Brote de gastroenteritis en turistas: limitaciones de información y respuesta

Hernando, Victoria; Herrera, Dionisio; Hernández, Gloria; Varela, Carmen; de Mateo, Salvador

doi:10.1157/13106809

array:24 ["pii" => "S0213911107720137" "issn" => "02139111" "doi" => "10.1157/13106809" "estado" => "S300" "fechaPublicacion" => "2007-05-01" "aid" => "72013" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "copyrightAnyo" => "2007" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Gac Sanit. 2007;21:247-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2997 "formatos" => array:3 [ "EPUB" => 143 "HTML" => 2344 "PDF" => 510 ] ] "itemSiguiente" => array:19 [ "pii" => "S0213911107720149" "issn" => "02139111" "doi" => "10.1157/13106810" "estado" => "S300" "fechaPublicacion" => "2007-05-01" "aid" => "72014" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "mis" "cita" => "Gac Sanit. 2007;21:250-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2803 "formatos" => array:3 [ "EPUB" => 116 "HTML" => 2185 "PDF" => 502 ] ] "es" => array:9 [ "idiomaDefecto" => true "cabecera" => "«Que 20 años no es NADA»" "titulo" => "Gaceta Sanitaria: del azul al salmón" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "250" "paginaFinal" => "251" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gaceta Sanitaria: from blue to salmon" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernando Rodríguez Artalejo" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Fernando" "apellidos" => "Rodríguez Artalejo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720149?idApp=WGSE" "url" => "/02139111/0000002100000003/v2_201301241604/S0213911107720149/v2_201301241604/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0213911107720125" "issn" => "02139111" "doi" => "10.1157/13106808" "estado" => "S300" "fechaPublicacion" => "2007-05-01" "aid" => "72012" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Gac Sanit. 2007;21:242-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3941 "formatos" => array:3 [ "EPUB" => 137 "HTML" => 3195 "PDF" => 609 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "Originales breves" "titulo" => "El impacto de la desigualdad de género en la violencia del compañero íntimo en España" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "242" "paginaFinal" => "246" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The impact of gender inequality on intimate partner violence in Spain" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carmen Vives-Cases, Carlos Álvarez-Dardet, Mercedes Carrasco-Portiño, Jordi Torrubiano-Domínguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Carmen" "apellidos" => "Vives-Cases" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Álvarez-Dardet" ] 2 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Carrasco-Portiño" ] 3 => array:2 [ "nombre" => "Jordi" "apellidos" => "Torrubiano-Domínguez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720125?idApp=WGSE" "url" => "/02139111/0000002100000003/v2_201301241604/S0213911107720125/v2_201301241604/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "cabecera" => "Originales breves" "titulo" => "Brote de gastroenteritis en turistas: limitaciones de información y respuesta" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "247" "paginaFinal" => "249" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Victoria Hernando, Dionisio Herrera, Gloria Hernández, Carmen Varela, Salvador de Mateo" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Victoria" "apellidos" => "Hernando" "email" => array:1 [ 0 => "vhernando@isciii.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "¿" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Dionisio" "apellidos" => "Herrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Gloria" "apellidos" => "Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "Carmen" "apellidos" => "Varela" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Salvador" "apellidos" => "de Mateo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Programa de Epidemiología Aplicada de Campo, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Alertas, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España" "etiqueta" => "b" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Sección de Enfermedades de Declaración Obligatoria, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España" "etiqueta" => "c" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dra. Victoria Hernando. Centro Nacional de Epidemiología. Instituto de Salud Carlos III. C/ Sinesio Delgado, 6. 28029 Madrid. España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gastroenteritis outbreak in tourists: limitations of information and response" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-03-23" "fechaAceptado" => "2006-07-21" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras claves" "identificador" => "xpalclavsec14166" "palabras" => array:4 [ 0 => "Gastroenteritis" 1 => "Brotes" 2 => "Turistas" 3 => "Limitaciones" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec14165" "palabras" => array:4 [ 0 => "Gastroenteritis" 1 => "Outbreaks" 2 => "Tourists" 3 => "Limitations" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónSe presentan los resultados de los distintos estudios realizados en la investigación de un brote de gastroenteritis y se exponen las dificultades y las limitaciones que condicionaron su estudio. MétodosSe diseñaron varios estudios analíticos: un estudio de cohortes y un estudio de casos y controles con diferente tamaño muestral. ResultadosDe los 189 participantes, el 43% respondió el cuestionario. Se identificaron 45 casos. Los factores que se asociaron significativamente con la enfermedad fueron: la cena del día 11 de diciembre en uno de los restaurantes del complejo, tanto en el estudio de cohortes como en el de casos y controles, y la excursión a una isla cercana en el de cohortes. DiscusiónSe confirmó la existencia de un brote, aunque debido a la baja tasa de respuesta y las dificultades para entrevistar a los participantes del viaje, no fue posible identificar la vía de transmisión." ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "BackgroundWe present the results of different studies performed in the investigation of a gastroenteritis outbreak and we describe the difficulties and limitations encountered during its study. MethodsSeveral analytical studies were designed: one cohort study and one case-control study with different samples sizes. ResultsOf the 189 trip participants, 43% answered the questionnaire. Forty-five cases were identified. The factors significantly associated with the disease were: dinner in one of the restaurants of the resort on December 11 in all analytical studies and the excursion to a nearby island in the cohort study. DiscussionThe outbreak was confirmed however due to the low response rate and the problems encountered to interview the participants in the trip, it was not possible to identify the route of transmission." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Organización Mundial del Turismo 2004. Disponible en: <a class="elsevierStyleInterRef" href="http://www%20world-tourism%20org/">www world-tourism org</a>" ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Food and waterborne infections associated with package holidays" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.Y. Cartwright" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Appl Microbiol" "fecha" => "2003" "volumen" => "94" "numero" => "Suppl" "paginaInicial" => "12" "paginaFinal" => "24" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Waterborne outbreak among Spanish tourists in a holiday resort in the Dominican Republic, August 2002" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Paez" 1 => "R. Pimentel" 2 => "M.V. Martínez de Aragon" 3 => "P.G. Hernández" 4 => "O.S. Mateo" 5 => "J.F. Martínez Navarro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Euro Surveill" "fecha" => "2004" "volumen" => "9" "paginaInicial" => "21" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15677851" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infectious diseases in air travellers arriving in the UK" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Gerard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J R Soc Health" "fecha" => "2002" "volumen" => "122" "paginaInicial" => "86" "paginaFinal" => "88" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brotes epidémicos 2001" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Dirección General de Salud Pública CdSCdM" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Boletín Epidemiológic de la Comunidad de Madrid" "fecha" => "2002" "volumen" => "8" "paginaInicial" => "45" "paginaFinal" => "67" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surveillance for foodborne-disease outbreaks: United States, 1993-1997" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.J. Olsen" 1 => "L.C. MacKinnon" 2 => "J.S. Goulding" 3 => "N.H. Bean" 4 => "L. Slutsker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "MMWR CDC Surveill Summ" "fecha" => "2000" "volumen" => "49" "paginaInicial" => "1" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12412614" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Limitations to successful investigation and reporting of foodborne outbreaks: an analysis of foodborne disease outbreaks in FoodNet catchment areas, 1998-1999" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.F. Jones" 1 => "B. Imhoff" 2 => "M. Samuel" 3 => "P. Mshar" 4 => "K.G. McCombs" 5 => "M. Hawkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/380848" "Revista" => array:7 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2004" "volumen" => "38" "numero" => "Suppl 3" "paginaInicial" => "297" "paginaFinal" => "302" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14699466" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brotes de enfermedades transmitidas por alimentos. España, 1993-2002 (excluye brotes hídricos)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.G. Hernández" 1 => "A. Torres" 2 => "P. Ordóñez" 3 => "C. Cevallos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Boletín Epidemiológic Semanal" "fecha" => "2004" "volumen" => "12" "paginaInicial" => "289" "paginaFinal" => "291" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brotes de enfermedades transmitidas por alimentos. España. 2003 (excluye brotes hídricos)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Cevallos" 1 => "P.G. Hernández" 2 => "A. Torres" 3 => "P. Ordóñez" 4 => "S. Villarrubia" 5 => "Bleda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Boletín Epidemiológic Semanal" "fecha" => "2005" "volumen" => "13" "paginaInicial" => "25" "paginaFinal" => "32" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of case-control studies in outbreak investigations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.M. Dwyer" 1 => "H. Strickler" 2 => "R.A. Goodman" 3 => "H.K. Armenian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Epidemiol Rev" "fecha" => "1994" "volumen" => "16" "paginaInicial" => "109" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7925720" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02139111/0000002100000003/v2_201301241604/S0213911107720137/v2_201301241604/es/main.assets" "Apartado" => array:4 [ "identificador" => "778" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales breves" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02139111/0000002100000003/v2_201301241604/S0213911107720137/v2_201301241604/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720137?idApp=WGSE"]

Gaceta Sanitaria

ISSN: 0213-9111

Gaceta Sanitaria es la revista científica y órgano de expresión de la Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS).
Gaceta Sanitaria acepta para su publicación artículos en español e inglés. Es una revista Open Access (OA); todos sus artículos son accesibles libremente sin cargo para el usuario y se distribuyen con la licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional

Call for papers: Special Issue on Health Economics

Convocatoria abierta y permanente para incorporar Editores/as asociados/as al Comité Editorial de Gaceta Sanitaria

Call for papers: Special Issue on Health Economics

Open and permanent call to incorporate Associate Editors to the Editorial Committee of Gaceta Sanitaria

Indexada en:

Web of Science (Science Citation Index, SCI, y Social Sciences Citation Index, SSCI), Medline/PubMed, Index Medicus, Scopus, Scielo, IBECS, Índice Médico Español, Toxline, Cancerlit, Aidsline, Cab Health, Bibliomed, Cuiden, Eventline y Healthstar

De los 189 participantes, el 43% respondió el cuestionario. Se identificaron 45 casos. Los factores que se asociaron significativamente con la enfermedad fueron: la cena del día 11 de diciembre en uno de los restaurantes del complejo, tanto en el estudio de cohortes como en el de casos y controles, y la excursión a una isla cercana en el de cohortes.

Discusión

Se confirmó la existencia de un brote, aunque debido a la baja tasa de respuesta y las dificultades para entrevistar a los participantes del viaje, no fue posible identificar la vía de transmisión.

Palabras claves:

Gastroenteritis

Brotes

Turistas

Limitaciones

Abstract

Background

We present the results of different studies performed in the investigation of a gastroenteritis outbreak and we describe the difficulties and limitations encountered during its study.

Methods

Several analytical studies were designed: one cohort study and one case-control study with different samples sizes.

Results

Of the 189 trip participants, 43% answered the questionnaire. Forty-five cases were identified. The factors significantly associated with the disease were: dinner in one of the restaurants of the resort on December 11 in all analytical studies and the excursion to a nearby island in the cohort study.

Discussion

The outbreak was confirmed however due to the low response rate and the problems encountered to interview the participants in the trip, it was not possible to identify the route of transmission.

Key Words:

Gastroenteritis

Outbreaks

Tourists

Limitations

El Texto completo está disponible en PDF

Bibliografía

[1.]

Organización Mundial del Turismo 2004. Disponible en: www world-tourism org

[2.]

R.Y. Cartwright.

Food and waterborne infections associated with package holidays.

J Appl Microbiol, 94 (2003), pp. 12-24

[3.]

J.A. Paez, R. Pimentel, M.V. Martínez de Aragon, P.G. Hernández, O.S. Mateo, J.F. Martínez Navarro.

Waterborne outbreak among Spanish tourists in a holiday resort in the Dominican Republic, August 2002.

Euro Surveill, 9 (2004), pp. 21-23

Medline

[4.]

E. Gerard.

Infectious diseases in air travellers arriving in the UK.

J R Soc Health, 122 (2002), pp. 86-88

[5.]

Dirección General de Salud Pública CdSCdM.

Brotes epidémicos 2001.

Boletín Epidemiológic de la Comunidad de Madrid, 8 (2002), pp. 45-67

[6.]

S.J. Olsen, L.C. MacKinnon, J.S. Goulding, N.H. Bean, L. Slutsker.

Surveillance for foodborne-disease outbreaks: United States, 1993-1997.

MMWR CDC Surveill Summ, 49 (2000), pp. 1-62

Medline

[7.]

T.F. Jones, B. Imhoff, M. Samuel, P. Mshar, K.G. McCombs, M. Hawkins, et al.

Limitations to successful investigation and reporting of foodborne outbreaks: an analysis of foodborne disease outbreaks in FoodNet catchment areas, 1998-1999.

Clin Infect Dis, 38 (2004), pp. 297-302

http://dx.doi.org/10.1086/380848 | Medline

[8.]

P.G. Hernández, A. Torres, P. Ordóñez, C. Cevallos.

Brotes de enfermedades transmitidas por alimentos. España, 1993-2002 (excluye brotes hídricos).

Boletín Epidemiológic Semanal, 12 (2004), pp. 289-291

[9.]

C. Cevallos, P.G. Hernández, A. Torres, P. Ordóñez, S. Villarrubia, Bleda, et al.

Brotes de enfermedades transmitidas por alimentos. España. 2003 (excluye brotes hídricos).

Boletín Epidemiológic Semanal, 13 (2005), pp. 25-32

[10.]

D.M. Dwyer, H. Strickler, R.A. Goodman, H.K. Armenian.