La pandemia de gripe española vista desde el siglo XXI

On the 4th of March in 2018, it was the first century of the worst pandemic of influence than the humankind has ever known.Spanish influence pandemic is, only, equal to Black Death; 500 millions of persons were infected, and it´s calculated that 50-100 millions of persons died.That event was the main reason for influence vaccine’s development after discovering influence virus, and the deployment of one of the most extensive webs of world monitoring of infectious disease.El 4 de marzo de 2018 se cumplió el primer centenario de la pandemia más grave de gripe que ha conocido la especie humana.La pandemia de gripe española sólo es compatible a la peste negra del S.XIV;afectó a 500 millones de personas de las que se calculan que fallecieron entre 50-100 millones.Aquel acontecimiento fue determinante para el desarrollo de las vacunas de la gripe tras el descubrimiento del virus y la implementación de una de las más extensas redes de vigilancia mundial de una enfermedad infecciosa

Epidemia de gripe en la temporada 2016-2017.

El objetivo de este artículo es ofrecer una descripción de la pasada temporada epidémica gripal apoyándose en datos procedentes de fuentes oficiales que analizan el modelo epidemiológico de presentación de la gripe y en los propios recogidos por el Centro Nacional de Gripe de Valladolid

Gingivocrevicular transudate for HIV screening

Producción CientíficaThe use of saliva as an alternative biological fluid to serum in diagnosis or screening of infectious diseases by antibody detection has been the main subject of several articles in the last few years [1, 2, 3, 4, 5, 6]. Saliva samples can be obtained simply, without specialized personnel, and the process is non-traumatic for the patient and economic and poses no contamination risks for health workers. For these reasons, saliva samples may be of great utility in underdeveloped nations, where there is a severe shortage of personnel and specialized equipment. Saliva is a mixture of the secretions produced by the salivary glands and gingival crevicular transudate (GCT). The use of GCT, which has a greater concentration of immunoglobulins (Ig) of the IgG type than does complete saliva [7], seems to improve detection of such Ig in the samples [8]

HIV-1 Infection in Persistently HIV-1-Seronegative Individuals: More Reasons for HIV RNA Screening

Producción CientíficaThe World Health Organization (WHO) has recently released updated guidelines for HIV diagnosis that recommend serum antibody testing by either EIAs or rapid tests and that encourage the identification of unrecognized HIV infections [1]. However, this approach may fail to identify subjects with acute infection. In consideration of the potential public health benefits of not missing individuals in the most contagious phase of infection, implementation of routine HIV RNA screening has been suggested [2]. We want to stress that there are other situations in which viral load is detectable in the absence of reactive antibody tests and in which the introduction of nucleic acid testing may be beneficial. This is the case for HIV-infected subjects in whom specific antibody responses are absent, as for the case reported here.Fondo de Investigaciones Sanitarias (project CP05/00300)Fundación para la Investigación y Prevención del Sida en España (project 36483/05)Fundación Investigación y Educación en Sida.RIS (project ISCIII-RETIC RD06

Diagnóstico microbiológico de la infección por el VIH

Producción CientíficaEn la actualidad se calcula que en España hay alrededor de 150.000 personas infectadas por el virus de la inmunodeficiencia humana (VIH). Este número, junto con el hecho de que esta enfermedad se haya convertido en una patología crónica gracias a los nuevos tratamientos antirretrovirales, condiciona una gran demanda asistencial en los laboratorios de microbiología de nuestros hospitales. Esta mayor demanda tiene lugar no sólo en el terreno del diagnóstico y tratamiento de las infecciones oportunistas, sino también en pruebas que ayudan en el diagnóstico y tratamiento terapéutico de la propia infección por el virus. Consciente de ello, la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica ha realizado una actualización de su procedimiento sobre el diagnóstico microbiológico de la infección por VIH. En dicho procedimiento se realiza una revisión de las principales novedades en el terreno del diagnóstico serológico, de la carga viral plasmática y de la detección de resistencias a los distintos retrovirales

Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008–2018

Hospitalization; Influenza; MortalityHospitalització; Grip; MortalitatHospitalización; Gripe; MortalidadBackground Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. Methods The study comprised ten epidemic seasons (2008/2009–2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487–488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480–488, 517.1; ICD-10: J09–J18), respiratory (ICD-9: 460–519; ICD-10: J00–J99), respiratory or cardiovascular (C&R, ICD-9: 390–459, 460–519; ICD-10: I00–I99, J00–J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. Results The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3–86.3) for all ages and 335.3 (95% CI: 293.2–377.5) in patients aged ≥ 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged ≥ 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was €142.9 million for all ages and €115.9 million for patients aged ≥ 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Conclusions Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people.The BARI study was funded by Sanofi. Martinón-Torres F has received support for the present work from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540/PI1601569/PI1901090) del plan nacional de I + D + I and ‘fondos FEDER’ and Proyectos GAIN Rescata-Covid_IN845D 2020/23 (GAIN, Xunta de Galicia)

Addressing influenza’s underestimated burden – Iberian experts call to action

Hospitalization; Influenza; PreventionHospitalització; Grip; PrevencióHospitalización; Gripe; PrevenciónHaving a proper understanding of the impact of influenza is a fundamental step towards improved preventive action. This paper reviews findings from the Burden of Acute Respiratory Infections study on the burden of influenza in Iberia, and its potential underestimation, and proposes specific measures to lessen influenza’s impact.The BARI study was funded by Sanofi

Macroloides for the treatment of severe respiratory illness caused by novel H1N1 swine influenza viral strains

Producción CientíficaThe current outburst of a new H1N1 swine influenza strain(s) in México and the United States is causing great concern in health authorities and in the general population [1]. With the World Health Organization (WHO) reporting the pandemic potential of the new strain, it is necessary to determine which therapeutic options are available until a specific vaccine is available. Based on information from the Centre for Disease Control (CDC), the virus is sensitive to oseltamivir and zanamivir. Antivirals are strongly affected by viral mutations; thus their efficiency could be lost as the virus changes

Retrospective assessment of the antigenic similarity of egg-propagated and cell culture-propagated reference influenza viruses as compared with circulating viruses across influenza seasons 2002–2003 to 2017–2018

Producción CientíficaSuboptimal vaccine effectiveness against seasonal influenza is a significant public health concern, partly explained by antigenic differences between vaccine viruses and viruses circulating in the environment. Haemagglutinin mutations within vaccine viruses acquired during serial passage in eggs have been identified as a source of antigenic variation between vaccine and circulating viruses. This study retrospectively compared the antigenic similarity of circulating influenza isolates with egg- and cell-propagated reference viruses to assess any observable trends over a 16-year period. Using annual and interim reports published by the Worldwide Influenza Centre, London, for the 2002–2003 to 2017–2018 influenza seasons, we assessed the proportions of circulating viruses which showed antigenic similarity to reference viruses by season. Egg-propagated reference viruses were well matched against circulating viruses for A/H1N1 and B/Yamagata. However, A/H3N2 and B/Victoria cell-propagated reference viruses appeared to be more antigenically similar to circulating A/H3N2 and B/Victoria viruses than egg-propagated reference viruses. These data support the possibility that A/H3N2 and B/Victoria viruses are relatively more prone to egg-adaptive mutation. Cell-propagated A/H3N2 and B/Victoria reference viruses were more antigenically similar to circulating A/H3N2 and B/Victoria viruses over a 16-year period than were egg-propagated reference viruses

Perfil de ingresos y urgencias pediátricas en período epidémico de rotavirus en Valladolid. Utilidad de un modelo predictivo

Producción CientíficaEste estudio pretende determinar las semanas de alta circulación de rotavirus en valladolid, y comparar las características de los ingresos y urgencias en período epidémico con respecto al período no epidémico. Se utilizaron las declaraciones al sistema de información microbiológica, el conjunto mínimo básico de datos y el registro de urgencias. Se calcularon los casos esperados para 2006 a partir de un modelo elaborado previamente. Si los casos observados superaban el umbral superior del 95% de los esperados, la semana se consideró epidémica. Se compararon las características de los ingresos y urgencias en ambos períodos. En 2006 se diagnosticaron un 42% menos de los casos esperados. La media de ingresos diarios fue superior en período epidémico (diferencia=1,49; p=0,01), y también fue mayor la duración media del ingreso. La actividad del servicio de pediatría se incrementó en período epidémico, por lo que es oportuna la implantación de actividades de vigilancia, programas de prevención y control frente a rotavirus en el ámbito hospitalario