Vigilancia del COVID-19 en centros de larga estancia: el efecto de la pandemia en las residencias de mayores

[ES] Este informe muestra la situación epidemiológica de la COVID-19 en los centros residenciales de mayores a lo largo del año 2021 y hasta la semana 17 del 2022. Desde su puesta en marcha en enero de 2021, esta vigilancia ha proporcionado datos semanales nacionales agregados, con información sobre la proporción de residencias afectadas por la COVID-19, la incidencia de COVID-19 y la letalidad entre una población vulnerable donde los efectos de la pandemia han sido y están siendo especialmente graves. La comparación con la incidencia y mortalidad de casos COVID-19 en población mayor no institucionalizada, nos demuestra cómo el impacto de la COVID-19 ha sido y está siendo mayor entre las personas mayores que viven en residencias de ancianos, con tasas de mortalidad superiores al resto de la población de la misma edad. [EN] This report shows the epidemiological situation of COVID-19 in the long-term care facilities (LTCF) for elderly throughout 2021 and until the 17th week of 2022. Since its start-up in January 2021, this surveillance has provided aggregated national weekly data, with information on the proportion of LTCF for elderly affected by COVID-19, the incidence of COVID-19 and fatal cases among a vulnerable population where the effects of the pandemic have been and are being especially severe. The comparison with the incidence and mortality of COVID-19 cases in non institutionalized elderly shows how the impact of COVID-19 is being greater among the elderly living in nursing homes, with more fatal cases than the rest of the population of the same age

Long-term care facilities (LTCF) for the elderly: the surveillance of communicable diseases as part of health care and protection

[ES] Durante las últimas décadas la asistencia sanitaria ha sufrido importantes cambios. La mayor esperanza de vida ha dado lugar a un envejecimiento de la población que, según las Naciones Unidas, está a punto de convertirse en una de las más importantes transformaciones sociales del siglo XXI. A nivel mundial, había 727 millones de personas de 65 años o más en 2020 (un 9,3% de la población total) y se estima que aumente al 16% en 2050 . En la Unión Europea (UE), el porcentaje de población de 65 años o más se ha incrementado de un 9,6% en 1960 a un 20,3% en 2019 y se proyecta que aumente a un 31,3% para 2100. Asistimos además a un proceso de envejecimiento de la población mayor, con una proporción de personas muy mayores (aquellas de 80 años y más) en la población total de la Unión Europea del 5,8% en 2019 . España es uno de los países con una mayor proporción de personas mayores, con un porcentaje de ciudadanos de 65 años o más en 2020 del 19,6% del total de la población, y con una proyección del 26,5% para 2035. Casi un tercio de esta población (6%) tienen 80 años o más. [EN] During the last decades, healthcare has undergone important changes. Increased life expectancy has given rise to an aging population that, according to the United Nations, is about to become one of the most important social transformations of the 21st century. Globally, there were 727 million people aged 65 or over in 2020 (9.3% of the total population) and this is estimated to increase to 16% by 2050 . In the European Union (EU), the percentage of the population aged 65 or over has increased from 9.6% in 1960 to 20.3% in 2019 and is projected to increase to 31.3% by 2100. We are also witnessing a process of aging of the elderly population, with a proportion of very old people (those aged 80 and over) in the total population of the European Union of 5.8% in 2019 . Spain is one of the countries with the highest proportion of older people, with a percentage of citizens aged 65 or over in 2020 of 19.6% of the total population, and with a projection of 26.5% for 2035. Almost a third of this population (6%) are 80 years or older.S

Comparative severity of COVID-19 cases caused by Alpha, Delta or Omicron SARS-CoV-2 variants and its association with vaccination

[EN] Background: This study compares the severity of SARS-CoV-2 infections caused by Alpha, Delta or Omicron variants in periods of co-circulation in Spain, and estimates the variant-specific association of vaccination with severe disease. Methods: SARS-CoV-2 infections notified to the national epidemiological surveillance network with information on genetic variant and vaccination status were considered cases if they required hospitalisation or controls otherwise. Alpha and Delta were compared during June-July 2021; and Delta and Omicron during December 2021-January 2022. Adjusted odds ratios (aOR) were estimated using logistic regression, comparing variant and vaccination status between cases and controls. Results: We included 5,345 Alpha and 11,974 Delta infections in June-July and 5,272 Delta and 10,578 Omicron in December-January. Unvaccinated cases of Alpha (aOR: 0.57; 95% CI: 0.46-0.69) or Omicron (0.28; 0.21-0.36) had lower probability of hospitalisation vs. Delta. Complete vaccination reduced hospitalisation, similarly for Alpha (0.16; 0.13-0.21) and Delta (June-July: 0.16; 0.14-0.19; December-January: 0.36; 0.30-0.44) but lower from Omicron (0.63; 0.53-0.75) and individuals aged 65+ years. Conclusion: Results indicate higher intrinsic severity of the Delta variant, compared with Alpha or Omicron, with smaller differences among vaccinated individuals. Nevertheless, vaccination was associated to reduced hospitalisation in all groups. [ES]Introducción: El objetivo es comprar la gravedad de las infecciones por las variantes Alfa, Delta y Ómicron del SARS-CoV-2 en periodos de co-circulación en España, y estimar la asociación entre vacunación y gravedad en cada variante. Métodos: Las infecciones por SARS-CoV-2 notificadas a la red nacional de vigilancia epidemiológica con información sobre la variante viral y el estado de vacunación se clasificaron como casos si habían requerido hospitalización, o como controles en caso contrario. Alfa y Delta se compararon durante junio-julio de 2021, y Delta y Ómicron durante diciembre de 2021-enero de 2022. Se estimaron odds ratios ajustadas (ORa) mediante regresión logística, comparando la variante y el estado de vacunación entre casos y controles. Resultados: Se incluyeron 5.345 infecciones por variante Alfa y 11.974 por Delta en junio-julio y 5.272 infecciones por Delta y 10.578 por Ómicron en diciembre-enero. Los casos no vacunados por Alfa (aOR: 0,57; IC 95%: 0,46-0,69) u Ómicron (0,28; IC 95%: 0,21-0,36) tuvieron menor probabilidad de hospitalización comparados con Delta. La vacunación completa se asoció a menor hospitalización de forma similar para Alfa (0,16; IC 95%: 0,13-0,21) y Delta (junio-julio: 0,16; IC 95%: 0,14-0,19; diciembre-enero: 0,36; IC 95%: 0,30-0,44) pero menor para Ómicron (0,63; IC 95%: 0,53-0,75) y para individuos con 65+ años. Conclusión: Los resultados indican una mayor gravedad intrínseca de la variante Delta comparada con Alfa u Ómicron, con menor diferencia entre personas vacunadas. La vacunación se asoció a menor hospitalización en todos los grupos.In this study the identification of variants by genomic sequencing has been partially supported by HERA-Incubator ECDC/GRANT/2021/024-Enhancing Whole Genome Sequencing (WGS) and/or Reverse Transcription Polymerase Chain Reaction (RT-PCR) national infrastructures and capacities to respond to the Covid-19 pandemic in Spain.S

Iniciación en la investigación dirigida a los alumnos de primero de Podología

Desde el año 1998 hasta la actualidad, la Universidad ha ido cambiando en su planteamiento pedagógico para responder a las necesidades de una sociedad también en cambio. Los profesores universitarios estamos viviendo, como consecuencia de ello, un proceso de adaptación de nuestras metodologías, que nos ha ido creando la necesidad de utilizar el proceso de “investigación-acción” para la valoración de nuestros cambios. La formación en competencias ha sido ampliamente discutida y es en este momento una de las características básicas de la enseñanza que muchas Universidades han establecido como prioritarias. El problema que se plantea ahora para los profesores es como organizar ese proceso de formación a lo largo de los distintos cursos y que metodologías son las que mejor se adaptan a cada caso específico. Las metodologías activas y participativas han demostrado implicar al alumno en su proceso formativo3 pero es necesario analizar en el aula si se ajustan a las necesidades que en cada área se plantean.SIN FINANCIACIÓNNo data 2005UE

Actitudes y prácticas de los médicos de atención primaria ante el diagnóstico de la infección por virus de la inmunodeficiencia humana

Objective: To explore the attitudes and practices of Primary Health Care professionals in the diagnosis of HIV infection according to current protocols and the degree of acceptance of simplified HIV testing (without a separate written consent and without asking about risk practices). Material and methods: An observational cross-sectional descriptive study conducted in Primary Care Centres of the Madrid Public Health Service. Data were collected by telephone surveys during 2009. Results: A total of 210 doctors were interviewed. Twenty one percent were already performing simplified HIV testing (and 28.6% expressed a favourable attitude towards the new recommendations). The majority (71.4% did not use a separate written consent for HIV testing, and 42% did not report any communication difficulties. Most of them considered that comparing HIV with other similar ways of transmission infections, making HIV testing exceptual may lead to stigma. Lack of time was not a problem for 75.2%, and 97.1% considered they had an essential role in controlling the HIV epidemic. Conclusions: The acceptance of simplified HIV testing is high and is already being performed by 1 out of 5 Primary Care Doctors in the Madrid Public Health Service.1.491 JCR (2011) Q3, 82/114 Microbiology; Q4, 55/70 Infectious disease

Vigilancia del COVID-19 en centros de larga estancia: el efecto de la pandemia en las residencias de mayores

[ES] Este informe muestra la situación epidemiológica de la COVID-19 en los centros residenciales de mayores a lo largo del año 2021 y hasta la semana 17 del 2022. Desde su puesta en marcha en enero de 2021, esta vigilancia ha proporcionado datos semanales nacionales agregados, con información sobre la proporción de residencias afectadas por la COVID-19, la incidencia de COVID-19 y la letalidad entre una población vulnerable donde los efectos de la pandemia han sido y están siendo especialmente graves. La comparación con la incidencia y mortalidad de casos COVID-19 en población mayor no institucionalizada, nos demuestra cómo el impacto de la COVID-19 ha sido y está siendo mayor entre las personas mayores que viven en residencias de ancianos, con tasas de mortalidad superiores al resto de la población de la misma edad. [EN] This report shows the epidemiological situation of COVID-19 in the long-term care facilities (LTCF) for elderly throughout 2021 and until the 17th week of 2022. Since its start-up in January 2021, this surveillance has provided aggregated national weekly data, with information on the proportion of LTCF for elderly affected by COVID-19, the incidence of COVID-19 and fatal cases among a vulnerable population where the effects of the pandemic have been and are being especially severe. The comparison with the incidence and mortality of COVID-19 cases in noninstitutionalized elderly shows how the impact of COVID-19 is being greater among the elderly living in nursing homes, with more fatal cases than the rest of the population of the same age

Listeriosis outbreak caused by contaminated stuffed pork, Andalusia, Spain, July to October 2019.

Between 1 July and 26 October 2019 in Andalusia, Spain, a large outbreak with 207 confirmed cases of listeriosis was identified. Confirmed cases had a median age of 44 years (range: 0-94) and 114 were women (55.1%). Most cases (n = 154) had mild gastroenteritis, 141 (68.1%) required hospitalisation and three died; five of 34 pregnant women had a miscarriage. The median incubation period was 1 day (range: 0-30), and was significantly shorter in cases presenting with gastroenteritis compared to those presenting without gastroenteritis (1 day vs. 3 days, respectively, p value

Mpox (formerly monkeypox) in women: epidemiological features and clinical characteristics of mpox cases in Spain, April to November 2022

Over 79,000 confirmed cases of mpox were notified worldwide between May and November 2022, most of them in men who have sex with men. Cases in women, for whom mpox might pose different risks, are rare, and Spain has reported more than one third of those in Europe. Using surveillance data, our study found similar time trends, but differences in delay of diagnosis, sexual transmission and signs and symptoms between men and women.S

Unprecedented increase of West Nile virus neuroinvasive disease, Spain, summer 2020.

Cases of West Nile neuroinvasive disease (WNND) in Spain increased in summer 2020. Here we report on this increase and the local, regional and national public health measures taken in response. We analysed data from regional surveillance networks and the National Epidemiological Surveillance Network, both for human and animal West Nile virus (WNV) infection. During the 2020 season, a total of 77 human cases of WNV infection (median age 65 years; 60% males) were detected in the south-west of Spain; 72 (94%) of these cases developed WNND, presenting as meningoencephalitis, seven of which were fatal. In the previous two decades, only six human cases of WNND were detected in Spain. Reduced activities for vector control this season, together with other factors, might have contributed to the massive increase. Public health measures including vector control, campaigns to raise awareness among physicians and the general population, and interventions to ensure the safety of donations of blood products, organs, cells and tissues were effective to reduce transmission. Going forward, maintenance of vector control activities and an update of the vector-borne diseases response plan in Spain is needed.S

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective