A mortality study of the last outbreak of yellow fever in Barcelona City (Spain) in 1870
Estudio de la mortalidad del último brote de fiebre amarilla en la ciudad de Barcelona (España) en 1870
Jaume Canela Solera,
,b, Maria Rosa Pallarés Fustéc, Rafael Abós Herràndizd, Carme Nebot Adellb,d, Robert S. Lawrencee
a Department of Public Health, Universitat de Barcelona, Barcelona, Spain
b Pan American Health Organization, Washington DC, USA
c Institut Municipal d’Assistència Sanitària, Spain
d Catalan Institute of Health, Generalitat de Catalunya, Barcelona, Spain
e Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
Read
11003
Timeswas read the article
2675
Total PDF
8328
Total HTML
Share statistics
array:21 [ "pii" => "S0213911108000642" "issn" => "02139111" "doi" => "10.1016/j.gaceta.2008.09.008" "estado" => "S300" "fechaPublicacion" => "2009-07-09" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2009;23:295-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4819 "formatos" => array:3 [ "EPUB" => 171 "HTML" => 3821 "PDF" => 827 ] ] "itemSiguiente" => array:17 [ "pii" => "S0213911108000502" "issn" => "02139111" "doi" => "10.1016/j.gaceta.2008.06.009" "estado" => "S300" "fechaPublicacion" => "2009-07-09" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2009;23:300-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4320 "formatos" => array:3 [ "EPUB" => 180 "HTML" => 3559 "PDF" => 581 ] ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Frecuencia y tendencia temporal de los defectos congénitos en Asturias. La necesidad de la vigilancia clinicoepidemiológica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "300" "paginaFinal" => "305" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prevalence and secular trend of congenital defects in Asturias, Spain. The need for clinical-epidemiological surveillance" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "138v23n04-13139922fig1.jpg" "Alto" => 1091 "Ancho" => 1638 "Tamanyo" => 287087 ] ] "descripcion" => array:1 [ "es" => "Prevalencia total y al nacimiento de los defectos congénitos en Asturias (1990–2004)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carmen Mosquera Tenreiro, Isolina Riaño Galán, Cristina Rodríguez Dehli, Joaquín Fernández Toral, Carmen Moro Bayón, Adela Rodríguez Fernández, M. Etelvina Suárez Menéndez, Enrique García López, Fernando Ariza Hevia" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Carmen" "apellidos" => "Mosquera Tenreiro" ] 1 => array:2 [ "nombre" => "Isolina" "apellidos" => "Riaño Galán" ] 2 => array:2 [ "nombre" => "Cristina" "apellidos" => "Rodríguez Dehli" ] 3 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Fernández Toral" ] 4 => array:2 [ "nombre" => "Carmen" "apellidos" => "Moro Bayón" ] 5 => array:2 [ "nombre" => "Adela" "apellidos" => "Rodríguez Fernández" ] 6 => array:2 [ "nombre" => "M. Etelvina" "apellidos" => "Suárez Menéndez" ] 7 => array:2 [ "nombre" => "Enrique" "apellidos" => "García López" ] 8 => array:2 [ "nombre" => "Fernando" "apellidos" => "Ariza Hevia" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108000502?idApp=WGSE" "url" => "/02139111/0000002300000004/v0_201307171006/S0213911108000502/v0_201307171007/es/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S0213911108000046" "issn" => "02139111" "doi" => "10.1016/j.gaceta.2008.07.002" "estado" => "S300" "fechaPublicacion" => "2009-07-09" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2009;23:287-94" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5370 "formatos" => array:3 [ "EPUB" => 191 "HTML" => 4289 "PDF" => 890 ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Estimating the health and economic benefits associated with reducing air pollution in the Barcelona metropolitan area (Spain)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "287" "paginaFinal" => "294" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estimación de los beneficios en salud y económicos asociados a la reducción de la contaminación atmosférica en el área metropolitana de Barcelona (España)" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "138v23n04-13139920fig1.jpg" "Alto" => 1774 "Ancho" => 3433 "Tamanyo" => 1324793 ] ] "descripcion" => array:1 [ "en" => "Average PM <span class="elsevierStyleInf">10</span> concentrations in urbanized areas of the 57 municipalities included in the area of study (population per 1000 for 2004 in parenthesis)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Pérez, Jordi Sunyer, Nino Künzli" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Pérez" ] 1 => array:2 [ "nombre" => "Jordi" "apellidos" => "Sunyer" ] 2 => array:2 [ "nombre" => "Nino" "apellidos" => "Künzli" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108000046?idApp=WGSE" "url" => "/02139111/0000002300000004/v0_201307171006/S0213911108000046/v0_201307171007/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "A mortality study of the last outbreak of yellow fever in Barcelona City (Spain) in 1870" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "295" "paginaFinal" => "299" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jaume Canela Soler, Maria Rosa Pallarés Fusté, Rafael Abós Herràndiz, Carme Nebot Adell, Robert S. Lawrence" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Jaume" "apellidos" => "Canela Soler" "email" => array:1 [ 0 => "jcanela@ub.edu" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 1 => array:3 [ "nombre" => "Maria Rosa" "apellidos" => "Pallarés Fusté" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] 2 => array:3 [ "nombre" => "Rafael" "apellidos" => "Abós Herràndiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] ] ] 3 => array:3 [ "nombre" => "Carme" "apellidos" => "Nebot Adell" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] ] ] 4 => array:3 [ "nombre" => "Robert S." "apellidos" => "Lawrence" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "affe" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Department of Public Health, Universitat de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Pan American Health Organization, Washington DC, USA" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "Institut Municipal d’Assistència Sanitària, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] 3 => array:3 [ "entidad" => "Catalan Institute of Health, Generalitat de Catalunya, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] 4 => array:3 [ "entidad" => "Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "affe" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Autor para correspondencia. jcanela@ub.edu" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio de la mortalidad del último brote de fiebre amarilla en la ciudad de Barcelona (España) en 1870" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "138v23n04-13139921fig1.jpg" "Alto" => 1432 "Ancho" => 1650 "Tamanyo" => 1797291 ] ] "descripcion" => array:1 [ "en" => "Map of Barcelona City in the second half of the 19th century." ] ] ] "textoCompleto" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStylePara">Yellow fever is an endemic and epidemic disease transmitted by the mosquito <span class="elsevierStyleItalic">Aedes aegypti</span> through the bite of females infected by a RNA virus named <span class="elsevierStyleItalic">Flavivirus.</span> Currently, yellow fever is spreading throughout several countries of Central and South America, and Africa, where it remains an endemic illness, with severe forms causing very serious liver damage and death. In those areas the disease affects about 200,000 people and causes an estimated 30,000 deaths annually<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">,</span><a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">,</span><a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a>. In 2006, 114 confirmed cases of yellow fever causing 58 deaths were reported by WHO<a href="#bib4" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a>. Even though the efficacy of yellow fever vaccine is almost 99%, yellow fever is still an important public health problem in developing countries due to underimmunization. In developed countries it is not longer a public health threat; in Barcelona city, the last epidemic outbreak of yellow fever occurred in 1870<a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">,</span><a href="#bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">,</span><a href="#bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">,</span><a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>.</p><p class="elsevierStylePara">Due to geography, Barcelona has always been a commercial port city, with a harbor connecting it to other cities located on the Mediterranean coast, and other foreign countries. Barcelona's harbor trade activity was a vital and decisive element for its development, favoring its settlers to set up contact with other cultures, as well as to exchange political, economic and social ideas. As described by some authors, Barcelona settlers suffered from different diseases and plagues throughout history; yellow fever was one of them<a href="#bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a><span class="elsevierStyleSup">,</span><a href="#bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">,</span><a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">,</span><a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a> and needs to be contextualized in the various outbreaks of yellow fever that ravaged Europe during the 18th and 19th centuries<a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a><span class="elsevierStyleSup">,</span><a href="#bib14" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">,</span><a href="#bib15" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleSup">,</span><a href="#bib16" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">16</span></a>.</p><p class="elsevierStylePara">Barcelona, with a surface area of about 2000 square miles, is located almost 100 miles south of the Pyrenees Mountains, at latitude of 41° 23′ N and longitude of 2° 11′ E, between the Llobregat and Besòs rivers. In 1870, about 225,000 people lived in Barcelona, distributed among four neighborhoods: La Barceloneta, La Ribera, Gòtic, and El Raval<a href="#bib17" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">17</span></a>. <a href="#fig1" class="elsevierStyleCrossRefs">figura 1</a> shows a map of the city and the harbor in 1862.</p><a name="fig1" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"><img src="138v23n04-13139921fig1.jpg" alt="Map of Barcelona City in the second half of the 19th century."></img></p><p class="elsevierStylePara">Figure 1. Map of Barcelona City in the second half of the 19th century.</p><p class="elsevierStylePara">As it is now, in 1870 there were two rainy periods in March-April and October-November, a warm period in May-September and a fresh period in December-February. The average precipitation was 22 inches per year, days were predominantly sunny and temperatures were mild. For water storage, the population used large clay and metallic containers that were incompletely covered or closed, allowing mosquitoes to reproduce there<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>.</p><p class="elsevierStylePara">The epidemic outbreak started in August 1870, with the first fatality being a waiter of the ship <span class="elsevierStyleItalic">María</span> coming from Havana<span class="elsevierStyleItalic">,</span> Cuba. Pallarés reports: «… that the steam vessel was not inspected and it was permitted to enter the seaport of Barcelona even though there had already been some deaths during the trip. Its load wasn’t inspected either; even several animal skins were delivered to a warehouse in Vermell Street».<span class="elsevierStyleSup">8(p227)</span> The objective of this epidemiological study is to describe and analyze the epidemic outbreak of yellow fever in the city of Barcelona in 1870, using the available mortality data.</p><span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStylePara">Although the outbreak began in August and lasted until December, most deaths occurred between September and November of 1870. The deaths were documented in the parish registries, as the city's East cemetery. According to these records, 1264 deaths were identified with the diagnosis of <span class="elsevierStyleItalic">Typhus Icterodes, Typhus Icteroides</span>, or the <span class="elsevierStyleItalic">acronym Calentura Amarilla</span><a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">,</span><a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a> during the period studied (August 1st through December 31st).</p><p class="elsevierStylePara">For purpose of this study, a database was prepared with the information available for each death: sex, age (in years), marital status (single, married or widow), date, profession, nationality, neighborhood (La Barceloneta, La Ribera, Gòtic and El Raval) and hospital where the deaths occurred (Santa Creu Hospital, the military and the provisional one). The provisional hospital was located in a convent (Las Arrepentidas), 2Km west from the city, and set up to manage the outbreak. Given the lack of information in some registries, there were some limitations to collect and analyze information on each death. Although the total number of deaths from yellow fever was 1,264, only 1,235 were analyzed in this study, since in 29 cases only the day when the death occurred was identified. For the neighborhood of La Barceloneta, the distance between the harbor's dock and the streets where the deaths occurred was also analyzed.</p><p class="elsevierStylePara">Statistical and epidemiological procedures were used to describe and analyze the epidemic outbreak according to characteristics of person, time, and place<a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleSup">,</span><a href="#bib19" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">19</span></a>. The age and sex population pattern was estimated by linear interpolation from the censuses of 1860 and 1877<a href="#bib17" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">17</span></a>. Parametric and non-parametric tests were used to determine the specific hypotheses and the program SPSS v13.0 was utilized to analyze data<a href="#bib20" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">20</span></a>. The significance level used was 5%.</p><span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStylePara">There were 1,235 deaths from yellow fever, representing 27.9% of all thel deaths occurred between August 1st and December 31st. The crude mortality rate in Barcelona in 1870 was 40.3 deaths per 1,000 inhabitants, with a specific mortality from yellow fever being 549.7 deaths per 100,000 inhabitants.</p><span class="elsevierStyleSectionTitle">Demographic characteristics</span><p class="elsevierStylePara">Of 1,235 deaths from yellow fever being studied, 767 occurred in men (62.10%) and 468 in women. The average age for all deaths was 37.5 years (standard deviation [SD]=16.5). The average age at death was 35.7 years (SD=16 years) among men and 40.6 years (SD=16.8 years) among women (t=−5.1; p=0.0001).</p><p class="elsevierStylePara">The mortality rate of yellow fever was 695.8 deaths per 100,000 inhabitants for men and 407.5/100,000 for women. Among the men who died, the 41–50 year age group was the most affected, with a mortality rate of 1,068.2/100,000 inhabitants. Among women, the highest mortality occurred among those over 60 years (874.8/100,000 inhabitants). The boys and girls between 1 and 10 years presented the lowest mortality rate (<a href="#tbl1" class="elsevierStyleCrossRefs">tabla 1</a>). The ratio between mortality rates from yellow fever in men versus women showed a different distribution by age groups.</p><p class="elsevierStylePara">Table 1. Distribution of deaths, census and mortality rate (per 100,000 inhabitants) from yellow fever in Barcelona City by age and sex, 1870</p><a name="tbl1" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td rowspan="0" colspan="0"> </td><td rowspan="0" colspan="3">Men</td><td rowspan="0" colspan="3">Women</td><td rowspan="0" colspan="0"> </td><td rowspan="0" colspan="3">Total</td></tr><tr align="left"><td rowspan="0" colspan="0">Age group (years)</td><td rowspan="0" colspan="0">Deaths</td><td rowspan="0" colspan="0">Census</td><td rowspan="0" colspan="0">Rate per 100,000 inhabitants</td><td rowspan="0" colspan="0">Deaths</td><td rowspan="0" colspan="0">Census</td><td rowspan="0" colspan="0">Rate per 100,000 inhabitants</td><td rowspan="0" colspan="0">Rate Ratio Men/Women</td><td rowspan="0" colspan="0">Deaths</td><td rowspan="0" colspan="0">Census</td><td rowspan="0" colspan="0">Rate per 100,000 inhabitants</td></tr><tr align="left"><td><1</td><td>6</td><td>2353</td><td>212.5</td><td>3</td><td>2342</td><td>128.1</td><td>1.66</td><td>9</td><td>4695</td><td>191.7</td></tr><tr align="left"><td>1 to 5</td><td>9</td><td>9402</td><td>74.4</td><td>4</td><td>9428</td><td>42.4</td><td>1.75</td><td>13</td><td>18830</td><td>69.1</td></tr><tr align="left"><td>6 to 10</td><td>5</td><td>8551</td><td>35.1</td><td>7</td><td>8744</td><td>80.1</td><td>0.44</td><td>12</td><td>17295</td><td>69.4</td></tr><tr align="left"><td>11 to 15</td><td>28</td><td>9098</td><td>318.7</td><td>13</td><td>9717</td><td>133.8</td><td>2.38</td><td>41</td><td>18815</td><td>217.9</td></tr><tr align="left"><td>16 to 20</td><td>72</td><td>10943</td><td>639.7</td><td>28</td><td>12489</td><td>224.2</td><td>2.85</td><td>100</td><td>23432</td><td>426.8</td></tr><tr align="left"><td>21 to 30</td><td>211</td><td>24925</td><td>882.6</td><td>82</td><td>24739</td><td>331.5</td><td>2.66</td><td>293</td><td>49664</td><td>589.9</td></tr><tr align="left"><td>31 to 40</td><td>156</td><td>17480</td><td>1006.9</td><td>107</td><td>18382</td><td>582.1</td><td>1.73</td><td>263</td><td>35862</td><td>733.4</td></tr><tr align="left"><td>41 to 50</td><td>143</td><td>12732</td><td>1068.2</td><td>100</td><td>12903</td><td>775.1</td><td>1.38</td><td>243</td><td>25635</td><td>947.9</td></tr><tr align="left"><td>51 to 60</td><td>70</td><td>8199</td><td>634.2</td><td>59</td><td>8679</td><td>679.8</td><td>0.93</td><td>129</td><td>16878</td><td>764.3</td></tr><tr align="left"><td>>60</td><td>67</td><td>6114</td><td>801.4</td><td>65</td><td>7430</td><td>874.8</td><td>0.92</td><td>132</td><td>13544</td><td>974.6</td></tr><tr align="left"><td>Total</td><td>767</td><td>109797</td><td>695.8</td><td>468</td><td>114853</td><td>407.5</td><td>1.71</td><td>1235</td><td>224650</td><td>549.7</td></tr></table><p class="elsevierStylePara">The deaths occurred in sea-related activity workers were 181 (14.6%), the highest proportion observed. The average age of the people who died from yellow fever and were sailors (35.9 years, SD=17.13 years) was lower than that of the people who died from yellow fever and were not sailors (38 years, SD=16.6 years). However, these data are incomplete and refer only to the stated information on age and occupation (t=−2.7; p=0.0056). There were only 5 fatalities among health workers.</p><p class="elsevierStylePara">Widows had the highest proportion of deaths among women (62.10%), while among men, there were the married ones (48.10%). Among all deaths, only 54 people (4.37%) had been born abroad, 49 of whom were men.</p><span class="elsevierStyleSectionTitle">Temporal characteristics</span><p class="elsevierStylePara">The first death from yellow fever was notified on August 12th and the last one on December 31st of 1870. During the first half of that period, 821 deaths occurred (66.47%). The monthly distribution of the 1,264 deaths with the fatality day identified was as follows: in August, 20 deaths (1.58%), 425 in September (33.62%), 579 in October (45.81%), 236 in November (18.67%), and 4 in December (0.32%). The curve of the deaths was bimodal: the first curve includes the time period between September 21st and October 4th and the second one encompasses the period between October 23rd and November 4th (<a href="#fig2" class="elsevierStyleCrossRefs">figura 2</a>). In terms of the days of week, Tuesdays had the highest (n=275) number of deaths from yellow fever, whereas Wednesdays had the least fatalities (n=123).</p><a name="fig2" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"><img src="138v23n04-13139921fig2.jpg" alt="Epidemic curve of the yellow fever outbreak of Barcelona City in 1870."></img></p><p class="elsevierStylePara">Figure 2. Epidemic curve of the yellow fever outbreak of Barcelona City in 1870.</p><p class="elsevierStylePara">Regarding the 1,235 cases with any other information besides the day of death, no epidemiological association between temporal distribution of deaths by age, sex or profession was confirmed. The deaths among children under 10 years occurred only between September and November.</p><span class="elsevierStyleSectionTitle">Geographical characteristics</span><p class="elsevierStylePara">The outbreak affected the four neighborhoods of Barcelona. The distribution of the fatalities was as follows: 276 in La Barceloneta, 315 in La Ribera, 93 in Gòtic, and 406 in El Raval. In 145 cases, the place of the death (11.74%) was not reported (<a href="#tbl2" class="elsevierStyleCrossRefs">tabla 2</a>). In the military hospital, located outside the city, 22 deaths occurred, all men; 16 of them were under age 25. During the outbreak, only 13.7% of all deaths from yellow fever occurred in those hospitals.</p><p class="elsevierStylePara">Table 2. Distribution of deaths from yellow fever by neighborhood, hospital, and sex. Barcelona City, 1870</p><a name="tbl2" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td rowspan="0" colspan="0"> </td><td rowspan="0" colspan="3">Hospital deaths</td><td rowspan="0" colspan="3">Deaths outside the hospitals</td><td rowspan="0" colspan="3">TOTAL</td></tr><tr align="left"><td rowspan="0" colspan="0">Neighborhood</td><td rowspan="0" colspan="0">Men</td><td rowspan="0" colspan="0">Women</td><td rowspan="0" colspan="0">Total</td><td rowspan="0" colspan="0">Men</td><td rowspan="0" colspan="0">Women</td><td rowspan="0" colspan="0">Total</td><td rowspan="0" colspan="0">Men</td><td rowspan="0" colspan="0">Women</td><td rowspan="0" colspan="0">Total</td></tr><tr align="left"><td>La Barceloneta</td><td>2</td><td>0</td><td>2</td><td>150</td><td>124</td><td>274</td><td>152</td><td>124</td><td>276</td></tr><tr align="left"><td>La Ribera</td><td>4</td><td>2</td><td>6</td><td>171</td><td>138</td><td>309</td><td>175</td><td>140</td><td>315</td></tr><tr align="left"><td>Gotic</td><td>0</td><td>0</td><td>0</td><td>54</td><td>39</td><td>93</td><td>54</td><td>39</td><td>93</td></tr><tr align="left"><td>El Raval</td><td>91</td><td>40</td><td>131</td><td>192</td><td>83</td><td>275</td><td>283</td><td>123</td><td>406</td></tr><tr align="left"><td>Missing</td><td>30</td><td>0</td><td>30</td><td>73</td><td>42</td><td>115</td><td>103</td><td>42</td><td>145</td></tr><tr align="left"><td>Total</td><td>127</td><td>42</td><td>169</td><td>640</td><td>426</td><td>1,066</td><td>767</td><td>468</td><td>1,235</td></tr></table><p class="elsevierStylePara">The first fatalities in the city occurred in <span class="elsevierStyleItalic">Vermell Street</span> of the neighborhood of La Ribera<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>. In Major Street of the neighborhood of La Barceloneta, the street with the highest mortality, 35 deaths occurred; second to that, there was Allada Street of the neighborhood of La Ribera. In total, deaths from yellow fever occurred in 272 streets. No deaths from yellow fever were reported in the main street, Las Ramblas.</p><p class="elsevierStylePara">The analysis of available information of the deaths from yellow fever in the neighborhood of La Barceloneta showed that the streets closest to the port had greater mortality than the more remote ones (r=0.83; p=0.0001) (<a href="#tbl3" class="elsevierStyleCrossRefs">tabla 3</a>).</p><p class="elsevierStylePara">Table 3. Distribution of deaths from yellow fever according to the distance from the harbour (La Barceloneta neighbourhood, 1870)</p><a name="tbl3" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td rowspan="0" colspan="0">Street name</td><td rowspan="0" colspan="0">Distance from the harbour (in meters)</td><td rowspan="0" colspan="0">Number of deaths</td></tr><tr align="left"><td>Mar</td><td>193</td><td>32</td></tr><tr align="left"><td>Sant Elm</td><td>225</td><td>29</td></tr><tr align="left"><td>Sant Miquel</td><td>258</td><td>30</td></tr><tr align="left"><td>Pescadors</td><td>290</td><td>26</td></tr><tr align="left"><td>Comte de Santa Clara</td><td>322</td><td>14</td></tr><tr align="left"><td>Sevilla</td><td>354</td><td>12</td></tr><tr align="left"><td>Baluard</td><td>386</td><td>6</td></tr><tr align="left"><td>Mestrança</td><td>418</td><td>18</td></tr><tr align="left"><td>Meer</td><td>483</td><td>5</td></tr><tr align="left"><td>Pontevedra</td><td>539</td><td>4</td></tr><tr align="left"><td>Atlantida</td><td>573</td><td>14</td></tr><tr align="left"><td>Vinaros</td><td>605</td><td>4</td></tr><tr align="left"><td>Grau i Torres</td><td>669</td><td>5</td></tr><tr align="left"><td>Guitar</td><td>702</td><td>6</td></tr></table><span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStylePara">This epidemic was the last outbreak of yellow fever in the city of Barcelona although it was not the last one in the Iberian Peninsula<a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">21</span></a>. It is a good example of an infectious disease transmitted by a mosquito in the urban Mediterranean Europe in the 19th century<a href="#bib14" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">,</span><a href="#bib15" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">15</span></a>. Two other epidemics of yellow fever had already occurred in that century in Barcelona (1803 and 1821)<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">,</span><a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleSup">,</span><a href="#bib22" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">22</span></a>; other cities in Spain such as Cadiz, Sevilla and Jerez were likewise hit between 1800 and 1803<a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">21</span></a>. In Europe, other cities, all located on the coast, were affected in the 19th century by yellow fever: Brest and Saint Nazaire in France, Lisboa in Portugal, and Swansea and Southampton in the United Kingdom<a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a><span class="elsevierStyleSup">,</span><a href="#bib14" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">,</span><a href="#bib16" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">,</span><a href="#bib23" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">23</span></a>. This study is limited by the fact that there were registered 1,264 deaths, but only 1,235 fatalities with available information such as age, sex or other variables<a href="#bib24" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">24</span></a>.</p><p class="elsevierStylePara">The mortality rate of this outbreak of yellow fever in the city of Barcelona was 549.7 per 100,000 inhabitants. The previous episode of yellow fever in Barcelona had been in 1821, affecting 80,000 inhabitants living inside the city and 25,000 living outside<a href="#bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a><span class="elsevierStyleSup">,</span><a href="#bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">,</span><a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">,</span><a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a>. Considering the yellow fever's lethality, which was between 10% and 50%, the estimated number of patients in the 1870s outbreak would be between 2,500 and 12,350 (up to 5.50% of the Barcelona population), a smaller impact than the episode of 1821<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">,</span><a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">,</span><a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a>. Both are examples of epidemics produced in European maritime cities as a consequence of the trade with the Caribbean and Latin America. Similarly, in 1870, 665 people died from yellow fever in Havana<span class="elsevierStyleItalic">,</span> Cuba<a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleSup">,</span><a href="#bib25" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">25</span></a><span class="elsevierStyleSup">,</span><a href="#bib26" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">26</span></a>; in the same year, a major epidemic of yellow fever occurred in Buenos Aires with 14.000 deaths<a href="#bib27" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">27</span></a>.</p><p class="elsevierStylePara">The average age of the deaths in the Barcelona outbreak confirms the predominant impact on adults, as described by other authors<a href="#bib28" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">28</span></a>. In particular, the average age in men was lower than in women, contrasting with the results observed in the outbreak occurring in Swansea in 1865, where the average age in men was 29.7 years whereas in women it was 27<a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a>.</p><p class="elsevierStylePara">The epidemic curve, as seen in <a href="#fig2" class="elsevierStyleCrossRefs">figura 2</a>, indicates clearly its bimodal form. The first epidemic wave affected the people working in the ship <span class="elsevierStyleItalic">María</span> as well as the people involved in dock activities, especially in the neighborhoods of La Barceloneta and La Ribera, which were the places where the outbreak started. The authorities were not aware of the magnitude of the problem until September, when the outbreak was at its peak. The second epidemic wave of this bimodal distribution seems to coincide with the expansion of the outbreak to the rest of the city<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>.</p><p class="elsevierStylePara">The distribution of some neighborhoods in Barcelona in 1870 was similar to the present, yet not exactly the same. For example, in La Barceloneta, located close to the port, the same grid pattern can currently be observed in that neighborhood. In contrast, the Via Laietana Street, which nowadays separates the neighborhoods of La Ribera and Gotic, did not exist in 1870<a href="#bib29" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">29</span></a><span class="elsevierStyleSup">,</span><a href="#bib30" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">30</span></a><span class="elsevierStyleSup">,</span><a href="#bib31" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">31</span></a>, facilitating any type of exchange between them. The outbreak initially affected the neighborhoods of La Barceloneta and La Ribera and then spread to the rest of the city. There were other areas affected outside the city (Gracia and Hostafranchs), but these cases have not been included in this study. In fact, La Barceloneta was evacuated and many of its inhabitants were transferred provisionally to neighboring localities as La Colonia Montalegre, located in Tiana<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>.</p><p class="elsevierStylePara">A limitation of this study is the lack of specific census by neighborhood in 1870. The distribution of the yellow fever fatalities during the outbreak was not uniform either within or between neighborhoods. There are records of deaths from yellow fever in 272 streets of Barcelona city in 1870. The fact that no deaths were registered in Las Ramblas Street and the few deaths registered in the neighborhood Gòtic suggests that the low social classes were the most affected. This hypothesis, however, has not been corroborated, given the limited availability of information on this epidemiological event<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>, although other authors mentioned this fact in the second half of the 19th century<a href="#bib32" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">32</span></a><span class="elsevierStyleSup">,</span><a href="#bib33" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">33</span></a>. A high linear correlation between a greater mortality in the streets adjacent to the port in the neighborhood of La Barceloneta suggests a higher risk of suffering and dying from yellow fever in the areas nearby the docks; this finding is consistent with the evidence that the mosquito <span class="elsevierStyleItalic">Aedes aegypti</span> rarely moves more than 100 meters<a href="#bib34" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">34</span></a> (<a href="#tbl3" class="elsevierStyleCrossRefs">tabla 3</a>).</p><p class="elsevierStylePara">Finally, the cold weather conditions and the appropriate hygienic measures adopted by health authorities, regarding not only the harbor but also the neighborhoods, completely eliminated the outbreak in December 1870. A report was published in 1871–72<a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a>, and one of its indirect consequences was the acceleration of the expansion of the city with a new neighborhood, called Eixample, planned by the urbanist Ildefonso Cerdá in 1854<a href="#bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a>.</p><p class="elsevierStylePara">In conclusion, the mortality distribution of the last urban epidemic of yellow fever occurred in Barcelona in 1870 presented a bimodal epidemic curve, with a greater impact in adult men and the La Barceloneta quarter.</p><p class="elsevierStylePara">Acknowledgements</p><p class="elsevierStylePara">To Mrs. Maria Dolors Pau Ramon for her administrative support to this scientific work and to Mr. Juan Chávez for his assistance in collecting the information necessary to carry out this study. To Mr. Martin Barclay for his helpful comments in reviewing this manuscript.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Contributors</span></p><p class="elsevierStylePara">JCS directed the study design, data analysis and wrote a substantial part of it. MRPF collected and organized data and contributed building crucial information. RAH organized data and contributed writing previous documents. CNA discussed, wrote and revised previous versions. RSL contributed to the discussion and revision of the article.</p><p class="elsevierStylePara">Received 25 March 2008 <br></br>Accepted 18 September 2008 </p><p class="elsevierStylePara">Autor para correspondencia. jcanela@ub.edu</p>" "pdfFichero" => "138v23n04a13139921pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec211829" "palabras" => array:3 [ 0 => "Yellow fever" 1 => "Epidemic" 2 => "Mortality" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec211830" "palabras" => array:3 [ 0 => "Fiebre amarilla" 1 => "Epidemia" 2 => "Mortalidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><br/><p class="elsevierStylePara">The last outbreak of yellow fever in the city of Barcelona, Spain, was caused by a ship arriving from Cuba. The objective of this study was to describe and analyze the epidemic of 1870 by using the available mortality data.</p><span class="elsevierStyleSectionTitle">Methods</span><br/><p class="elsevierStylePara">The information on 1,235 deaths identified in the parochial registries was analyzed, using statistical and epidemiological procedures for epidemic outbreaks.</p><span class="elsevierStyleSectionTitle">Results</span><br/><p class="elsevierStylePara">Mortality due to yellow fever was 549.7 per 100,000 inhabitants. The temporal distribution of the deaths showed two peaks at the end of September and October with the last fatalities occurring in December 1870. The distribution of the fatalities in the city's neighborhoods was unequal. In La Barceloneta, in particular, more fatalities were found in the streets adjacent to the port than in the most remote streets (r=0.83; p<0.0001).</p><span class="elsevierStyleSectionTitle">Conclusions</span><br/><p class="elsevierStylePara">This study reveals a temporal bimodal mortality distribution for yellow fever during the outbreak, with a high impact in adult men and in the La Barceloneta neighborhood.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><br/><p class="elsevierStylePara">El último brote de fiebre amarilla en la ciudad de Barcelona, España, se originó a partir de un barco que venía de Cuba. El objetivo de este estudio es describir y analizar esa epidemia ocurrida en 1870, utilizando los datos disponibles de mortalidad.</p><span class="elsevierStyleSectionTitle">Métodos</span><br/><p class="elsevierStylePara">La información de las 1235 defunciones identificadas en los registros parroquiales se ha analizado utilizando los procedimientos estadísticos y epidemiológicos para brotes epidémicos.</p><span class="elsevierStyleSectionTitle">Resultados</span><br/><p class="elsevierStylePara">La tasa de mortalidad por fiebre amarilla fue de 549.7 por 100,000 habitantes. La distribución temporal de las muertes tenía dos modas en el final de septiembre y octubre, y los últimos muertos ocurrieron en diciembre de 1870. La distribución de las defunciones según los barrios de la ciudad fue desigual. En La Barceloneta, en particular, hubo mas muertos en las calles adyacentes al puerto que en las más lejanas (r=0,83; p<0,0001).</p><span class="elsevierStyleSectionTitle">Conclusiones</span><br/><p class="elsevierStylePara">Este estudio muestra una distribución bimodal de la mortalidad por fiebre amarilla durante el brote, con un impacto alto en hombres adultos, y en el barrio de La Barceloneta.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "138v23n04-13139921fig1.jpg" "Alto" => 1432 "Ancho" => 1650 "Tamanyo" => 1797291 ] ] "descripcion" => array:1 [ "en" => "Map of Barcelona City in the second half of the 19th century." ] ] 1 => array:8 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "138v23n04-13139921fig2.jpg" "Alto" => 1609 "Ancho" => 2138 "Tamanyo" => 781647 ] ] "descripcion" => array:1 [ "en" => "Epidemic curve of the yellow fever outbreak of Barcelona City in 1870." ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Impact of yellow fever on the developing world." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Tomori O." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Adv Virus Res" "fecha" => "1999" "volumen" => "53" "paginaInicial" => "5" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10582093" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Roth C, Shope R. Fiebre Amarilla. En: Heymann DL, editor. El control de las enfermedades transmisibles. 18a edición. Washington DC. Informe oficial de la Asociación Estadounidense de Salud Pública, Organización Panamericana de la Salud. 2005. Publicación Científica y Técnica No. 613. p. 268–73." "idioma" => "es" ] ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Duran A. Carlos J Finlay salvó millones de vidas. Finlay-online. [fecha de acceso 29 de diciembre 2005]; Nicolás Gutiérrez. Academy. Historia de la medicina en Cuba. [consultado 18/03/2008]. Disponible en: http://www.finlay-online.com/nicolasgutierrez/CONTACTOMAGAZINE-CARLOSFINLAY.htm." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Duran A. Carlos J Finlay salvó millones de vidas. Finlay-online. [fecha de acceso 29 de diciembre 2005]; Nicolás Gutiérrez. Academy. Historia de la medicina en Cuba. [consultado 18/03/2008]. Disponible en: http://www.finlay-online.com/nicolasgutierrez/CONTACTOMAGAZINE-CARLOSFINLAY.htm." ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Yellow fever in Africa and South America, 2006." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "WHO." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Wkly Epidemiol Rec" "fecha" => "2008" "volumen" => "83" "paginaInicial" => "60" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18293534" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Memoria histórico-científica de la epidemia de fiebre amarilla en Barcelona en 1870." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Mendoza A" 1 => "Robert B" 2 => "Torent R." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Barcelona Imp Jaime Jepús" "fecha" => "1872" "paginaInicial" => "1" "paginaFinal" => "224" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Historia de la fiebre amarilla." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Angolotti E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev San Hig Pub" "fecha" => "1974" "volumen" => "48" "paginaInicial" => "89" "paginaFinal" => "102" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artigas Raventós V. Las epidemias barcelonesas de fiebre amarilla en el S.XIX y su influencia en la reforma sanitaria de la ciudad. Medicina e Historia (2ª. Época). 1974 num. 31." "idioma" => "es" ] ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pallarés Fusté MR. Epidemia de fiebre amarilla en Barcelona en el año 1870. Universidad de Barcelona; 1994." "idioma" => "es" ] ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "El problema de la fiebre amarilla." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Pittaluga G." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicina de los Países Cálidos" "fecha" => "1928" "paginaInicial" => "5" "paginaFinal" => "25" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Fiebre amarilla en España (epidemiología histórica)." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Rico-Abelló C." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev San Hig Pub" "fecha" => "1953" "volumen" => "1–2" "paginaInicial" => "29" "paginaFinal" => "87" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "La historia y el estado actual. La fiebre amarilla en Barcelona en 1821." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Angolotti E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev San Hig Púb" "fecha" => "1980" "volumen" => "54" "paginaInicial" => "89" "paginaFinal" => "102" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The «plague» of Barcelona. Yellow fever epidemic of 1821." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Chastel C." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bull Soc Pathol Exot" "fecha" => "1999" "volumen" => "92" "paginaInicial" => "405" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11000949" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Yellow fever in South Wales, 1865." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Smith CE" 1 => "Gibson M.E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Hist" "fecha" => "1986" "volumen" => "30" "paginaInicial" => "322" "paginaFinal" => "340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3523078" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Yellow fever." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Vainio J" 1 => "Cutts F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Yellow fever." "fecha" => "1998" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Historia de la entomologia medica." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Machado-Allison C.E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Entomotrópica" "fecha" => "2004" "volumen" => "19" "paginaInicial" => "65" "paginaFinal" => "77" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO. Wkly Epidemiol Rec. 2005; 80(29): 249–256. [consultado 18/03/2008]. Disponible en: http://www.who.int/wer/2005/wer8029.pdf." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "WHO. Wkly Epidemiol Rec. 2005; 80(29): 249–256. [consultado 18/03/2008]. Disponible en: http://www.who.int/wer/2005/wer8029.pdf." ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Centre d’Estudis Demografics (CED). Banc de Dades. Universitat Autònoma de Barcelona (Bellaterra). Barcelona. 2007. [consultado 18/01/2007]. Disponible en: http://ced.esigmat.net/index.php?module=pagesetter&tid=8&filter=menu:eq:57&orderby=ordre&pubcnt=1&menuCED=57." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Centre d’Estudis Demografics (CED). Banc de Dades. Universitat Autònoma de Barcelona (Bellaterra). Barcelona. 2007. [consultado 18/01/2007]. Disponible en: http://ced.esigmat.net/index.php?module=pagesetter&tid=8&filter=menu:eq:57&orderby=ordre&pubcnt=1&menuCED=57." ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Outbreak investigation: A perspective." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Reingold A." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Epidemiol Bull" "fecha" => "2000" "volumen" => "21" "paginaInicial" => "1" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11206021" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "La investigación de una epidemia." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Gili Miner M" 1 => "Canela Soler J" 2 => "Martínez Navarro F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "1991" "volumen" => "9" "paginaInicial" => "69" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1854852" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1935861X11001495" "estado" => "S300" "issn" => "1935861X" ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "SPSS Inc, Chicago, IL, USA 2006. [consultado 18/01/2007]. Disponible en: http://www.spss.com/terms.htm?source=homepage&hpzone=footer." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "SPSS Inc, Chicago, IL, USA 2006. [consultado 18/01/2007]. Disponible en: http://www.spss.com/terms.htm?source=homepage&hpzone=footer." ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Worldwide invasion of vector mosquitoes: present European distribution and challenges for Spain." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Eritja R" 1 => "Escosa R" 2 => "Lucientes J" 3 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Biological Invasions" "fecha" => "2005" "volumen" => "7" "paginaInicial" => "87" "paginaFinal" => "97" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Danon J. Un brote de fiebre amarilla en el puerto de Barcelona de 1803. Congreso Nacional de Historia de la Medicina. Barcelona 1977. Revista Asclepio vol I, p. 119–28." "idioma" => "es" ] ] "host" => array:1 [ 0 => null ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "A Dublin observer of the Lisbon yellow fever epidemic." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Lyons J.B." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Vesalius" "fecha" => "1995" "volumen" => "1" "paginaInicial" => "8" "paginaFinal" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11618546" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Counting the dead and what they died from: an assessment of the global status of cause of death data." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Mathers CD" 1 => "Fat DM" 2 => "Inoue M" 3 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "/S0042-96862005000300009" "Revista" => array:6 [ "tituloSerie" => "Bull World Health Organ" "fecha" => "2005" "volumen" => "83" "paginaInicial" => "171" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15798840" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Historia de la Medicina. La otra historia de la fiebre amarilla en Cuba. 1492–1909." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Toledo Curbelo G.J." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Cubana Hig Epidemiol" "fecha" => "2000" "volumen" => "38" "paginaInicial" => "220" "paginaFinal" => "227" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Epidemia de fiebre amarilla en Tocopilla: 1912." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Laval R.E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Rev Chil Infectol" "fecha" => "2003" "volumen" => "20" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Jankilevich A. La gran epidemia de fiebre amarilla. En: Historia de los hospitales, la salud y las organizaciones solidarias. Online; Historia de las organizaciones de socorro. 2006. [consultado 18/01/2007]. Disponible en: http://www.aadhhos.org.ar/OrgSocorro/MarcoC.htm." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Jankilevich A. La gran epidemia de fiebre amarilla. En: Historia de los hospitales, la salud y las organizaciones solidarias. Online; Historia de las organizaciones de socorro. 2006. [consultado 18/01/2007]. Disponible en: http://www.aadhhos.org.ar/OrgSocorro/MarcoC.htm." ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Paul-Louis Simond and yellow fever." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Lowy I" 1 => "Rodhain F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bull Soc Pathol Exot" "fecha" => "1999" "volumen" => "92" "paginaInicial" => "392" "paginaFinal" => "395" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11000946" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ajuntament de Barcelona. Districte de Ciutat Vella. 2007. [consultado 18/01/2007]. Disponible en: http://w3.bcn.es/V14/Home/V14HomeLinkPl/0,2851,2071881_2077085_1,00.html." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Ajuntament de Barcelona. Districte de Ciutat Vella. 2007. [consultado 18/01/2007]. Disponible en: http://w3.bcn.es/V14/Home/V14HomeLinkPl/0,2851,2071881_2077085_1,00.html." ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Google Earth. 2007. [consultado 18/01/2007]. Disponible en: http://earth.google.es/tour/thanks-win.html." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Google Earth. 2007. [consultado 18/01/2007]. Disponible en: http://earth.google.es/tour/thanks-win.html." ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Institut Cartogràfic de Catalunya. Barcelona. 2007. [consultado 18/01/2007]. Disponible en: http://www.icc.cat/vissir/home.php?&toponim=Barcelona%2C%20ciutat%20vella#." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Institut Cartogràfic de Catalunya. Barcelona. 2007. [consultado 18/01/2007]. Disponible en: http://www.icc.cat/vissir/home.php?&toponim=Barcelona%2C%20ciutat%20vella#." ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Errores y fraudes de la ciencia y la técnica: equivocaciones, abusos y desastres en el camino de la sabiduría." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Voltes P." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Barcelona: Planeta" "fecha" => "1995" "paginaInicial" => "250" "paginaFinal" => "254" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Buj Buj A. La vivienda salubre. El saneamiento de poblaciones (1908) en la obra del ingeniero militar Eduardo Gallego Ramos. Scripta Nova. Revista electrónica de geografía y ciencias sociales 2003. [fecha de acceso 23 Diciembre 2005]. VII: 146(012). [consultado 18/01/2007]. Disponible en: http://www.ub.es/geocrit/sn/sn-146(012).htm." "idioma" => "es" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Buj Buj A. La vivienda salubre. El saneamiento de poblaciones (1908) en la obra del ingeniero militar Eduardo Gallego Ramos. Scripta Nova. Revista electrónica de geografía y ciencias sociales 2003. [fecha de acceso 23 Diciembre 2005]. VII: 146(012). [consultado 18/01/2007]. Disponible en: http://www.ub.es/geocrit/sn/sn-146(012).htm." ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Yellow fever in the 1790s: the British army in occupied Saint Domingue." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Geggus D." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Hist" "fecha" => "1979" "volumen" => "23" "paginaInicial" => "38" "paginaFinal" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/368468" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02139111/0000002300000004/v0_201307171006/S0213911108000642/v0_201307171007/en/main.assets" "Apartado" => array:4 [ "identificador" => "764" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02139111/0000002300000004/v0_201307171006/S0213911108000642/v0_201307171007/en/138v23n04a13139921pdf001.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108000642?idApp=WGSE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 115 | 24 | 139 |
| 2024 September | 160 | 40 | 200 |
| 2024 August | 156 | 32 | 188 |
| 2024 July | 134 | 40 | 174 |
| 2024 June | 187 | 32 | 219 |
| 2024 May | 120 | 33 | 153 |
| 2024 April | 153 | 16 | 169 |
| 2024 March | 126 | 29 | 155 |
| 2024 February | 145 | 33 | 178 |
| 2024 January | 119 | 58 | 177 |
| 2023 December | 155 | 36 | 191 |
| 2023 November | 150 | 27 | 177 |
| 2023 October | 108 | 41 | 149 |
| 2023 September | 117 | 33 | 150 |
| 2023 August | 90 | 18 | 108 |
| 2023 July | 98 | 33 | 131 |
| 2023 June | 96 | 22 | 118 |
| 2023 May | 133 | 30 | 163 |
| 2023 April | 86 | 26 | 112 |
| 2023 March | 146 | 48 | 194 |
| 2023 February | 84 | 14 | 98 |
| 2023 January | 84 | 27 | 111 |
| 2022 December | 96 | 38 | 134 |
| 2022 November | 127 | 46 | 173 |
| 2022 October | 64 | 58 | 122 |
| 2022 September | 44 | 39 | 83 |
| 2022 August | 75 | 59 | 134 |
| 2022 July | 38 | 48 | 86 |
| 2022 June | 32 | 32 | 64 |
| 2022 May | 48 | 36 | 84 |
| 2022 April | 34 | 44 | 78 |
| 2022 March | 38 | 39 | 77 |
| 2022 February | 39 | 33 | 72 |
| 2022 January | 42 | 45 | 87 |
| 2021 December | 48 | 35 | 83 |
| 2021 November | 42 | 58 | 100 |
| 2021 October | 52 | 48 | 100 |
| 2021 September | 42 | 43 | 85 |
| 2021 August | 27 | 30 | 57 |
| 2021 July | 26 | 31 | 57 |
| 2021 June | 41 | 30 | 71 |
| 2021 May | 54 | 45 | 99 |
| 2021 April | 76 | 49 | 125 |
| 2021 March | 62 | 35 | 97 |
| 2021 February | 38 | 30 | 68 |
| 2021 January | 54 | 16 | 70 |
| 2020 December | 47 | 24 | 71 |
| 2020 November | 47 | 18 | 65 |
| 2020 October | 41 | 33 | 74 |
| 2020 September | 30 | 18 | 48 |
| 2020 August | 45 | 19 | 64 |
| 2020 July | 52 | 15 | 67 |
| 2020 June | 50 | 15 | 65 |
| 2020 May | 48 | 10 | 58 |
| 2020 April | 48 | 25 | 73 |
| 2020 March | 71 | 7 | 78 |
| 2020 February | 86 | 28 | 114 |
| 2020 January | 72 | 17 | 89 |
| 2019 December | 45 | 20 | 65 |
| 2019 November | 30 | 15 | 45 |
| 2019 October | 26 | 9 | 35 |
| 2019 September | 23 | 9 | 32 |
| 2019 August | 23 | 13 | 36 |
| 2019 July | 33 | 4 | 37 |
| 2019 June | 17 | 21 | 38 |
| 2019 May | 96 | 11 | 107 |
| 2019 April | 40 | 8 | 48 |
| 2019 March | 35 | 17 | 52 |
| 2019 February | 40 | 21 | 61 |
| 2019 January | 28 | 19 | 47 |
| 2018 December | 57 | 31 | 88 |
| 2018 November | 138 | 31 | 169 |
| 2018 October | 116 | 28 | 144 |
| 2018 September | 187 | 18 | 205 |
| 2018 August | 178 | 28 | 206 |
| 2018 July | 45 | 13 | 58 |
| 2018 June | 56 | 14 | 70 |
| 2018 May | 64 | 14 | 78 |
| 2018 April | 40 | 13 | 53 |
| 2018 March | 37 | 6 | 43 |
| 2018 February | 30 | 11 | 41 |
| 2018 January | 31 | 4 | 35 |
| 2017 December | 31 | 7 | 38 |
| 2017 November | 47 | 10 | 57 |
| 2017 October | 22 | 10 | 32 |
| 2017 September | 37 | 12 | 49 |
| 2017 August | 23 | 9 | 32 |
| 2017 July | 25 | 15 | 40 |
| 2017 June | 46 | 10 | 56 |
| 2017 May | 61 | 7 | 68 |
| 2017 April | 27 | 24 | 51 |
| 2017 March | 37 | 7 | 44 |
| 2017 February | 26 | 6 | 32 |
| 2017 January | 24 | 4 | 28 |
| 2016 December | 43 | 8 | 51 |
| 2016 November | 53 | 17 | 70 |
| 2016 October | 42 | 5 | 47 |
| 2016 September | 22 | 12 | 34 |
| 2016 August | 0 | 11 | 11 |
| 2016 July | 0 | 17 | 17 |
| 2016 April | 0 | 8 | 8 |
| 2016 March | 0 | 13 | 13 |
| 2016 February | 0 | 5 | 5 |
| 2016 January | 0 | 8 | 8 |
| 2015 December | 1 | 8 | 9 |
| 2015 November | 0 | 14 | 14 |
| 2015 October | 1 | 10 | 11 |
| 2015 September | 0 | 10 | 10 |
| 2015 August | 2 | 0 | 2 |
| 2015 July | 0 | 9 | 9 |
| 2015 June | 1 | 0 | 1 |
| 2015 May | 1 | 3 | 4 |
| 2015 April | 1 | 4 | 5 |
| 2015 March | 1 | 3 | 4 |
| 2015 February | 1 | 4 | 5 |
| 2015 January | 1 | 1 | 2 |
| 2014 December | 5 | 0 | 5 |
| 2014 November | 4 | 3 | 7 |
| 2014 October | 4 | 1 | 5 |
| 2014 September | 2 | 4 | 6 |
| 2014 August | 4 | 7 | 11 |
| 2014 July | 12 | 3 | 15 |
| 2014 June | 3 | 2 | 5 |
| 2014 May | 5 | 7 | 12 |
| 2014 April | 6 | 5 | 11 |
| 2014 March | 32 | 6 | 38 |
| 2014 February | 31 | 5 | 36 |
| 2014 January | 34 | 3 | 37 |
| 2013 December | 34 | 6 | 40 |
| 2013 November | 36 | 7 | 43 |
| 2013 October | 56 | 9 | 65 |
| 2013 September | 39 | 10 | 49 |
| 2013 August | 60 | 6 | 66 |
| 2013 July | 64 | 6 | 70 |
| 2013 June | 22 | 2 | 24 |
| 2013 May | 21 | 4 | 25 |
| 2013 April | 10 | 9 | 19 |
| 2013 March | 13 | 5 | 18 |
| 2013 February | 2 | 4 | 6 |
| 2013 January | 2 | 1 | 3 |
| 2012 December | 2 | 0 | 2 |
| 2012 November | 0 | 2 | 2 |
| 2012 October | 2 | 1 | 3 |
| 2009 July | 1194 | 0 | 1194 |
Show all
