[Trichinellosis outbreaks in Aragón (1998-2017)]. / Brotes epidémicos de triquinosis ocurridos en Aragón durante el periodo 1998 ­ 2017.

OBJECTIVE: In Aragon, official veterinary controls to detect the presence of Trichinella in meat products have allowed trichinosis to be a low-incidence disease in the form of outbreaks associated with family consumption of meat products that are not sanitarily controlled. The aim of the work was to describe the epidemiological characteristics of the trichinosis outbreaks that occurred in Aragon during the study period and the action measures carried out, which served as a basis for redesigning and strengthening prevention and control measures. METHODS: Descriptive study of the characteristics of time, place, person, food implicated, etiological agent and control measures implemented in the outbreaks identified by the Epidemiological Surveillance Network of Aragón from 01/01/1998 to 31/12/2017. For the descriptive analysis, the mean with its standard deviation and proportions were calculated. RESULTS: During the study period (from 01/01/1998 until 31/12/2017) there were 7 family outbreaks with 294 exposed, 103 cases (Attack Rate 35%), of which 29 were hospitalized (28.1%). The case fatality rate was 1%. The average age of the cases was 43.3 years (standard deviation 15.9). 70.8% of the cases were male. Outbreaks were concentrated between December and May. Five outbreaks originated after consumption of wild boar. The etiological agent identified in meat and/or biological samples from the cases was Trichinella spiralis in four outbreaks and Trichinella britovi in two other outbreaks, while the agent could not be identified in one outbreak. In all outbreaks, actions were carried out in accordance with the recommendations established by the National Epidemiological Surveillance Network (RENAVE). CONCLUSIONS: Trichinosis in Aragon takes the form of sporadic family outbreaks coinciding with the time of wild boar hunting and home slaughtering of pigs and is associated with the consumption of meat products not controlled sanitarily, so it is necessary to strengthen health education and intersectoral collaboration in the development and implementation of prevention and control strategies.

OBJETIVO: En Aragón, los controles oficiales veterinarios para detectar la presencia de triquina en productos cárnicos, han permitido que la triquinosis sea una enfermedad de baja incidencia, que se presenta en forma de brotes, asociados al consumo familiar de productos cárnicos no controlados sanitariamente. El objetivo del trabajo fue describir las características epidemiológicas de los brotes de triquinosis ocurridos en Aragón durante el periodo de estudio y las medidas de actuación llevadas a cabo, lo que sirvió de base para rediseñar y fortalecer las medidas de prevención y control. METODOS: Estudio descriptivo de las características tiempo, lugar, persona, alimentos implicados, agente etiológico y medidas de control implementadas en los brotes identificados por la Red de Vigilancia Epidemiológica de Aragón desde el 01/01/1998 al 31/12/2017. Para el análisis descriptivo se calcularon la media con su desviación estándar y las proporciones. RESULTADOS: Durante el periodo de estudio (desde el 01/01/1998 hasta el 31/12/2017) se declararon 7 brotes familiares con 294 expuestos, 103 casos (Tasa de Ataque 35%), de los que 29 fueron hospitalizados (28,1%). La tasa de letalidad fue del 1%. La media de edad de los casos fue de 43,3 años (desviación típica 15,9). El 70,8% de los casos fueron varones. Los brotes se concentraron entre diciembre y mayo. Cinco brotes se originaron tras el consumo de jabalí. El agente etiológico aislado en muestras cárnicas y/o muestras biológicas procedentes de los casos, fue Trichinella spiralis en cuatro brotes y Trichinella britovi en otros dos brotes. En todos los brotes las actuaciones se realizaron conforme a las recomendaciones establecidas por la Red Nacional de Vigilancia Epidemiológica (RENAVE). CONCLUSIONES: La triquinosis en Aragón se presenta en forma de brotes familiares esporádicos coincidentes con la época de caza de jabalí y matanza domiciliaria del cerdo y se asocia al consumo de productos cárnicos no controlados sanitariamente, por lo que es necesario reforzar la educación para la salud y la colaboración intersectorial en la elaboración e implantación de estrategias de prevención y control.

Brotes Epidémicos de Triquinosis ocurridos en Aragón durante el Periodo 1988 - 2017 / Trichinellosis outbreaks in Aragón (1998-2017)

OBJETIVO: En Aragón, los controles oficiales veterinarios para detectar la presencia de triquina en productos cárnicos, han permitido que la triquinosis sea una enfermedad de baja incidencia, que se presenta en forma de brotes, asociados al consumo familiar de productos cárnicos no controlados sanitariamente. El objetivo del trabajo fue describir las características epidemiológicas de los brotes de triquinosis ocurridos en Aragón durante el periodo de estudio y las medidas de actuación llevadas a cabo, lo que sirvió de base para rediseñar y fortalecer las medidas de prevención y control. MÉTODOS: Estudio descriptivo de las características tiempo, lugar, persona, alimentos implicados, agente etiológico y medidas de control implementadas en los brotes identificados por la Red de Vigilancia Epidemiológica de Aragón desde el 01/01/1998 al 31/12/2017. Para el análisis descriptivo se calcularon la media con su desviación estándar y las proporciones. RESULTADOS: Durante el periodo de estudio (desde el 01/01/1998 hasta el 31/12/2017) se declararon 7 brotes familiares con 294 expuestos, 103 casos (Tasa de Ataque 35%), de los que 29 fueron hospitalizados (28,1%). La tasa de letalidad fue del 1%. La media de edad de los casos fue de 43,3 años (desviación típica 15,9). El 70,8% de los casos fueron varones. Los brotes se concentraron entre diciembre y mayo. Cinco brotes se originaron tras el consumo de jabalí. El agente etiológico aislado en muestras cárnicas y/o muestras biológicas procedentes de los casos, fue Trichinella spiralis en cuatro brotes y Trichinella britovi en otros dos brotes. En todos los brotes las actuaciones se realizaron conforme a las recomendaciones establecidas por la Red Nacional de Vigilancia Epidemiológica (RENAVE). CONCLUSIONES: La triquinosis en Aragón se presenta en forma de brotes familiares esporádicos coincidentes con la época de caza de jabalí y matanza domiciliaria del cerdo y se asocia al consumo de productos cárnicos no controlados sanitariamente, por lo que es necesario reforzar la educación para la salud y la colaboración intersectorial en la elaboración e implantación de estrategias de prevención y control

OBJECTIVE: In Aragon, official veterinary controls to detect the presence of Trichinella in meat products have allowed trichinosis to be a low-incidence disease in the form of outbreaks associated with family consumption of meat products that are not sanitarily controlled. The aim of the work was to describe the epidemiological characteristics of the trichinosis outbreaks that occurred in Aragon during the study period and the action measures carried out, which served as a basis for redesigning and strengthening prevention and control measures. METHODS: Descriptive study of the characteristics of time, place, person, food implicated, etiological agent and control measures implemented in the outbreaks identified by the Epidemiological Surveillance Network of Aragón from 01/01/1998 to 31/12/2017. For the descriptive analysis, the mean with its standard deviation and proportions were calculated. RESULTS: During the study period (from 01/01/1998 until 31/12/2017) there were 7 family outbreaks with 294 exposed, 103 cases (Attack Rate 35%), of which 29 were hospitalized (28.1%). The case fatality rate was 1%. The average age of the cases was 43.3 years (standard deviation 15.9). 70.8% of the cases were male. Outbreaks were concentrated between December and May. Five outbreaks originated after consumption of wild boar. The etiological agent identified in meat and/or biological samples from the cases was Trichinella spiralis in four outbreaks and Trichinella britovi in two other outbreaks, while the agent could not be identified in one outbreak. In all outbreaks, actions were carried out in accordance with the recommendations established by the National Epidemiological Surveillance Network (RENAVE). CONCLUSIONS: Trichinosis in Aragon takes the form of sporadic family outbreaks coinciding with the time of wild boar hunting and home slaughtering of pigs and is associated with the consumption of meat products not controlled sanitarily, so it is necessary to strengthen health education and intersectoral collaboration in the development and implementation of prevention and control strategies

Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330 / Investigación epidemiológica del primer caso de brucelosis humana en España por Brucella suis biovariedad 1 cepa 1330

INTRODUCTION: No cases of human brucellosis caused by Brucella suis has been reported in Spain. METHODS: This study involved interviews with the case and his co-workers, inspection of their workplace, checking infection control measures, and typing the Brucella strain isolated in the blood culture. RESULTS: Brucella suis biovar 1 strain 1330 was isolated from a patient who worked in a waste treatment plant. Food borne transmission, contact with animals, and risk jobs were ruled out. An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. CONCLUSION: There should be controls to ensure that waste containers are sealed

INTRODUCCIÓN: En España no se habían comunicado casos humanos de brucelosis por Brucella suis anteriores a este. MÉTODOS: La investigación incluyó entrevistas con el caso y sus compañeros de trabajo, inspección del lugar de trabajo, comprobación de las medidas de control de la infección, y tipificación de la cepa de Brucella aislada en el hemocultivo. RESULTADOS: Se aisló Brucella suis biovariedad 1 cepa 1330 en un paciente que trabajaba en una empresa de tratamiento de residuos. Se descartó la fuente alimentaria, el contacto con animales y trabajos de riesgo. Un pinchazo accidental con una aguja contaminada de un contenedor procedente de un laboratorio de investigación fue la forma de transmisión más probable. CONCLUSIÓN: Se deben realizar controles para asegurar que los contenedores de residuos están sellados

Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330.

INTRODUCTION: No cases of human brucellosis caused by Brucella suis has been reported in Spain. METHODS: This study involved interviews with the case and his co-workers, inspection of their workplace, checking infection control measures, and typing the Brucella strain isolated in the blood culture. RESULTS: Brucella suis biovar 1 strain 1330 was isolated from a patient who worked in a waste treatment plant. Food borne transmission, contact with animals, and risk jobs were ruled out. An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. CONCLUSION: There should be controls to ensure that waste containers are sealed.

Brote escolar de parotiditis: estimación de la efectividad vacunal. Zaragoza 2011 / An outbreak of mumps in a high school: estimation of vaccine effectiveness. Zaragoza 2011

INTRODUCCIÓN: Tras la consolidación de los programas de vacunación, los brotes de parotiditis siguen ocurriendo. En diciembre de 2011 se produjo en Zaragoza un brote escolar de parotiditis. OBJETIVO: Describir el brote y calcular la efectividad vacunal. MÉTODO: Definición de caso: persona con inflamación de parótida/s u otras glándulas salivares de más de 2 días sin otras causas aparentes. Población de referencia: Persona perteneciente al Instituto de Educación Secundaria Obligatoria Parque Goya o con origen de la cadena de transmisión en el instituto. Periodo del brote: Desde 2 días antes del inicio de síntomas del primer caso hasta 5 días después del inicio del último caso. Se recogieron muestras para confirmación del virus (IgM, cultivo de orina y de exudado orofaríngeo) y los virus aislados fueron genotipados. Se realizó un estudio de cohortes retrospectivo en 2 aulas del instituto para el cálculo de la efectividad vacunal. Se implantó vigilancia activa, aislamiento de los casos y recomendación de vacunación a contactos susceptibles. RESULTADOS: Hubo 27 casos. El 77,8% estaban vacunados con 2 dosis de triple vírica. El 44% fueron confirmados microbiológicamente. Se determinó el genotipo G1 en 6 casos. Según el estudio de cohortes, la efectividad vacunal para una dosis fue del 34%, (IC 95%: −44 a 70) y para 2, del 67% (IC 95%: 28 a 83). CONCLUSIONES: La efectividad vacunal se encuentra por debajo de lo esperado. La detección precoz y el aislamiento de los casos son fundamentales para prevenir nuevos casos en el ámbito escolar

INTRODUCTION: Mumps outbreaks continue to occur, even after the consolidation of vaccination programs. An outbreak of mumps occurred in a high school in Zaragoza during December 2011. OBJECTIVE: To describe the outbreak and estimate vaccine effectiveness. METHODS: Case definition: unilateral or bilateral swelling of the parotid or other salivary glands for three or more days without any other apparent cause. Reference population: People attending the 'Parque Goya' High School or with transmission chain origin in the High School. Outbreak period: From two days before the onset of symptoms of the first case to five days after the last case. Samples were collected for virus confirmation (IgM, urine culture and oropharyngeal exudate), and isolates were processed for genotyping. A retrospective cohort study was performed in two high school classrooms to estimate vaccine efficacy. Public health authorities conducted active surveillance, isolation of cases, and vaccination of susceptible contacts. RESULTS: There were 27 cases. Twenty-one (77.8%) were vaccinated with two doses of Measles-Mumps-Rubella vaccine. Twelve (44%) were confirmed microbiologically. G1 genotype was determined in six cases. According to the cohort study, vaccine efficacy for one dose was 34% (95% CI: −44 to 70), and was 67% (95% CI: 28 to 83) for two doses. CONCLUSIONS: Vaccine effectiveness was lower than expected. Early detection and isolation of cases have been instrumental in preventing new cases in schools

Es necesario rotular con más claridad los tubos emisores de luz ultravioleta C para la prevención de lesiones en la piel y los ojos / Clearer labelling is required on tubes emitting ultraviolet C to prevent skin and eye lesions

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[An outbreak of mumps in a high school: Estimation of vaccine effectiveness. Zaragoza 2011]. / Brote escolar de parotiditis: estimación de la efectividad vacunal. Zaragoza 2011.

INTRODUCTION: Mumps outbreaks continue to occur, even after the consolidation of vaccination programs. An outbreak of mumps occurred in a high school in Zaragoza during December 2011. OBJECTIVE: To describe the outbreak and estimate vaccine effectiveness. CASE DEFINITION: unilateral or bilateral swelling of the parotid or other salivary glands for three or more days without any other apparent cause. REFERENCE POPULATION: People attending the 'Parque Goya' High School or with transmission chain origin in the High School. OUTBREAK PERIOD: From two days before the onset of symptoms of the first case to five days after the last case. Samples were collected for virus confirmation (IgM, urine culture and oropharyngeal exudate), and isolates were processed for genotyping. A retrospective cohort study was performed in two high school classrooms to estimate vaccine efficacy. Public health authorities conducted active surveillance, isolation of cases, and vaccination of susceptible contacts. RESULTS: There were 27 cases. Twenty-one (77.8%) were vaccinated with two doses of Measles-Mumps-Rubella vaccine. Twelve (44%) were confirmed microbiologically. G1 genotype was determined in six cases. According to the cohort study, vaccine efficacy for one dose was 34% (95%CI: -44 to 70), and was 67% (95%CI: 28 to 83) for two doses. CONCLUSIONS: Vaccine effectiveness was lower than expected. Early detection and isolation of cases have been instrumental in preventing new cases in schools.