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Hurtado J.C.,University of Barcelona | Mosquera M.M.,University of Barcelona | de Lazzari E.,University of Barcelona | Martinez E.,University of Barcelona | And 7 more authors.
BMC Infectious Diseases | Year: 2015

Background: Influenza virus infections are responsible for significant morbidity and mortality in both pediatric and adult populations worldwide. Rapid and accurate diagnosis of influenza is necessary for appropriate patient management during the influenza season and for optimal utilization of anti-influenza therapy. We prospectively tested the accuracy of a simple and rapid diagnostic method. Methods: Ninety-eight samples (nasal and pharyngeal swabs) from patients with upper respiratory tract infection symptoms who presented to primary healthcare centres in Barcelona (Spain) were prospectively analyzed. The samples were collected as part of influenza surveillance program. Samples that had enough volume to make the new test after aliquoting the amount needed to perform routine tests were included. None of the samples were pre-selected as a result of their status in relation to influenza virus. Samples were analyzed by in-house real-time PCR and Alere™ i Influenza A & B (Alere™ i), which uses isothermal amplification of nucleic acids for the qualitative detection of influenza A and B in nasal swabs transported in viral transport media. The two techniques were compared by positive percent agreement (PPA) and negative percent agreement (NPA). Statistical analysis was performed with Stata. Results: Of the 98 samples analysed 90 were concordant; 46 (46.9%) were positive and 44 (44.9%) were negative. Five samples showed invalid results with the Alere™ i test and could be not re-tested due to insufficient sample volume and were not included in the final statistical analysis. In the 93 remaining samples, the Alere™ i test showed 97% of accuracy having correctly classified 90 samples. We obtained discordant results in 3 samples (3%). The PPA was 93.8% for influenza A and 94.1% for influenza B, and NPA was 100% for influenza A and influenza B virus. In addition, the Alere™ i was very rapid (15 minutes or less) and extremely easy to use. Conclusions: The Alere™ i test provided a good correlation compared to the real-time PCR test for the diagnosis of influenza. Since this method can be performed in minutes, it allows immediate, accurate clinical decisions to prescribe appropriate antiviral treatment or isolation of patients. © Hurtado et al. Source

Plans-Rubio P.,Public Health Agency of Catalonia | Plans-Rubio P.,CIBER ISCIII
Expert Review of Anti-Infective Therapy | Year: 2014

Elimination of measles and rubella in Europe is a feasible objective, but it requires achieving a maintaining a high prevalence of protected individuals in order to prevent cases and outbreaks from imported cases. The epidemiology of measles and rubella in Europe in the period 2003-2013 suggests that we are far away from the elimination target for measles, while the situation is better for rubella. In this situation, a new preventive strategy based on serological surveillance systems should be developed in Europe in order to identify and immunise individuals in population groups without sufficient herd immunity against measles and rubella. © 2014 Informa UK, Ltd.. Source

Torner N.,Public Health Agency of Catalonia | Torner N.,CIBER ISCIII | Torner N.,University of Barcelona | Solano R.,CIBER ISCIII | And 5 more authors.
Human Vaccines and Immunotherapeutics | Year: 2015

Healthcare personnel (HCP) play an important role in transmission of highly contagious diseases such as measles. Current immunization guidelines in Catalonia include Measles-Mumps-Rubella (MMR) immunization for HCP born after 1967 without evidence of immunity. Despite high vaccination coverage (90%) a high burden of measles cases related to outbreaks have occurred. The aim of this study was to assess the implication of HCP in measles transmission related to healthcare setting. A review of surveillance case data from 2001 to 2013 gathered through the Measles Elimination Program in Catalonia was performed. Twenty six outbreaks involving 797 cases were reported, 52 (6.5%) were HCP aged 21-41 years, 72,5% (38) patient were care personnel (doctors and nurses) and 22,5% (14) other health care related personnel. Forty six 87%) were unvaccinated, 4(10%) had only one dose and 2 had two doses of MMR. In community outbreaks 30 clusters with HCP involved were observed, yet none were identified as index cases. Non-vaccinated HCPs against measles were all under 45 years of age. Vaccination is the only reliable protection against nosocomial spread of measles from HCPs. Assessing vaccination status of HCPs and implementing a 2 dose vaccination in those lacking evidence of immunity is needed in order to set to zero the risk of acquiring and spreading measles in healthcare (HC) settings. © 2015 Landes Bioscience. Source

Fuentes C.,University of Barcelona | Guix S.,University of Barcelona | Perez-Rodriguez F.J.,University of Barcelona | Fuster N.,University of Barcelona | And 3 more authors.
Food Microbiology | Year: 2014

A quadruplex Real-Time RT-PCR assay for the simultaneous quantitative detection of hepatitis A virus (HAV), norovirus (NoV) GI and GII, and mengovirus (used as process control for determination of the virus/nucleic acid extraction efficiency) has been developed. This multiplex assay has been comparatively evaluated with the individual monoplex assays and showed to be slightly less sensitive, with average δCq values of 0.90, 0.28 and 0.44 for HAV, NoV GI and NoV GII, respectively, in standard curves of viral RNA, or 0.32, 0.37 and 0.51 for the same viruses respectively, in naturally-contaminated samples. These δCq values were mostly negligible since it represented, in the worst case scenario, a loss of 0.43 log in genome copy numbers.The quadruplex assay shows similar theoretical detection limits than the monoplex assay for NoV GII, and 10 times higher for HAV and NoV GI. However, when naturally-contaminated food and water samples were tested, these theoretical detection thresholds were often exceeded and very low genome copy numbers (below the limit of detection) could be quantified.The quadruplex assay fulfills the requirements of the method developed by the European Committee on Standardization (CEN) for virus detection in selected foodstuffs with significant advantages in labor and reagent costs. © 2013. Source

Ballbe M.,Institute Catala dOncologia | Ballbe M.,A+ Network | Ballbe M.,Institute Dinvestigacio Biomedica Of Bellvitge Idibell | Ballbe M.,Institute of Neurosciences | And 14 more authors.
International Journal of Epidemiology | Year: 2013

Background Second-hand smoke is associated with adverse health effects. Many countries have extended smoke-free policies to public buildings and workplaces such as hospitals, but mental health units have usually been exempted from complete smoke-free bans. The objective of this study was to evaluate second-hand smoke levels in mental health units with different types of smoking bans. Method We conducted a cross-sectional study to evaluate second-hand smoke in 64 mental health inpatient units (95.5% of the all such units) inCatalonia, Spain. We measured air concentrations of particulate matter <2.5 mm (PM2.5) asa marker of second-hand smoke in different locations at each unit. Results Thegeometric mean (95% confidence interval) of the PM2.5 concentration was 8.81 mg/m3 (8.06-9.56) in units with indoor and outdoor smoking bans, 13.80 mg/m3 (13.23-14.36)in units with indoorsmoking bans that allowed smoking in outdoor areas, 24.29 mg/m3 (23.50-25.03) in units with indoor smoking rooms and 51.00 mg/m3 (49.83-52.04) in units that allowed smoking in common indoor areas (P<0.05). The regression model adjusted for confounding variables showed a linear increase of PM2.5. The PM2.5 concentration in smoking rooms was 286.50 mg/m3 (283.95-288.89). Conclusions Only units with indoor and outdoor smoking bans had PM2.5 levels below the standard recommended WHO levels of 10 mg/m3. Units withmore permissive smoking policies had PM2.5 levels from second-hand smoke that have harmful health effects©The Author 2013; all rights reserved. Source

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