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Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Cia F.,Red de Medicos Centinela de Gripe de Navarra | Zubicoa J.,Red de Medicos Centinela de Gripe de Navarra | And 3 more authors.
Eurosurveillance | Year: 2012

In the 2011/12 season, three influenza outbreaks were studied in nursing homes with high vaccination coverage in Navarre, Spain. Attack rates ranged from 2.9% to 67%. Influenza A/Stockholm/18/2011(H3N2) virus strain was isolated from the three outbreaks. Vaccination should be complemented with other hygiene measures in nursing homes. Early detection of influenza outbreaks in nursing homes can aid in their control. ©2007-2011. All rights reserved. Source


Sanchez S.,Institute Salud Carlos III | Cenoz M.G.,Institute Salud Publica Of Navarra | Martin C.,Complejo Hospitalario de Navarra | Beristain X.,Complejo Hospitalario de Navarra | And 2 more authors.
Epidemiology and Infection | Year: 2014

SUMMARY A Spanish household was identified through a Public Health follow up on a Shiga toxin-producing Escherichia coli (STEC)-positive 14-month-old girl reporting bloody diarrhoea, with the four household members experiencing either symptomatic or asymptomatic STEC and/or atypical enteropathogenic E. coli (aEPEC) shedding. In total, two different O76:H19 STEC strains and six aEPEC strains belonging to multiple serotypes were isolated and characterized in the household during a 5-month period. Prolonged asymptomatic shedding of O76:H19 STEC and O51:H49 aEPEC was detected in two family members. Although there was no conclusive evidence, consumption of vegetables fertilized with sheep manure was the suspected source of infection. This study highlights the risk of cross-infections posed by prolonged asymptomatic carriage and close household contact between family members, and illustrates the importance of molecular epidemiology in understanding disease clusters. © Cambridge University Press 2013. Source


Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII
Anales del Sistema Sanitario de Navarra | Year: 2013

Background. To assess the risk of herpes zoster in people with diabetes mellitus in comparison with the general population. Methods. Using computerized clinical reports form primary health care in Navarre, Spain, we analyzed the incidence of herpes zoster in people aged over 30 years in 2006 by diagnosis of diabetes, and adjusting for age and sex. Results. Among 26,793 diabetes patients 409 cases of herpes zoster were diagnosed (15 per 1000). Nineteen point three percent of cases occurred in diabetes patients. Diabetes presented an adjusted relative risk of 2.1 (95% CI 1.9-2.4), and increased to 3.7 (95% CI 2.0-6.8) in the 30-44 year age group. Of the total number of cases of herpes zoster in the population, 7.2% were attributable to diabetes. Conclusion. Diabetes increases the risk of, and has a relevant role in, the incidence of herpes zoster. Source


De Angelis R.,Centro Nazionale Of Epidemiologia | Sant M.,Analytical Epidemiology and Health Impact Unit | Coleman M.P.,London School of Hygiene and Tropical Medicine | Francisci S.,Centro Nazionale Of Epidemiologia | And 12 more authors.
The Lancet Oncology | Year: 2014

Background: Cancer survival is a key measure of the effectiveness of health-care systems. EUROCARE-the largest cooperative study of population-based cancer survival in Europe-has shown persistent differences between countries for cancer survival, although in general, cancer survival is improving. Major changes in cancer diagnosis, treatment, and rehabilitation occurred in the early 2000s. EUROCARE-5 assesses their effect on cancer survival in 29 European countries. Methods: In this retrospective observational study, we analysed data from 107 cancer registries for more than 10 million patients with cancer diagnosed up to 2007 and followed up to 2008. Uniform quality control procedures were applied to all datasets. For patients diagnosed 2000-07, we calculated 5-year relative survival for 46 cancers weighted by age and country. We also calculated country-specific and age-specific survival for ten common cancers, together with survival differences between time periods (for 1999-2001, 2002-04, and 2005-07). Findings: 5-year relative survival generally increased steadily over time for all European regions. The largest increases from 1999-2001 to 2005-07 were for prostate cancer (73·4% [95% CI 72·9-73·9] vs 81·7% [81·3-82·1]), non-Hodgkin lymphoma (53·8% [53·3-54·4] vs 60·4% [60·0-60·9]), and rectal cancer (52·1% [51·6-52·6] vs 57·6% [57·1-58·1]). Survival in eastern Europe was generally low and below the European mean, particularly for cancers with good or intermediate prognosis. Survival was highest for northern, central, and southern Europe. Survival in the UK and Ireland was intermediate for rectal cancer, breast cancer, prostate cancer, skin melanoma, and non-Hodgkin lymphoma, but low for kidney, stomach, ovarian, colon, and lung cancers. Survival for lung cancer in the UK and Ireland was much lower than for other regions for all periods, although results for lung cancer in some regions (central and eastern Europe) might be affected by overestimation. Survival usually decreased with age, although to different degrees depending on region and cancer type. Interpretation: The major advances in cancer management that occurred up to 2007 seem to have resulted in improved survival in Europe. Likely explanations of differences in survival between countries include: differences in stage at diagnosis and accessibility to good care, different diagnostic intensity and screening approaches, and differences in cancer biology. Variations in socioeconomic, lifestyle, and general health between populations might also have a role. Further studies are needed to fully interpret these findings and how to remedy disparities. Funding: Italian Ministry of Health, European Commission, Compagnia di San Paolo Foundation, Cariplo Foundation. © 2014 Elsevier Ltd. Source


Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Martinez-Baz I.,Institute Salud Publica Of Navarra | Martinez-Baz I.,CIBER ISCIII | And 10 more authors.
Eurosurveillance | Year: 2014

We estimate mid-2013/14 season vaccine effectiveness (VE) of the influenza trivalent vaccine in Navarre, Spain. Influenza-like illness cases attended in hospital (n=431) and primary healthcare (n=344) were included. The overall adjusted VE in preventing laboratory-confirmed influenza was 24% (95% CI: -14 to 50). The VE was 40% (95% CI: -12 to 68) against influenza A(H1)pdm09 and 13% (95% CI: -36 to 45) against influenza A(H3). These results suggest a moderate preventive effect against influenza A(H1)pdm09 and low protection against influenza A(H3). Source

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