[First record of Aedes albopictus in Galicia, obtained by citizen science through Mosquito Alert]

The first detection of the tiger mosquito, Aedes (Stegomyia) albopictus (Skuse, 1894), in the autonomous community of Galicia (Spain) is reported. The finding has been possible thanks to the collaboration between citizens, the citizen science application Mosquito Alert and the Rede Galega de Vixilancia de Vectores (ReGaViVec). At the beginning of August 2023, a same person submitted through the app several reports consistent with the tiger mosquito in the municipality of Moaña, in Pontevedra. The ReGaViVec entomological team confirmed the species and conducted vector surveillance in the area by placing traps (11 ovitraps and 3 BG-Sentinel 2 with BG-Lure attractant) with a weekly collection frequency. This finding represents the most northwestern detection of the tiger mosquito in the Iberian Peninsula and shows the crucial role of citizen science in vector surveillance.

[Biomedical research and innovation and COVID-19 syndemic. SESPAS Report 2022]

Objetivo

Describir críticamente la respuesta en investigación e innovación (I + I) contra la sindemia por COVID-19 en el ámbito nacional, contextualizada internacionalmente.

Método

Revisión narrativa dirigida.

Resultados

En la sindemia por COVID-19 se ha pasado la presión a la comunidad científica en general, e innovadora biomédica en particular, para aportar soluciones sobre todo de productos biotecnológicos. La mayoría de las recomendaciones de paneles expertos no van orientadas a una respuesta biotecnológica (que también debe existir), sino de gobernanza, organizativa, socioeconómica y de apoyo a las infraestructuras de salud pública. Existe un déficit importante en la inclusión de la perspectiva de género en la I + I por COVID-19. La sindemia ha ofrecido una oportunidad (desaprovechada) para potenciar la I + I desde la perspectiva epidemiológica contra brotes infecciosos con potencial de provocar crisis en salud pública reivindicando el liderazgo desde la epidemiología. Hace falta evaluar si la gran inversión en I + I biomédica orientada a la medicina personalizada puede integrarse eficientemente en los proveedores públicos de salud ante crisis sanitarias.

Conclusiones

Es urgente diseñar una estrategia de I + I en España en línea con los fondos disponibles internacionalmente y que se beneficie de ellos, pero que provea al país del máximo de independencia de cara a afrontar situaciones críticas para la salud pública.

[Lessons learnt from COVID-19 surveillance. Urgent need for a new public health surveillance. SESPAS Report 2022]

Este artículo recoge los aspectos epidemiológicos más destacados en las primeras fases de la pandemia y unas primeras reflexiones desde una unidad, el Centro de Coordinación de Alertas y Emergencias Sanitarias, que ha coordinado la vigilancia en el ámbito nacional. La COVID-19 ha puesto de manifiesto las carencias de la vigilancia y la dificultad para gestionar una crisis sanitaria sin un modelo robusto de salud pública. El compromiso de los profesionales durante la epidemia ha suplido en muchas ocasiones la falta de recursos y se ha evidenciado la necesidad de incorporar nuevas profesiones a los equipos de vigilancia. Es urgente contar con herramientas para automatizar los procesos y realizar una recogida oportuna de información. Para ello, la salud pública y la vigilancia deben participar en el proceso de desarrollo digital del Sistema Nacional de Salud. Es importante también reforzar la capacidad de análisis promoviendo alianzas y acciones conjuntas. La necesidad de adaptación rápida ha supuesto una mejora en los sistemas existentes y el desarrollo de nuevas herramientas, que deben convertirse en cambios estructurales que mejoren la calidad de la vigilancia, disminuyendo brechas territoriales y asegurando una respuesta coordinada ante futuras crisis. Son necesarios cambios profundos en la vigilancia en salud pública, que debe estar integrada en todos los niveles asistenciales. Se ha visto también durante esta alerta la importancia de la coordinación en materia de salud pública en un Estado descentralizado, en especial cuando nos enfrentamos a situaciones de crisis. En el contexto internacional es preciso revisar las herramientas para compartir datos desde etapas tempranas en una alerta.

[Deaths by COVID-19: Not all were registered and others should not be accounted for]

The death counts from COVID-19 have generated public controversy. The regional health councils' need for information regardind the cases, has generated a variety of formats and procedures, used to report this information. Consecuently, this data has not always been communicated in a comparable maner to the Ministry of Health. The compilation of mortality statistics is complex. Central and autonomous public administrations are involved, and not in the same way. The medical death certificate (DC) is the main source of information that allows to specify place of occurrence and causes of death. The on-line registration of the DC in the computerized civil registry and/or digital medical records, would allow to establish a statistical processing circuit, and to obtain a death count more quickly according to causes of death in the event of a health emergency. This requires a multi-level institutional agreement for a total telematics statistic process of death causes in Spain.

Impact of the MMR vaccine on the incidence of mumps in the Community of Madrid and evaluation of the effectiveness of the Jeryl-Lynn strain. Years 1998-2016

INTRODUCTION

Mumps is characterised by parotid inflammation and fever and is preventable by vaccination with MMR vaccine. The objective of the study is to assess the impact and effectiveness of the vaccine.

MATERIAL AND METHODS

Cases notified to the Notifiable Disease System between 1998 and 2016 were used for the study. The vaccine effectiveness (VE) was calculated in cohorts vaccinated with two doses of Jeryl-Lynn, and the impact was calculated by comparing incidences by age and by Rubini (1995-1998) and Jeryl-Lynn (1999-2002) cohorts during the periods 1998-2004, 2005-2009 and 2010-2015. The incidences for age group and period were compared with the previous period and the incidences for cohorts were compared within a period with incidence ratios (IR) using Poisson models. The VE was estimated using the screening method using logistic regression models.

RESULTS

13,816 cases were reported. The incidence in 2005-2009 was higher than in 1998-2004 (IR: 1.46, 95% CI: 1.40-1.53), and it remained stable in 2010-2015 (IR: 0.99, 95% CI: 0.95-1.03). The average incidence rate of the Rubini cohort was 69.43 and the Jeryl-Lynn cohort was 32.24. The IR was 0.25 (95% CI: 0.22-0.29), 0.55 (95% CI: 0.49-0.61) and 0.88 (95% CI: 0.76-1.00) for each period respectively. 2,574 cases were included in the VE study. EV decreased over time reaching not significant values after seven years of follow-up (VE: 55%, 95% CI: 82 to -12%).

CONCLUSIONS

Parotiditis behavior is characterised by fluctuations, changes in presentation and a decrease in VE.

[Monitoring social determinants of health]

Public health surveillance is the systematic and continuous collection, analysis, dissemination and interpretation of health-related data for planning, implementation and evaluation of public health initiatives. Apart from the health system, social determinants of health include the circumstances in which people are born, grow up, live, work and age, and they go a long way to explaining health inequalities. A surveillance system of the social determinants of health requires a comprehensive and social overview of health. This paper analyses the importance of monitoring social determinants of health and health inequalities, and describes some relevant aspects concerning the implementation of surveillance during the data collection, compilation and analysis phases, as well as dissemination of information and evaluation of the surveillance system. It is important to have indicators from sources designed for this purpose, such as continuous records or periodic surveys, explicitly describing its limitations and strengths. The results should be published periodically in a communicative format that both enhances the public's ability to understand the problems that affect them, whilst at the same time empowering the population, with the ultimate goal of guiding health-related initiatives at different levels of intervention.

[Contextual indicators to assess social determinants of health and the Spanish economic recession]

OBJECTIVE

To provide indicators to assess the impact on health, its social determinants and health inequalities from a social context and the recent economic recession in Spain and its autonomous regions.

METHODS

Based on the Spanish conceptual framework for determinants of social inequalities in health, we identified indicators sequentially from key documents, Web of Science, and organisations with official statistics. The information collected resulted in a large directory of indicators which was reviewed by an expert panel. We then selected a set of these indicators according to geographical (availability of data according to autonomous regions) and temporal (from at least 2006 to 2012) criteria.

RESULTS

We identified 203 contextual indicators related to social determinants of health and selected 96 (47%) based on the above criteria; 16% of the identified indicators did not satisfy the geographical criteria and 35% did not satisfy the temporal criteria. At least 80% of the indicators related to dependence and healthcare services were excluded. The final selection of indicators covered all areas for social determinants of health, and 62% of these were not available on the Internet. Around 40% of the indicators were extracted from sources related to the Spanish Statistics Institute.

CONCLUSIONS

We have provided an extensive directory of contextual indicators on social determinants of health and a database to facilitate assessment of the impact of the economic recession on health and health inequalities in Spain and its autonomous regions.

[Excess mortality associated with influenza in Spain in winter 2012]

OBJECTIVE

An excess of mortality was detected in Spain in February and March 2012 by the Spanish daily mortality surveillance system and the «European monitoring of excess mortality for public health action» program. The objective of this article was to determine whether this excess could be attributed to influenza in this period.

METHODS

Excess mortality from all causes from 2006 to 2012 were studied using time series in the Spanish daily mortality surveillance system, and Poisson regression in the European mortality surveillance system, as well as the FluMOMO model, which estimates the mortality attributable to influenza. Excess mortality due to influenza and pneumonia attributable to influenza were studied by a modification of the Serfling model. To detect the periods of excess, we compared observed and expected mortality.

RESULTS

In February and March 2012, both the Spanish daily mortality surveillance system and the European mortality surveillance system detected a mortality excess of 8,110 and 10,872 deaths (mortality ratio (MR): 1.22 (95% CI:1.21-1.23) and 1.32 (95% CI: 1.29-1.31), respectively). In the 2011-12 season, the FluMOMO model identified the maximum percentage (97%) of deaths attributable to influenza in people older than 64 years with respect to the mortality total associated with influenza (13,822 deaths). The rate of excess mortality due to influenza and pneumonia and respiratory causes in people older than 64 years, obtained by the Serfling model, also reached a peak in the 2011-2012 season: 18.07 and 77.20, deaths per 100,000 inhabitants, respectively.

CONCLUSION

A significant increase in mortality in elderly people in Spain was detected by the Spanish daily mortality surveillance system and by the European mortality surveillance system in the winter of 2012, coinciding with a late influenza season, with a predominance of the A(H3N2) virus, and a cold wave in Spain. This study suggests that influenza could have been one of the main factors contributing to the mortality excess observed in the winter of 2012 in Spain.

[New design of the Health Survey of Catalonia (Spain, 2010-2014): a step forward in health planning and evaluation]

This article presents the genesis of the Health Survey of Catalonia (Spain, 2010-2014) with its semiannual subsamples and explains the basic characteristics of its multistage sampling design. In comparison with previous surveys, the organizational advantages of this new statistical operation include rapid data availability and the ability to continuously monitor the population. The main benefits are timeliness in the production of indicators and the possibility of introducing new topics through the supplemental questionnaire as a function of needs. Limitations consist of the complexity of the sample design and the lack of longitudinal follow-up of the sample. Suitable sampling weights for each specific subsample are necessary for any statistical analysis of micro-data. Accuracy in the analysis of territorial disaggregation or population subgroups increases if annual samples are accumulated.