Plan de Acción en España para la erradicación de la poliomelitis: Vigilancia de la Parálisis Flácida Aguda y Vigilancia de Enterovirus en España. Informe 2020

Centro Nacional de Epidemiología y Centro Nacional de Microbiología. ISCIII. Plan de acción en España para la Erradicación de la Poliomielitis. Vigilancia de la Parálisis Flácida Aguda y Vigilancia de Enterovirus en España, Informe año 2020. Madrid, 5 de noviembre de 2021.[ES] En España la situación libre de polio se monitoriza con la vigilancia de Parálisis Flácida Aguda (PFA) en niños menores de 15 años, como recomienda la Organización Mundial de la Salud (OMS). La vigilancia la realizan los servicios de vigilancia autonómicos y la red de laboratorios de PFA y a nivel nacional se coordina en el Centro Nacional de Epidemiología (CNE, ISCIII) y en el Laboratorio de Poliovirus del Centro Nacional de Microbiología (CNM, ISCIII). En el año 2020 en España no hubo casos de poliomielitis. Se notificaron 0,17 casos de PFA por 100.000 niños menores de 15 años, por debajo del objetivo de sensibilidad establecido por la OMS de un caso de PFA al año por cada 100.000 menores de 15 años. Solamente se detectaron enterovirus no-polio (EVNP) en las muestras de dos casos (EV-D68 y EV-B, respectivamente). En España también se realiza la vigilancia de EVNP en otros síndromes neurológicos para complementar el sistema de vigilancia de PFA. En las muestras investigadas en 2020 no se identificó ningún poliovirus y los EVNP más frecuentemente identificados fueron E-18, CV-A6 y E-21. Mientras haya circulación de poliovirus en el mundo hay que mantener activos los sistemas de vigilancia para detectar a tiempo cualquier importación de poliovirus. [EN] Spain monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). The AFP surveillance is performed by the 19 Regional Epidemiological Surveillance Units and the AFP Surveillance Laboratory Network, coordinated at national level by the National Centre for Epidemiology (CNE. ISCIII) and the National Poliovirus Laboratory at Nacional Center of Microbiology (CNM. ISCIII) respectively. In 2020, no cases of poliomyelitis were reported from clinical surveillance; Spain reported 0.17 non-polio AFP cases per 100,000 children, below the WHO's performance criterion for a sensitive surveillance system (1 non-polio AFP cases per 100,000 children). The non-polio enteroviruses EV-D68, EV-B were identified from clinical specimens collected from AFP cases. Spain also performs enterovirus surveillance to complement the clinical system In 2020, non poliovirus were identified; The non-polioviruses E-18, CV-A6 y E-21 were the most frequently identified serotypes. As long as poliovirus is circulating in the world, surveillance systems must remain active to detect any importation of poliovirus in a timely manner.1. Resumen. 2. Introducción. 3. Resultados de la vigilancia de Parálisis Flácida Aguda (PFA) en España, 2020. 4. Resultados de la vigilancia de enterovirus, España 2020. 5. Resultados de la vigilancia medioambiental de poliovirus. España, 2020. 6. Sistema de Información Microbiológica (SIM). Meningitis por enterovirus. Tendencia. 7. Conclusiones.N

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Encuesta de portadores de "N. Meningitidis" en el Area de Salud de Gran Canaria

Background: A) To ascertain tbe tate of cartiers and the Types of Neisseriu MeninglrirZis circulating in the population resident in the health jurisdiction of Gran Canaria. B) to ascertain the pattem of disuibution of sucb caniers. Methods: A descriptiva transversal design was made, with a random sampling in multiple stages and by conglomerates. A minimum sample size was detennined at 707 individuals for an expected prevalence of 8.6 %, with arate of reliabiiity of 95.6 % and a precísion of 0.02. AssumQ that 15 Sb if the individuals would not be willing to co-operate, the satnple site was increased to 83 1 individuals, distibuted iu each conglomerate in pmportion to the existing population. This size was disnibuted UI tum into four gmups by age and sex, in proportion to their significauce in each basic health care zone selected at random. The individuals in the sample were identified from among those who attended the blood extraction units, sud after they had passed the criteria of exclusion, their co-opemtion was requested as volunteers in the study. If they accepted, a questionnaire was fi- Iled out with a number of variables of epidemiological interest and a phatyngeal smear was taken. Since the Primary Care units were selected on a simple random hasis, and the same methcd was usedto select the individuals within the units, the estimate of the prevaIence was made by meaus of au unbiased estimator. Results: A total of 828 samples were obtained, that is, 99.6% of the uumber foreseen. Witb the exception of three, al1 of tlte individuals selected participated valuntatily in the study, a circumstance reudering it ltighly represeutative. A1I of the suains obtained corresponded to N. Meningitidis Serogroup B, except for ene identified as N. Meningitidis Serogroup C Sem/Subtype 4:Pf.2,5. The strains of N. Menmgitidis serogmup B identified corresponded to 25 different sero-subtypes. The prrvalencz detennined after having studied tbe sample was 6,45 %, the vtiance = 0.0275 and the standard error = 1.66. We can conclude witb a 95 5% degree of reliability that the prevalence of carriers of N. Meningitidis in the Gran Canaria 1~1th jutisdiction is estimated ta be between 3.2 % and 9.7 k. CkUdLdOUS: A clear predcxninance of N. Meningitidis serogmup B strains among cticrs has been v&fied. There are no statisticnlly significant differences in the prevalence observed among the different age gmups nor between sexes.Fundamentos: Se plantea A) Conocer la tasa de portadores y los tipos circulantes de Neissetiu Meningiridis en la población residente en el área de salud de Gran Canaria. B) Conocer el pattin de distribución de estos podom. Métodos: Se realizó un diseiio descriptivo transversal, con un muestreo aleatorio en etapas mUiples y por conglomendos. Se determinó un tamaíío muestml mínimo de 707 personas para und prevalencia esperada del 8,6 5%. con una confianza del 95,6 % y precisión de 0,02. Asumiendo que uu 15 % de las personas uo quisieran colaborar, se incrementó el tamafio muesaal a 831 personas, distribuidas en cada conglomemdo de manerA pmprcional a la pblación existente. Este tamallo se distribuyó a su vez, en cuatm grandes grupos de edUd y sexo, proporcionalmente a su importancia en cada zona bkica de salud seleccionada aleatoriamente. Los individuos de la muesti se identifkaban entre los que acudían a las unidades de extracción, y una vez superados los &erios de exclusión se les solicitaba su culaboraciki voluntaria en el estudio. Si aceptaban, se IGS cumplimentaba un :aestionario que engIobaba diferentes variables de inteds epidemiológico y se les realizaba un frotis ftigeo. Al hater seleccionado lo& equipos de Atención Primaria con mues- aleatorio simple y seguir el misnm método para elegir los individuos denrro de ellos, la estimación de la prevaleucia se realiz.6 mediante estimador no sesgado. Resultados: Se obtuvieron un total de 828 muestras, lo que supuso un 99,6% de las previstas. Salvo tres, todos los individuos seleccionados participaron voluntariamente en el estudio, lo que le confiere una alta repretseutatividad Todas las cepas obtenidas correspndiun B N. Meni@idis Serogmpo B, salvo una identificada como N. Meningitidis Serogrupn C Sero/Subtip 4:P1.2,5. Las cepas de N. Meningitidis serogrupo B identificadas, correspondían a 25 semsubtips diferentes. La prevalencia puntual IXIS haber estudiado la muestra fue de 6,45 !7c, la varianza=0,0275 y el error esthdar = 1,66. Podemos afirmar con una confianza del 95 W, que la prevalencia de prtadores de N. Meningitidis en el tiea de salud de Gran Cantia, se estima entre el 3,2 % y el 9,7 %. thxlusiones: Se compmeba uu clan, predominio de cepas N. Meniagitidis semgrupo B entre los portadores. No aparecen diferencias estadísticamente significativas en la prevalen& observadd enltre los distintos grupos de edad, ni entre ambos sexos