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Torres I, Bellido-Blasco JB, Gimeno C, Burgos JS, Albert E, Moya-Malo R, Gascó-Laborda JC, Tornero A, Soriano J, Meseguer-Ferrer N, Martínez-Serrano M, Ortíz-Rambla J, Buj H, Hernández N, Peiró S, Salas D, Limón R, Vanaclocha H, Sánchez-Payá J, Díez-Domingo J, Comas I, González-Candelas F, Navarro D. SARS-CoV-2 Delta-variant breakthrough infections in nursing home residents at mid-term after Comirnaty® COVID-19 vaccination. J Med Virol 2022; 94:3776-3782. [PMID: 35445415 PMCID: PMC9088586 DOI: 10.1002/jmv.27799] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta variant breakthrough infections in nursing home residents following vaccination with Comirnaty® COVID‐19 vaccine were characterized. In total, 201 participants (median age, 87 years; range, 64–100; 133 female) from two nursing homes in the Valencian community (Spain) were included. SARS‐CoV‐2‐Spike (S) antibody responses were determined by a lateral flow immunocromatography (LFIC) assay and by quantitative electrochemiluminescent assay in LFIC‐negative participants. SARS‐CoV‐2‐S‐IFNγ T cells were enumerated by flow cytometry in 10 participants. Nasopharyngeal SARS‐CoV‐2 RNA loads were quantified by real‐time polymerase chain reaction assays. Vaccine breakthrough COVID‐19 due to the Delta variant occurred in 39 residents (median age, 87 years; range, 69–96; 31 female) at a median of 6.5 months after vaccination (nine requiring hospitalization). Breakthrough infections occurred at a higher rate (p < 0.0001) in residents who had not been previously infected with SARS‐CoV‐2 (naïve) (33/108; 18%) than in those with prior diagnosis of SARS‐CoV‐2 infection (experienced) (6/93; 6.4%), and were more likely (p < 0.0001) to develop in residents who tested negative by LFIC (20/49) at 3 months after vaccination as compared to their LFIC‐positive counterparts (19/142). Among LFIC‐negative residents, a trend towards lower plasma anti‐RBD antibody levels was noticed in those developing breakthrough infection (p = 0.16). SARS‐CoV‐2 RNA loads in nasopharyngeal specimens were lower in SARS‐CoV‐2‐experienced residents (p < 0.001) and in those testing positive by LFIC (p = 0.13). The frequency of SARS‐CoV‐2‐S‐reactive T cells at 3 months was similar in LFIC‐negative residents with (n = 7) or without (n = 3) breakthrough infection. Prior history of SARS‐CoV‐2 infection and detection of S‐reactive antibodies by LFIC at 3 months is associated with a lower risk of Delta‐variant breakthrough infection in nursing home residents at midterm after Comirnaty® COVID‐19 vaccination.
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Affiliation(s)
- Ignacio Torres
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Juan B Bellido-Blasco
- Sección de Epidemiología, Centro de Salud Pública de Castellón, Valencia, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Valencia, Spain.,Universitat Jaume I (UJI), Castelló, Spain
| | - Concepción Gimeno
- Microbiology Service, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Javier S Burgos
- General Directorate of Research and Healthcare Supervision, Department of Health, Valencia Government, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | | | | | - Ana Tornero
- Primary Health Directory, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Josefa Soriano
- Primary Health Directory, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | | | - María Martínez-Serrano
- Microbiology Service, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Javier Ortíz-Rambla
- Unidad de Hospitalización Domiciliaria del Departamento de Salud de la Plana, Castellón, Spain
| | - Helena Buj
- Laboratory Service, Hospital de la Plana, Vila-Real, Castellón, Spain
| | - Noelia Hernández
- Laboratory Service, Hospital de la Plana, Vila-Real, Castellón, Spain
| | - Salvador Peiró
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Dolores Salas
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain.,General Directorate of Public Health, Department of Health, Valencia Government, Valencia, Spain
| | - Ramón Limón
- General Directorate of Healthcare. Department of Health, Valencian Government, Valencia, Spain
| | - Hermelinda Vanaclocha
- General Directorate of Public Health, Department of Health, Valencia Government, Valencia, Spain
| | - José Sánchez-Payá
- Preventive Medicine Service, Alicante General and University Hospital, Alicante, Spain.,Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Javier Díez-Domingo
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Iñaki Comas
- Biomedicine Institute of Valencia, Spanish Research Council (CSIC).,CIBER in Epidemiology and Public Health, Spain
| | - Fernando González-Candelas
- CIBER in Epidemiology and Public Health, Spain.,Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Valencia, Spain.,Institute for Integrative Systems Biology (I2SysBio), CSIC-University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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Arnedo-Pena A, Puig-Barberà J, Artero-Civera A, Romeu-Garcia MA, Meseguer-Ferrer N, Fenollosa-Amposta C, Vizcaino-Batllés A, Silvestre-Silvester E, Pac-Sa MR, Segura-Navas L, Dubón MA, Fabregat-Puerto J, Bellido-Blasco JB. Atopic dermatitis incidence and risk factors in young adults in Castellon (Spain): A prospective cohort study. Allergol Immunopathol (Madr) 2020; 48:694-700. [PMID: 32402624 DOI: 10.1016/j.aller.2020.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/29/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION There are few atopic dermatitis (AD) incidence cohort studies in young adults, the etiology of this disease remains obscure, and AD risk factors in adults are not well understood. The objective of this study was to estimate AD ten-year incidence and prevalence in a cohort of adolescent aged 14-16 at inception in Castellon province in Valencia Region, Spain and describe related risk factors. MATERIAL AND METHODS From 2002 to 2012, a population-based prospective cohort study was carried out. Questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used with an additional questionnaire for related factors completed by participants and their parents, respectively, in 2002. In 2012 the same questionnaires were completed by the participants' through a telephone interview, and incidence and prevalence of AD were estimated. Directed acyclic graphs, Poisson regression and inverse probability weighted regression adjustment were used. RESULTS The participation rate was 79.5% (1435/1805) with AD lifetime prevalence of 34.9% and AD incidence of 13.5 per 1000 person years. Females presented higher prevalence and incidence than males. After adjustment significant risk factors were being female, history of asthma or allergic rhinitis, family history of AD, history of respiratory infections, history of bronchitis, history of pneumonia, history of sinusitis, and birthplace outside Castellon province. The highest AD population attributable risks were female, 30.3%, and history of respiratory infections 15.3%. Differences with AD childhood risk factors were found. CONCLUSIONS AD incidence in our cohort was high and several risks factors were related to AD.
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Affiliation(s)
- A Arnedo-Pena
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain; Department Health Sciences, Public University Navarra, Pamplona, Spain; CIBER Salud Pública Epidemiología (CIBERESP), Barcelona, Spain.
| | | | | | - M A Romeu-Garcia
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain
| | - N Meseguer-Ferrer
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain
| | | | | | | | - M R Pac-Sa
- International Health, Sanidad Exterior, Castelló de la Plana, Spain
| | | | - M A Dubón
- Public Health Center, Castelló de la Plana, Spain
| | | | - J B Bellido-Blasco
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain; CIBER Salud Pública Epidemiología (CIBERESP), Barcelona, Spain; Department Health Sciences, Universitat Jaume I, Castelló de la Plana, Spain
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3
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Arnedo-Pena A, Juan-Cerdán JV, Romeu-Garcia M, Sorribes-Segura S, Tirado-Balaguer M, Gil-Fortuño M, Garcia-Ferrer D, Sabater-Vidal S, Iborra-Millet J, Vizcaino-Batllés A, Meseguer-Ferrer N, Vivas-Fornas I, Moreno-Muñoz R, Bellido-Blasco JB. Vitamin D status and latent tuberculosis infection: conversion in nursing homes, Spain. Int J Tuberc Lung Dis 2020; 24:278-286. [PMID: 32228757 DOI: 10.5588/ijtld.19.0365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To examine the potential association between vitamin D (VitD) deficiency and latent tuberculosis infection (LTBI) and its effect on TB infection conversion (TBIC) incidence.MATERIAL AND METHODS: We carried out a cross-sectional and prospective cohort study of nine pulmonary TB cases that occurred in 2015-2016 in five nursing homes and one mental disability institution in Castellon, Spain. QuantiFERON®-TB Gold and the tuberculin skin test were used to detect LTBI and TBIC, respectively. Serum 25-hydroxyvitamin D was measured using chemiluminescence immunoassay. Poisson regression and inverse probability weighting were used for statistical analyses.RESULTS: The study included 448 residents, 341 staff members with 48 relatives of TB cases (participation rate 82%): of these, respectively 122 (27.2%), 37 (10.9%) and 7 (14.6%) were LTBI-positive; and respectively 22 (7.7%), 10 (3.8%) and 1 (3.7%) were TBIC-positive. LTBI was not associated with VitD status. Severe VitD deficiency (SVDD; defined as VitD level < 10 ng/ml), found in 45.1% of residents, as well as VitD levels of <30 ng/ml (aRR 10.41 95% CI 1.48-73.26), were associated with increased TBIC risk (adjusted relative risk [aRR] 12.1, 95% CI 1.51-97.10), suggesting SVDD as a threshold effect. CONCLUSION: Severe VitD deficiency is a TBIC risk factor.
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Affiliation(s)
- A Arnedo-Pena
- Epidemiology Division, Public Health Centre, Castelló de la Plana, Castellon, Department of Health Sciences, Public University of Navarra, Pamplona, Centro de Investigación Biomédica en Red, Epidemiology and Public Health, CIBERESP, Barcelona
| | - J V Juan-Cerdán
- Biochemical Laboratory, University Hospital General, Castelló de la Plana, Castellon
| | - M Romeu-Garcia
- Epidemiology Division, Public Health Centre, Castelló de la Plana, Castellon
| | - S Sorribes-Segura
- Medical Care, Municipal Nursing Homes, Almassora and Benicassim, Castellon
| | - M Tirado-Balaguer
- Microbiology Laboratory, University General Hospital, Castelló de la Plana, Castellon
| | - M Gil-Fortuño
- Microbiology Laboratory, University La Plana Hospital, Vila-Real, Castellon
| | - D Garcia-Ferrer
- Biochemical Laboratory, University Hospital General, Castelló de la Plana, Castellon
| | - S Sabater-Vidal
- Microbiology Laboratory, University General Hospital, Castelló de la Plana, Castellon
| | - J Iborra-Millet
- Biochemical Laboratory, University Hospital General, Castelló de la Plana, Castellon
| | - A Vizcaino-Batllés
- Epidemiology Division, Public Health Centre, Castelló de la Plana, Castellon
| | - N Meseguer-Ferrer
- Epidemiology Division, Public Health Centre, Castelló de la Plana, Castellon
| | - I Vivas-Fornas
- Primary Care, Health Centre, El Palleter, Castelló de la Plana, Castellon
| | - R Moreno-Muñoz
- Microbiology Laboratory, University General Hospital, Castelló de la Plana, Castellon
| | - J B Bellido-Blasco
- Epidemiology Division, Public Health Centre, Castelló de la Plana, Castellon, Centro de Investigación Biomédica en Red, Epidemiology and Public Health, CIBERESP, Barcelona, Department of Epidemiology, Faculty of Medicine, Jaume I University, Castelló de la Plana, Castellon, Spain
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Yagüe-Muñoz A, Arnedo-Pena A, Herrera-León S, Meseguer-Ferrer N, Vizcaíno-Batllés A, Romeu-García MÀ, Safont-Adsuara L, Bellido-Blasco JB. Descriptive epidemiology of Yersinia enterocolitica infection in a high-incidence area over an 8-year period, 2006-2013. EDICS project. Enferm Infecc Microbiol Clin 2018; 37:441-447. [PMID: 30553619 DOI: 10.1016/j.eimc.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022]
Abstract
Descriptive epidemiology of Yersinia enterocolitica infection in an area of Castellón (Spain) between 2006 and 2013 from Yersinia enterocolitica strains isolated in the area and confirmed by the Spanish national reference laboratory. There were a total of 144 cases. The estimated incidence was 9.7 cases per 105 person-year. The age group most affected was 0-4 years (rate 110.3 per 105 p-y), with a maximum in infants aged 6 to 11 months of age (190.4 per 105 p-y). The average duration of the disease was 15.5 days. 7% of the patients were hospitalised. Only 2 outbreaks of a family nature related to the consumption of pork were detected. The temporal evolution reflects higher incidence during the winter season (January). The most common exposure factor among the cases was the consumption of dried pork sausage (50% of the cases interviewed). The 58 typed strains were all of the biotype 4, serotype O:3, except one O:9. We distinguished 21 pulsotypes grouped in 8 clusters with a similarity of 97%. Over a number of years, a substitution of some pulsotypes for others was observed. Yersiniosis has a high incidence in our area, with a clear seasonality of winter predominance. It affects very young children, in particular. The strains are of the same serotype, but the variety of pulsotypes changed over time. As an exposure factor for further analytical studies, the consumption of some pork products is proposed, without ruling out other factors.
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Affiliation(s)
| | - Alberto Arnedo-Pena
- Sección Epidemiología, Centro Salud Pública, Castelló, España; CIBER-ESP grupo 41; Facultad Ciencias de la Salud, Universidad Pública Navarra, Pamplona, España
| | | | | | | | | | | | - Juan Bautista Bellido-Blasco
- Sección Epidemiología, Centro Salud Pública, Castelló, España; CIBER-ESP grupo 41; Departamento de Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), España.
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5
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Segura-Navas L, Arnedo-Pena A, Tosca-Segura R, Romeu-García MA, Meseguer-Ferrer N, Silvestre-Silvestre E, Conde F, Fernández-González S, Dubon M, Ortuño-Forcada M, Fabregat-Puerto J, Fenollosa-Amposta C, Pac-Sa MR, Museros-Recatala L, Vizcaino-Batllés A, Bellido-Blasco JB. Incidence of asthma in young adults from Castellon, Spain: A prospective cohort study. Allergol Immunopathol (Madr) 2018; 46:112-118. [PMID: 28676230 DOI: 10.1016/j.aller.2017.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND The objective was to estimate the incidence of asthma in young adults from 13-15 years old to 23-25 years old, and associated factors. METHODS In 2012, a population-based prospective cohort study was carried out in Castellon from the cohort who had participated in the International Study of Asthma and Allergy in Childhood in 1994 and 2002. A telephone survey was undertaken using the same questionnaires. A new case of asthma was defined as a participant free of the disease in 2002 who suffered asthma, was diagnosed with asthma, or took medications against asthma based on self-report from 2002 to 2012. RESULTS The mean age of participants was 24.9±0.6 with a follow-up of 79.1%. Asthma cumulative incidence was 3.4%: 44 new cases occurred among 1280 participants. The incidence was higher in females than males with relative risk (RR)=2.02 (95% confidence interval [CI] 1.1-3.8). A significant decrease of asthma incidence density was observed (8.2 cases to 3.5 cases per 1000 person/year). Factors associated with the incidence of asthma were allergic rhinitis (RR=4.05; 95% CI 1.7-9.6), bronchitis (RR=2.13; 95% CI 1.0-4.5), mother's age at time of birth (RR=0.87; 95% CI 0.8-0.9) and a pet other than a dog or cat (RR=0.42; 95% CI 0.2-0.9). For gender, some variations in the risk factors were observed. CONCLUSIONS A significant decrease in the incidence of asthma was observed. Several risk and protective factors were found.
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Affiliation(s)
| | - A Arnedo-Pena
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain; CIBER: Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
| | - R Tosca-Segura
- Service of Pediatrics, Hospital General, Castellon, Spain
| | | | | | | | - F Conde
- Public Health Centre, Castellon, Spain
| | | | - M Dubon
- Public Health Centre, Castellon, Spain
| | | | | | | | - M R Pac-Sa
- International Health, Sanidad Exterior, Castellon, Spain
| | | | | | - J B Bellido-Blasco
- Epidemiologic Division, Public Health Centre, Castellon, Spain; CIBER: Epidemiology and Public Health (CIBERESP), Barcelona, Spain
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Arnedo-Pena A, Romeu-Gracia MA, Bellido-Blasco JB, Meseguer-Ferrer N, Silvestre-Silvestre E, Conde F, Fernández-González S, Dubon MA, Ortuño-Forcada M, Fabregat-Puerto J, Fenollosa-Amposta C, Segura-Navas L, Pac-Sa MR, Museros-Recatala L, Vizcaino A, Tosca-Segura R. Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain). Allergol Immunopathol (Madr) 2017; 45:251-257. [PMID: 27863816 DOI: 10.1016/j.aller.2016.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/19/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors. METHODS A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012. RESULTS Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor. CONCLUSIONS An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender.
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Affiliation(s)
- A Arnedo-Pena
- Epidemiologic Division, Public Health Center, Castellon, Spain(1); CIBER: Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
| | | | - J B Bellido-Blasco
- Epidemiologic Division, Public Health Center, Castellon, Spain(1); CIBER: Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | - F Conde
- Public Health Center, Castellon, Spain
| | | | | | | | | | | | | | - Mª R Pac-Sa
- International Health, Sanidad Exterior, Castellon, Spain
| | | | - A Vizcaino
- Epidemiologic Division, Public Health Center, Castellon, Spain(1)
| | - R Tosca-Segura
- Service of Pediatrics, Hospital General, Castellon, Spain
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7
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Bellido-Blasco JB, Pardo-Serrano F, Ballester-Rodríguez I, Arnedo-Pena A, Tirado-Balaguer MD, Romeu-García MÁ, Silvestre-Silvestre E, Meseguer-Ferrer N, Herrero-Carot C, Caylà-Buqueres JA. An estimate of the incidence of influenza-like illness during the influenza pandemic of 2009. Arch Bronconeumol 2014; 51:373-8. [PMID: 25287416 DOI: 10.1016/j.arbres.2014.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 04/28/2014] [Revised: 07/08/2014] [Accepted: 07/31/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The influenza pandemic of 2009 had a great social impact. Many health resources were devoted to the care, prevention and surveillance of this disease. Epidemiological surveillance is based on the reporting of cases of influenza-like illness (ILI) and confirmed influenza cases. The objective was to estimate the true incidence of ILI during the influenza pandemic of 2009. METHODS The capture-recapture method was applied during the month of highest influenza incidence in Castellón. Two notification systems were used: (i)electronic reporting of Notifiable Diseases (ND), and (ii)laboratory-based (LAB) data collection. Estimates were made by stratifying by age group and week. Independence coefficients were calculated for those strata. RESULTS No dependence was found between stratification variables and the reporting system. A total of 7,181 ND cases and 524 LAB cases were identified, of which 211 were recorded in both systems. The estimated total of cases was 17,785 in a single month. In the study period, almost 4% of people in the area suffered flu symptoms (cumulative incidence), with 1% being affected each day (daily prevalence). The sensitivity of the ND system was 40%, i.e., the percentage of patients seeking primary care. CONCLUSIONS To obtain an estimate of the actual incidence of influenza-like illness in the population during a pandemic period, the number of medical consultations should be multiplied by a factor of 2.5. This factor is lower than that estimated for periods without pandemic alert.
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Affiliation(s)
- Juan B Bellido-Blasco
- Sección de Epidemiología, Centro Salud Pública de Castellón, Castellón, España; Facultad de Medicina, Universidad Cardenal Herrera - CEU, Castellón, España; CIBER de Epidemiología y Salud Pública, CIBERESP, España.
| | | | - Isabel Ballester-Rodríguez
- Sección de Epidemiología, Centro Salud Pública de Castellón, Castellón, España; CIBER de Epidemiología y Salud Pública, CIBERESP, España
| | - Alberto Arnedo-Pena
- Sección de Epidemiología, Centro Salud Pública de Castellón, Castellón, España; CIBER de Epidemiología y Salud Pública, CIBERESP, España
| | | | | | | | | | | | - Joan A Caylà-Buqueres
- Servicio de Epidemiología, Agència de Salut Pública de Barcelona - ASPB, Barcelona, España; CIBER de Epidemiología y Salud Pública, CIBERESP, España
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