Azithromycin to Prevent Pertussis in Household Contacts, Catalonia and Navarre, Spain, 2012-2013

We retrospectively assessed the effectiveness of azithromycin in preventing transmission of pertussis to a patient's household contacts. We also considered the duration between symptom onset in the primary patient and azithromycin administration. We categorized contacts into 4 groups: those treated within 21 days after illness onset in the primary patient. We studied 476 primary index patients and their 1,975 household contacts, of whom 4.5% were later identified as having pertussis. When contacts started chemoprophylaxis within 14 days after primary patient's symptom onset was less effective. We recommend that contacts of persons with pertussis begin chemoprophylaxis within <14 days after primary patient's symptom onset

Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016

In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections also occur but are generally not reported in the literature. This study aimed to determine the epidemiologic characteristics of cases of nosocomial influenza compared with the remaining severe cases of severe influenza in acute hospitals in Catalonia (Spain) which were identified by surveillance. An observational case-case epidemiological study was carried out in patients aged ≥18 years from Catalan 12 hospitals between 2010 and 2016. For each laboratory-confirmed influenza case (nosocomial or not) we collected demographic, virological and clinical characteristics. We defined patients with nosocomial influenza as those admitted to a hospital for a reason other than acute respiratory infection in whom ILI symptoms developed ≥48 h after admission and influenza virus infection was confirmed using RT-PCR. Mixed-effects regression was used to estimate the crude and adjusted OR. One thousand seven hundred twenty-two hospitalized patients with severe laboratory-confirmed influenza virus infection were included: 96 (5.6%) were classified as nosocomial influenza and more frequently had > 14 days of hospital stay (42.7% vs. 27.7%, P <.001) and higher mortality (18.8% vs. 12.6%, P <.02). The variables associated with nosocomial influenza cases in acute-care hospital settings were chronic renal disease (aOR 2.44 95% CI 1.44-4.15) and immunodeficiency (aOR 1.79 95% CI 1.04-3.06). Nosocomial infections are a recurring problem associated with high rates of chronic diseases and death. These findings underline the need for adherence to infection control guidelines

GNSS transpolar earth reflectometry exploriNg system (G-TERN): Mission concept

The global navigation satellite system (GNSS) Transpolar Earth Reflectometry exploriNg system (G-TERN) was proposed in response to ESA's Earth Explorer 9 revised call by a team of 33 multi-disciplinary scientists. The primary objective of the mission is to quantify at high spatio-temporal resolution crucial characteristics, processes and interactions between sea ice, and other Earth system components in order to advance the understanding and prediction of climate change and its impacts on the environment and society. The objective is articulated through three key questions. 1) In a rapidly changing Arctic regime and under the resilient Antarctic sea ice trend, how will highly dynamic forcings and couplings between the various components of the ocean, atmosphere, and cryosphere modify or influence the processes governing the characteristics of the sea ice cover (ice production, growth, deformation, and melt)? 2) What are the impacts of extreme events and feedback mechanisms on sea ice evolution? 3) What are the effects of the cryosphere behaviors, either rapidly changing or resiliently stable, on the global oceanic and atmospheric circulation and mid-latitude extreme events? To contribute answering these questions, G-TERN will measure key parameters of the sea ice, the oceans, and the atmosphere with frequent and dense coverage over polar areas, becoming a "dynamic mapper" of the ice conditions, the ice production, and the loss in multiple time and space scales, and surrounding environment. Over polar areas, the G-TERN will measure sea ice surface elevation (&lt;10 cm precision), roughness, and polarimetry aspects at 30-km resolution and 3-days full coverage. G-TERN will implement the interferometric GNSS reflectometry concept, from a single satellite in near-polar orbit with capability for 12 simultaneous observations. Unlike currently orbiting GNSS reflectometry missions, the G-TERN uses the full GNSS available bandwidth to improve its ranging measurements. The lifetime would be 2025-2030 or optimally 2025-2035, covering key stages of the transition toward a nearly ice-free Arctic Ocean in summer. This paper describes the mission objectives, it reviews its measurement techniques, summarizes the suggested implementation, and finally, it estimates the expected performance

Detection of norovirus in saliva samples from acute gastroenteritis cases and asymptomatic subjects : Association with age and higher shedding in stool

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017-2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections

Factors influencing the spread of pertussis in households: a prospective study, Catalonia and Navarre, Spain, 2012 to 2013

We aimed to investigate transmission rates of pertussis in household contacts of cases and factors associated with transmission. A prospective epidemiological study was conducted in 2012 and 2013 to determine the incidence of pertussis among household contacts of reported cases in Catalonia and Navarre, Spain. An epidemiological survey was completed for each case and contact, who were followed for 28 days to determine the source of infection (primary case) and detect the occurrence of secondary cases. Odds ratios (ORs) were used to estimate the effectiveness of vaccination and chemoprophylaxis in preventing new cases, using the formula (1 - OR) × 100. For the 688 primary cases, a total of 2,852 contacts were recorded. The household transmission rate was 16.1% (459/2,852) and rose according to the age (> 18 years) and lack of immunisation of the primary cases, and also the age (0-18 years), family relationship (siblings and children), lack of vaccination and chemoprophylaxis of contacts. Pertussis vaccine effectiveness in preventing new cases was 65.0% (95% confidence interval (CI): 11.6 to 86.2) for full vaccination (≥ 4 doses) and 59.7% (95% CI: -6.8 to 84.8) for incomplete vaccination (< 4 doses). The effectiveness of chemoprophylaxis was 62.1% (95% CI: 40.3 to 75.9). To reduce household transmission, contacts should be investigated to detect further cases and to administer chemoprophylaxis. The current vaccination status of cases and contacts can reduce household transmission

Los fundamentos cosmológicos de la mecánica y las leyes fundamentales de la dinámica

Filosofía de la naturaleza; causalidad; determinismo; mecanicismo; ciencia moderna y contemporánea; movimiento; Aristóteles; Santo Tomás de Aquino