Atopic dermatitis incidence and risk factors in young adults in Castellon (Spain): A prospective cohort study.

INTRODUCTION: There are few atopic dermatitis (AD) incidence cohort studies in young adults, the etiology of this disease remains obscure, and AD risk factors in adults are not well understood. The objective of this study was to estimate AD ten-year incidence and prevalence in a cohort of adolescent aged 14-16 at inception in Castellon province in Valencia Region, Spain and describe related risk factors. MATERIAL AND METHODS: From 2002 to 2012, a population-based prospective cohort study was carried out. Questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used with an additional questionnaire for related factors completed by participants and their parents, respectively, in 2002. In 2012 the same questionnaires were completed by the participants' through a telephone interview, and incidence and prevalence of AD were estimated. Directed acyclic graphs, Poisson regression and inverse probability weighted regression adjustment were used. RESULTS: The participation rate was 79.5% (1435/1805) with AD lifetime prevalence of 34.9% and AD incidence of 13.5 per 1000 person years. Females presented higher prevalence and incidence than males. After adjustment significant risk factors were being female, history of asthma or allergic rhinitis, family history of AD, history of respiratory infections, history of bronchitis, history of pneumonia, history of sinusitis, and birthplace outside Castellon province. The highest AD population attributable risks were female, 30.3%, and history of respiratory infections 15.3%. Differences with AD childhood risk factors were found. CONCLUSIONS: AD incidence in our cohort was high and several risks factors were related to AD.

Incidence of asthma in young adults from Castellon, Spain: A prospective cohort study.

BACKGROUND: The objective was to estimate the incidence of asthma in young adults from 13-15 years old to 23-25 years old, and associated factors. METHODS: In 2012, a population-based prospective cohort study was carried out in Castellon from the cohort who had participated in the International Study of Asthma and Allergy in Childhood in 1994 and 2002. A telephone survey was undertaken using the same questionnaires. A new case of asthma was defined as a participant free of the disease in 2002 who suffered asthma, was diagnosed with asthma, or took medications against asthma based on self-report from 2002 to 2012. RESULTS: The mean age of participants was 24.9±0.6 with a follow-up of 79.1%. Asthma cumulative incidence was 3.4%: 44 new cases occurred among 1280 participants. The incidence was higher in females than males with relative risk (RR)=2.02 (95% confidence interval [CI] 1.1-3.8). A significant decrease of asthma incidence density was observed (8.2 cases to 3.5 cases per 1000 person/year). Factors associated with the incidence of asthma were allergic rhinitis (RR=4.05; 95% CI 1.7-9.6), bronchitis (RR=2.13; 95% CI 1.0-4.5), mother's age at time of birth (RR=0.87; 95% CI 0.8-0.9) and a pet other than a dog or cat (RR=0.42; 95% CI 0.2-0.9). For gender, some variations in the risk factors were observed. CONCLUSIONS: A significant decrease in the incidence of asthma was observed. Several risk and protective factors were found.

[Dermatitis outbreaks caused by Pyemotes]. / Brotes de dermatitis originados por Pyemotes.

BACKGROUND: We describe three outbreaks of pyemotes dermatitis. METHODS: We undertook case-control studies and samples of several suspected materials were taken. RESULTS: There were 126 cases, with no cases admitted in hospitals. Contact which suspected vegetable materials were the only risk factor identified. Among orange picker workers risk factor was the exposure to orange trees, where Pyemotes mite was found. CONCLUSION: To our knowledge this kind of occupational risk among orange pickers has not been described before.

[Epidemic outbreak of Salmonella richmond infection in Castellón, Spain]. / Brote epidémico por Salmonella richmond en Castellón, España.

A case-control study was carried out to investigate an outbreak of acute gastroenteritis among a military detachment stationed in a rural area of Castellón, España. The purpose of the study was to determine the causes of the outbreak and develop control measures. Of the 153 men in the detachment, 135 were included in the study. Between 9 and 11 August 1993, 45 cases were reported; the patients' average age was 19.2 +/- 1.5 years. The attack rate was 33.3%. The clinical picture was dominated by the following symptoms: diarrhea (76%), vomiting (67%), nausea (67%), and abdominal pain (28%). The median duration of symptoms was one day, and that of the incubation period was 33 hours. Only one patient required hospitalization and all of them recovered. Salmonella richmond (6.7: and :1.2) was isolated in 5 of the 14 stool cultures performed. An association was also discovered between the illness and consumption of water from an aqueduct that flowed near the camp. A logistic regression model showed that consumption of water from this source remained associated with cases after adjusting for age and the consumption of various foods (odds ratio = 96.5; 95% confidence interval, 11.4-814.4). The risk of suffering from the illness rose with the amount of water consumed (chi 2 trend test = 65.4, P < 0.0001). Chemical and bacteriological analyses of the aqueduct water indicated the presence of fecal contamination. The aqueduct had not been subject to sanitary monitoring, even though the water was used to irrigate agricultural crops. The widespread presence in the environment of species of Salmonella was demonstrated. Health education and microbiological studies of water courses can be of great value in preventing such epidemics.

[Collective scombroid fish poisoning following tuna consumption in Castellon]. / Escombrointoxicación colectiva por consumo de atún en Castellón.

BACKGROUND: To investigate and control of a collective scombroid-fish poisoning (SFP) outbreak, that took place in Castellón, Spain. METHODS: Description of the outbreak and case-control study in order to identify risk factors. Active surveillance of SFP cases, and inspection of implicated markets. Histamine determination in urine of cases and foods. RESULTS: During June 1994, 15 cases of SFP were found out, with 12 cases occurred on June, 28 and 29. Five families were affected (attack rate 68.2%). The median incubation period was 45 minutes. Disease symptoms included facial or general flushing, headache, diarrhea, nausea, abdominal pain, and peppery taste. Implicated food was fresh tuna, bought in a hypermarket of Castellón (odds ratio = 26.4, 95% confidence intervals: 1.05-666.8), adjusted by age and sex using logistic regression analysis. Four samples of urine from cases presented histamine concentration above 35 micrograms/l. Three samples of tuna consumed by cases and one sample of tuna from the hypermarket had histamine concentration above a 200 ppm. Considering the situation of risk, remaining suspected tuna was confiscated from the hypermarket. Rest unknown if the descompositions of tuna occurred in the hypermarket or during capture and distribution. CONCLUSIONS: SFP was caused by fresh tuna ingestion with epidemiologic and analytic confirmation. Determination of histamine in urine of patients could permit to confirm SFP.

[Diffusion of hepatitis B among residents of an institution for handicapped children]. / Difusión de la hepatitis B entre los residentes de una institución para niños con minusavalías.

BACKGROUND: To estimate the prevalence of serologic markers of hepatitis B (SMHB) among residents of an institution for social or mental handicapped children in Castellón, and its association with risk factors. METHODS: A cross-sectional study with determination of SMHB by radioimmunoassay. 98 of the 100 residents participate in the study. RESULTS: Prevalence of SMHB was 24.5% (95% confidence interval: 16.4%-34.1%). Seven residents were hepatitis B surface antigen positive with three hepatitis B e antigen positive. SMHB prevalence was 0 in infants, 18.8% in toddlers, 24.5% in schoolchildren, 11.1% in special education, and 76.9% in permanent residents. Logistic regression analysis found associations of SMHB prevalence with age (Odds ratio [OR] = 5.8, 95% CI: 1.1-29.0), old age at admission with protective character (OR = 0.6, 95% CI: 0.4-0.8), and duration of stay (OR = 1.2 95% CI: 1.0-1.3), adjusting by sex, mental deficiency, and hepatitis B (HB) determinants like surgery, blood transfusion, odontology, bites, and injections. CONCLUSIONS: A predominant transmission of HB in young ages is suggested. Vaccination against HB, hygienic measures, and periodic serologic studies of HB are essential to prevent this disease.

[Parotiditis in postvaccination period. Epidemiologic pattern and vaccine effectiveness in an epidemic outbreak]. / La parotiditis en época posvacunal. Patrón epidemiológico y efectividad vacunal en un brote epidémico.

BACKGROUND: Upon the detection of an excess number of cases of parotiditis in La Almolda (Zaragoza) a descriptive study of the epidemic was carried out with vaccination efficacy being quantified. METHODS: The definition and system of detection of the cases was established. To calculate the rate of infection the available demographic data were used as denominators. A study of retrospective groups was designed to calculate the vaccination efficacy including one group of vaccinated subjects and another of non vaccinated subjects. Age and viral contact were considered as inclusion criteria. RESULTS: Fifty-two cases of parotiditis were detected. The rate of infection in a population of under 30 years of age was 18.9%. The most affected age group corresponded to the interval of between 10-14 years of age with a specific rate of 46.5%. The risk of infection was greatest amongst public school students (RR = 5; p = 0.00015). Vaccination efficacy was 74.68%. CONCLUSIONS: This study confirms the tendency that parotiditis affects older subjects during the prevaccination period. The vaccination efficacy found to be 74.68% was lower the efficacy determined from seroconversion studies.