ABSTRACT
We describe a community-wide outbreak of measles due to a D4 genotype virus that took place in the Region of Madrid, Spain, between February 2011 and August 2012, along with the control measures adopted. The following variables were collected: date of birth, sex, symptoms, complications, hospital admission, laboratory test results, link with another cases, home address, places of work or study, travel during the incubation period, ethnic group, and Mumps-Measles-Rubella (MMR) vaccination status. Incidences were calculated by 100,000 inhabitants. A total of 789 cases were identified. Of all cases, 36.0% belonged to Roma community, among which 68.7% were 16 months to 19 y old. Non-Roma cases were predominantly patients from 6 to 15 months (28.1%) and 20 to 39 y (52.3%). Most cases were unvaccinated. We found out that 3.0% of cases were healthcare workers. The first vaccination dose was brought forward to 12 months, active recruitment of unvaccinated children from 12 months to 4 y of age was performed and the vaccination of healthcare workers and of members of the Roma community was reinforced. High vaccination coverage must be reached with 2 doses of MMR vaccine, aimed at specific groups, such as young adults, Roma population and healthcare workers.
Subject(s)
Disease Eradication , Disease Outbreaks , Measles/epidemiology , Adult , Child , Child, Preschool , Communicable Disease Control/methods , Community-Acquired Infections/epidemiology , Community-Acquired Infections/ethnology , Community-Acquired Infections/virology , Disease Outbreaks/prevention & control , Female , Humans , Infant , Male , Measles/complications , Measles/ethnology , Measles/prevention & control , Measles-Mumps-Rubella Vaccine/administration & dosage , Morbillivirus/genetics , Morbillivirus/isolation & purification , Spain/epidemiology , Vaccination , Young AdultABSTRACT
The seroprevalence (SP) of measles and rubella virus antibodies is presented by age groups obtained in the IV Serosurvey of the Region of Madrid (2008-2009). The target population is composed of residents with ages ranging between 2 and 60 years in the Region of Madrid. A two-stage cluster sample is used. The SP of measles virus antibodies is 97.8% (CI 95%: 97.3-98.2). The highest SP is observed in the 2-5 year and 41-60 year age groups. The point estimate does not reach 95% in the 16-20 and 21-30 year age groups. The SP of rubella virus antibodies is 97.2% (CI 95%: 96.5-97.7). The SP is over 95% in all of the age groups. In immigrant women between the ages of 16 and 49, the SP is 95.9% (CI 95%: 93.7-97.4). The identification of groups susceptible to the measles virus in young adults could lead to outbreaks as a result of importing the virus. The circulation of the rubella virus is possible among immigrant women aged between 16 and 49 years, which could lead to the appearance of SRC cases. Epidemiological surveillance will allow the impact on the measles and rubella elimination plan to be determined in the future.
Subject(s)
Antibodies, Viral/blood , Measles virus/immunology , Measles/epidemiology , Rubella virus/immunology , Rubella/epidemiology , Adolescent , Adult , Age Factors , Child , Child, Preschool , Emigrants and Immigrants , Epidemiological Monitoring , Female , Humans , Male , Measles/prevention & control , Middle Aged , Rubella/prevention & control , Seroepidemiologic Studies , Spain/epidemiology , Young AdultSubject(s)
Meningitis, Viral/epidemiology , Adolescent , Adult , Child , Child, Preschool , Echovirus 6, Human/isolation & purification , Echovirus Infections/epidemiology , Echovirus Infections/virology , Female , Health Education , Humans , Incidence , Infant , Male , Meningitis, Viral/prevention & control , Meningitis, Viral/virology , Meningoencephalitis/mortality , Middle Aged , Morbidity/trends , Population Surveillance , Spain/epidemiologyABSTRACT
Antecedentes En una escuela infantil de Madrid se ha producido entre octubre de 2002 y febrero de 2003 un brote de hepatitis A que se ha diseminado a las familias de los alumnos. Pacientes y métodos Se realiza estudio descriptivo del brote y de las medidas de control adoptadas. Resultados El brote afectó a 23 personas: ocho alumnos entre 1 y 3 años (tasa de ataque 8,7 por ciento), dos trabajadores (tasa de ataque 10,5 por ciento) y 13 contactos familiares. Diecisiete de los 23 casos han sido confirmados mediante serología y ocho precisaron ingreso hospitalario. Las medidas de control fueron: a) intensificación de las prácticas higiénicas generales en la escuela y en los hogares, específicamente en el cambio de pañal, y b) vacunación de todos los alumnos mayores de 1 año (92 niños), de los trabajadores (16 adultos) y de los familiares convivientes de los casos. Tras la vacunación, la curva epidémica muestra exclusivamente transmisión intrafamiliar. Los casos en familiares han sido adultos relacionados con alumnos asintomáticos. Conclusiones La vacunación ha demostrado ser una medida eficaz en el control del brote epidémico dentro de la escuela infantil. Sin embargo, cuando se produce un brote se debería indicar la vacunación a los convivientes de todos los alumnos -con o sin sintomatología de hepatitis A-, en especial padres y hermanos. También debería hacerse efectiva la recomendación de vacunación de los trabajadores de escuelas infantiles al inicio de su actividad laboral, ya que no se realiza de manera sistemática. La vacunación universal sería la medida más eficaz para prevenir brotes en centros escolares (AU)
Subject(s)
Male , Infant , Humans , Female , Child, Preschool , Adult , Disease Outbreaks , Family Health , Spain , Hepatitis A , Child Day Care CentersABSTRACT
BACKGROUND: An outbreak of hepatitis A occurred in a day care center in Madrid between October 2002 and February 2003 and spread to the children's families. PATIENTS AND METHODS: We performed a descriptive study of this outbreak and of the control measures adopted. RESULTS: The outbreak affected 23 people: eight children aged 1-3 years (attack rate= 8.7 %), two staff members (attack rate=10.5 %), and 13 household contacts. Of the 23 cases, 17 were confirmed by serology and eight patients were hospitalized. The control measures were: (i) increasing general hygiene measures in the home and school and, in particular, those concerning diaper changing by staff, and (ii) vaccination of all pupils aged more than one year (92 children), staff members (16 adults) and family contacts of affected individuals. After vaccination, the epidemic curve showed intrafamilial transmission exclusively. Cases among familial contacts affected adults in contact with asymptomatic children. CONCLUSIONS: Vaccination was effective in controlling the epidemic outbreak within the day care center. However, when outbreaks occur, vaccination should be prescribed to close contacts of all the children, whether symptomatic or not, especially parents and siblings. The recommendation that day care center workers undergo vaccination on taking up their posts should be put into practice, since vaccination is not systematically performed. General vaccination would be the most effective measure for preventing outbreaks in educational centers.
Subject(s)
Disease Outbreaks , Family Health , Hepatitis A/epidemiology , Hepatitis A/transmission , Adult , Child Day Care Centers , Child, Preschool , Female , Hepatitis A/prevention & control , Humans , Infant , Male , Spain/epidemiologySubject(s)
Bone Neoplasms , Drama , Literature, Modern , Medicine in Literature , Osteosarcoma , Female , HumansABSTRACT
It has been shown that relatively high doses of epinephrine (E) injected intraperitoneally (IP) produce hypophagia and conditioned taste aversion (CTA) in rats. We examined the possibility that E effects involve malaise. For this purpose, changes in saccharin preference induced by E injected IP (100 microg/kg) were determined after a previous administration of trimethobenzamide (TMB, 5 mg/kg), an antiemetic agent. E alone decreased saccharin preference by 54% (p < 0.01), but only by 16% (not significant) in the presence of TMB. In contrast, the injection of 75 or 100 microg/kg E reduced food intake by 50 and 85%, respectively (p < 0.01), regardless of previous injection of TMB. In conclusion, the results suggest that E-induced malaise is not the direct cause of the hypophagia it elicits.
