[Effect of systematic vaccination on the epidemiology of urlian parotiditis in the population of Bucharest]. / Efectul vaccinarii sistematice asupra epidemiologiei parotiditei urliene în populatia municipiului Bucuresti.

OBJECTIVE: describe the mumps evolution during the time period that immediately followed the introduction of routine mumps vaccine into the Bucharest municipality's population. METHODS: observational, descriptive, and retrospective study. The temporal frequencies were taken from official reports of clinically confirmed mumps cases with annually sequence during the 1951-2001 period and monthly sequence during the 2002-2009 period of time respectively. The temporal frequencies were graphically represented in semilogarithmic scale; the temporal trend of the frequencies was estimated through linear regression. RESULTS: in the time period of 5 years subsequently to the introduction of mumps routine vaccination with two doses of measles-mumps-rubella triple vaccine, the following events intervened in the evolution of mumps in the population of Bucharest municipality: (a) starting with the year of 2006 the annual frequency of cases became constantly placed under the lower limit of 1000 cases of the prevaccine era's distribution, (b) starting with September 2005 the monthly frequency of mumps cases decreased under the lower limit of 100 cases of the prevaccine era's distribution, (c) the decline rhythm of the annual frequency account for 1156 units (r2 = 0.76; p = 0.03) and, (d) due to the herd protection effect induced by vaccine, decreasing affected all age groups. CONCLUSIONS: although late implemented (in European context) the routine vaccination determined a fairly consistent declining of the mumps morbidity and very probably of the serious complications and/or sequels associated to natural disease, being in this way an outstanding achievement of preventive medicine

[Prevalence of risk factors and mechanisms of transmission of acute viral hepatitis type B and C in Bucharest municipality: 2001-2008]. / Prevalenta factorilor de risc si a mecanismelor de transmitere a hepatitei acute virale tip B si C în municipiul Bucuresti: 2001-2008.

OBJECTIVE: Analysis of risk factors for achieving clinically overt hepatitis B and hepatitis C in the population of Bucharest municipality. METHODS: retrospective and descriptive study on hospital patients cohort. Cases - in the study have been enrolled all acute viral hepatitis B and C confirmed by the two infectious diseases university clinics of Bucharest municipality, during the time interval 2001-2008, among the residents of the municipality. Infection risk factors - for every case of hepatitis B and hepatitis C with the simptoms onset placed during the time interval 2001-2008, it was associated "the most plausible" risk factor, detected by case investigation. For contemplation of control strategies the risk factors were stratified by mechanisms of virus transmission and by age groups. The analysis consists mainly in statistical comparing of cases prevalence in each etiology by risk factors and mechanisms of visus transmission. RESULTS: Patients cohort included 1440 hepatitis B cases and 227 hepatitis C cases, respectively. The most prevalent individual risk factor in hepatitis B was the sexual contact with multiple partners (51,0%) while in hepatitis C the use of ilegal injectable drugs (46,3%). The prevalences of hepatitis B and hepatitis C cases by the four mechanisms of virus transmmission were similar (p = 0,52). For both etiologies the high risk behaviours represented the principal mechanism of virus transmission (64,1% in hepatitis B and 63,4% in hepatitis C, respectively); additionaly, for both etiologies the most prevalent mechanisms of virus transmission by age groups were indentically, namely: (a) consumption of medical services in the age group 55+ years, (b) high risk behaviours in the age group 13-54 years and (c) contact with case or virus carrier in the age group 0-12 years, respectively. CONCLUSIONS: in the time period 2001 - 2008 the structure by mechanisms of virus transmission in hepatitis B and hepatitis C cases reported in the population of Bucharest municipaly was statistically similar, for both etiologies the most prevalent mechanism (> 60%) was represented by high risk behaviours. This reality strongly suggests that additionaly to the current strategies for prevention of the infection with hepatitic visuses B and C, the decisive strategy to control of the two infection needs to be extended with an effective education satelite focused on high risk groups.

[Nature and severity of the complications in the measles cases hospitalized during the epidemics in 2005-2006 in Bucharest]. / Natura si severitatea complicatiilor la cazurile de rujeola spitalizate în epidemia 2005-2006 din municipiul Bucuresti.

AIM: analysis of the nature and the severity of medical complications of the hospitalized cases associated to an measles outbreak which appeared after a period of consistent interruption of measles virus circulation in the Bucharest municipality population. METHODS: analytical study on the cohort of measles cases hospitalized during the main period of the 2005-2006 outbreak from Bucharest municipality: data source--medical records of the cases enrolled in the study. Enrolled cases were allocated to 5 classes, based on the first two discharging diagnosis. Epi Info software has been used in order to: (a) analyze cases' prevalence by diagnosis classes and demographic characteristics and (b) analysis the prevalence of severe cases defined as cases with duration of hospitalization higher the value calculated at the 75 percentile of the series. RESULTS: 63% of laboratory confirmed measles cases have been hospitalized, the prevalence of measles cases with specific complications decreased with age. Longer hospitalization was strictly associated (p < .05) with the need to care for cases with measles specifically complications. CONCLUSIONS: when cases severity was expressed in terms of resources allocate (days of hospital stay) it was found that severity is not depending on age group (OR: 1.57: IC 95%: 0.93-2.63; p = 0.09), the study produced solid arguments regarding the good medical strategy (rational resources use) practiced in the infectious diseases clinics of the Bucharest municipality, demonstrated through.: (a) hospitalization authorized with priority for complicated cases and (b) longer hospitalization associated in special with clinically severe cases.