ABSTRACT
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.
Subject(s)
Cryptosporidiosis/epidemiology , Disease Outbreaks , Case-Control Studies , Child, Preschool , Female , Humans , Infant , Male , Spain , Urban PopulationABSTRACT
OBJECTIVES: Main aim: to study the application of mixed prophylaxis against Hepatitis B viral infection (HB) in children injured by discarded needles and/or syringes. Secondary aim: to find in the group under study the incidence of HIV infection caused by these accidents. DESCRIPTION: Descriptive study. SETTING: 12 de octubre University Hospital, Madrid. PATIENTS: Children injured by discarded needles and/or syringes and referred to the Preventive Medicine Service between May 1988 and April 1995 (7 years). INTERVENTIONS: 1) Serological study for HB and HIV; 2) application to unprotected children of HB mixed prophylaxis (specific Immunoglobulin--IGHB--plus vaccination) and 3) Post-vaccination serological check-ups for HB and HIV at 6 and 12 months from the incident. MEASUREMENTS AND MAIN RESULTS: 249 children, whose average age was 5.8 +/- 3.37, were seen (158 boys, 63.5% and 91 girls, 36.5%). 189 (75.9% of the total) received a dose of IGHB and 171 (71.8%) completed the HB vaccinations. Post-vaccination serological check-ups covered 144 children (84.2%). 101 children (40.6%) completed the HIV check-ups. No HIV infection was detected. CONCLUSIONS: 1) HB mixed prophylaxis in children without serological protection is adequate for dealing with these incidents. 2) The risk of HIV infection should not be discounted, but is probably very slight. 3) The procedure should be put into practice in PC, with some shortening of HIV follow-up periods, as a measure to improve compliance.
