Changes in the epidemiology of hepatitis A in Spain (2005­2008): trends of acute hepatitis A hospitalizations, comorbidities, and costs associated with the hospitalization.

INTRODUCTION: The objective of this study is to analyze data related to hospitalization, comorbidities, median stays and costs associated with the hospitalization cases of hepatitis A in Spain, during the 2005-2008 periods. METHODS: A retrospective study of the characteristics of acute hepatitis A patients admitted to Spanish hospitals was performed using the minimum basic dataset. Costs were calculated using the diagnosis-related groups for the disease. RESULTS: The total number of hospitalized patients diagnosed with acute hepatitis A was 2395 (2.66/100,000 inhabitants); 61.5% were diagnosed in men. The highest rate corresponds to the group aged 20-39 years (4.01/100,000 inhabitants). When compared with year 2005 ascending tendencies in hospitalization was found for the year 2008 (incidence rate ratio 1.36 confidence interval 95% 1.32-1.39). Twenty-four deaths (1%) were reported out of the total of hospitalized patients. The median hospital stay was 5 days. An increase of cost from euro 1.272.608 in the year 2005 to euro 2.586.657 in 2008 was observed. Therefore, the total cost derived from these hospitalizations, above the retail price index, has increased by 90%. CONCLUSION: The incidence of hospitalized patients diagnosed with acute hepatitis A in Spain has remained stable from 2005 to 2007 and increased significantly in the year 2008. Therefore, a change in the epidemiology of hepatitis A may be taking place in Spain and this disease could become a public problem in the young adult population. It is necessary to conduct a cost-effectiveness study to assess the need for including hepatitis A in the universal immunizations schedule.

Trends of acute hepatitis B hospitalizations, comorbidities, fatality rate, and costs associated with the hospitalization in Spain (2001-2006).

INTRODUCTION: The objective of this study is to analyze data related to hospitalization, comorbidities, fatality rate, average stays, and costs associated with hospitalized cases of acute hepatitis B in Spain, during 2001-2006. METHODS: A retrospective study to analyze the characteristics of acute hepatitis B patients admitted to Spanish hospitals was performed using the minimum basic data set. Costs were calculated using the diagnosis-related groups for the disease. RESULTS: The total number of hospitalized patients diagnosed with acute hepatitis B was 2160, of which 73.8% were diagnosed in men. The highest rate corresponds to the group aged 20-39 years (2.33/100 000 inhabitants). Ninety deaths (4.2%) were reported out of the total hospitalized patients. The average hospital stay was 10 days. The trends in the rate of hospitalized acute hepatitis B cases were not statistically significant. There were no differences found in the average length of stay or in the cost during the study period. The estimated total cost was 7 451 098 euros. CONCLUSION: The rate of hospitalized acute hepatitis B patients in Spain did not change during the 2001-2006 period. Having an adequate surveillance system and continuing with the universal immunization and risk group programs, and health education, remain a high priority.

[Surveillance and control measures of avian influenza in birds. Implications for public health]. / Medidas de vigilancia y contención de la influenza aviar en aves. Implicaciones para la salud pública.

Avian influenza is an infectious disease that mainly affects birds, caused by influenza A type viruses, in most cases of low pathogenecity. Rapid mutations of these viruses to highly pathogenic forms represent a serious risk for animal and public health. Since 2003, an outbreak of highly pathogenic avian influenza in birds is taking place with transmission and resulting illness in humans and which is believed to be able to start a human influenza pandemic. To face these outbreaks, a joint effort between the animal and public health sector is needed to identify areas affected by animal disease and to intensify surveillance of human cases in them. Control measures in animals must be compatible with risk reduction of human exposure. The aim of this article is to review the general control measures developed against avian influenza in birds, highlighting coordination and communication aspects between Animal Health and Public Health, taking into account that legislation is constantly being updated as the dynamic of the disease changes.

Medidas de vigilancia y contención de la influenza aviar en aves. Implicaciones para la salud pública / Surveillance and control measures of avian influenza in birds. Implications for public health

La Influenza Aviar es una enfermedad infecciosa que afecta principalmentea las aves, producida por virus de la gripe A, en la mayoríade los casos de baja patogenicidad. Debido a la rápida mutaciónde estos virus a formas altamente patógenas, el nivel de riesgo parala sanidad animal y la salud pública puede ser alto. Desde el año2003, está teniendo lugar un brote de Influenza Aviar en aves producidopor el subtipo H5N1 de alta patogenicidad, con transmisión yafectación humana y que presenta un riesgo potencial de produciruna nueva pandemia de gripe. Ante estos brotes, es fundamental lacolaboración entre los sectores implicados de la Sanidad Animal ySalud Pública que permita localizar con precisión las zonas de actividadde la enfermedad en los animales e intensificar en ellas la vigilanciade los casos en humanos. Las medidas de control de la enfermedaden animales deben ser compatibles con la reducción del riesgode exposición humana.El objetivo de este artículo es hacer una revisión de las medidasgenerales desarrolladas contra la Influenza Aviar en aves, destacandolos aspectos de coordinación y comunicación entre las autoridadesde Sanidad Animal y Salud Pública, teniendo en cuenta que lalegislación está sujeta a una renovación rápida y constante en consonanciacon la dinámica de esta enfermedad(AU)

Avian influenza is an infectious disease that mainly affectsbirds, caused by influenza A type viruses, in most cases of lowpathogenecity. Rapid mutations of these viruses to highly pathogenicforms represent a serious risk for animal and public health. Since2003, an outbreak of highly pathogenic avian influenza in birdsis taking place with transmission and resulting illness in humansand which is believed to be able to start a human influenza pandemic.To face these outbreaks, a joint effort between the animal andpublic health sector is needed to identify areas affected by animaldisease and to intensify surveillance of human cases in them. Controlmeasures in animals must be compatible with risk reduction ofhuman exposure.The aim of this article is to review the general control measuresdeveloped against avian influenza in birds, highlighting coordinationand communication aspects between Animal Health and PublicHealth, taking into account that legislation is constantly being updatedas the dynamic of the disease changes(AU)