Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta variant breakthrough infections in nursing home residents following vaccination with Comirnaty® COVID‐19 vaccine were characterized. ...In total, 201 participants (median age, 87 years; range, 64–100; 133 female) from two nursing homes in the Valencian community (Spain) were included. SARS‐CoV‐2‐Spike (S) antibody responses were determined by a lateral flow immunocromatography (LFIC) assay and by quantitative electrochemiluminescent assay in LFIC‐negative participants. SARS‐CoV‐2‐S‐IFNγ T cells were enumerated by flow cytometry in 10 participants. Nasopharyngeal SARS‐CoV‐2 RNA loads were quantified by real‐time polymerase chain reaction assays. Vaccine breakthrough COVID‐19 due to the Delta variant occurred in 39 residents (median age, 87 years; range, 69–96; 31 female) at a median of 6.5 months after vaccination (nine requiring hospitalization). Breakthrough infections occurred at a higher rate (p < 0.0001) in residents who had not been previously infected with SARS‐CoV‐2 (naïve) (33/108; 18%) than in those with prior diagnosis of SARS‐CoV‐2 infection (experienced) (6/93; 6.4%), and were more likely (p < 0.0001) to develop in residents who tested negative by LFIC (20/49) at 3 months after vaccination as compared to their LFIC‐positive counterparts (19/142). Among LFIC‐negative residents, a trend towards lower plasma anti‐RBD antibody levels was noticed in those developing breakthrough infection (p = 0.16). SARS‐CoV‐2 RNA loads in nasopharyngeal specimens were lower in SARS‐CoV‐2‐experienced residents (p < 0.001) and in those testing positive by LFIC (p = 0.13). The frequency of SARS‐CoV‐2‐S‐reactive T cells at 3 months was similar in LFIC‐negative residents with (n = 7) or without (n = 3) breakthrough infection. Prior history of SARS‐CoV‐2 infection and detection of S‐reactive antibodies by LFIC at 3 months is associated with a lower risk of Delta‐variant breakthrough infection in nursing home residents at midterm after Comirnaty® COVID‐19 vaccination.
An outbreak of S.Typhimurium occurred in several towns and cities in the province of Castellon (Spain) between 23 February and 27 May 2011. On April 5, the microbiology laboratory of a hospital in ...Castellon alerted the health authorities to the increase in S.Typhimurium isolated in fecal culture of children with gastroenteritis. The serotype and phage-type of 83 positive cases of S.Typhimurium isolated in these period included 49 monophasic/biphasic S.Typhimurium phage type 138, phage type 193, S.Derby, and 34 other S.Typhimurium phage-types. The median of age of patients was 4 years with a range of 0.6-80 years, and the 18% of patients were hospitalised. Two incident matched case-control studies were carried out; the first with S.Typhimurium phage type 138, 193, and S.Derby cases and the second with the other cases. The two studies found that the consumption of brand X dried pork sausage, purchased in a supermarket chain A, was associated with the disease (matched Odds Ratio mOR=13.74 95% Confidence Interval CI 4.84-39.06 and mOR=8.20 95% CI 2.32-28.89), respectively). S.Typhimurium phage type 193 and S.Derby were isolated in the food taken from the household of two patients and from the supermarket chain's A central warehouse. The pulsed-field gel electrophoresis study confirmed the similarity of the strains from the patients and the food. On May 25 2011, a national food alert led to the withdrawal of the food from the chain A and the outbreak ended.
Highlights ► We use an systematic incident diarrhea study to identify cases and controls. ► We used a regional immunization information system to get vaccine status. ► A case–case study to asses the ...effectiveness of rotavirus vaccination. ► A counterfactual analysis using pneumococcal vaccine to asses bias and specificity.
FUNDAMENTOS // La pandemia de la COVID-19 ha tenido un fuerte impacto sobre otras enfermedades infecciosas. El objetivo de este trabajo fue analizar los cambios epidemiológicos acaecidos durante la ...pandemia en ocho enfermedades infecciosas con patrones epidemiológicos distintos: la gripe; virus respiratorio sincitial; rotavirus; neumococo; Campylobacter; Salmonella no tifoidea; gonococia; herpes zóster.
MÉTODOS // A partir de la Red de Vigilancia Microbiológica, se trazó la serie temporal de casos desde enero de 2017 a marzo de 2023. Se distinguieron tres periodos: prepandemia (referencia), pandemia e inicio de la pospandemia. Se analizó la distribución por edad y sexo en esos periodos. Se calcularon las tasas de incidencia y las razones de tasas (RT). Se estimaron esas RT globales y sus intervalos de confianza al 95% por cada año de edad en menores de cinco años.
RESULTADOS // Se encontraron diferencias estadísticamente significativas en el impacto que la pandemia tuvo en cada una de esas enfermedades. Algunas, tras un periodo de silencio epidémico, revelaron un repunte intenso pospandémico. Incrementaron la RT global postpandémica la gripe (2,4), VRS (1,9) y gonococia (3,1); recuperó su nivel prepandémico el rotavirus (1,07); y disminuyeron el neumococo (0,84), Campylobacter (0,83) y Salmonella (0,60). En menores de cinco años, los patrones fueron específicos y heterogéneos para cada enfermedad.
CONCLUSIONES // El impacto de la pandemia es muy diferente en estas enfermedades. Las infecciones víricas estacionales pediátricas y de transmisión respiratoria son las que más se ven afectadas, pero con patrones de recuperación de la normalidad distintos. Las infecciones bacterianas gastrointestinales sufren menos variaciones, salvo el rotavirus. La gonococia no interrumpe su tendencia al aumento avistada ya en la prepandemia. El herpes zóster muestra un ligero incremento pospandémico. Se han estudiado varias enfermedades con distinto patrón epidemiológico durante un periodo suficiente para observar cómo se produce la salida de la fase aguda de la pandemia.
OBJECTIVESTo describe an outbreak of multidrug-resistant tuberculosis (MDR-TB) in two schoolsMETHODSThis was a prospective, observational study of an outbreak of MDR-TB in 2 schools located in the ...towns of Onda and Nules, in the Spanish province of Castellon, from the moment of detection in November 2008 until November 2014, including patient follow-up and contact tracing.RESULTSFive cases of MDR-TB were diagnosed. Overall attack rate was 0.9%, and among the contacts traced, 66 had latent tuberculous infection, with an infection rate of 14.4%. Molecular characterization of the 5M. tuberculosis isolates was performed by restriction fragment length polymorphism (RFLP) analysis of the IS6110 sequence. In all 5 patients, cultures were negative at 4-month follow-up, showing the efficacy of the treatment given. No recurrence has been reported to date.CONCLUSIONSIn the context of globalization and the increased prevalence of MDR-TB, outbreaks such as the one presented here are only to be expected. Contact tracing, strict follow-up of confirmed cases, the availability of fast diagnostic techniques to avoid treatment delay, and chemoprophylaxis, together with the molecular characterization of strains, are still essential.
Binge drinking is a matter of current social, media and political concern, and the focus of much policy activity in the UK. Binge drinking is associated with causing a wide range of harm to ...individuals (e.g. accidents), and the wider community (e.g. crime and disorder). Within the current discourse, binge drinking is seen primarily as a youth issue. Binge drinking is sometimes portrayed as a recent phenomenon, but we know from history that heavy drinking has been endemic in British society over many centuries. Using a contemporary history perspective, this paper explores the concept of binge drinking. It considers the definitions in use, recent shifts in meaning and also the way in which different definitions of binge drinking impact on perceptions of the extent and nature of binge drinking. The paper concludes with some thoughts and questions about the usefulness of the concept of binge drinking as it currently used, and areas for further research.
FUNDAMENTOS // Este estudio abordó un brote de la COVID-19 en una residencia de ancianos, donde los residentes estaban vacunados con dos dosis de Comirnaty® y treinta de ellos habían pasado ...anteriormente la infección. Los brotes en colectivos cerrados son oportunidades para estudiar todo el espectro clínico de la enfermedad y, como en este caso, el efecto de la inmunidad híbrida sobre la transmisión, la progresión de la infección y la carga viral.
MÉTODOS // Se realizó un estudio descriptivo y de cohortes retrospectivo en la población de residentes. Se calcularon las tasas de ataque para uno de cuatro estadios de la enfermedad: infección, infección sintomática, hospitalización y defunción. Después se estimaron los riesgos relativos (RR) mediante regresión de Poisson simple y multivariante para cada uno de esos estadios.
RESULTADOS // La tasa de ataque fue del 59% (56/95). El espectro clínico fue igual en ambos sexos. Hubo un notable efecto protector de la inmunidad híbrida contra la transmisión (67%). En términos de progresión, aquellos con inmunidad híbrida presentaron un riesgo menor de infección sintomática. La carga viral nasofaríngea fue significativamente menor en individuos con inmunidad híbrida y asintomáticos, respaldando la idea de una menor transmisibilidad en este grupo. La edad se identificó como un factor de riesgo para la progresión de la enfermedad. El análisis molecular identificó la variante Delta B.1.617.2 en los pacientes y una muestra de aire, lo que respaldó la transmisión por aerosol en entornos cerrados y mal ventilados.
CONCLUSIONES // Este estudio proporciona una visión integral de un brote en una residencia de ancianos vacunados, destacando la importancia de la inmunidad híbrida. Los resultados respaldan la consideración individual de la historia de infección previa al evaluar el riesgo de la COVID-19, contribuyendo a la comprensión de la evolución de la pandemia en el futuro.
INTRODUCTIONThe influenza pandemic of 2009 had a great social impact. Many health resources were devoted to the care, prevention and surveillance of this disease. Epidemiological surveillance is ...based on the reporting of cases of influenza-like illness (ILI) and confirmed influenza cases. The objective was to estimate the true incidence of ILI during the influenza pandemic of 2009.METHODSThe capture-recapture method was applied during the month of highest influenza incidence in Castellón. Two notification systems were used: (i)electronic reporting of Notifiable Diseases (ND), and (ii)laboratory-based (LAB) data collection. Estimates were made by stratifying by age group and week. Independence coefficients were calculated for those strata.RESULTSNo dependence was found between stratification variables and the reporting system. A total of 7,181 ND cases and 524 LAB cases were identified, of which 211 were recorded in both systems. The estimated total of cases was 17,785 in a single month. In the study period, almost 4% of people in the area suffered flu symptoms (cumulative incidence), with 1% being affected each day (daily prevalence). The sensitivity of the ND system was 40%, i.e., the percentage of patients seeking primary care.CONCLUSIONSTo obtain an estimate of the actual incidence of influenza-like illness in the population during a pandemic period, the number of medical consultations should be multiplied by a factor of 2.5. This factor is lower than that estimated for periods without pandemic alert.
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