[Waterborne outbreak of gastroenteritis caused by Norovirus transmitted through drinking water]. / Brote de gastroenteritis por Norovirus causado por el consumo de agua de suministro público.

BACKGROUND: The aim of this study was to conduct an investigation into an outbreak of waterborne disease caused by Norovirus due to the consumption of contaminated drinking water. METHODS: The first week after the school summer holidays we detected an outbreak of gastroenteritis at a school in Borges Blanques (Lleida, Spain). A retrospective cohort study was carried out to investigate: water consumption and food (six items). We assessed RNA Norovirus by RT-PCR in 6 stool samples. The risk of gastroenteritis was assessed by applying adjusted risk ratio (RRa) analysis at 95% confidence intervals (CI). RESULTS: The overall attack rate was 45% (96/213). The main symptoms were: abdominal pain, 88.4% (84/95); nausea, 65.9% (62/94), and vomiting, 64.6% (62/96). The consumption of school drinking water was statistically associated with the disease (RRa: 2.8; 95% CI: 1.3-6.2). The school water tank was dirty, but this drinking water was qualified as potable. Six stool samples gave positive results for Norovirus. CONCLUSIONS: Norovirus caused this waterborne outbreak of gastroenteritis transmitted through treated drinking water. It should be obligatory to regularly clean school drinking water deposit tanks, especially after the summer holidays.

Factores sociodemográficos y psicosociales que influyen en el estado nutricional de los mayores de 65 años de diferentes niveles asistenciales / Sociodemographic and psychosocial factors affecting the nutritional state in the population older than 65 years from different attending levels

En este estudio se pretende analizar qué factores sociodemográficos y psicosociales repercuten de manera más negativa sobre el estado nutricional en la población mayor de 65 años de diferentes niveles asistenciales. El instrumento de medición del estado nutricional fue el Mini Nutricional Assessment (MNA). Ciento noventa sujetos fueron incluidos en el estudio: 44,9% hombres y 55,1% mujeres, con edad media de 75,81 años. Presentaban peor estado nutricional los sujetos ingresados en los centros de media y larga estancia, los mayores de 80 años, los que no salían de su domicilio, los que subjetivamente se encontraban tristes y solos, los que eran dependientes en las ABVD y los que tenían deterioro cognitivo

We pretend to analize which have the most negative repercusions on the nutritional state in the population older than 65 years from different attending levels. The measuring tool for the nutritional state was the Mini Nutricional Assessment (MNA). 190 subjects were included in the study: 44,9% men and 55,1% women, mean age: 75,81 years. The subjects who showed the worst nutritional state were those who were at middle and long stay centres, those older than 80 years, the subjects who were all day at home, those who felt sad and alone, those who were dependent on the basic activities of daily life and the subjects with cognoscitive damage

[Waterborne outbreak of gastroenteritis transmitted through the public water supply]. / Brote de gastroenteritis por agua potable de suministro público.

INTRODUCTION: The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies. METHODS: A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area. Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI). RESULTS: The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria. CONCLUSIONS: This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection).

Brote de gastroenteritis por agua potable de suministro público / Waterborne outbreak of gastroenteritis transmitted through the public water supply

El objetivo fue investigar un brote de gastroenteritis por agua potable de suministro público. Métodos: Después de la notificación de un brote de gastroenteritis en el municipio de Baqueira (Valle de Arán) se diseñó un estudio epidemiológico de cohortes retrospectivo. Mediante un muestreo sistemático se eligió a 87 personas hospedadas en los hoteles y a 62 alojadas en diferentes apartamentos. Se recogió información sobre 4 factores (consumo de agua de la red, bocadillos, agua y alimentos en las pistas de esquí) y presencia de síntomas. Se determinó la existencia de cloro, se analizó el agua de la red y se realizó un coprocultivo a 4 enfermos. La implicación de cada factor se determinó con el riesgo relativo (RR) y su intervalo de confianza (IC) del 95 por ciento. Resultados: La incidencia de gastroenteritis fue del 51,0 por ciento (76/149). Los porcentajes de los síntomas fueron los siguientes: fiebre, 27,0 por ciento; diarrea, 87,5 por ciento; náuseas, 50,7 por ciento; vómitos, 30,3 por ciento, y dolor abdominal, 80,0 por ciento. El único factor que presentó un riesgo estadísticamente significativo fue el consumo de agua de la red (RR = 11,0; IC del 95 por ciento, 1,6-74,7). La calificación sanitaria del agua fue de potabilidad. Se observó un defecto de situación del clorador en el depósito, que fue corregido. Se recomendó incrementar aún más las concentraciones de cloro, lo cual se acompañó de una disminución de los casos. Los coprocultivos de los 4 enfermos fueron negativos para las enterobacterias investigadas. Conclusiones: El estudio demuestra la posibilidad de presentación de brotes hídricos por agua cualificada como potable y sugiere la necesidad de mejorar la investigación microbiológica (determinación de protozoos y virus) en este tipo de brotes (AU)

Introduction: The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies. Methods: A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area. Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI). Results: The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria. Conclusions: This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptableand suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection) (AU)

[Assessment of the nutritional status of elderly patients treated at a home-hospital unit]. / Evaluación del estado nutricional de los pacientes mayores atendidos en una unidad de hospitalización a domicilio.

GOALS: To establish the nutritional status of our elderly patients, assess the usefulness of the various anthropometric and biochemical parameters as markers of malnutrition and to determine which of the variables studied have the greatest correlation with malnutrition. SCOPE: Home Hospital Unit of the Arnau de Vilanova Teaching Hospital in Lerida. PATIENTS: 57 patients > or = 60 years. Mean admission to our unit: 12.1 days. VARIABLES: Age, sex, groups by treatment complexity, associated pathology, diagnosis, reason for admission, duration of stay in hospital, surgery performed, complications during the stay at the Home Hospital Unit, weight, height, PCT, AC, BMI, albumin, haemoglobin and RTL. RESULTS: Patients of great age present lower levels of serum albumin (p < 0.005), total proteins (p < 0.001), transferrin (p < 0.03), haemoglobin (p < 0.02) and RTL (p < 0.04) than "younger" elderly patients. Serum albumin and haemoglobin are lower in patients in a complicated post-surgical condition (p < 0.04 and p < 0.02, respectively) and this group is the one with the longest stays (p < 0.001). Those patients with hypoalbuminaemia (74.1%) present lower PCT and RTL (p < 0.02) and a longer stay in hospital (p < 0.01) than those with normal levels of albumin in blood. Patients with anaemia (63.3%) present a lower RTL (p < 0.01) and a greater hospitalization time than those without anaemia. Total proteins (p < 0.0001), albumin (p < 0.004), transferrin (p < 0.003) and RTL (p < 0.005) correlate negatively with age. Albumin (p < 0.001), haemoglobin (p < 0.006) and RTL (p < 0.0001) present a negative correlation with length of hospital stay. CONCLUSION: The prevalence of global malnutrition is high (51% moderate-severe). The nutritional status worsens with age. The length of hospitalization increases gradually with age, with deteriation in the nutritional status and with complexity of the treatment provided.

Evaluación del estado nutricional de los pacientes mayores atendidos en una unidad de hospitalización a domicilio / Assessment of the nutritional status of elderly patients treated at a home-hospital unit

Objetivos: Establecer el estado nutricional de nuestros pacientes mayores, valorar la utilidad de los distintos parámetros antropométricos y bioquímicos como marcadores de desnutrición y determinar qué variables estudiadas tienen mayor correlación con la malnutrición. Ámbito: Unidad de Hospitalización a Domicilio del Hospital Universitario Arnau de Vilanova de Lleida. Pacientes: 57 pacientes 60 años. Media de estancia en nuestra unidad: 12,1 días. Variables: Edad, sexo, grupos según la complejidad de las curas, patología asociada, diagnóstico, motivo de ingreso, tiempo de estancia hospitalaria, intervención quirúrgica practicada, complicaciones durante la estancia en la UHD, peso, talla, PCT, CB, IMC, CMB, albúmina, hemoglobina y RTL. Resultados: Los pacientes de "más edad" presentan una tasa de seroalbúmina (p < 0,005 ) de proteínas totales (p < 0,001), de transferrina (p < 0,03), de hemoglobina (p < 0,02) y de RTL (p < 0,04) menor, que los ancianos "más jóvenes". La hemoglobina y la albúmina sérica están más descendidas en los pacientes con un postoperatorio complicado (p < 0,02 y p < 0,04 respectivamente); siendo este grupo los que están más tiempo hospitalizados (p < 0,001). Los pacientes con hipoalbuminemia (74,1 per cent) presentan un PCT y RTL menor (p < 0,02) y una estancia hospitalaria mayor (p < 0,01) que los que presentan normoalbuminemia. Los pacientes con anemia (63,3 per cent) presentan un RTL menor (p < 0,01) y una estancia hospitalaria mayor que los pacientes sin anemia. Las proteínas totales (p<0,0001), la albúmina (p<0,004), la transferrina (p<0,003), y el RTL (<0,005) presentan una correlación negativa con la edad. La albúmina (p<0,001), la hemoglobina (p<0,006), y el RTL (p<0,0001 ) presentan una correlación negativa con la estancia hospitalaria. Conclusión: La prevalencia de malnutrición global es elevada (51 per cent moderada-severa). El estado nutricional empeora con la edad. La estancia hospitalaria se incrementa progresivamente con la edad, con el deterioro del estado nutricional y con la complejidad de las curas (AU)

Goals. To establish the nutritional status of our elderly patients, assess the usefulness of the various anthropometric and biochemical parameters as markers of malnutrition and to determine which of the variables studied have the greatest correlation with malnutrition. Scope: Home Hospital Unit of the Arnau de Vilanova Teaching Hospital in Lerida. Patients: 57 patients ≥ 60 years. Mean admission to our unit: 12.1 days. Variables: Age, sex, groups by treatment complexity, associated pathology, diagnosis, reason for admission, duration of stay in hospital, surgery performed, complications during the stay at the Home Hospital Unit, weight, height, PCT, AC, BMI, albumin, haemoglobin and RTL. Results: Patients of great age present lower levels of serum albumin (p < 0.005), total proteins (p < 0.001), transferrin (p < 0.03), haemoglobin (p < 0.02) and RTL (p < 0.04) than "younger" elderly patients. Serum albumin and haemoglobin are lower in patients in a complicated post-surgical condition (p < 0.04 and p < 0.02, respectively) and this group is the one with the longest stays (p < 0.001). Those patients with hypoalbuminaemia (74.1%) present lower PCT and RTL (p < 0.02) and a longer stay in hospital (p < 0.01) than those with normal levels of albumin in blood. Patients with anaemia (63.3%) present a lower RTL (p < 0.01) and a greater hospitalization time than those without anaemia. Total proteins (p < 0.0001), albumin (p < 0.004), transferrin (p < 0.003) and RTL (p < 0.005) correlate negatively with age. Albumin (p < 0.001), haemoglobin (p < 0.006) and RTL (p < 0.0001) present a negative correlation with length of hospital stay. Conclusion: The prevalence of global malnutrition is high (51% moderate-severe). The nutritional status worsens with age. The length of hospitalization increases gradually with age, with deterioration in the nutritional status and with complexity of the treatment provided (AU)

Experimental reproduction of cysticercoids from Anoplocephala perfoliata Blanchard, 1848 in Scheloribates sp. Berlese, 1908 (Acarina-Oribatulidae).

For the first time in America, a potential intermediate host for Anoplocephala perfoliata has been reported, obtaining cysticercoids in mites of the genus Scheloribates. Epidemiological aspects of anoplocephalides in horses related to other cestodiasis from domestic herbivores in Argentina are discussed.