RESUMO
BACKGROUND: Immunity of healthcare workers (HCWs) against measles is a particular concern. They are more likely to contract it than the general population due to their occupational exposure which may cause a nosocomial outbreak. AIM: To assess the measles immune status of HCWs at five Spanish university hospitals. PATIENTS AND METHODS: Serologic testing (IgG) for measles by chemiluminescence indirect immunoassay (CLIA) was carried out prospectively and consecutively in HCWs from five university hospitals. All HCWs were classified into four epidemiological groups: vaccinated individuals, those with a history of measles disease, subjects with no history of measles or vaccination, and those who did not know whether they had measles or were vaccinated, and into five professional categories: physicians, nurses, nursing assistants, other clinical workers and non-clinical workers. A logistic regression model was constructed to identify the factors independently associated with immunity to measles. RESULTS: The study group was composed of 2157 HCWs. 89% had protective antibodies against measles. Of the 238 non-immune HCWs, 199 (83.6%) had been vaccinated, compared with 1084 of the 1919 (56.5%) immune individuals (P<0.0001). The parameters significantly predictive of having protective antibodies against measles were: older age (P<0.0001), epidemiological status (P=0.0002, mainly past measles disease), and professional category (P=0.02, in particular nurses). CONCLUSION: This study shows that HCWs, including those previously vaccinated, are currently at risk of measles and suggests that those with a natural history of infection are better protected. Therefore, knowledge and maintenance of immunity to measles are an essential part of infection control among HCWs.
RESUMO
Objetivo: Describir un brote de gastroenteritis aguda originado por Giardia en la Comunidad de Madrid, así como las medidas de control implementadas. Métodos: Se llevó a cabo un estudio epidemiológico descriptivo de los casos afectados mediante encuestas. Se realizaron coprocultivos y estudio de parásitos y se analizaron las muestras de agua de las viviendas de los afectados y de la red pública. Resultados: 31 vecinos de una urbanización resultaron afectados. Las muestras de agua de las viviendas indicaron elevada contaminación fecal y ausencia de cloro. El estudio microbiológico de 14 muestras de heces aportó resultados positivos para Giardia. Se recomendó incrementar las medidas higiénicas y no ingerir agua de la red hasta la localización del foco, lo cual impidió la aparición de nuevos casos y el control del brote. Todos los afectados evolucionaron favorablemente. Conclusiones: El análisis epidemiológico y microbiológico permitió identificar Giardia como agente causal del brote, señalando una posible asociación con la contaminación de la red de agua de abastecimiento público (AU)
Objective: Description of an outbreak of acute gastroenteritis caused by Giardia in the Community of Madrid and the control measured implemented. Methods: We conducted a descriptive study of the affected cases. Faecal cultures and studies of parasites were performed on cases, and water samples taken in the homes of cases and public supplies were also analyzed. Results: 31 residents of the neighborhood were affected. The results of the water home samples showed high faecal contamination and absence of chlorine. The microbiological study of 14 stool samples gave positive results for Giardia. The recommendations were to increase hygiene measures and abstinence to drink water from public network until the contaminating focus were located, what prevented the emergence of new cases and caused the outbreak control. All cases evolved favourably. Conclusions: Epidemiological and microbiological analysis of the outbreak identified Giardia as the cause, citing the probably association with the contamination of public water supply (AU)
