ABSTRACT
Introducción: se describe un brote de gastroenteritis causada por Salmonella poona en una guardería infantil en la ciudad de Valladolid (España) en los primeros tres meses del año 2011. Objetivos: describir las características epidemiológicas del brote, su relación con un brote supracomunitario declarado en España en 2010 y analizar el mecanismo de transmisión. Métodos: se realizó un estudio descriptivo bidireccional. Partiendo del caso índice, se elaboró una base de datos con la totalidad de niños asistentes a la guardería y se completó con la información recibida de los pediatras y con la información microbiológica. Se calcularon tasas de ataque por aulas y curva epidémica. Resultados: se encontraron 13 casos, de edades comprendidas entre los cinco meses y los cinco años, tres de los cuales fueron asintomáticos. La tasa de ataque global en la guardería fue del 28,2%, no encontrándose diferencias significativas entre las diferentes aulas. Todas las salmonelas aisladas excepto dos fueron enviadas al Centro Nacional de Microbiología (CNM) para su caracterización, identificándose todas ellas como Salmonella poona 13,22:z:1,6, idéntica a la aislada en el brote nacional. Conclusiones: parece evidente que el brote ocurrido en la guardería fue producido por el mismo microorganismo que el que causó el brote supracomunitario y que la fórmula láctea implicada en dicho brote fue el vehículo de transmisión que permitió la introducción del microorganismo en la guardería, propagándose por otras vías entre los alumnos de la misma (AU)
Introduction: during the first three months of 2011, a gastroenteritis outbreak caused by Salmonella poona was described in one of the Valladolid´s nurseries. Objectives: to describe the epidemiologic characteristics of the outbreak, its relation between a supracommunity outbreak and its transmission mechanism. Methods: a descriptive bidireccional study. Starting from an index case a database from the nursery of the children records, the pediatrics and the microbiology records was done. The overall attack rate and the epidemic curve from each classroom was calculated. Results: thirteen cases between five months and five years old were found; all of them were asymptomatic. The overall attack rate was 28,2% without significant difference between the classrooms. Salmonella poona 13,22:z:1,6 was found, and it was identical to that isolated in the national outbreak. Conclusions: It seems that the nursery´s outbreak was caused by the same organism related to the supracommunity outbreak and the powdered infant formula was the vehicle involved in the transmission and it allowed the introduction of the organism in the nursery spreading through other pathways between students (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Leptospira interrogans serovar pomona/isolation & purification , Salmonella Infections/complications , Salmonella Infections/diagnosis , Salmonella Infections/microbiology , Salmonella/isolation & purification , Child Day Care Centers/organization & administration , Child Day Care Centers/standards , Child Day Care Centers , Gastroenteritis/complications , Gastroenteritis/microbiology , Seedlings , Seedlings/microbiology , Child Day Care Centers/methods , Child Day Care Centers/statistics & numerical data , Gastroenteritis/diagnosisABSTRACT
BACKGROUND: In spring of 1998, an acute gastroenteritis outbreak, which mainly affected preschool children, took place in Guadarrama (Community of Madrid, Spain). METHODS: A descriptive and analytical (cases and controls) study of the outbreak was done. Stool samples of the cases were taken to microbiological investigation. The tap water getting system of the municipality was inspected and samples were collected to microbiological analysis. RESULTS: Twenty one children from 0 to 5 years-old had liquid diarrhea which lasted more than five days. A significant statistical association was found within tap water consumption and gastroenteritis [OR = 5.73 (1.18-43.30); p < 0.05]. It did not have association with other variables investigated. Cryptosporidium parvum (Cp) oocysts were detected in stool samples of eight cases. Deficiencies were observed in the tap water getting and treatment system of the municipality but no oocysts were found in the analysis of the water. CONCLUSIONS: The results of the epidemiological investigation support that the source of the gastroenteritis outbreak was tap water, likely contaminated with Cp. While this parasite was not detected in the analysis of the water, it is explainable for the difficulties which this technique involves. In our review similar descriptions of outbreaks have not been found in Spain, but it seems that this reports are not infrequent in neighbour countries. Therefore, Cp should be borne in mind in diagnostic and management of these situations.
