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H Pañella

Publications and source records attributed to H Pañella.

10 recordsLinked to original sources
PubMed2003

Meningococcal disease in catalonia 1 year after mass vaccination campaign with meningococcal group C polysaccharide vaccine.

BACKGROUND: The aim of this study was to investigate the clinical and epidemiological characteristics of meningococcal disease in Catalonia (Spain) after vaccination with the polysaccharide vaccine. PATIENTS AND METHODS: Cases were collected by the Statutory Diseases Reporting System. RESULTS: 176 cases were reported, an overall incidence of 2.9/100,000 persons/year. 60% of cases occurred during winter and spring. The case fatality rate was 6.3%. The highest age incidence was in children under 2 years of age (48/100,000 persons/year). Comparison of the cases detected by the Statutory Diseases Reporting System with those obtained by the Microbiological Reporting System shows that meningococcal disease surveillance in Catalonia was relatively complete (95.7%), with a positive predictive value of 66.3%. 115 cases (65%) were culture-confirmed with a rate of 1.9/100,000 persons/year. 86 (75%) cases were due to Neisseria meningitidis serogroup B and 21 to serogroup C (18%). CONCLUSION: Although infections due to serogroup C have decreased after mass vaccination with the polysaccharide vaccine, it is likely that the number of infections will decrease further with the conjugate meningococcal group C vaccine.

Adolescent↗
PubMed2001

Carriers of Neisseria meningitidis in household contacts of meningococcal disease cases in Catalonia (Spain).

A population-based study was carried out in Catalonia (Spain) from May 1998 to April 1999 to determine the prevalence of Neisseria meningitidis strains in meningococcal disease (MD) cases and their contacts, as well as the prevalence of meningococci in close contacts of patients with MD, and risk factors for its carriage. A total of 364 close contacts of 87 patients with MD were studied. Throat samples were collected by hospital staff before rifampicin chemoprophylaxis was begun. For each contact, a questionnaire was completed for sociodemographic and epidemiological data. A total of 61 contacts (an overall prevalence of 16.8%) were carriers of meningococcal strains (40 B, 10 C, 1 Z and 10 non-groupable isolates). This prevalence is two to three times higher than in the general population (5-10%). In 33/61 microbiologically confirmed cases (54%) and in 9/26 probable cases (35%), contacts carrying N. meningitidis were found. In 22/33 confirmed cases with carrier contacts, it was possible to study the phenotype of the carrier and patient strains (sero-group, serotype and serosubtype). In 14 cases (64%), both strains were identical, in four cases, only a minor change was observed, in three cases, some strain (from the case or from his contact) was non-serotypable and non-serosubtypable, and in one case, both isolates were completely different. Bivariate analysis identified five statistically significant risk factors for meningococcal carriage: age (5-9 years old), meningococcal A+C vaccination, severe household overcrowding, social class and heavy active smoking (>20 cigarettes a day). Multivariate analysis revealed that of these five variables, only heavy active smoking remained statistically significant when the other factors were controlled.

Adolescent↗
PubMed2000

[Hysteria epidemics, epidemic conversion disorder or epidemic somatotrophic disorders?: a new case of a fact for the 21st century].

OBJECTIVES: To describe a new outbreak of "mass hysteria" or "epidemic conversion disorder" occurring in Barcelona in 1997. Based on this outbreak's features differentiating it from other similar outbreaks described in the literature or treated by the same team, to propose a change in the theoretical framework for these group somatomorphic phenomena. DESIGN: A study describing clinical epidemiological research and the interventions performed. SETTING: Urban health centre. Epidemiological research and data analysis performed by the Municipal Health Institute (MHI) of Barcelona. INTERVENTIONS AND MEASUREMENTS: The following were performed: a) Diagnostic screening of population. b) The usual epidemiological surveys of the MHI. c) Semi-structured interviews with the quarter's care professionals. d) Two group sessions with the quarter's health professionals. MHI experts analysed statistically the data provided by measurements b) and c). RESULTS: 276 people (42% of the population of the quarter) were studied. The attack rate was 10%. Data analysis noted that communication of the fantasy of the outbreak of scabies facilitated self-diagnosis and even diagnosis by health professionals. CONCLUSIONS: Given the frequency and the social and health implications of this kind of somatomorphic disorder, both in the developed countries and those "on the road to development", clinical researchers and epidemiologists should not wait to pose the possibility of hysteria until after the "organic" aetiology of an epidemic outbreak has been completely discounted. The second series of conclusions points towards the incorrectness of defining all these outbreaks as mass hysterical disorders. In reality, we should be thinking, more openly and in a more scientifically modern way, of epidemic somatomorphic disorders of various kinds. The outbreak described in the current study could be referred to as the hypochondriform variety of outbreak, whereas those described elsewhere by the same team could be understood as the conversion variety.

Adolescent↗
PubMed1999

[Haemophilus influenzae type b invasive disease and meningococcal disease: incidence and characteristics in Barcelona, 1994-1995. Work Group IMS-IUSPC for Surveillance and Control of Meningitis].

BACKGROUND: The purpose of the study is to estimate the incidence of Haemophilus influenzae type b invasive disease (HibID) and meningococcal disease (MD) in Barcelona (Catalonia, Spain) for the years 1994-1995. MATERIAL AND METHODS: Data were obtained from the nominal registry of the surveillance system for reportable transmissible diseases of the Barcelona City Health Department, combining the reporting system with active surveillance, including microbiological reports and the review of hospital discharge registries to ensure completeness. RESULTS: During this two-years period there were 17 cases of HibID (12 meningitis), and for 12 cases there was a laboratory confirmation. The annual incidence rate can be estimated at 15.4 cases of HibID for 100,000 children below 5 years of age, and 4.5 cases for 100,000 children below 15 years. The annual incidence rates for Hib meningitis were 3.2 for 100,000 below 15 years. There were 60 cases of MD, and for 33 there was a laboratory confirmation, with a majority of serogroup B. The annual incidence rate of MD can be estimated at 32.6 cases for 100,000 below 5 years and 16 cases for 100,000 below 15 years. The incidence rate of meningococcal meningitis is at least 5.9 cases for 100,000 below 15 years of age. CONCLUSIONS: These results confirm the relatively low incidence of Hib meningitis in Barcelona, Spain, while the Hib vaccine was not in systematic use, much lower than the incidence of MD. The incidence rates are similar to all other population-based studies in Spain, except for the Basque Country study.

Adolescent↗
PubMed1998

[Tuberculosis trends in Barcelona (1987-1995). Impact of the human immunodeficiency virus and control measures].

BACKGROUND: To study the epidemiology to tuberculosis (TB) in Barcelona, Spain from 1987 to 1995, analyzing the influence of HIV infection and the impact of control measures. PATIENTS, MATERIAL AND METHODS: All cases detected by the Barcelona Tuberculosis Prevention and Control Program were included in the study of the evolution of TB incidence according to different variables. The impact of HIV infection was analyzed through the attributable risk per cent (AR), and control measures through the evolution of the rate of treatment compliance, contact studies, and diagnostic delay. RESULTS: We detected 8,942 patients, 23.2% of whom were found through the active epidemiological surveillance system, representing an average annual incidence of 60.4/100,000. The incidence peaked in 1991 (68.7/100,000) and slowly declined to 55.7/100,000 in 1995. Men showed higher incidence (RR: 2.74; CI 95%: 2.62-2.87), particularly among the young (25-34 years olds), 53.3% of whom were HIV (+). The AR for HIV was 92.7%. In this period there was an increase in TB HIV (+), IVDU, and prisoners. Treatment compliance (80.8% in 1987 to 93.8% in 1995) and contact studies (3.2 studies/case in 1995) evolved favorably, unlike but diagnostic delay (35 days in 1995) did not. CONCLUSIONS: The Active Epidemiological Surveillance System has affored us a clear view of the actual situation regarding TB in Barcelona, Spain. Despite the HIV epidemics and the high number of IVDU, the evolution of TB has shown a steady decline due to improvement in control measures.

Adolescent↗
PubMedDate not supplied

[An evaluation of the epidemiological surveillance system for infectious diseases in the Barcelona Olympic Games of 1992].

Due to the 1992 Barcelona Olympic Games some modifications were introduced in the epidemiologic surveillance system for infectious diseases in place in the city, in order to expand its coverage and shorten its timeliness in detecting outbreaks and investigating cases. These modifications were introduced for a group conditions (hepatitis, meningococcal disease, legionnaire's disease and food outbreaks), selected on the basis of incidence, time of the year, previous experience in other settings, and likelihood of outbreak occurrence. In the June-August 1992 period (Olympic period), no increases in the incidence of selected conditions were observed when compared to the same period in 1986 to 1991. Major changes were observed in the source of food outbreak reporting, with a large increase in outbreaks reported by emergency room departments. There was an increase in the number of domestic foodborne outbreaks and a reduction in those related with restaurants. Timeliness in the detection of cases was shortened. The use of similar modifications can be useful for epidemiologic surveillance systems in other comparable settings or occasions.

Communicable Diseases↗
PubMedDate not supplied

[Epidemic outbreak of hepatitis A related to a day care center].

The aim of this study was to describe an outbreak of hepatitis A in a family group which extended to a day care center and to the families of the children attending the same and to determine the risk of acquiring the disease based on exposure to one or several sources of infection. The temporary distribution of the cases and the rate of hepatitis A in the population at risk were analyzed. The risk of acquiring hepatitis by exposure to one or more sources of infection was studied by logistic regression, calculating the odds ratio and the confidence interval of 95%. Initiation of the outbreak was in May 1996, in a 25-year-old male and finalized in November, having affected 63 people. The rate of global attack was of 12% and the risk of infection 18-fold greater (CI 95% = 5.4-61.8) in those exposed to more than one source of infection than in those exposed to only one source and 3.5-fold greater (CI 95% = 1.2-9.9) in the group from 15 to 29 years of age than in those under 14. The massive administration of immunoglobulin was useful to control the hepatitis in the day care center and in the school. The size of this epidemic of hepatitis A was due to its occurrence in a population little exposed to the virus. The greatest involvement was observed in young adults, with person to person transmission and the greater risk of acquiring hepatitis A on exposure to several sources of infection characterizing the outbreak. The possible usefulness of designing prevention strategies with the vaccine should be considered.

Adolescent↗