Capture-recapture and anti-tuberculosis drug prescriptions, Balearic Islands, Spain, 2010-2012.

SETTING: Tuberculosis (TB) control requires accurate knowledge of TB incidence, but few studies have been published on TB incidence using individual data from drug prescriptions. OBJECTIVE: To measure the estimated completeness of regional surveillance system data before and after adding data from anti-tuberculosis drug prescriptions. DESIGN: We compiled data on all individuals who received specific anti-tuberculosis drugs from three sources-the passive surveillance system, the active surveillance system and the anti-tuberculosis drug prescription database-in the Balearic Islands, Spain, between 2010 and 2012. We applied the capture-recapture method to measure completeness of data reporting. Statistical significance was set at P < 0.05, and 95% confidence intervals (CIs) were calculated. RESULTS: We detected 605 incident cases, compared with an estimated incidence of 719 cases (95%CI 646-793), representing 84.1% data completeness. We detected 480 of an estimated 559 pulmonary TB cases (95%CI 501-617; 85.9% data completeness) and 125 of an estimated 161 extra-pulmonary TB cases (95%CI 113-211; 77.6% data completeness). CONCLUSIONS: By adding a new source, we increased detection with respect to a previous study by 10.4% for all forms of TB, 9.7% for pulmonary TB and 13% for extra-pulmonary TB.

Estimated incidence of tuberculosis by capture-recapture in the Balearic Islands, 2010-2012.

SETTING: The Balearic Islands, Spain, 2010-2012. OBJECTIVE: To assess the completeness of TB surveillance, and to examine observed and estimated incidence rates (IR) compared with the period 2005-2007. DESIGN: The completeness of TB surveillance was assessed using the capture-recapture method. Confidence intervals were calculated using log-linear models. Data sources were records of mandatory notifiable diseases, active hospital surveillance and computerised primary health care history. RESULTS: Surveillance completeness for respiratory TB (R-TB) was 99.5%; it was 100% for non-respiratory TB (NR-TB). The overall observed IR was 16.32 cases/100 000 for all types of TB, 3.4 for NR-TB and 12.9 for R-TB. The estimated IR of TB all forms was 16.35/100 000 (95%CI 16.26-16.53), for NR-TB it was 3.4/100 000 (95%CI not calculated) and for R-TB it was 13.0/100 000 (95%CI 12.85-13.12). Surveillance completeness for R-TB during the period 2005-2007 was 65.2%; the observed IR was 22.6/100 000 and the estimated IR 31.3/10 000 (95%CI 25.0-37.7). CONCLUSION: The similarity of observed and estimated IR during the period 2010-2012 indicates the validity of the surveillance and the use of improved systems such as electronic medical records in recent years.

Epidemiology and molecular investigation of hepatitis C infection following holiday haemodialysis.

BACKGROUND: Hepatitis C virus infection (HCV) is not infrequent among haemodialysis patients. Most published reports suggest that patient-to-patient spread, either directly or indirectly, is the most common mode of transmission in renal units. AIM: To investigate the source of an outbreak, and the route of transmission, of acute HCV infection in two Scottish patients occurring within eight weeks of receiving haemodialysis in the same unit while on holiday in Majorca. METHODS: This was an international epidemiological and molecular investigation of HCV infection among a cohort of haemodialysis patients from nine countries. FINDINGS: No further HCV-positive infections were observed among residents and holidaymakers receiving haemodialysis at the unit in Majorca. Molecular investigations confirmed that a Spanish healthcare worker (HCW) was the source of infection for the two Scottish patients. The investigators were unable to determine the route of transmission. CONCLUSIONS: This outbreak is the first reported case of HCW-to-patient transmission of HCV in a renal unit, and the third reported case of transmission involving a HCW who had not performed invasive procedures. The issue of whether renal units are an exceptional case with regards to the risk of transmission associated with non-invasive procedures should be considered, in conjunction with the need to improve surveillance of blood-borne virus transmissions in renal units in the UK and abroad.

Cohort study of an outbreak of viral gastroenteritis in a nursing home for elderly, Majorca, Spain, February 2008.

An outbreak of acute gastroenteritis occurred in a nursing home for elderly in Majorca between 4 and 23 February 2008. To know its aetiology and mechanism of transmission a retrospective cohort study was conducted with a fixed cohort including 146 people (96 residents and 50 employees). The data were collected from clinical histories and through a survey by questionnaire. In total 71 cases were identified (53 residents, 18 employees), corresponding to an overall attack rate (AR) of 48.6%.

Aumento de la hospitalización por varicela y de sus graves complicaciones en los niños de la isla de Mallorca / Increase in hospital admissions due to varicella and in the severe complications of this disease in children on the Island of Mallorca, Spain

El objetivo de este estudio es determinar las tasas de infección, hospitalización y complicaciones de la varicela en la isla de Mallorca. Para estudiar la incidencia de esta infección, revisamos retrospectivamente los casos notificados a la Red de Vigilancia Epidemiológica durante el periodo 1982-2005. Las tasas de hospitalización se obtuvieron de los registros de alta de los pacientes ingresados en los tres hospitales públicos de la isla de Mallorca, durante los periodos 1995-2000 y 2001-2005. Las tasas de admisión y las complicaciones se estudiaron también específicamente en el hospital de referencia. LA incidencia de varicela descendió desde 994/100.000 habitantes en el periodo 1982-1989, a 521 en el periodo 2001-2005 (p<0,001). Globalmente, la tasa de hospitalización por varicela aumentó significativamente desde 10,6/100.000 habitantes menores de 15 años (0 1,62/1.000 casos de varicela) en el periodo 1995-2000 a 26,4/100.000 (0 3,54/1.000 casos) en el periodo 2001-2005 (p<0,001). La edad media de los pacientes fue de 2,8 años, y la mortalidad fue nula. Las complicaciones más frecuentes en los 147 niños ingresados en el hospital de referencia fueron: celulitis (13%), impétigo (10,2%), neumonía (9,5%), convulsiones (8,8%) y artritis (4,8%). Se observó un aumento de la prevalencia de sepsis en pacientes hospitalizados por varicela (2/46 frente a 9/101; p=0,3). Aunque parece haber un descenso de los casos de varicela en la isla de Mallorca, observamos un incremento de la hospitalización y de complicaciones graves por esta infección. La vacuna contra la varicela a la edad de 12-18 mese probablemente reduciría esta tendencia(AU)

The objective of this study was to determine the rates of infection, hospitalization and complications of varicella on the Island of Mallorca. To study the incidence of varicella, we retrospectively reviewed the cases reported to the National Network of Epidemiologic Surveillance during the period 1982-2005. Rates of hospitalization were obtained from the discharge records of the patients admitted to the three public hospitals of the islands during the periods 1995-2000 and 2001-2005. Rates of admission and complications in the reference hospital (Hospital Universitario Son Dureta) were also studied. The incidence of varicella decreased from 994/100,000 population during the period 1982-1989 to 521 in 2001-2005 (p<0.001). Overall, the rate of hospitalization for varicella increased significantly from 10.6/100,000 population aged <15 years (or 1.62/1,000 varicella cases) in 2001-2005 (p<0.001). The mean age of the patients was 2.8 years and there were no deaths. The most frequent complication among the 147 children admitted to the reference hospital were: cellulitis (13%), impetigo (10.2%), pneumonia (9.5%), seizures (8.8%) and arthritis (4.8%). An increase in the prevalence of sepsis in hospitalized varicella patients was observed (2/45 versus 9/101, p=0.3). Although the incidence of varicella infection seems to be decreasing in Mallorca, we have observed and increase in hospital admissions and severe complications due to this infection. Vaccination against varicella at 12-18 months would probably reduce this trend(AU)

Travel associated legionellosis among European tourists in Spain.

Depuis la deuxieme moitie des annees 1980, la legionellose associee au voyage est devenue preoccupante pour les pays europeens en raison de la morbidite dans la population europeenne; de plus, l'apparition de cas chez les touristes constitue une menace p