Effectiveness of 3 COVID-19 Vaccines in Preventing SARS-CoV-2 Infections, January-May 2021, Aragon, Spain.

Reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is a worldwide challenge; widespread vaccination could be one strategy for control. We conducted a prospective, population-based cohort study of 964,258 residents of Aragon, Spain, during December 2020-May 2021. We used the Cox proportional-hazards model with vaccination status as the exposure condition to estimate the effectiveness of 3 coronavirus disease vaccines in preventing SARS-CoV-2 infection. Pfizer-BioNTech had 20.8% (95% CI 11.6%-29.0%) vaccine effectiveness (VE) against infection after 1 dose and 70.0% (95% CI 65.3%-74.1%) after 2 doses, Moderna had 52.8% (95% CI 30.7%-67.8%) VE after 1 dose and 70.3% (95% CI 52.2%-81.5%) after 2 doses, and Oxford-AstraZeneca had 40.3% (95% CI 31.8%-47.7%) VE after 1 dose. All estimates were lower than those from previous studies. Results imply that, although high vaccination coverage remains critical to protect people from disease, it will be difficult to effectively minimize transmission opportunities.

Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330.

INTRODUCTION: No cases of human brucellosis caused by Brucella suis has been reported in Spain. METHODS: This study involved interviews with the case and his co-workers, inspection of their workplace, checking infection control measures, and typing the Brucella strain isolated in the blood culture. RESULTS: Brucella suis biovar 1 strain 1330 was isolated from a patient who worked in a waste treatment plant. Food borne transmission, contact with animals, and risk jobs were ruled out. An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. CONCLUSION: There should be controls to ensure that waste containers are sealed.

[An outbreak of mumps in a high school: Estimation of vaccine effectiveness. Zaragoza 2011]. / Brote escolar de parotiditis: estimación de la efectividad vacunal. Zaragoza 2011.

INTRODUCTION: Mumps outbreaks continue to occur, even after the consolidation of vaccination programs. An outbreak of mumps occurred in a high school in Zaragoza during December 2011. OBJECTIVE: To describe the outbreak and estimate vaccine effectiveness. CASE DEFINITION: unilateral or bilateral swelling of the parotid or other salivary glands for three or more days without any other apparent cause. REFERENCE POPULATION: People attending the 'Parque Goya' High School or with transmission chain origin in the High School. OUTBREAK PERIOD: From two days before the onset of symptoms of the first case to five days after the last case. Samples were collected for virus confirmation (IgM, urine culture and oropharyngeal exudate), and isolates were processed for genotyping. A retrospective cohort study was performed in two high school classrooms to estimate vaccine efficacy. Public health authorities conducted active surveillance, isolation of cases, and vaccination of susceptible contacts. RESULTS: There were 27 cases. Twenty-one (77.8%) were vaccinated with two doses of Measles-Mumps-Rubella vaccine. Twelve (44%) were confirmed microbiologically. G1 genotype was determined in six cases. According to the cohort study, vaccine efficacy for one dose was 34% (95%CI: -44 to 70), and was 67% (95%CI: 28 to 83) for two doses. CONCLUSIONS: Vaccine effectiveness was lower than expected. Early detection and isolation of cases have been instrumental in preventing new cases in schools.

[Trichinellosis outbreaks in Aragón (1998-2017)]. / Brotes epidémicos de triquinosis ocurridos en Aragón durante el periodo 1998 ­ 2017.

OBJECTIVE: In Aragon, official veterinary controls to detect the presence of Trichinella in meat products have allowed trichinosis to be a low-incidence disease in the form of outbreaks associated with family consumption of meat products that are not sanitarily controlled. The aim of the work was to describe the epidemiological characteristics of the trichinosis outbreaks that occurred in Aragon during the study period and the action measures carried out, which served as a basis for redesigning and strengthening prevention and control measures. METHODS: Descriptive study of the characteristics of time, place, person, food implicated, etiological agent and control measures implemented in the outbreaks identified by the Epidemiological Surveillance Network of Aragón from 01/01/1998 to 31/12/2017. For the descriptive analysis, the mean with its standard deviation and proportions were calculated. RESULTS: During the study period (from 01/01/1998 until 31/12/2017) there were 7 family outbreaks with 294 exposed, 103 cases (Attack Rate 35%), of which 29 were hospitalized (28.1%). The case fatality rate was 1%. The average age of the cases was 43.3 years (standard deviation 15.9). 70.8% of the cases were male. Outbreaks were concentrated between December and May. Five outbreaks originated after consumption of wild boar. The etiological agent identified in meat and/or biological samples from the cases was Trichinella spiralis in four outbreaks and Trichinella britovi in two other outbreaks, while the agent could not be identified in one outbreak. In all outbreaks, actions were carried out in accordance with the recommendations established by the National Epidemiological Surveillance Network (RENAVE). CONCLUSIONS: Trichinosis in Aragon takes the form of sporadic family outbreaks coinciding with the time of wild boar hunting and home slaughtering of pigs and is associated with the consumption of meat products not controlled sanitarily, so it is necessary to strengthen health education and intersectoral collaboration in the development and implementation of prevention and control strategies.

OBJETIVO: En Aragón, los controles oficiales veterinarios para detectar la presencia de triquina en productos cárnicos, han permitido que la triquinosis sea una enfermedad de baja incidencia, que se presenta en forma de brotes, asociados al consumo familiar de productos cárnicos no controlados sanitariamente. El objetivo del trabajo fue describir las características epidemiológicas de los brotes de triquinosis ocurridos en Aragón durante el periodo de estudio y las medidas de actuación llevadas a cabo, lo que sirvió de base para rediseñar y fortalecer las medidas de prevención y control. METODOS: Estudio descriptivo de las características tiempo, lugar, persona, alimentos implicados, agente etiológico y medidas de control implementadas en los brotes identificados por la Red de Vigilancia Epidemiológica de Aragón desde el 01/01/1998 al 31/12/2017. Para el análisis descriptivo se calcularon la media con su desviación estándar y las proporciones. RESULTADOS: Durante el periodo de estudio (desde el 01/01/1998 hasta el 31/12/2017) se declararon 7 brotes familiares con 294 expuestos, 103 casos (Tasa de Ataque 35%), de los que 29 fueron hospitalizados (28,1%). La tasa de letalidad fue del 1%. La media de edad de los casos fue de 43,3 años (desviación típica 15,9). El 70,8% de los casos fueron varones. Los brotes se concentraron entre diciembre y mayo. Cinco brotes se originaron tras el consumo de jabalí. El agente etiológico aislado en muestras cárnicas y/o muestras biológicas procedentes de los casos, fue Trichinella spiralis en cuatro brotes y Trichinella britovi en otros dos brotes. En todos los brotes las actuaciones se realizaron conforme a las recomendaciones establecidas por la Red Nacional de Vigilancia Epidemiológica (RENAVE). CONCLUSIONES: La triquinosis en Aragón se presenta en forma de brotes familiares esporádicos coincidentes con la época de caza de jabalí y matanza domiciliaria del cerdo y se asocia al consumo de productos cárnicos no controlados sanitariamente, por lo que es necesario reforzar la educación para la salud y la colaboración intersectorial en la elaboración e implantación de estrategias de prevención y control.

[Streptococcus pneumoniae transmission in a nursing home: analysis of an epidemic outbreak]. / Transmisión de Streptococcus pneumoniae en una residencia de ancianos: análisis de un brote epidémico.

BACKGROUND AND OBJECTIVE: On the basis of an outbreak of pneumococcal pneumonia in a nursing home, we analyze causes and patterns of transmission and discuss preventive interventions carried out on the target population. PATIENTS AND METHOD: A retrospective cohort study was designed on 232 residents to identify risk factors associated with the outbreak. A descriptive study of those nasopharyngeal carriers of pneumococcus among nursing home workers was also carried out. RESULTS: Twenty cases of pneumococcal pneumonia were detected with 4 deaths; 13 cases were confirmed. Cases occurred on a close temporal aggregation form but they were quite disseminated spatially. Among the factors investigated, an older age was the only factor significantly associated (p = 0.02) with the risk of disease. In 4 workers, strains of Streptococcus pneumoniae were isolated from nasopharyngeal swabs; two of them corresponded to the serotype 3, as it was the strain isolated from the blood of a nursing home case. The number of new cases decreased dramatically after vaccination and/or chemoprophylaxis. CONCLUSIONS: Vaccination and chemoprophylaxis administered to nursing home residents seemed effective measures to halt the spread of this outbreak. Detection of the S. pneumoniae antigen by immunochromatographic tests in urine samples is a valuable tool for detecting an outbreak.