Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities.

BACKGROUND: Older adults living in long-term care facilities (LTCFs) are at increased risk for severe outcomes from COVID-19 and were identified as a priority group in COVID-19 vaccination strategies. Emerging evidence suggests vaccine effectiveness in LTCF populations, but data about median and long-term durability of immune response after vaccination are still limited. OBJECTIVES: In this study, we assessed the humoral response to BNT162b2 mRNA COVID-19 vaccine 3 months after the second dose, in a cohort of 495 residents aged ≥65 years from 11 LTCF in Granada, Spain. METHOD: Between April 19 and April 30, 2021, we measured anti-SARS-CoV-2 Spike IgG to evaluate the humoral vaccination response. Antibody titers were reported in binding antibody units (BAU/mL). Bivariate and multivariate logistic regression models were performed to investigate the impact of age, sex, underlying health conditions, and prior COVID-19 infection on the antibody levels. RESULTS: Over 96% of the participants developed an adequate humoral response. We detected higher antibody titers in previously infected individuals, compared with those previously uninfected (B: 1,150.059 BAU/mL, p < 0.001). Moreover, we found a significant inverse association between age and antibody levels (B: -7.943 BAU/mL, p < 0.05). This negative age-dependent response was more noticeable among residents over 85 years old. In contrast, baseline health conditions and cognitive status were not associated with different antibody levels. CONCLUSIONS: These findings support monitoring COVID-19 vaccination response trend in older adults, in order to optimize future disease prevention and control strategies in this vulnerable population.

[COVID-19 and functional dependence: cohort study of an outbreak in a nursing home for elderly.] / COVID-19 y dependencia funcional: análisis de un brote en un centro sociosanitario de personas mayores.

OBJECTIVE: Older people have been severely affected by the COVID-19 pandemic. The aim of this study was to describe the main epidemiological findings of a COVID-19 outbreak occurred in March 2020 at a nursing home for elderly in Granada. Risk factors associated with the spread of the virus in the center were investigated. METHODS: A retrospective cohort study was conducted, collecting the most relevant clinical and epidemiological findings, occurred during the outbreak follow-up period (from 03/13/2020 to 06/20/2020). The association between the residents' health conditions (underlying diseases, level of physical dependence, level of cognitive impairment) and the risk of infection was estimated using multivariate Cox regression. RESULTS: 52 PCR-confirmed COVID-19 cases were identified among the residents and 50 cases among the employees of the nursing home. The epidemic curve was characteristic of a person to person transmission. Among residents with a higher level of physical dependence, according to the Barthel index score, a higher incidence of infection was detected, adjusting for age, sex and health conditions. At 55 days of exposure, moderately (RR 2.82), severely (RR 4.71) and completely (RR 3.49) dependent residents had between 2-4 times greater risk of infection than the minimally dependent residents (p<0.05). CONCLUSIONS: The epidemic curve supports the hypothesis of a cross-transmission of infections between residents and staff members of the nursing home. In the context of sustained transmission of the virus, physical dependence of the residents increases the risk of exposure to the virus, facilitating its spreading.

OBJETIVO: Los mayores institucionalizados han sido el grupo más afectado por la pandemia de COVID-19. El objetivo del presente estudio fue describir las principales características epidemiológicas de un brote de COVID-19, detectado en marzo 2020 en una residencia para mayores de Granada, e identificar los factores de riesgo asociados a la propagación del virus en el centro. METODOS: Estudio observacional de cohorte retrospectivo. Se describieron los principales aspectos clínicos y epidemiológicos registrados durante el período de seguimiento del brote (13/03/2020-20/06/2020). Mediante regresión de Cox multivariante se estimó la asociación entre las condiciones de salud de los residentes (enfermedades de base, nivel de dependencia física y deterioro cognitivo) y el riesgo de contraer la infección. RESULTADOS: Se encontraron 52 casos, confirmados mediante PCR, entre los residentes y 50 casos entre los trabajadores del centro. La curva epidémica fue compatible con un tipo de transmisión persona-persona. Se detectó una mayor incidencia de infección entre los residentes más dependientes, de acuerdo con la puntuación del Índice de Barthel, ajustando por edad, sexo y condiciones de salud. Los residentes con nivel de dependencia moderada (RR 2.82), grave (RR 4.71) y total (RR 3.49) tuvieron de 2 a 4 veces más riesgo de contraer la infección que aquellos con dependencia leve, a los 55 días de exposición (p<0,05). CONCLUSIONES: La curva epidémica orienta hacia la hipótesis de un fenómeno de transmisión cruzada trabajadores-residentes al origen del brote. En un contexto de elevada circulación del virus, el nivel de dependencia funcional de las personas institucionalizadas multiplica el riesgo de exposición al virus, facilitando su transmisión.

Norovirus: ¿un huésped más en residencias de la tercera edad? / Norovirus: One more guest in residential homes for the elderly?

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Cryptosporidiosis outbreak in a child day-care center caused by an unusual Cryptosporidium hominis subtype / Brote de cryptosporidiosis en una guardería causado por un subtipo inusual de Cryptosporidium hominis

INTRODUCTION: This work describes the genetic characterization of Cryptosporidium and Giardia involved in an outbreak in a nursery school in Granada, Spain, that affected seven children under the age of 4. METHODS: Nucleic acids were extracted from the seven stool samples positive to Cryptosporidium or Giardia by microscopy and/or immunochromatography. The species and subtypes of Cryptosporidium were identified by PCR-RFLP and PCR of the SSUrRNA and gp60 genes, respectively. The assemblages of Giardia duodenalis isolates were characterized by PCR of the tpi gene. PCR products were sequenced and analyzed. RESULTS: All of the isolates were positive for Cryptosporidium hominis. Five of them belonged to subtype IaA11R2, one to subtype IbA10G2R2, and the other could not be identified. Three of these samples were positive for G. duodenalis by PCR, two belonging to the assemblage A, and the other one to assemblage B. DISCUSSION: This is the first report of Cryptosporidium hominis subtype IaA11R2 as a cause of an outbreak in Europe where subtype IbA10G2R2 is the most frequently identified. In the case of Giardia, an outbreak could not be confirmed because of the low number of positive samples and the low genetic variability of the amplified fragments for assemblage A of tpi gene. CONCLUSIONS: A new subtype, of Cryptosporidium hominis named IaA11R2, has been described as a cause of an outbreak in a nursery school in Granada, Spain. However an outbreak of giardiasis could not be confirmed

INTRODUCCIÓN: Este trabajo describe la caracterización genética de Cryptosporidium y Giardia implicados en un brote en una guardería de Granada, España, que afectó a 7 niños menores de 4 años de edad. MÉTODOS: La extracción de ácidos nucleicos se realizó a partir de las 7 muestras de heces positivas para Cryptosporidium o Giardia mediante técnicas de microscopia y/o inmunocromatografía. Las especies y subtipos de Cryptosporidium fueron identificados por PCR-RFLP y PCR de los genes SSUrRNA ygp60, respectivamente. Los genotipos de los aislamientos Giardia duodenalis fueron caracterizados por PCR del gen tpi. Los productos de PCR obtenidos fueron secuenciados y analizados. RESULTADOS: Todos los aislamientos fueron positivos para Cryptosporidium hominis. Cinco de ellos correspondieron al subtipo IaA11R2, uno al subtipo IbA10G2R2 y otro no pudo ser identificado. Tres de las muestras resultaron positivas para G. duodenalis por PCR, 2 de ellas pertenecientes al genotipo A y la restante al genotipo B. DISCUSIÓN: Esta es la primera identificación del subtipo IaA11R2 de Cryptosporidium hominis como causa de un brote en Europa, donde el subtipo IbA10G2R2 es el más frecuentemente identificado. En el caso de Giardia, el bajo número de muestras positivas y la baja variabilidad genética del fragmento del gen tpiamplificado para el genotipo A no permitieron confirmar un brote. CONCLUSIONES: Un nuevo subtipo de Cryptosporidium hominis, denominado IaA11R2, ha sido descrito como causa de un brote en una guardería de Granada, España. Sin embargo, los resultados obtenidos no permiten confirmar un brote de giardiasis

Cryptosporidiosis outbreak in a child day-care center caused by an unusual Cryptosporidium hominis subtype.

INTRODUCTION: This work describes the genetic characterization of Cryptosporidium and Giardia involved in an outbreak in a nursery school in Granada, Spain, that affected seven children under the age of 4. METHODS: Nucleic acids were extracted from the seven stool samples positive to Cryptosporidium or Giardia by microscopy and/or immunochromatography. The species and subtypes of Cryptosporidium were identified by PCR-RFLP and PCR of the SSUrRNA and gp60 genes, respectively. The assemblages of Giardia duodenalis isolates were characterized by PCR of the tpi gene. PCR products were sequenced and analyzed. RESULTS: All of the isolates were positive for Cryptosporidium hominis. Five of them belonged to subtype IaA11R2, one to subtype IbA10G2R2, and the other could not be identified. Three of these samples were positive for G. duodenalis by PCR, two belonging to the assemblage A, and the other one to assemblage B. DISCUSSION: This is the first report of Cryptosporidium hominis subtype IaA11R2 as a cause of an outbreak in Europe where subtype IbA10G2R2 is the most frequently identified. In the case of Giardia, an outbreak could not be confirmed because of the low number of positive samples and the low genetic variability of the amplified fragments for assemblage A of tpi gene. CONCLUSIONS: A new subtype, of Cryptosporidium hominis named IaA11R2, has been described as a cause of an outbreak in a nursery school in Granada, Spain. However an outbreak of giardiasis could not be confirmed.

Encuesta epidemiológica frente a historia clínica digital en la investigación de un brote por Cryptosporidium en una guardería / Epidemiological survey versus the electronic medical record in the investigation of a Cryptosporidium outbreak in a dayschool

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[Investigation of an outbreak of acute respiratory illness due to exposure to chlorine gas in a public swimming pool]. / Investigación de un brote respiratorio agudo por exposición a cloro gas en una piscina pública.

A case-control study was designed to investigate a chemical accident that occurred in a swimming-pool in the summer of 2005. The aim was to describe the environmental factors involved in the accident, to assess the effect of chlorine gas on the respiratory system, and to perform a clinical and spirometric follow-up. The following interventions were carried out: environmental inspection, epidemiologic survey (including sociodemographic variables), location at the time of the accident, perception of an abnormal smell, and clinical and spirometric outcomes to assess respiratory function. Sixty-five cases and 48 controls were identified and interviewed. The accident was produced by accidental admixture of hydrochloric acid with sodium hypochlorite resulting in chlorine gas release. The main clinical symptoms were dyspnea and cough. The risk of becoming ill was 10-fold higher in children with a previous lung disease and was 4-fold higher when the distance from the chlorine source was less than 40 m. All cases recovered completely, except one who had a history of asthma.

Investigación de un brote respiratorio agudo por exposición a cloro gas en una piscina pública / Investigation of an outbreak of acute respiratory illness due to exposure to chlorine gas in a public swimming pool

Se diseñó un estudio de casos y controles para investigarel accidente químico ocurrido en una piscina pública en el verano de 2005 y describir los factores ambientales responsables, analizar el efecto del cloro gas y valorar la evolución clínica y funcional del aparato respiratorio. Las intervenciones fueron las siguientes: inspecciones ambientales, encuesta epidemiológica(variables sociodemográficas), ubicación en el momentodel accidente, olor percibido y seguimiento clínico y espirométrico de la función respiratoria. Se encuestaron 65 casos y 48 controles. El suceso se produjo al mezclar accidentalmente ácido clorhídrico e hipoclorito sódico, lo que generó cloro gas. Los síntomas predominantes fueron tos y disnea. El riesgo de enfermar en niños era 10 veces mayor si tenían una enfermedad respiratoria previa y 4 veces superior si estaban a una distancia inferior a 40 m del lugar del accidente. Todoslos casos evolucionaron hacia la curación, excepto uno que tenía antecedentes asmáticos

A case-control study was designed to investigate a chemical accident that occurred in a swimming-pool in the summer of 2005. The aim was to describe the environmental factors involved in the accident, to assess the effect of chlorine gas on the respiratory system, and to perform a clinical and spirometricfollow-up. The following interventions were carried out:environmental inspection, epidemiologic survey (including sociodemographic variables), location at the time of the accident, perception of an abnormal smell, and clinical and spirometric outcomes to assess respiratory function. Sixty-five cases and48 controls were identified and interviewed. The accident was produced by accidental admixture of hydrochloric acid with sodium hypochlorite resulting in chlorine gas release. The main clinical symptoms were dyspnea and cough. The risk of becoming ill was 10-fold higher in children with a previous lung disease and was 4-fold higher when the distance from the chlorine source was less than 40 m. All cases recovered completely, except one who had a history of asthma

[Outbreak of gastroenteritis caused by Norwalk virus at a senior citizens assisted living facility in Granada, Spain]. / Brote de gastroenteritis por virus Norwalk en una residencia de ancianos de Granada.

BACKGROUND: The outbreaks of acute gastroenteritis caused by a virus are currently one of the health problems having the greatest impact on those living in senior citizen facilities. The objective of this study is that of investigating the causes of the start and contagion of an outbreak of acute gastroenteritis caused by a Norwalk-Like virus. METHOD: At a senior citizen living facility with 141 residents and 71 employees exposed, the relations between the disease in question and different independent variables: personal traits, features of location, date of onset of symptoms, clinical pattern of the disease and causal factors (food and drinking water intake). A descriptive study, a contingency table and a hypothesis ?2 test, design of cases and controls with the calculation of the unprocessed and subsequently adjusted Odds Ratio (IC 95%) were carried out using logic regression. RESULTS: No significant differences were found in the personal trait and features of location variables. The attack rate among the residents was 30.1%, being 21.12% among the employees. In the adjusted Odds Ratio calculation, solely the whipped cream mousse showed causal relationship values (adjusted Odds Ratio = 4.66; IC-95% 1.15-18.91; p = 0.031). Ten patient stool samples were sent for analysis, no disease-causing bacteria having been detected, Norwalk-Like virus however having been isolated in three samples. CONCLUSIONS: The whipped cream mousse having been found to possibly have been responsible for the outbreak is a first involving Norwalk virus, but this result is subject to limitations, such as the possible bias of classification due to failing to recall having eaten foods. Even so, this is an element to be taken into account in the control of acute viral gastroenteritis.

[Seroprevalence of brucelosis in the workers of a plant of treatment of sanitary wastes]. / Seroprevalencia de brucelosis en los trabajadores de una planta de tratamiento de residuos biosanitarios.

BACKGROUND AND OBJECTIVES: The management of biosanitary (hospital) waste, while being a key issue in the prevention of public health risks, involves professional risks as well. The objective of this study was to analyze the risks of infection and their relation with the various works within a cluster of brucellosis detected in an infectious waste plant. SUBJECTS AND METHOD: Cross-descriptive study of the total of 24 employees at the waste plant. A survey was carried out taking into account personal as well as professional items and serological tests. Both bivariant (contingency charts and mean comparison) and multivariant (logistic regression) analyses were carried out. RESULTS: The seroprevalence of brucella infection was 45.93% (CI95%, 26.17-66.76). The estimated risk (OR) for processing workers was 33.72 (CI95%, 2.73-415.96). The permanence within the posts was not different among groups. CONCLUSIONS: Infection seroprevalence was higher than that found in endemic populations. The post of processing was found to hold a relation with the contact with Brucella sp.

Brote de gastroenteritis por virus norwalk en unaresidencia de ancianos de Granada / Outbreak of gastroenteritis caused by norwalk virus at a senior citizen assisted living facility in Granada, Spain

Fundamento: Los brotes de gastroenteritis aguda de origen vírico son actualmente uno de los problemas de salud que más están afectando a las personas residentes en instituciones de la tercera edad. El objetivo del estudio es investigar las causas del origen y transmisión de un brote de gastroenteritis aguda por virus NorwalLike. Método: En una residencia de ancianos con 141 residentes y 71 trabajadores expuestos, se investigó la relación entre un brote de gastroenteritis aguda y distintas variables: características personales, de lugar, fecha de inicio de los síntomas, clínica de la enfermedad y factores causales (alimentos y agua de consumo). Se realizó un estudio descriptivo, tabla de contingencia y test de hipótesis 2, diseño de casos y controles con el calculo de Odds Ratio cruda y posteriormente ajustada (IC al 95 por ciento) utilizando regresión logística. Resultados: No se observaron diferencias significativas en las variables de características personales y de lugar. La tasa de ataque en los residentes fue del 30,1 por ciento y en trabajadores fue del 21,12 por ciento. En el calculo de la Odds Ratio ajustada sólo tuvo valores de relación causal la mousse de nata (Odds Ratio ajustada=4,66; IC-95 por ciento 1,1518,91; p=0,031). Se remitieron 10 muestras de heces de enfermos para su análisis, no detectándose ninguna bacteria patógena, pero si se aisló en 3 de ellas virus Norwal-Like. Conclusiones: El hallazgo de la mousse de nata como posible responsable del brote supone una primicia en la presencia de virus Norwalk, pero este resultado está sujeto a limitaciones, como el posible sesgo de clasificación por no recuerdo de consumo de alimentos. Aún así, supone un elemento a tener en cuenta en el control de gastroenteritis agudas por virus (AU)

Background: The outbreaks of acute gastroenteritis caused by a virus are currently one of the health problems having the greatest impact on those living in senior citizen facilities. The objective of this study is that of investigating the causes of the start and contagion of an outbreak of acute gastroenteritis caused by a Norwalk-Like virus. Method: At a senior citizen living facility with 141 residents and 71 employees exposed, the relations between the disease in question and different independent variables: personal traits, features of location, date of onset of symptoms, clinical pattern of the disease and causal factors (food and drinking water intake). A descriptive study, a contingency table and a hypothesis ?2 test, design of cases and controls with the calculation of the unprocessed and subsequently adjusted Odds Ratio (IC 95%) were carried out using logic regression. Results: No significant differences were found in the personal trait and features of location variables. The attack rate among the residents was 30.1%, being 21.12% among the employees. In the adjusted Odds Ratio calculation, solely the whipped cream mousse showed causal relationship values (adjusted Odds Ratio = 4.66; IC-95% 1.15-18.91; p=0.031). Ten patient stool samples were sent for analysis, no disease-causing bacteria having been detected, Norwalk-Like virus however having been isolated in three samples. Conclusions: The whipped cream mousse having been found to possibly have been responsible for the outbreak is a first involving Norwalk virus, but this result is subject to limitations, such as the possible bias of classification due to failing to recall having eaten foods. Even so, this is an element to be taken into account in the control of acute viral gastroenteritis (AU)

Seroprevalencia de brucelosis en los trabajadores de una planta de tratamiento de residuos biosanitarios / Seroprevalence of brucelosis in the workers of a plant of treatment of sanitary wastes

FUNDAMENTO Y OBJETIVOS: La gestión de los residuos biosanitarios supone un control del riesgo para la Salud Pública, además de ser una actividad con riesgo profesional. A partir de la detección de una agrupación de casos de brucelosis en una planta de tratamiento de residuos infecciosos se pretende conocer si existe riesgo de contagio y su relación con los puestos laborales. SUJETOS Y MÉTODO: Se realizó un estudio descriptivo transversal que incluyó a los 24 trabajadores de la planta de tratamiento. Se llevó a cabo una encuesta en la que se incluyeron los datos individuales y laborales, así como pruebas serológicas. Los puestos de trabajo se definieron como higienización, proceso, administrativo, conductor, mantenimiento y técnico de vehículos. En el proceso se realizaban el pesado de los contenedores, la desinfección y el triturado del residuo. En la higienización se llevaba a cabo el lavado, secado y preparación de los contenedores. El estudio estadístico se efectuó mediante un análisis bivariante (tablas de contingencia y comparación de medias) y multivariante (regresión logística).RESULTADOS: La seroprevalencia de infección por Brucella fue del 45,93 por ciento (intervalo de confianza [IC] del 95 por ciento, 26,17-66,76). El riesgo estimado (OR) por haber desempeñado el puesto de trabajo 'proceso' fue de 33,72 (IC del 95 por ciento, 2,73415,96). El tiempo de permanencia en los diferentes puestos no fue diferente entre los sujetos seronegativos y seropositivos. CONCLUSIONES: La seroprevalencia de infección por Brucella es superior a la encontrada en poblaciones endémicas. La actividad profesional 'proceso' está asociada al contacto con Brucella sp (AU)