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Gavilán AM, Perán-Ramos P, Sanz JC, García-Comas L, Pérez-Abeledo M, Castellanos AM, Berciano JM, López-Perea N, Masa-Calles J, Echevarría JE, Fernández-García A. Investigating Local Patterns of Mumps Virus Circulation, Using a Combination of Molecular Tools. Viruses 2023; 15:2420. [PMID: 38140661 PMCID: PMC10747990 DOI: 10.3390/v15122420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Mumps is a vaccine-preventable disease caused by the mumps virus (MuV). However, MuV has re-emerged in many countries with high vaccine coverage. The World Health Organization (WHO) recommends molecular surveillance based on sequencing of the small hydrophobic (SH) gene. Additionally, the combined use of SH and non-coding regions (NCR) has been described in different studies, proving to be a useful complement marker to discriminate general patterns of circulation at national and international levels. The aim of this work is to test local-level usefulness of the combination of SH and MF-NCR sequencing in tracing hidden transmission clusters and chains during the last epidemic wave (2015-2020) in Spain. A database with 903 cases from the Autonomous Community of Madrid was generated by the integration of microbiological and epidemiological data. Of these, 453 representative cases were genotyped. Eight different SH variants and thirty-four SH haplotypes were detected. Local MuV circulation showed the same temporal pattern previously described at a national level. Only two of the thirteen previously identified outbreaks were caused by more than one variant/haplotype. Geographical representation of SH variants allowed the identification of several previously undetected clusters, which were analysed phylogenetically by the combination of SH and MF-NCR, in a total of 90 cases. MF-NCR was not able to improve the discrimination of geographical clusters based on SH sequencing, showing limited resolution for outbreak investigations.
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Affiliation(s)
- Ana M. Gavilán
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Paula Perán-Ramos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Juan Carlos Sanz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Luis García-Comas
- Servicio de Epidemiología, Consejería de Sanidad de la Comunidad de Madrid, 28009 Madrid, Spain;
| | - Marta Pérez-Abeledo
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Ana M. Castellanos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - José M. Berciano
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Noemí López-Perea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPAZ, 28049 Madrid, Spain
| | - Josefa Masa-Calles
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Juan E. Echevarría
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Aurora Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
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Gavilán AM, Díez-Fuertes F, Sanz JC, Castellanos AM, López-Perea N, Jiménez SM, Ruiz-Sopeña C, Masa-Calles J, García-Comas L, de Ory F, Pérez-Olmeda M, Fernández-García A, Echevarría JE. Increase of Diversity of Mumps Virus Genotype G SH Variants Circulating Among a Highly Immunized Population: Spain, 2007-2019. J Infect Dis 2022; 227:151-160. [PMID: 35524966 DOI: 10.1093/infdis/jiac176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 01/19/2023] Open
Abstract
MuV caused three epidemic waves in Spain since genotype G emerged in 2005, despite high vaccination coverage. SH gene sequencing according to WHO protocols allowed the identification of seven relevant variants and 88 haplotypes. While the originally imported MuVi/Sheffield.GBR/1.05/-variant prevailed during the first two waves, it was subsequently replaced by other variants originated by either local evolution or importation, according to the additional analysis of hypervariable NCRs. The time of emergence of the MRCA of each MuV variant clade was concordant with the data of the earliest sequence. The analysis of Shannon entropy showed an accumulation of variability on six particular positions as the cause of the increase on the number of circulating SH variants. Consequently, SH gene sequencing needs to be complemented with other more variable markers for mumps surveillance immediately after the emergence of a new genotype, but the subsequent emergence of new SH variants turns it unnecessary.
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Affiliation(s)
- A M Gavilán
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - F Díez-Fuertes
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - J C Sanz
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Madrid, Spain
| | - A M Castellanos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - N López-Perea
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - S M Jiménez
- Servicio de Microbiología, Hospital de Segovia, Segovia, Spain
| | - C Ruiz-Sopeña
- Servicio de Epidemiología, Consejería de Sanidad de Castilla y León, Valladolid, Spain
| | - J Masa-Calles
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - L García-Comas
- Servicio de Epidemiología, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
| | - F de Ory
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - M Pérez-Olmeda
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - A Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - J E Echevarría
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
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Ibarra-Meneses AV, Carrillo E, Nieto J, Sánchez C, Ortega S, Estirado A, Latasa Zamalloa P, Sanz JC, García-Comas L, Ordobás M, Moreno J. Prevalence of asymptomatic Leishmania infection and associated risk factors, after an outbreak in the south-western Madrid region, Spain, 2015. ACTA ACUST UNITED AC 2020; 24. [PMID: 31164191 PMCID: PMC6549460 DOI: 10.2807/1560-7917.es.2019.24.22.1800379] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BackgroundA large outbreak of leishmaniasis with 758 cutaneous and visceral leishmaniasis cases occurred in 2009 in Fuenlabrada, in the south-west of the Madrid region of Spain.AimWe aimed to determine the prevalence of asymptomatic Leishmania infection after this outbreak, and its associated risk factors.MethodsA cross-sectional study of 804 healthy individuals living in Fuenlabrada who had no history of leishmaniasis, was conducted between January and July 2015. Asymptomatic infections were sought by either a combination of PCR, immunofluorescent antibody titre, and direct agglutination tests, or by whole blood stimulation assay (WBA) with interleukin-2 (IL-2) quantification.ResultsUsing the first approach, prevalence of asymptomatic individuals was 1.1% (9/804), while the second returned a value of 20.7% (143/804). Older age, being male, proximity to the park where the focus of infection was identified, and living in a detached house, were all strongly associated with the prevalence of asymptomatic infection.ConclusionsThe true number of infected individuals may be underestimated if only serological methods are used. The combination of WBA with IL-2 quantification may allow to better determine the prevalence of asymptomatic Leishmania infection, which would be useful in establishing control measures and in quantifying their impact. In our study, the use of WBA with IL-2 quantification also helped establish the risk factors that influence exposure to and infection by Leishmania.
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Affiliation(s)
- Ana Victoria Ibarra-Meneses
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Javier Nieto
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Carmen Sánchez
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Sheila Ortega
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alicia Estirado
- Department of Epidemiology, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
| | - Pello Latasa Zamalloa
- Department of Epidemiology, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
| | - Juan Carlos Sanz
- Regional Public Health Laboratory, Health Department of the Community of Madrid, Madrid, Spain
| | - Luis García-Comas
- Department of Epidemiology, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
| | - María Ordobás
- Department of Epidemiology, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
| | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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Sanz JC, Rodríguez-Avial I, Ríos E, García-Comas L, Ordobás M, Cercenado E. Increase of serotype 8, ST53 clone, as the prevalent strain of Streptococcus pneumoniae causing invasive disease in Madrid, Spain (2012-2015). Enferm Infecc Microbiol Clin 2019; 38:105-110. [PMID: 31253424 DOI: 10.1016/j.eimc.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In recent years, Streptococcus pneumoniae serotype 8 has become the most prevalent cause of invasive pneumococcal disease (IPD) in Madrid, Spain. The objective of this study was to characterize the invasive clones of S. pneumoniae serotype 8 in Madrid over the 2012-2015 period. METHODS From January 2012 to December 2015, a total of 1543 invasive isolates were studied. Serotyping was carried out by Pneumotest-Latex agglutination and Quellung reaction. Susceptibilities to penicillin, erythromycin and levofloxacin were determined by the Etest®. All serotype 8 strains were typed by multilocus sequence typing (MLST) and by pulsed-field gel electrophoresis (PFGE). RESULTS Two hundred and forty-eight (248) serotype 8 strains were detected (16.1%) and 243 of them were available for molecular typing. Nine sequence types (STs) by MLST (8-ST53, 8-ST63, 8-ST404, 8-ST1107, 8-ST989, 8-ST1110, 8-ST2231, 8-ST3544 and 8-ST4301), and nine PFGE profiles were identified (one corresponding to each ST). The 8-ST53 clone was the most widespread, and increased from 53.8% among all serotype 8 isolates in 2012, to 90.1% in 2015. In contrast, the 8-ST63 clone, resistant to levofloxacin and erythromycin, decreased from 30.8%, among all serotype 8 strains in 2012, to 5.0% in 2015. CONCLUSIONS The increase in our region of S. pneumoniae serotype 8, not included in conjugated vaccines, occurred at the expense of the 8-ST53 clone. On the contrary, the 8-ST63 clone decreased. Since clone 8-ST63 has the theoretical advantage of its levofloxacin-erythromycin resistance in comparison to 8-ST53, the predominance of 8-ST53 over 8-ST63 is striking.
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Affiliation(s)
- Juan Carlos Sanz
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Comunidad de Madrid, Centro de Especialidades Médicas Vicente Soldevilla 2ª planta, Madrid 28053, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | | | - Esther Ríos
- Servicio de Microbiología, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Luis García-Comas
- Servicio de Epidemiología, Dirección General de Salud Pública, Comunidad de Madrid, 28035, Spain
| | - María Ordobás
- Servicio de Epidemiología, Dirección General de Salud Pública, Comunidad de Madrid, 28035, Spain
| | - Emilia Cercenado
- Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain
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Latasa P, Gil de Miguel A, Barranco Ordoñez MD, Rodero Garduño I, Sanz Moreno JC, Ordobás Gavín M, Esteban Vasallo M, Garrido-Estepa M, García-Comas L. Effectiveness and impact of a single-dose vaccine against chickenpox in the community of Madrid between 2001 and 2015. Hum Vaccin Immunother 2018; 14:2274-2280. [PMID: 29771626 DOI: 10.1080/21645515.2018.1475813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND Chickenpox is a contagious airborne disease. Immunization by varicella vaccine is an effective preventive measure. The objective of this study is to evaluate the impact and effectiveness of a single-dose vaccination against chickenpox at 15 months of age. METHODS Observational study based on data from the Epidemiological Surveillance System of the Autonomous Community of Madrid from 2001 to 2015. The years were grouped into 4 periods according to epidemic cycles and vaccination schedule: 2001-06, 2007-10, 2011-13 and 2014-15. The impact was calculated as Relative Risk (RR) between the incidence of chickenpox in children between 15 months and 13 years of age between 2011-13 and 2001-06 through Poisson regression using notifications made to the Diseases of Compulsory Declaration (DCD) system, the Sentinel Physicians Network (SPN) and hospital discharge records noted as Minimum Basic Data Set (MBDS). The vaccine effectiveness (VE) was calculated using the screening method and a 1:2 case-control study paired by age and paediatrician in population from 15 months to 13 years and between 2007 and 2015 using SPN source data. RESULTS The RR2011-13/2001-06 using data from the DCD was 0.14 (95% CI: 0.14 to 0.15), 0.07 (95% CI: 0.06 to 0.08) from SPN and 0.17 (95% CI: 0.15 to 0.20) from MBDS. A total of 338 cases were included in the VE screening obtaining an overall of 76.7% (IC 95%: 71.9 to 80.7%). For a case-control study, 120 cases and 247 controls were recruited obtaining a VE of 92.4% (IC 95%: 80.8 to 97.0%). CONCLUSIONS The single-dose vaccination against chickenpox at 15 months of age has high impact and effectiveness.
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Affiliation(s)
- Pello Latasa
- a Health Department of the Community of Madrid , Subdirectorate of Epidemiology , Madrid , Spain
| | | | - Maria Dolores Barranco Ordoñez
- c Health Department of the Community of Madrid , Subdirectorate of Promotion, Prevention and Health Education , Madrid , Spain
| | | | - Juan Carlos Sanz Moreno
- d Health Department of the Community of Madrid , Regional Public Health Laboratory , Madrid , Spain
| | - María Ordobás Gavín
- a Health Department of the Community of Madrid , Subdirectorate of Epidemiology , Madrid , Spain
| | - María Esteban Vasallo
- a Health Department of the Community of Madrid , Subdirectorate of Epidemiology , Madrid , Spain
| | | | - Luis García-Comas
- a Health Department of the Community of Madrid , Subdirectorate of Epidemiology , Madrid , Spain
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Latasa Zamalloa P, Sanz Moreno JC, Ordobás Gavín M, Barranco Ordoñez MD, Insúa Marisquerena E, Gil de Miguel Á, Fernández Chávez AC, García-Comas L. Trends of invasive pneumococcal disease and its serotypes in the Autonomous Community of Madrid. Enferm Infecc Microbiol Clin 2017; 36:612-620. [PMID: 29221826 DOI: 10.1016/j.eimc.2017.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/27/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Streptococcus pneumoniae is an important cause of morbidity. Vaccination is the most effective measure to prevent it. The aim of this study is to analyse the evolution of invasive pneumococcal disease (IPD). MATERIAL AND METHODS Observational study of IPD cases notified to the Epidemiological Surveillance Network of the Autonomous Community of Madrid between 2008 and 2015. The IPD case was defined as the disease caused by Streptococcus pneumoniae, with isolation and DNA or antigen detection, in samples from normally sterile sites. The isolated strains were sent to the Regional Public Health Laboratory for identification of the serotype. Serotypes were classified according to their inclusion in the 7-valent conjugate vaccine (PCV7), in the 13-valent vaccine, but not in the 7-valent vaccine (PCV13-additional) and not included in the 13-valent vaccine (non-PCV). The Incidence Rate Ratios (IRRs) were calculated comparing the 2011-2012 and 2013-2015 periods with the 2008-2010 period. RESULTS 4,307 cases were reported. 86.6% were serotyped. The IRR of IPD was 0.67 and 0.67 for all serotypes; 0.43 and 0.45 for PCV7 serotypes; 0.46 and 0.25 for PCV13-additional serotypes, and 1.01 and 1.32 for non-PCV13 serotypes in the 2011-2012 and 2013-2015 periods. The incidence of serotypes 8, 9N, 10A, 23B, 24F and serogroup 33 increased significantly in the 2013-2015 period. Serotypes 15B and 24F accounted for 24% of non-PCV13 cases in children under 5years, serotypes 8 and 9N for 51% in the population aged 5 to 59years and serotypes 8 and 22F for 25% in the population aged over 59years. CONCLUSIONS The incidence of serotypes not included in conjugate vaccines has increased, especially in children under 5years, but the total incidence of IPD has decreased. It is important to continue with the epidemiological and microbiological surveillance programmes to assess the effect of vaccination on the incidence of IPD.
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Affiliation(s)
- Pello Latasa Zamalloa
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España.
| | - Juan Carlos Sanz Moreno
- Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
| | - María Ordobás Gavín
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
| | - María Dolores Barranco Ordoñez
- Subdirección General de Promoción, Prevención y Educación para la Salud, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
| | - Esther Insúa Marisquerena
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
| | - Ángel Gil de Miguel
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | | | - Luis García-Comas
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
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Latasa P, Ordobás M, Garrido-Estepa M, Gil de Miguel A, Sanz JC, Barranco MD, Insúa E, García-Comas L. Effectiveness of different vaccine schedules for heptavalent and 13-valent conjugate vaccines against pneumococcal disease in the Community of Madrid. Vaccine 2017; 35:5381-5387. [PMID: 28807606 DOI: 10.1016/j.vaccine.2017.07.089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/22/2017] [Accepted: 07/25/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The heptavalent pneumococcal conjugate vaccine (PCV-7) was added to the childhood routine vaccination program in the Community of Madrid in November of 2006 with 3+1 recommended doses and a catch-up for those under 2years old. In June 2010, PCV-7 was replaced by 13-valent vaccine (PCV-13) with 2+1 recommended doses. In July of 2012, the PCV-13 was removed from the funded program and reintroduced again (2+1 recommended doses) in December 2014. In between, children were vaccinated privately with 3+1 recommended doses of PCV-13. The aim of this study was to evaluate the effectiveness of each vaccination schedule used in the Community of Madrid. METHODS We included all cases of invasive pneumococcal disease (IPD) reported between 2007 and 2015 to the Notifiable Diseases Surveillance System. Vaccination information was obtained from the Immunization Registry. Vaccine effectiveness (VE) was estimated using the indirect cohort design for cases with serotype information. RESULTS A total 779 cases were included in the study. Among them 47.6% of the cases were primo-vaccinated with booster, 20% primo-vaccinated, 15.9% incompletely primo-vaccinated and 16.5% not vaccinated. The VE for ≥1 doses of any PCV was 82% (CI 95%: 67.8-89.9%): 91.9% (CI 95%: 76.5-97.2%) for PCV-7 and 77.2% (48.6-89.9%) for PCV-13. VE in those receiving the full 2+1 or 3+1 schedules was 100% for both vaccines. CONCLUSIONS A high number of vaccine failures were reported in children before they had the opportunity to receive the booster dose, especially due to PCV-13-non-PCV-7 serotypes. VE was higher for PCV-7 compared to PCV-13, except for those that received the complete schedule with booster that achieved 100% of VE, which shows the relevance of the vaccines and complying with all doses scheduled.
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Affiliation(s)
- P Latasa
- Epidemiology, Health Department of the Community of Madrid, Madrid, Spain.
| | - M Ordobás
- Epidemiology, Health Department of the Community of Madrid, Madrid, Spain
| | - M Garrido-Estepa
- Health Technology Assessment Agency, Carlos III Health Institute (ISCIII-CNE), Madrid, Spain
| | - A Gil de Miguel
- Department of Public Health, University Rey Juan Carlos, Madrid, Spain
| | - J C Sanz
- Regional Public Health Laboratory, Health Department of the Community of Madrid, Madrid, Spain
| | - M D Barranco
- Promotion, Prevention and Health Education, Health Department of the Community of Madrid, Madrid, Spain
| | - E Insúa
- Epidemiology, Health Department of the Community of Madrid, Madrid, Spain
| | - L García-Comas
- Epidemiology, Health Department of the Community of Madrid, Madrid, Spain
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Sanz JC, Ramos B, Fernández A, García-Comas L, Echevarría JE, de Ory F. Serological diagnosis of mumps: Value of the titration of specific IgG. Enferm Infecc Microbiol Clin 2017; 36:172-174. [PMID: 28126326 DOI: 10.1016/j.eimc.2016.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate a cut-off point of the titration of IgG by ELISA in the diagnosis of mumps. METHODS A study was made of serum samples from 85 mumps cases (confirmed by PCR in saliva) and 2,351 controls of the general population of the Region of Madrid. RESULTS The IgM detection was positive in 21 cases (sensitivity of 24.7%). The best cut-off point corresponded to IgG titres ≥4,900 (sensitivity of 64.7% and specificity of 86.1%). Among 42 patients immunised with at least one dose of measles mumps, rubella vaccine IgM was detected in 4 cases. However, the detection of IgG ≥4,900 was positive in 29 (sensitivity of 69.0%). CONCLUSIONS An IgG result of ≥4.900 was almost 5 times more probable in a patient with mumps than in a non-infected patient. The detection of high titres of IgG against mumps could improve the IgM results in vaccinated people.
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Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Madrid, España; Programa de Prevención, Vigilancia y control de las Enfermedades Transmisibles (PREVICET), Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | - Belén Ramos
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Madrid, España
| | - Aurora Fernández
- Laboratorio Nacional de Referencia de Parotiditis, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, España; Programa de Prevención, Vigilancia y control de las Enfermedades Transmisibles (PREVICET), Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | | | - Juan Emilio Echevarría
- Laboratorio Nacional de Referencia de Parotiditis, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, España; Programa de Prevención, Vigilancia y control de las Enfermedades Transmisibles (PREVICET), Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Fernando de Ory
- Laboratorio Nacional de Referencia de Parotiditis, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, España; Programa de Prevención, Vigilancia y control de las Enfermedades Transmisibles (PREVICET), Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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9
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García-Comas L, Ordobás Gavín M, Sanz Moreno JC, Ramos Blázquez B, Gutiérrez Rodríguez MA, Barranco Ordóñez D. Seroprevalencia de anticuerpos frente al virus de la varicela zóster tras la introducción reciente de la vacunación infantil universal en la Comunidad de Madrid. Enferm Infecc Microbiol Clin 2016; 34:633-638. [DOI: 10.1016/j.eimc.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/22/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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10
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Vera I, García-Comas L, Ordobas M, Gutierrez A, Sanz JC, Barranco D. Incidence trends in pertussis in the Autonomous Region of Madrid, Spain: 1982-2005. Euro Surveill 2007; 12:E7-8. [DOI: 10.2807/esm.12.09.00731-en] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to describe the incidence (1982-2005) and epidemiologic characteristics of pertussis cases (1998-2005) in the Autonomous Region of Madrid using data drawn from the epidemiologic surveillance network and computerised hospital discharge data. In the 1990s, the trend in the pertussis incidence in the Autonomous Region of Madrid was clearly falling. The typical seasonal pattern of pertussis remained. A peak in incidence were observed in 2000, and another peak, 2.5 times higher, in 2003. They affected all age groups, but children under one year of age were the most frequent cases, followed by the five to nine year-olds. The greatest increase was seen in the age groups from 10 to 14 and from five to nine. Since 2002, the proportion of cases diagnosed serologically has increased. The incidence of hospital discharges among small children exceeded that of reported cases. More than half of the cases with known vaccination status had received at least three doses of vaccine. The upward trend observed since 2002 could be due to improved case detection, availability of serologic techniques, and a rise in the susceptible population aged five to 14 years. The fact that epidemic peaks continue to occur and that there is a seasonality to the disease seems to indicate that despite the vaccination programme the circulation of the bacteria has not been interrupted. The introduction of the acellular vaccine in 2000 does not appear to have played a significant role in the increase in disease incidence.
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Affiliation(s)
- I Vera
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
| | - L García-Comas
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
| | - M Ordobas
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
| | - A Gutierrez
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
| | - J C Sanz
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
| | - D Barranco
- Instituto de Salud Pública de la Comunidad de Madrid (Institute of Public Health of the region of Madrid), Madrid, Spain
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11
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Pérez-Farinós N, Ordobás M, García-Fernández C, García-Comas L, Cañellas S, Rodero I, Gutiérrez-Rodríguez Á, García-Gutiérrez J, Ramírez R. Varicella and herpes zoster in Madrid, based on the Sentinel General Practitioner Network: 1997-2004. BMC Infect Dis 2007; 7:59. [PMID: 17570859 PMCID: PMC1913920 DOI: 10.1186/1471-2334-7-59] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 06/15/2007] [Indexed: 02/04/2023] Open
Abstract
Background Varicella (chickenpox) is the primary disease caused by varicella-zoster virus. It is extremely contagious and is frequent in children. Indeed, in the absence of vaccination, a high proportion of the population is liable to contract it. Herpes zoster -more frequent among adults- is caused by reactivation of the latent virus. The objective of this study is to describe the status of and time trend for varicella and herpes zoster in the Madrid Autonomous Region prior to the introduction of the vaccine to the general population. Methods Data source: individualised varicella and herpes zoster case records kept by the Madrid Autonomous Region Sentinel General Practitioner Network for the period 1997–2004. Cumulative incidences, crude and standardised incidence rates, and age-specific rates of varicella and herpes zoster were calculated for each year. Kendall's Tau-b correlation coefficient was calculated to evaluate whether incidence displayed a time trend. Spectral density in the time series of weekly incidences was estimated using a periodogram. Results Standardised annual varicella incidence rates ranged from 742.5 (95% CI: 687.2 – 797.7) to 1239.6 (95% CI: 1164.5 – 1313.4) cases per 100 000 person-years. Most cases affected children, though complications were more frequent in adults. Varicella incidence displayed an annual periodicity but no trend over time. Most herpes zoster cases occurred at advanced ages, with incidence registering a rising annual trend but no seasonality factor. Conclusion In the absence of vaccination, no significant changes in varicella incidence were in evidence recent years, though these were observed in the incidence of herpes zoster. Sentinel general practitioner networks are a valid instrument for surveillance of diseases such as varicella. Further varicella vaccination-coverage and vaccine-efficacy studies are called for.
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Affiliation(s)
- Napoleón Pérez-Farinós
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - María Ordobás
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - Cristina García-Fernández
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - Luis García-Comas
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - Soledad Cañellas
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - Inmaculada Rodero
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | | | - Juan García-Gutiérrez
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
| | - Rosa Ramírez
- Department of Epidemiology, Madrid Public Health Institute, Julián Camarillo 4B, 28037 Madrid, Spain
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12
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Abstract
Between 26 January and 16 March 2006, 59 cases of measles were notified in the Autonomous Region of Madrid, Spain
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Affiliation(s)
- L García-Comas
- Red de Vigilancia Epidemiologica de la Comunidad de Madrid (Epidemiological Surveillance Network of the Autonomous Region of Madrid), Madrid, Spain.
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13
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Ordóñez-Iriarte JM, Ferrer-Simó JB, Pelaz-Antolín C, García-Comas L. Prevalencia de Legionella en torres de refrigeración de la Comunidad de Madrid. Med Clin (Barc) 2006; 126:189-95. [PMID: 16469281 DOI: 10.1157/13084545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- José M Ordóñez-Iriarte
- Dirección General de Salud Pública y Alimentación, Consejería de Sanidad y Consumo, Comunidad de Madrid, Madrid, Spain.
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Sanz-Moreno JC, Limia-Sánchez A, García-Comas L, Mosquera-Gutiérrez MM, Echevarria-Mayo JE, Castellanos-Nadal A, de Ory-Manchón F. Detection of secondary mumps vaccine failure by means of avidity testing for specific immunoglobulin G. Vaccine 2005; 23:4921-5. [PMID: 15996797 DOI: 10.1016/j.vaccine.2005.05.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Revised: 05/18/2005] [Accepted: 05/20/2005] [Indexed: 11/29/2022]
Abstract
The aim of this study was to discriminate between primary and secondary vaccine failure in children with mumps using IgG avidity testing. Thirty-nine serum samples from children with mumps, confirmed by specific IgM, were studied. The patients were grouped according to their immunization status. The secondary immune response was defined by IgG with an avidity index >32%. A secondary response in infected children previously immunized was considered as a secondary vaccine failure. Vaccinated children presented higher IgG titers and IgG avidity than unvaccinated children. The proportion of secondary immune responses in unvaccinated patients was lower than that obtained in previously vaccinated infected patients. Avidity testing can be a useful tool to detect secondary vaccine failure in mumps.
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Affiliation(s)
- Juan Carlos Sanz-Moreno
- Laboratorio Regional de Salud Pública, Instituto de Salud Pública de la Comunidad de Madrid, C/General Oráa 15, 28006 Madrid, Spain.
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15
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Sanz JC, Fernández M, Sagües MJ, Ramírez R, García-Comas L, López-Brea M. [Age-dependent seroprevalence of Helicobacter pylori in children and adolescents in the community of Madrid]. Enferm Infecc Microbiol Clin 2000; 18:147-8. [PMID: 10905022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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González-Enríquez J, García-Comas L, Conde-Olasagasti JL. [Report on the surgery for epilepsy]. Rev Neurol 1999; 29:680-92. [PMID: 10599122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE We review the clinical indications and outcomes of surgical procedures in epilepsy which is resistant to medical treatment and the current situation and future possibilities of carrying out surgery for epilepsy in Spain. DEVELOPMENT Search of the scientific literature included in the data base MEDLINE for the period 1995-1997, retrieval of reports in relation to agencies for the evaluation of health technology of the INAHTA network and the data base of the Cochrane library. The surgery of epilepsy reduces the frequency of seizures (the basic result analyzed) in all groups of patients, although in a very variable manner, depending on the clinical situation and type of operation. The results in patients with temporal lobe epilepsy and in those with localized lesions are particularly good (temporal lobe epilepsy and lesionectomy) (67-69% without seizures), with a follow up period of one to two years. It is estimated that in Spain between 75 and 300 new cases per year would benefit from surgery. The number of patients with drug-resistant epilepsy operated on in Spain is approximately 100-150 patients per year. CONCLUSIONS Operations for epileptic syndromes, where there are surgically resectable lesions, should be justified by the gravity and impact of the disease on the psychosocial and functional development of the patient. Insufficiency resources are dedicated to the option of surgical treatment and perhaps they are also underused. These operations should be carried out in highly specialized centres, with adequate resources and an annual volume which guarantees excellence.
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Affiliation(s)
- J González-Enríquez
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, España.
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