[Mumps epidemic in the health area of Toledo with immunization intervention. Estimation of vaccine effectiveness]. / Epidemia de parotiditis en el área sanitaria de Toledo con intervención mediante inmunización. Estimación de la efectividad de la vacuna.

BACKGROUND: The aim of this study was to describe a mumps epidemic occurred among school children in Toledo, Spain, between 1993 and 1994 were vaccination was undertaken as control measure, and to estimate vaccine efficacy under field conditions. MATERIAL AND METHODS: Attack rates for vaccinated (at 15 months of age) and unvaccinated population were calculated. A retrospective cohort study was designed to estimate vaccine efficacy. RESULTS: A total of 19 outbreaks in different schools were declared. 216 cases and 4,059 contacts, between 10-17 years old, were investigated. The attack rate for the school population was 5.3%. By age, the highest attack rate was for those in the 12-13 age group (7.9%). Estimated vaccine efficacy was 76% (95% confidence interval 66-87%) for the whole study population: For children among 10-13 years old it was 87% (95% confidence interval 76-93%), and 46% (95% confidence interval 20-70%) for those aged 14-17 years. CONCLUSIONS: Vaccination is a good control measure in mumps outbreaks (the attack rate for the study population was 5.1%). Vaccine efficacy was high for the 10-13 age group and in agreement with the results of seroepidemiological studies.

[Evolution of cardiovascular disease mortality in the Toledo Province, 1975-1994]. / Evolución de la mortalidad por enfermedades cardiovasculares en la provincia de Toledo, 1975-1994.

BACKGROUND: Cardiovascular diseases are the leading cause of death in the developed countries. The cardiovascular mortality varies throughout the different parts of Spain. In this study, an analysis is made of the 1975-1994 trend in the cardiovascular death rate due to heart disease and ischemic heart disease among those falling within the 35-74 age range in the province of Toledo. METHODS: Based on the deaths recorded by the Spanish National Statistics Institute, standardized rates were calculated by the direct method for the causes selected. The trend is assessed based on the mean percentage variance in the rates. The male gender-related ratios are given by causes. RESULTS: A markedly downward trend is found for the cardiovascular death rate as a whole, showing an average drop of 2.58% among males and of 4.78% among females. The decrease is less for heart disease in general, 1.13% among men and 2.68% among women. The trend in the mortality due to ischemic heart disease shows no specific trend, it being possible to term these rates as being stable. For all of the causes, a greater number of deaths among males are recorded, especially with regard to ischemic heart disease, showing a male/female ratio = 1.75. CONCLUSIONS: The cardiovascular mortality in Toledo is dropping similarly to the nationwide rate. The heart disease group as a whole is undergoing a gradual decrease. The stabilization of the death rate due to ischemic heart disease can be explained by the fact that Toledo has low rates as compared to the rest of Spain.