunían criterios clínicos de gravedad y fueron dados de alta hospitalaria al segundo o tercer día de su ingreso. Conclusiones: El cuadro clínico dominante en los primeros casos hacía muy difícil alcanzar un alto grado de sospecha de la existencia del virus de la gripe nueva A(H1N1), a loque hay que sumar la falta de nexo epidemiológico. Por tanto, el haber lanzado la voz de alarma ya es motivo de orgullo y consideramos que fue importante para la contención del brote la precocidad en el inicio de las actuaciones. La colaboración con las Autoridades Civiles fue, en contra de lo que notificaron muchos medios de comunicación, precoz, intensa y continuada, facilitando así mismo la resolución temprana del brote. Dadas las circunstancias particulares que presentaba el caso, se siguieron estrictamente las recomendaciones oficiales, con algunas modificaciones de las mismas, siempre de común acuerdo con las Autoridades Sanitarias Civiles, artífices de dichas recomendaciones (AU)

Objectives: to describe the form of presentation of the first cases of the new influenza A (H1N1) in the Army Engineer and Signal School in Hoyo de Manzanares. To describe the measures adopted during the outbreak. To critically assess the rapidity and efficacy of the Medical Service intervention. Material and Methods: the initial situation and the chronological evolution of the intervention are described. An epidemiological survey was utilized to study the outbreak. The different interventions, institutional meetings, medical activities, etc, are described. Their conformity with the official regulations and instructions is evaluated as well as their efficacy or inefficacy. Results: the outbreak was detected the 19th May and ended the 1st June. The predominant symptoms in the 16 cases studied among the 21 that alerted the medical service were general malaise, cough, headache and pharyngeal discomfort. Only one third of these first cases of the outbreak had fever. The medical authorities of the Ministry of Defense had several joint meetings and activities with representatives from different organizations of the Ministry of Health and Social Policy. The Health Department of the Autonomous Community of Madrid was also informed and cooperated. The inspections and epidemiological surveys were carried out jointly. All cases were treated with oseltamivir and close contacts were quarantined without chemoprophylaxis. Hospitalized patients did not present severe clinical symptoms and were discharged after two or three days. Conclusions: the predominant clinical symptoms in the first cases made very difficult to suspect the presence of the new influenza A (H1N1) in addition to the lack of an epidemiological nexus. For this reason to have detected the outbreak is already a motive for pride and we consider that the early intervention was important for the containment of the outbreak. The cooperation with the civilian authorities was, contrary to what was commonly reported in the media, early, intense and continuous, facilitating the speedy resolution of the outbreak. Given the particular circumstances of this situation the official recommendations were strictly followed, with some modifications always agreed with the civilian medical authorities, originators of these recommendations (AU)

Epidemiología y prevención de la Encefalitis transmitida por garrapatas (TBE) / Epidemiology and prevention of Encefalitis transmitted by ticks (TBE)

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