Effectiveness of 3 COVID-19 Vaccines in Preventing SARS-CoV-2 Infections, January-May 2021, Aragon, Spain.

Reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is a worldwide challenge; widespread vaccination could be one strategy for control. We conducted a prospective, population-based cohort study of 964,258 residents of Aragon, Spain, during December 2020-May 2021. We used the Cox proportional-hazards model with vaccination status as the exposure condition to estimate the effectiveness of 3 coronavirus disease vaccines in preventing SARS-CoV-2 infection. Pfizer-BioNTech had 20.8% (95% CI 11.6%-29.0%) vaccine effectiveness (VE) against infection after 1 dose and 70.0% (95% CI 65.3%-74.1%) after 2 doses, Moderna had 52.8% (95% CI 30.7%-67.8%) VE after 1 dose and 70.3% (95% CI 52.2%-81.5%) after 2 doses, and Oxford-AstraZeneca had 40.3% (95% CI 31.8%-47.7%) VE after 1 dose. All estimates were lower than those from previous studies. Results imply that, although high vaccination coverage remains critical to protect people from disease, it will be difficult to effectively minimize transmission opportunities.

Imported malaria cases: the connection with the European ex-colonies.

BACKGROUND: Imported malaria is increasing in non-endemic areas due to the increment of international travels, migration and, probably, other unknown factors. The objective of this study was to describe the epidemiological and clinical characteristics of malaria cases in a region of Spain; analyse the possible association between the variables of interest; compare this series with others; and evaluate the characteristics of imported malaria cases according to the country of origin, particularly cases from Equatorial Guinea (Spanish ex-colony) and from the rest of sub-Saharan Africa. METHODS: A descriptive observational study was carried out with a retrospective data collection of cases of malaria reported in Aragon from 1996 to 2017. Univariate and bivariate analysis of clinical-epidemiological variables was performed. In addition, an analysis of cases from sub-Saharan Africa was carried out using logistic regression, calculating odds ratio with its 95% confidence interval. RESULTS: 609 cases of malaria were recorded in Aragon from 1996 to 2017. An autochthonous case in 2010. 50.33% were between 15 and 39 years old. 45.65% of the cases were notified of the 4-weeks 9 to 12. 82.6% reside in the main province, urban area, of which 65.4% were VFR (Visiting Friends and Relatives), 23.8% new immigrants and 10.9% travellers. The infectious Plasmodium species par excellence was Plasmodium falciparum (88%). Analysing the cases from sub-Saharan Africa (95.2% of the total), 48.1% were from Equatorial Guinea. Comparing these with the cases from the rest of sub-Saharan Africa, it was observed that the cases from the Spanish ex-colony have association with the female gender, being under 5 years old, residing in the main province (urban area) and being a new immigrant. CONCLUSIONS: The epidemiological profile of imported malaria cases can be defined as VFR between 15 and 39 years old, coming from sub-Saharan Africa, particularly from Equatorial Guinea. Immigrants education about the importance of chemoprophylaxis when travelling to visit friends and relatives, emphasizing on those who are originally from the ex-colonies of destination country, is necessary; as well as to raise awareness among health professionals to make advice in consultations, specially before summer vacations.

[Streptococcus pneumoniae transmission in a nursing home: analysis of an epidemic outbreak]. / Transmisión de Streptococcus pneumoniae en una residencia de ancianos: análisis de un brote epidémico.

BACKGROUND AND OBJECTIVE: On the basis of an outbreak of pneumococcal pneumonia in a nursing home, we analyze causes and patterns of transmission and discuss preventive interventions carried out on the target population. PATIENTS AND METHOD: A retrospective cohort study was designed on 232 residents to identify risk factors associated with the outbreak. A descriptive study of those nasopharyngeal carriers of pneumococcus among nursing home workers was also carried out. RESULTS: Twenty cases of pneumococcal pneumonia were detected with 4 deaths; 13 cases were confirmed. Cases occurred on a close temporal aggregation form but they were quite disseminated spatially. Among the factors investigated, an older age was the only factor significantly associated (p = 0.02) with the risk of disease. In 4 workers, strains of Streptococcus pneumoniae were isolated from nasopharyngeal swabs; two of them corresponded to the serotype 3, as it was the strain isolated from the blood of a nursing home case. The number of new cases decreased dramatically after vaccination and/or chemoprophylaxis. CONCLUSIONS: Vaccination and chemoprophylaxis administered to nursing home residents seemed effective measures to halt the spread of this outbreak. Detection of the S. pneumoniae antigen by immunochromatographic tests in urine samples is a valuable tool for detecting an outbreak.

Transmisión de Streptococcus pneumoniae en una residencia de ancianos: análisis de un brote epidémico / Streptococcus pneumoniae transmission in a nursing home: analysis of an epidemic outbreak

FUNDAMENTO Y OBJETIVO: Ante la aparición de un brote de neumonía neumocócica en una residencia de ancianos se analizan las causas y el patrón de transmisión de la enfermedad y se discuten las intervenciones preventivas llevadas a cabo. PACIENTES Y MÉTODO: Se diseñó un estudio de cohortes retrospectivo sobre los 232 ancianos residentes para identificar los factores de riesgo asociados al brote, y se efectuó un estudio descriptivo de portadores nasofaríngeos de neumococo entre los trabajadores de la residencia. RESULTADOS: Se detectaron 20 casos de neumonía neumocócica, 13 de ellos confirmados, con cuatro fallecimientos. Los casos presentaron intensa agregación temporal y una amplia diseminación espacial. La edad, mayor en los enfermos, fue el único de los factores investigados que se asoció significativamente (p = 0,02) con el riesgo de enfermar. En 4 de los trabajadores de la residencia se aislaron cepas de Streptococcus pneumoniae en nasofaringe, dos de ellas del serotipo 3, al igual que la obtenida del hemocultivo de un enfermo. El número de enfermos disminuyó drásticamente tras la administración de vacuna o quimioprofilaxis a los residentes. CONCLUSIONES: La vacunación y la quimioprofilaxis recomendadas a los residentes parecen haber sido, en su conjunto, efectivas para interrumpir la diseminación del brote. La detección de antígeno de S. pneumoniae en muestras de orina mediante inmunocromatografía es una herramienta útil para la detección de brotes epidémicos (AU)