3 research outputs found
Brote de gastroenteritis por agua potable de suministro p煤blico
ResumenIntroducci贸nLa potabilidad del agua induce a descartar el posible origen h铆drico de los brotes. El objetivo fue investigar un brote de gastroenteritis por agua potable de suministro p煤blico.M茅todosDespu茅s de la notificaci贸n de un brote de gastroenteritis en el municipio de Baqueira (Valle de Ar谩n) se dise帽贸 un estudio epidemiol贸gico de cohortes retrospectivo. Mediante un muestreo sistem谩tico se eligi贸 a 87 personas hospedadas en los hoteles y a 62 alojadas en diferentes apartamentos. Se recogi贸 informaci贸n sobre 4 factores (consumo de agua de la red, bocadillos, agua y alimentos en las pistas de esqu铆) y presencia de s铆ntomas. Se determin贸 la existencia de cloro, se analiz贸 el agua de la red y se realiz贸 un coprocultivo a 4 enfermos. La implicaci贸n de cada factor se determin贸 con el riesgo relativo (RR) y su intervalo de confianza (IC) del 95%.ResultadosLa incidencia de gastroenteritis fue del 51,0% (76/149). Los porcentajes de los s铆ntomas fueron los siguientes: fiebre, 27,0%; diarrea, 87,5%; n谩useas, 50,7%; v贸mitos, 30,3%, y dolor abdominal, 80,0%. El 煤nico factor que present贸 un riesgo estad铆sticamente significativo fue el consumo de agua de la red (RR = 11,0; IC del 95%, 1,6-74,7). La calificaci贸n sanitaria del agua fue de potabilidad. Se observ贸 un defecto de situaci贸n del clorador en el dep贸sito, que fue corregido. Se recomend贸 incrementar a煤n m谩s las concentraciones de cloro, lo cual se acompa帽贸 de una disminuci贸n de los casos. Los coprocultivos de los 4 enfermos fueron negativos para las enterobacterias investigadas.ConclusionesEl estudio demuestra la posibilidad de presentaci贸n de brotes h铆dricos por agua cualificada como potable y sugiere la necesidad de mejorar la investigaci贸n microbiol贸gica (determinaci贸n de protozoos y virus) en este tipo de brotes.AbstractIntroductionThe chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies.MethodsA historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Ar谩n, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area.Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI).ResultsThe overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria.ConclusionsThis study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection)
Colorectal cancer screening: strategies to select populations with moderate risk for disease Cribado del c谩ncer colorrectal: estrategias para seleccionar a poblaciones con un riesgo moderado para esta enfermedad
Objective: to analyse the association between rectal bleeding or a family history of colorectal cancer (CRC) and the results obtained in two rounds of a CRC screening pilot programme performed in L'Hospitalet, Barcelona, Spain. Subjects: males and females (50-69 years) were the target population. Together with the invitation letter, they received a questionnaire in which they were askaed about rectal bleeding, family history of CRC and related neoplasms. The screening test was a guaiac-based faecal occult blood test (FOBT), and colonoscopy for positive tests. Results: 25,829 FOBT were performed in 18,405 individuals. Information on rectal bleeding and a family history of CRC were obtained for 9,849 and 9,865 cases, respectively. Male sex (OR = 1.32), 60-69 years of age (OR = 1.48), rectal bleeding (OR = 1.84) and history of CRC (OR = 1.54) were independent predictors of positive FOBT. With regard to colonoscopy, a greater risk of diagnosing advanced neoplasm was observed among men (OR = 2.47) and subjects with a family history of CRC (OR = 1.98). Conclusions: CRC screening programmes must have instruments that make it possible to select the candidate population and the possibility of offering a study suited to the risk of individuals who are not susceptible to population screening by means of FOBT