ABSTRACT
INTRODUCTION AND AIM OF THE STUDY: A notable proportion of COVID outbreaks are generated by "super-spreading events", where a few subjects transmit the pathogen to many secondary cases, increasing contact networks and the spread of the pathogen. We conducted a description of a COVID-19 superspreading event in Córdoba during July 2020, linked to a nightlife establishment. MATERIAL AND METHODS: Retrospective observational study describing characteristics of person, time, PCR result and contact network of confirmed cases. PCR results in Córdoba during July and August and information collected in surveillance systems were analyzed. RESULTS: 935 individuals associated with the outbreak were included; 120 (12.83%) became confirmed cases. July 17 was the day with the highest incidence, with 27 new cases (22.5% of the total). People under 25 years old represented 69.2% of the cases. The average number of close contacts per person was 10.7, with a decrease as age raised. During the outbreak, incidence increased at the provincial level compared to previous weeks; at the end, incidence did not return to initial values but remained high with a relevant percentage of cases having unknown epidemiological association. CONCLUSIONS: A greater transmission capacity of SARS-CoV-2 was observed in a closed, crowded space, and among young people that tended to report a greater number of social contacts and may present little or no symptoms. Developing preventive measures in scenarios that combine these factors and early detection of cases are essential to avoid an increase in the spread of the virus.
Subject(s)
COVID-19 , Adolescent , Adult , COVID-19/epidemiology , Disease Outbreaks/prevention & control , Humans , Retrospective Studies , SARS-CoV-2 , Spain/epidemiologyABSTRACT
Objetivos: Estudio retrospectivo observacional en niños ingresados con sospecha clínica de infección por el virus Influenza A (H1N1) 2009 entre los meses de octubre de 2009 y febrero de 2010, haciendo especial énfasis en los que requirieron tratamiento intensivo. Material y métodos: Se analizaron factores de riesgo, síntomas, evolución, complicaciones, mortalidad, tiempo de negativización de RT-PCR Influenza A (H1N1) 2009, estancia media y duración del tratamiento con Oseltamivir, comparando pacientes críticos (grupo I) con el resto de hospitalizados (grupo II). Resultados: Ingresaron 38 niños con una edad media de 5,3±4,6 años. Seis precisaron cuidados intensivos, presentando el 83,3% factores de riesgo de complicaciones para virus Influenza A (H1N1) 2009 frente al 62,5% en el grupo II. El síntoma predominante fue la fiebre >38° C (92,1%); la sintomatología respiratoria fue significativamente más frecuente en el grupo I (83,3% vs. 21,9%; p<0,01). Dos de los pacientes críticos precisaron ventilación mecánica por síndrome de distrés respiratorio agudo; un paciente con insuficiencia respiratoria crónica reagudizada respondió favorablemente a oxigenoterapia de alto flujo. Un paciente precisó oxigenación de membrana extracorpórea por shock cardiogénico secundario a miocarditis fulminante, evolucionando a fallo multiorgánico y muerte cerebral. Se mantuvo oseltamivir 8, 6 días en el grupo I y 4,5 días en el grupo II (p<0,05), comprobándose un tiempo medio de negativización de la RT-PCR de 7±2 días en el conjunto de la serie. La estancia media fue significativamente mayor en el grupo I (p<0,001). Dos pacientes ingresados en UCIP fallecieron. Conclusiones: La presencia de factores de riesgo aumenta la probabilidad de evolución desfavorable, con una mortalidad significativa en los pacientes que precisaron cuidados intensivos. La monitorización de la RT-PCR podría ayudar a establecer la duración de las medidas de aislamiento (AU)
Objective: Retrospective, observational study in children hospitalized due to Influenza A (H1N1) between October 2009 and February 2010, emphasizing on those who required intensive therapy. Material and methods: Risk factors, symptoms, course, complications, mortality, time of disappearance of RT-PCR Influenza A (H1N1), average length of stay and duration of treatment with oseltamivir, were studied, comparing critically ill patients (group I) with the rest of hospitalized patients (group II). Results: A total of 38 children, with a mean age of 5.03±4.6 years were admitted during the study period. Six patients required intensive care, 83.3% had risk factors for influenza A (H1N1) compared with 62.5% in group II. Fever > 38°C was the predominant symptom (92.1%). Respiratory symptoms were significantly more frequent in group I (83.3% vs. 33.6; P<0.01). Two critically ill patients required mechanical ventilation due to ARDS (acute respiratory distress syndrome). One patient with exacerbation of chronic respiratory failure responded favourably to high-flow oxygen. One patient developed fulminant myocarditis and required ECMO (Extracorporeal Membrane Oxygenation) because of secondary cardiogenic shock, which developed into multiple organ dysfunction and brain death. Oseltamivir therapy was given for an average of 8.6 days in group I and 4.5 days in group II (P<0.05), checking the negativity of RT-PCR Influenza A (H1N1) in 7±2 days. The average stay was significantly higher in group I. Two patients admitted to PICU died. Conclusions: The presence of risk factors increases the likelihood of unfavourable outcome: high mortality among patients requiring intensive care. Monitoring of RT-PCR Influenza A (H1N1) could help establish the duration of isolation measures (AU)
Subject(s)
Humans , Influenza, Human/epidemiology , Influenza A Virus, H1N1 Subtype/isolation & purification , Myocarditis/epidemiology , Respiratory Insufficiency/epidemiology , Intensive Care Units, Pediatric , Risk FactorsABSTRACT
OBJECTIVE: Retrospective, observational study in children hospitalized due to Influenza A (H1N1) between October 2009 and February 2010, emphasizing on those who required intensive therapy. MATERIAL AND METHODS: Risk factors, symptoms, course, complications, mortality, time of disappearance of RT-PCR Influenza A (H1N1), average length of stay and duration of treatment with oseltamivir, were studied, comparing critically ill patients (group I) with the rest of hospitalized patients (group II). RESULTS: A total of 38 children, with a mean age of 5.03±4.6 years were admitted during the study period. Six patients required intensive care, 83.3% had risk factors for influenza A (H1N1) compared with 62.5% in group II. Fever > 38°C was the predominant symptom (92.1%). Respiratory symptoms were significantly more frequent in group I (83.3% vs. 33.6; P<.01). Two critically ill patients required mechanical ventilation due to ARDS (acute respiratory distress syndrome). One patient with exacerbation of chronic respiratory failure responded favourably to high-flow oxygen. One patient developed fulminant myocarditis and required ECMO (Extracorporeal Membrane Oxygenation) because of secondary cardiogenic shock, which developed into multiple organ dysfunction and brain death. Oseltamivir therapy was given for an average of 8.6 days in group I and 4.5 days in group II (P<.05), checking the negativity of RT-PCR Influenza A (H1N1) in 7±2 days. The average stay was significantly higher in group I. Two patients admitted to PICU died. CONCLUSIONS: The presence of risk factors increases the likelihood of unfavourable outcome: high mortality among patients requiring intensive care. Monitoring of RT-PCR Influenza A (H1N1) could help establish the duration of isolation measures.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/therapy , Child, Preschool , Female , Humans , Influenza, Human/complications , Male , Retrospective StudiesABSTRACT
We report a case of botulism in a 40 day old infant. The patient presented a descending flaccid paralysis requiring mechanical ventilation for 12 days. She is the first European patient treated with Human Botulism Immune Globulin. A few weeks later a second case of infant botulism was detected in our geographical region in Southern Spain. We emphasise the importance of an early diagnosis and treatment with Human Botulism Immune Globulin to decrease morbidity.
Subject(s)
Botulism/complications , Botulinum Toxins/therapeutic use , Botulinum Toxins, Type A , Botulism/diagnosis , Botulism/drug therapy , Diagnosis, Differential , Female , Humans , Infant , Neuromuscular Agents/therapeutic use , Paraplegia/diagnosis , Paraplegia/etiologyABSTRACT
Comunicamos la detección de botulismo en un lactante de 40 días que presentó parálisis flácida descendente con insuficiencia respiratoria grave que requirió ventilación mecánica durante 12 días. Se le administró inmunoglobulina humana específica (IHE) para el botulismo del lactante, y es el primer caso europeo que recibe esta medicación. Unas semanas más tarde se ha detectado un segundo caso en nuestra comunidad autónoma. Destacamos la importancia del diagnóstico e indicación precoz del tratamiento con IHE, lo que disminuye la morbilidad (AU)
We report a case of botulism in a 40 day old infant. The patient presented a descending flaccid paralysis requiring mechanical ventilation for 12 days. She is the first European patient treated with Human Botulism Immune Globulin. A few weeks later a second case of infant botulism was detected in our geographical region in Southern Spain. We emphasise the importance of an early diagnosis and treatment with Human Botulism Immune Globulin to decrease morbidity (AU)
Subject(s)
Humans , Female , Infant , Botulism/complications , Botulism/diagnosis , Respiratory Insufficiency/complications , Immunoglobulin E/therapeutic use , Paralysis/complications , Respiration, Artificial , Botulinum Toxins/analysis , Clostridium botulinum/isolation & purification , Clostridium Infections/complications , Diagnosis, Differential , Botulism/epidemiology , Blepharoptosis/complications , Clostridium botulinum/pathogenicity , Botulism/therapy , Sleep-Wake Transition Disorders/complications , Muscle Hypotonia/complications , Tidal Volume/physiology , Neuromuscular Diseases/complications , Neuromuscular ManifestationsSubject(s)
Abdominal Injuries/etiology , Child Abuse/diagnosis , Child, Preschool , Female , Humans , Injury Severity ScoreSubject(s)
Brain Neoplasms , Neoplasms, Neuroepithelial , Adolescent , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Brain Neoplasms/physiopathology , Child , Female , Humans , Infant , Magnetic Resonance Imaging , Neoplasms, Neuroepithelial/diagnosis , Neoplasms, Neuroepithelial/pathology , Neoplasms, Neuroepithelial/physiopathology , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Female , Child, Preschool , Humans , Abdominal Injuries/etiology , Child Abuse/diagnosis , Abdominal Injuries/complications , Accidents, Home , ParentsABSTRACT
No disponible
No disponible
