RESUMO
In accordance with European Centre for Disease Prevention and Control recommendations, the Spanish Influenza Surveillance System (SISS) maintained its activity during the summer of 2009, and since July 2009 the pandemic virus activity was monitored by the SISS. In this paper, we describe the epidemiological and virological characteristics of the 2009 pandemic in the Spain through the SISS. Spain experienced a transmission of the new A(H1N1)pdm09 influenza virus during the summer of 2009, which gradually increased, resulting in the pandemic wave in early autumn of that year. The reproductive number R0, estimated during the growth phase of the pandemic wave (1.32; 95% confidence interval [95%CI], 1.29-1.36), showed a transmissibility comparable to preceding pandemics. There was an almost complete replacement of the previous seasonal A(H1N1) influenza virus by the pandemic virus A(H1N1)pdm09. The pandemic virus produced a greater burden of illness than seasonal influenza in children younger than 15 years old, while the incidence in those older than 64 years was lower compared with previous inter-pandemic seasons. Nevertheless, in Spain the 2009 pandemic was characterized as mild, considering the duration of the pandemic period and the influenza detection rate, both in the range of those observed in previous inter-pandemic seasons. Also, the case fatality ratio (CFR) was estimated at 0.58 deaths/1,000 confirmed ILI cases (95%CI, 0.52-0.64), in the range of the two previous pandemics of 1957 and 1968, with the highest CFR observed in the older than 64 years age group. In the 2009 pandemic there was a higher percentage of pandemic confirmed deaths in the younger ages, compared to seasonal influenza, since only 28% of the reported deaths occurred in persons aged 64 years and older.
Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Pandemias , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Influenza Humana/complicações , Pessoa de Meia-Idade , Vigilância da População , Índice de Gravidade de Doença , Espanha/epidemiologia , Adulto JovemRESUMO
There are three types of influenza viruses: A, B, C. These viruses evolves constantly due to two main characteristics: the first one is the lack of the correction ability of the viral polymerase which causes the accumulation of single nucleotide mutations in the viral genes introduced by an error-prone viral RNA polymerase, (antigenic shift). The second one is the nature of their genome, formed by eight segments, which allows the interchange of genes between two different viral strains (antigenic drift). This viral plasticity, has allowed to the influenza A viruses to infect new host species and to cause infections with a pandemic characteristics. The Spanish influenza surveillance system, SVGE (its Spanish acronym), arises as a response to the possibility of facing a pandemic situation, especially after the transmission of avian influenza viruses to humans. This surveillance system is formed by sixteen physician and paediatrics network, nineteen epidemiological services coordinated by the National Epidemiological Centre (CNE) and eighteen laboratories , the Spanish Laboratories of Influenza network (ReLEG), coordinated by the National Centre of Microbiology. The aim of this article is to show the action of the ReLEG, in the pandemic caused by the influenza virus A(H1N1) during the season 2009-2010. The main objective of this network is the surveillance of the circulating viruses by means of their detection and their subsequent antigenic and genetic characterization, including the detection of resistance mutations against the main drugs, such as Oseltamivir.
Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Laboratórios , Pandemias , Vigilância da População , Virologia , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Vigilância da População/métodos , Espanha/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: In Spain, influenza vaccine effectiveness (EV) is estimated since 2008-09 season through the cycEVA case-control study, the Spanish component of the European I-MOVE (Monitoring Influenza Vaccine Effectiveness in the EU/EEA) network. We aimed at describing cycEVA performance in its five consolidated editions 2008/09 -; 2012/13. METHODS: During the study period the following indicators were analysed: 1) the participation of sentinel general practitioners and pediatricians (MP), 2) the population studied and the study period, 3) the data quality and 4) the dissemination of the cycEVA results. Trend analysis of the indicators was done using the Cochran-Armitage test to compute the Annual Percentage Change (PCA). RESULTS: The number of participating MP increased from 164 in 2008-09 to 246 in the following editions. The percentage of MP recruiting at least one patient increased significantly annually (PCA = 15.33%). The percentage of recruited patients included into the analysis increased (PCA=5.91%) from 77% in 2008-09 to more than 95% in the following editions. The percentage of cycEVA patients contributing to the I-MOVE study ranged between 23% and 30% in the pilot and 2011-12 editions respectively.. Final results were disseminated in quartile 2 peer-reviewed journals and 2010-11 and 2011-12 preliminary EV estimates were published in quartile 1 journals. cycEVA publications received 97 citations. CONCLUSION: cycEVA study achieved more quality information, timely EV estimates and a higher impact of the results.
Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Vigilância da População , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Editoração , Estações do Ano , Espanha/epidemiologiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Surtos de Doenças/estatística & dados numéricos , Erradicação de Doenças/métodos , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Saúde Pública/métodos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Microbiologia/normas , Microbiologia/tendênciasRESUMO
Fundamentos: Desde 2008-09 la efectividad de la vacuna (EV) antigripal en España se estima con el estudio de casos y controles para la evaluación de la EV antigripal (cycEVA), componente español de la red europea (Influenza- Monitoring Vaccine Effectiveness (I-MOVE). El objetivo es describir la evolución del estudio cycEVAdurante las cinco temporadas del período 2008/09-2012/13. Métodos: Se analizaron los siguientes indicadores: 1) participación de los médicos/pediatras centinela (MP); 2) población y periodo de estudio, 3) calidad de los datos y 4) difusión de los resultados mediantes publicaciones. Se calculó el porcentaje anual de cambio constante de los indicadores analizándose su tendencia mediante el test de Cochran-Armitage. Resultados: El número de MP participantes aumentó de 164 en 2008-09 hasta 246 en ediciones posteriores. El porcentaje de médicos que reclutaron al menos un paciente experimentó un cambio anual significativo (PCA) del 15,33%. El porcentaje de pacientes reclutados incluidos en el análisis aumentó del 77% en 2008-09 a más del 95% en las siguientes ediciones (PCA=5,91%). El porcentaje de casos y controles participantes en cycEVA sobre el total de pacientes que contribuyeron al estudio europeo I-MOVE osciló entre el 23% en la edición piloto y 30% en la temporada 2011-12. Los resultados finales se difundieron en revistas científicas con un factor de impacto situado en el cuartil 2 y en 2010-11 y 2011-12 se publicaron resultados preliminares en revistas con un factor de impacto situado en el cuartil 1 (97 citas). Conclusiones: La experiencia del estudio cycEVA se reflejó en una mejora en la oportunidad e impacto de sus resultados, cruciales para orientar las recomendaciones anuales de vacunación antigripal (AU)
Background: In Spain, influenza vaccine effectiveness (EV) is estimated since 2008-09 season through the cycEVAcase-control study, the Spanish component of the European I-MOVE (Monitoring Influenza Vaccine Effectiveness in the EU/EEA) network.We aimed at describing cycEVAperformance in its five consolidated editions 2008/09 - 2012/13. Methods: During the study period the following indicators were analysed: 1) the participation of sentinel general practitioners and pediatricians (MP), 2) the population studied and the study period, 3) the data quality and 4) the dissemination of the cycEVA results. Trend analysis of the indicators was done using the Cochran-Armitage test to compute theAnnual Percentage Change (PCA). Results: The number of participatingMP increased from 164 in 2008-09 to 246 in the following editions. The percentage of MP recruiting at least one patient increased significantly annually (PCA = 15.33%). The percentage of recruited patients included into the analysis increased (PCA=5.91%) from 77% in 2008-09 to more than 95% in the following editions. The percentage of cycEVA patients contributing to the I-MOVE study ranged between 23% and 30% in the pilot and 2011-12 editions respectively.. Final results were disseminated in quartile 2 peer-reviewed journals and 2010-11 and 2011-12 preliminary EV estimates were published in quartile 1 journals. cycEVA publications received 97 citations. Conclusion: cycEVA study achieved more quality information, timely EV estimates and a higher impact of the results (AU)
Assuntos
Humanos , Influenza Humana/epidemiologia , Vacinas contra Influenza/administração & dosagem , Efetividade , Estudos de Casos e Controles , Controle de Doenças Transmissíveis/métodos , Avaliação de Eficácia-Efetividade de IntervençõesRESUMO
Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included.
Assuntos
Bioterrorismo , Defesa Civil/tendências , Planejamento em Desastres , Controle de Infecções/tendências , Microbiologia/tendências , Saúde Pública , Antraz/prevenção & controle , Defesa Civil/métodos , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/transmissão , Diagnóstico Precoce , Órgãos Governamentais , Humanos , Controle de Infecções/métodos , Anamnese , Vigilância da População , Espanha , Toxinas Biológicas/análise , Toxinas Biológicas/intoxicaçãoRESUMO
Existen tres tipos de virus de la gripe: A, B y C. Estos virus evo-lucionan constantemente debido a que presentan dos características principales, la primera es la falta de capacidad correctora de la poli-merasa viral que hace que se acumulen mutaciones puntuales en sus genes (deriva antigénica), y la segunda la naturaleza de su genoma formando por ocho segmentos lo que le permite el intercambio de genes entre distintos virus (salto antigénico). Esta plasticidad viral ha permitido que los virus de la gripe A sean capaces de adaptarse a diferentes hospedadores y adquirir capacidades pandémicas. El sistema de vigilancia de la gripe en España (SVGE) surgió como respuesta a la preocupación de que se produjera una pandemia, máxime después de los casos de gripe aviar detectados en el ser humano. Este sistema de vigilancia esta formado por dieciséis redes de médicos generales y pediatras centinela y diecinueve servicios de epidemiología, coordinados por el Centro Nacional de Epidemiolo-gía (CNE) y una red de dieciocho laboratorios, la red de laboratorios de Españoles de Gripe (ReLEG), coordinados por el Centro Nacio-nal de Microbiología (CNM). El objetivo de este artículo es presentar la actuación de la ReLEG durante la pandemia producida por el virus de la gripe (H1N1)2009, durante la temporada 2009-2010. La función principal de la red es la vigilancia de los virus circulantes mediante su detección y posterior caracterización genética y antigénica, incluyendo la detección de las mutaciones de resistencia que afectan a los fármacos en uso, princi-palmente el Oseltamivir(AU)
There are three types of influenza viruses: A, B, C. These viruses evolves constantly due to two main characteristics: the first one is the lack of the correction ability of the viral polymerase which causes the accumulation of single nucleotide mutations in the viral genes intro-duced by an error-prone viral RNA polymerase, (antigenic shift). The second one is the nature of their genome, formed by eight seg-ments, which allows the interchange of genes between two different viral strains (antigenic drift). This viral plasticity, has allowed to the influenza A viruses to infect new host species and to cause infections with a pandemic characteristics. The Spanish influenza surveillance system, SVGE (its Spanish acronym), arises as a response to the possibility of facing a pandemic situation, especially after the transmission of avian influenza viruses to humans. This surveillance system is formed by sixteen physician and paediatrics network, nineteen epidemiological services coordi-nated by the National Epidemiological Centre (CNE) and eighteen laboratories , the Spanish Laboratories of Influenza network (ReLEG), coordinated by the National Centre of Microbiology. The aim of this article is to show the action of the ReLEG, in the pandemic caused by the influenza virus A(H1N1) during the season 2009-2010. The main objective of this network is the surveillance of the circulating viruses by means of their detection and their subse-quent antigenic and genetic characterization, including the detection of resistance mutations against the main drugs, such as Oseltamivir(AU)
Assuntos
Humanos , Masculino , Feminino , Surtos de Doenças/prevenção & controle , Doenças Transmissíveis/epidemiologia , Monitoramento Epidemiológico/tendências , Monitoramento Epidemiológico , Influenza Humana/epidemiologia , Monitoramento Epidemiológico/normas , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H1N1/patogenicidade , Vigilância Sanitária/organização & administraçãoRESUMO
El bioterrorismo y el uso potencial de armas biológicas se ha convertido en una preocupación importante de los gobiernos y autoridades competentes. Como ejemplo, el envío de cartas con esporas del agente causante del carbunco en Estados Unidos en 2001 ocasionó varias muertes, causó pánico y tuvo repercusiones negativas en la economía mundial. Si este incidente, a pequeña escala, produjo semejante impacto, los efectos de un ataque masivo podrían ser catastróficos. En muchos países éste fue el punto que marcó el inicio de la toma de medidas encaminadas a prevenir y responder ante amenazas y actos bioterroristas, acciones que, en su conjunto, se conocen como biodefensa. Este artículo pretende analizar someramente algunos aspectos relacionados con la detección e identificación de este tipo de acciones y los agentes biológicos implicados. Se considera el diagnóstico microbiológico que permite la identificación del agente causal, punto clave para la toma de medidas de control adecuadas (AU)
Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included (AU)