Estimando el número de casos de COVID-19 mediante una herramienta web: resultados de la primera semana del proyecto «Covid-19 Trends» en Euskadi / Estimating the number of COVID-19 cases using a web-based tool: results from the first week of the 'Covid-19 Trends' project in the Basque Country

OBJETIVO: En Euskadi, dos casos de COVID-19 fueron diagnosticados el 28 de febrero de 2020. El 14 de marzo el Gobierno español estableció el estado de alarma. La única información acerca del número de casos de COVID-19 eran los confirmados por RT-PCR. Lanzamos una herramienta de vigilancia basada en la web para estimar el número mínimo de casos sintomáticos de COVID-19 y generar información útil para la toma de decisiones en salud pública. MATERIAL Y MÉTODOS: Implementamos un cuestionario web anónimo y lo difundimos a través de redes sociales. Recopilamos información epidemiológica sobre variables de «tiempo» (fecha de inicio de los síntomas), «lugar» (código postal) y «persona» (género, edad). Comparamos los casos positivos detectados mediante RT-PCR con los casos estimados según la definición de caso del Ministerio de Sanidad Consumo y Bienestar Social. Calculamos la tasa de respuesta al cuestionario y la incidencia acumulada a 14días. RESULTADOS: Entre el 19 y 26 de marzo de 2020 el cuestionario fue contestado por 128.182 personas (5,5% de la población vasca). De ellas, 27.599 cumplieron la definición de caso. Los casos estimados fueron seis veces más que los RT-PCR positivos para COVID-19. La incidencia acumulada a 14días fue de 463,3 por 100.000 habitantes, mientras que la de los casos positivos por RT-PCR fue de 139,6 por 100.000 habitantes. CONCLUSIONES: Esta herramienta mostró su utilidad para estimar el mínimo número de casos sintomáticos en Euskadi, lo cual podría apoyar acciones de salud pública

OBJECTIVE: In the Basque Country, two cases of COVID-19 were diagnosed on February 28 2020. On March 14, the Spanish Government established a state of alarm. Only cases confirmed by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]) were known. We launched a web-based surveillance tool to estimate the number of symptomatic cases of COVID-19 to contribute to Public Health decision-making. MATERIAL AND METHODS: We implemented an anonymous web questionnaire and disseminated it through online social media social. We collected epidemiological information about «time» (date of onset of symptoms), «place» (zip code), and «person» (gender, age). We compared cases detected by RT-PCR with the estimated cases, according to the case definition of the Ministry of Health. We calculated the questionnaire response rate and the cumulative incidence at 14days. RESULTS: Between March 19 and 26, 128,009 people answered the questionnaire (5.5% of the Basque population). Of these, 26,375 met the case definition (symptom prevalence of 21.4%). The estimated cases were almost six times more than COVID-19 positive RT-PCR. The estimated 14-day cumulative incidence was 578.3 per 100,000 population compared to RT-PCR positive cases, which was 139.6 per 100,000 population. CONCLUSIONS: This tool was useful in estimating the minimum number of symptomatic cases in the Basque Country, which could support Public Health actions

[Estimating the number of COVID-19 cases using a web-based tool: Results from the first week of the 'Covid-19 Trends' project in the Basque Country]. / Estimando el número de casos de COVID-19 mediante una herramienta web: resultados de la primera semana del proyecto «Covid-19 Trends¼ en Euskadi.

OBJECTIVE: In the Basque Country, two cases of COVID-19 were diagnosed on February 28 2020. On March 14, the Spanish Government established a state of alarm. Only cases confirmed by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]) were known. We launched a web-based surveillance tool to estimate the number of symptomatic cases of COVID-19 to contribute to Public Health decision-making. MATERIAL AND METHODS: We implemented an anonymous web questionnaire and disseminated it through online social media social. We collected epidemiological information about «time¼ (date of onset of symptoms), «place¼ (zip code), and «person¼ (gender, age). We compared cases detected by RT-PCR with the estimated cases, according to the case definition of the Ministry of Health. We calculated the questionnaire response rate and the cumulative incidence at 14days. RESULTS: Between March 19 and 26, 128,009 people answered the questionnaire (5.5% of the Basque population). Of these, 26,375 met the case definition (symptom prevalence of 21.4%). The estimated cases were almost six times more than COVID-19 positive RT-PCR. The estimated 14-day cumulative incidence was 578.3 per 100,000 population compared to RT-PCR positive cases, which was 139.6 per 100,000 population. CONCLUSIONS: This tool was useful in estimating the minimum number of symptomatic cases in the Basque Country, which could support Public Health actions.

Outbreak of Shigella sonnei infections in the Orthodox Jewish community of Antwerp, Belgium, April to August 2008.

In the beginning of April 2008 three cases of Shigella sonnei infection were identified among the Orthodox Jewish community of Antwerp, Belgium. We conducted a descriptive study and a household cohort study to identify potential risk factors. Stool samples were cultured and antibiotic susceptibility of the isolates was determined. Between April and August 2008, 42 cases were registered. All characterised isolates (n=20) shared an identical pulsed-field gel electrophoresis profile and were indistinguishable from one of the twelve main strains detected in Israel in 2008, where the index case's father had stayed before the outbreak. The secondary attack rate in households was 8.5% (95% confidence interval (CI): 4.3­12.7). Multivariate analysis identified the following risk factors for secondary spread: households with more than three children (adjusted relative risk (RR): 9.17; 95% CI: 1.21­69.13), children younger than five years (adjusted RR: 5.45; 95% CI: 2.44­12.62), and children younger than 12 years assisting in washing younger siblings (adjusted RR: 5.45; 95% CI: 2.44­12.17). Rigorous hand washing, use of disposable towels, information for parents and caregivers, and exclusion of symptomatic children from day care, preschool and school for a minimum of 48 hours were implemented.

Shigellosis outbreak linked to canteen-food consumption in a public institution: a matched case-control study.

On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02-14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.

Patología importada del viajero: paludismo / Important disease of the traveler: malaria

El aumento de los viajes a países en vías de desarrollo incrementa la posibilidad de importar enfermedades infecciosas a nuestro medio y obliga al médico de Atención Primaria y de los servicios de urgencias a tener un alto índice de sospecha y unos conocimientos básicos de las patologías tropicales más comunes en el enfermo que ha viajado en los últimos meses. Resulta fundamental en todo enfermo obtener información de los viajes que haya realizado. En todo paciente se deberá preguntar por el antecedente de viajes previos y a qué país, zona, tipo de actividades que realizó y qué medidas preventivas utilizó. Las consultas más frecuentes son la fiebre, la diarrea y las lesiones cutáneas

The increase of trips to developing countries increases the possibility of importing infectious diseases to our setting and requires the Primary Care physician and those in emergency services to have a high index of suspicion and basic knowledge on the most common tropical diseases in the patient who has traveled in recent months. It is fundamental in all patient to obtain information on the trips they have made. Every patient should be asked about the background of previous trials and what country, zone they went to, type of activity carried out and preventive measures used. The most frequent consultations are fever, diarrhea and skin lesions