Impact of universal two-dose vaccination on varicella epidemiology in Navarre, Spain, 2006 to 2012

In 2007 in Navarre, Spain, universal varicella vaccination with two doses of Varivax was introduced in the childhood immunisation schedule for children aged 15 months and three years. This study describes changes in the epidemiology of varicella in the period 2006 to 2012 and evaluates vaccination effectiveness using epidemiological surveillance data. The incidence of varicella in children aged 0 to 14 years decreased by 98.1%, from 50.1 cases per 1,000 inhabitants in 2006, to 1.0 per 1,000 in 2012. Children aged one to eight years were the vaccinated cohorts, and their incidence of varicella decreased by 98.5% (p<0.0001). In unvaccinated age groups, important reductions were also achieved between 2006 and 2012: 90.5% (p<0.0001) in infants under one year of age, and 89.4% (p<0.0001) in children aged nine years. In the period 2006 to 2012, the hospital admissions rate for varicella or its complications decreased by 89.0%, and in 2012, there was only one admission of a newborn with neonatal varicella. Vaccine effectiveness for at least one dose was 96.8% (95% confidence interval: 96.3-97.2%). Universal vaccination with two doses has reduced varicella circulation to minimum levels within five years and has proved highly effective.

Early estimates of influenza vaccine effectiveness in Navarre, Spain: 2012/13 mid-season analysis

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Decline in influenza vaccine effectiveness with time after vaccination, Navarre, Spain, season 2011/12

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Influenza outbreaks in nursing homes with high vaccination coverage in Navarre, Spain, 2011/12

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.

Influenza outbreaks in nursing homes with high vaccination coverage in Navarre, Spain, 2011/12

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.

Effectiveness of trivalent seasonal and monovalent influenza A(H1N1)2009 vaccines in population with major chronic conditions of Navarre, Spain: 2010/11 mid-season analysis

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A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

[Epidemiological surveillance of HIV/AIDS in Navarra]

More than fifteen years have passed since the first cases of AIDS were diagnosed in Navarra in 1985. According to the notifications received from then until December 2001, 2,400 people have been counted with HIV infection, of whom approximately 700 have developed AIDS, and 565 have died of AIDS or other causes. The incidence of new infections by HIV, cases of AIDS and deaths related to the latter, have shown a clear tendency to decline in Navarra in recent years. The decrease in cases is very important amongst the users of intravenous drugs, while the cases amongst masculine homo/bisexuals and amongst persons infected following a heterosexual encounter have remained fairly stable. For the first time, starting in 1999, persons infected through a sexual encounter are higher than the users of parenteral drugs. There has been an increase in the proportion of cases of AIDS and infection in persons originating from countries where the disease is endemic, accounting for over 23% of new cases of infection in the years 2000 and 2001. The figures for Navarra also reflect the important reduction of cases of AIDS and AIDS-related deaths since the introduction of more efficient anti-retroviral treatments in 1996. The strategies for the detection of HIV infection in persons who have maintained risk practices is important if we consider that in the years 2000 and 2001, there was a simultaneous diagnosis of infection and disease in one in every five patients. This implies that these persons did not benefit from treatments in the same way as they would have if the diagnosis had been made earlier.