Cohort study of an outbreak of viral gastroenteritis in a nursing home for elderly, Majorca, Spain, February 2008.

An outbreak of acute gastroenteritis occurred in a nursing home for elderly in Majorca between 4 and 23 February 2008. To know its aetiology and mechanism of transmission a retrospective cohort study was conducted with a fixed cohort including 146 people (96 residents and 50 employees). The data were collected from clinical histories and through a survey by questionnaire. In total 71 cases were identified (53 residents, 18 employees), corresponding to an overall attack rate (AR) of 48.6%

Vigilancia de la tuberculosis en las Islas Baleares y caracterización de los casos infradeclarados entre los años 2005 y 2007

ResumenEstudio descriptivo de los casos de tuberculosis detectados por el Sistema de Vigilancia Epidemiológica en Baleares, en el trienio de 2005 a 2007. El objetivo fue caracterizar los casos infradeclarados en términos sociodemográficos y de su contacto con la atención primaria de salud. Globalmente, la infradeclaración de la tuberculosis se sitúa en torno al 20%. Las características que resultan significativas en el análisis multivariado son la marginalidad social (alcoholismo, usuarios de drogas por vía parenteral o indigencia) (odds ratio ajustada [ORa]:2,6 [1,2-5,3]), el contacto con la atención primaria (ORa:3,2 [1,4-7,1]) y la tuberculosis extrapulmonar (ORa:5,5 [3,2-9,6]). Se recomienda reforzar la notificación de los especialistas hospitalarios mediante la adecuación informática de la historia clínica hospitalaria, y se observa que la información obtenida desde la informatización de la historia en atención primaria resulta de utilidad para mejorar la vigilancia epidemiológica de la tuberculosis.AbstractWe performed a descriptive study of tuberculosis cases detected by the Epidemiological Surveillance System in the Balearic Islands in the triennium 2005-2007. Our goal was to characterize underreported cases in sociodemographic terms and their contact with primary care. Overall, underreporting of tuberculosis was approximately 20%. Significant factors in multivariate analysis were social marginality (consisting of alcoholism, intravenous drug use or indigence) (aOR: 2.6 [1.2 to 5.3]), contact with primary care (aOR: 3.2 [1.4 to 7.1]), and extrapulmonary tuberculosis (aOR: 5.5[3.2-9.6]). We recommend strengthening notification by hospital specialists through the use of hospital electronic records. Our findings show that the information obtained from the primary care computerized history is helpful in improving the epidemiological surveillance of tuberculosis

[Tuberculosis surveillance in the Balearic Islands and characteristics of unreported cases from 2005 to 2007].

We performed a descriptive study of tuberculosis cases detected by the Epidemiological Surveillance System in the Balearic Islands in the triennium 2005-2007. Our goal was to characterize underreported cases in sociodemographic terms and their contact with primary care. Overall, underreporting of tuberculosis was approximately 20%. Significant factors in multivariate analysis were social marginality (consisting of alcoholism, intravenous drug use or indigence) (aOR: 2.6 [1.2 to 5.3]), contact with primary care (aOR: 3.2 [1.4 to 7.1]), and extrapulmonary tuberculosis (aOR: 5.5[3.2-9.6]). We recommend strengthening notification by hospital specialists through the use of hospital electronic records. Our findings show that the information obtained from the primary care computerized history is helpful in improving the epidemiological surveillance of tuberculosis

Epidemiology and molecular investigation of hepatitis C infection following holiday haemodialysis

Background Hepatitis C virus infection (HCV) is not infrequent among haemodialysis patients. Most published reports suggest that patient-to-patient spread, either directly or indirectly, is the most common mode of transmission in renal units. Aim To investigate the source of an outbreak, and the route of transmission, of acute HCV infection in two Scottish patients occurring within eight weeks of receiving haemodialysis in the same unit while on holiday in Majorca. Methods This was an international epidemiological and molecular investigation of HCV infection among a cohort of haemodialysis patients from nine countries. Findings No further HCV-positive infections were observed among residents and holidaymakers receiving haemodialysis at the unit in Majorca. Molecular investigations confirmed that a Spanish healthcare worker (HCW) was the source of infection for the two Scottish patients. The investigators were unable to determine the route of transmission. Conclusions This outbreak is the first reported case of HCW-to-patient transmission of HCV in a renal unit, and the third reported case of transmission involving a HCW who had not performed invasive procedures. The issue of whether renal units are an exceptional case with regards to the risk of transmission associated with non-invasive procedures should be considered, in conjunction with the need to improve surveillance of blood-borne virus transmissions in renal units in the UK and abroad

Brote de gripe por virus pandémico (H1N1) 2009 en una residencia para personas discapacitadas psíquicas en las Islas Baleares

Fundamentos: La temporada gripal 2009-2010 ha sido más corta y benigna de lo esperado. Desde enero de 2010 los sistemas de vigilancia de gripe indicaban unas tasas de incidencia muy bajas sin detección de circulación del virus. En este contexto, un hospital comunicó una sospecha de brote de enfermedad respiratoria grave, cuya etiología resultó ser gripe (H1N1) 2009. Describimos el brote y las actuaciones de Salud Pública para su control. Métodos: Estudio descriptivo de un brote epidémico por virus gripal pandémico en una residencia para discapacitados mentales. Establecimiento de vigilancia activa. La definición de caso de gripe fue muy sensible para detectar los nuevos casos al inicio, tratarlos precozmente y minimizar la transmisión. Se adoptaron medidas de contención de la infección por virus gripal. Resultados: De 38 casos detectados 7 (todos con factores de riesgo) sufrieron complicaciones graves. No hubo defunciones. La tasa global de ataque fue del 35,2%. Los primeros casos eran trabajadores. Los casos en residentes se acumularon en el pico del brote y entre trabajadores la presentación fue más dispersa. Ninguno de los trabajadores y sólo tres residentes habían sido vacunados. Conclusiones: El brote se inició en los trabajadores de la residencia, a partir de los cuales se difundió a las personas residentes. Destacamos la necesidad de cumplir las recomendaciones de vacunación, no sólo de las personas con factores de riesgo, sino también muy especialmente de los trabajadores en contacto con aquello