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        "titulo" => "Chickenpox outbreak in Herrera del Duque&#44; Badajoz&#44; Spain"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La varicela es una enfermedad de distribuci&#243;n mundial con una elevada morbilidad y pocas complicaciones&#44; aunque puede presentar cuadros cl&#237;nicos graves en inmunodeprimidos y adultos sanos&#46; El objeto de este estudio es identificar y describir las caracter&#237;sticas y los costes de un brote epid&#233;mico en Extremadura&#44; cuya tasa anual de casos declarados al sistema de Enfermedades de Declaraci&#243;n Obligatoria &#40;EDO&#41; oscila en alrededor de 5 por 1&#46;000 habitantes&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo con b&#250;squeda activa de casos entre los meses de noviembre del a&#241;o 2000 y marzo de 2001&#44; y de la susceptibilidad de la cohorte escolarizada del colegio de Herrera del Duque &#40;Badajoz&#41;&#46; Las definiciones de casos fueron recogidas de los protocolos de la Red de Vigilancia de la comunidad extreme&#241;a&#46; La confirmaci&#243;n microbiol&#243;gica se realiz&#243; por aislamiento del virus y por presencia de marcadores IgM e IgG en el suero del enfermo&#46; Se analizaron los costes tangibles directos e indirectos y los no tangibles del brote&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 75 casos identificados&#44; 71 &#40;94&#44;7&#37;&#41; eran ni&#241;os de entre uno y 9 a&#241;os&#44; predominando el sexo masculino&#46; La tasa de ataque fue de 18&#44;5 casos por 1&#46;000 habitantes&#44; y del 68&#44;2&#37; en convivientes menores de 10 a&#241;os&#46; La evoluci&#243;n fue benigna&#44; sin ingresos hospitalarios ni complicaciones&#46; Se encontr&#243; un 71&#44;6&#37; de ni&#241;os susceptibles en los de entre 3 y 8 a&#241;os&#46; Se analiz&#243; una posible agregaci&#243;n temporal de casos en el colegio&#44; obteni&#233;ndose un riesgo relativo &#40;RR&#41; de 5&#44;01 &#40;p &#60; 0&#44;001&#41;&#46; Se aisl&#243; el virus en las 4 muestras de ves&#237;culas estudiadas y la serolog&#237;a &#40;IgM&#41; fue positiva en los 9 sueros estudiados&#46; El coste total de brote fue de 927&#44;21 e&#44; con una media de 12&#44;53 e por caso&#44; y 205 d&#237;as de p&#233;rdida escolar&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se confirm&#243; la existencia de un brote de varicela en el colegio de la localidad de Herrera del Duque&#44; con transmisi&#243;n persona a persona&#44; que afect&#243; a ni&#241;os de entre uno y 9 a&#241;os&#46; La elevada susceptibilidad del alumnado&#44; las caracter&#237;sticas de la docencia y las reuniones previas a los carnavales tuvieron un papel determinante en la propagaci&#243;n de la epidemia&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">El coste estimado para este brote se corresponde con un gasto un 76&#37; menor del producido por la vacunaci&#243;n con una dosis de los 75 casos de este brote&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Chickenpox is a worldwide disease with high morbidity but few complications&#44; although complications can be sevre in immunocompromised individuals and healthy adults&#46; The annual chickenpox rate declared to the National Notification Disease Surveillance System is approximately 5 cases per 1&#44;000 inhabitants in Extremadura &#40;Spain&#41;&#46; The aim of this study was to identify and describe the characteristics and cost of an epidemic outbreak of chickenpox in Extremadura&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Between November 2000 and March 2001&#44; a descriptive study was performed&#46; Cases of chickenpox were actively sought in a cohort of schoolchildren in Herrera del Duque &#40;Badajoz&#41;&#46; The protocols of the Monitoring Network of the Autonomous Community of Extremadura was used for case definition&#46; Microbiological confirmation was performed by isolation of the virus and the presence of IgM and IgG markers in serum&#46; We analyzed the direct and indirect tangible costs as well as the intangible costs of the outbreak&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Seventy-five cases were identified&#44; of which 94&#46;7&#37; occurred in children aged between 1-9 years&#44; mainly boys&#46; The attack rate was 18&#46;5 cases per 1&#44;000 inhabitants and 68&#46;2&#37; occurred in children aged less than 10 years charing a home&#46; The clinical course was benign&#44; without hospital admissions or complications&#46; A total of 71&#46;6&#37; of children aged between 3 and 8 years were susceptible&#46; A possible temporary aggregation of cases in the school was analyzed and a relative risk of 5&#46;01 &#40;p &#60; 0&#46;0001&#41; was obtained&#46; The virus was isolated in the 4 vesicle samples studied and serology was positive &#40;IgM&#41; in the 9 serum samples studied&#46; The total cost of the outbreak was of 927&#44;21 e&#44; with a mean of 12&#44;53 e per case and 205 school days lost&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A chickenpox outbreack was confirmed in Herrera del Duque&#44; with person-to-person transmission&#44; affecting children aged between 1 and 9 years&#46; The high susceptibility of the pupils&#44; the characteristics of teaching&#44; and the meetings prior to the carnivals played a determining role in the transmission of the epidemic&#46; The estimated cost of this outbreak was 76&#37; less than the cost that would have been generated by single-dose vaccination of the 75 individuals who contracted the disease&#46;</p>"
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