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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">El 25 de septiembre de 2005 m&#225;s de un centenar de reclusos presentaron s&#237;ntomas de gastroenteritis&#44; casi un 5&#37; de los 1&#46;800 reclusos de una prisi&#243;n&#46; El objetivo del estudio fue confirmar la existencia de un brote&#44; identificar los factores de riesgo&#44; implementar medidas de control y establecer recomendaciones&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un an&#225;lisis de cohortes de una muestra aleatoria estratificada de todos los internos&#44; un an&#225;lisis de cohortes de uno de los m&#243;dulos de la prisi&#243;n y una investigaci&#243;n medioambiental&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 221 internos de toda la prisi&#243;n&#44; de los cuales se entrevist&#243; a 196&#46; Un 28&#37; eran casos&#44; cuya sintomatolog&#237;a principal fue dolor abdominal &#40;85&#37;&#41; y diarrea &#40;71&#37;&#41;&#46; Todos los alimentos consumidos presentaron tasas de ataque similares&#46; Se asoci&#243; con la enfermedad el hecho de comer toda la raci&#243;n de salpic&#243;n de marisco de la comida &#40;riesgo relativo &#91;RR&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#44;1-3&#44;8&#41; o toda la raci&#243;n de gambas rebozadas en la cena &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;8&#59; IC del 95&#37;&#44; 1&#44;1-3&#44;1&#41; del d&#237;a 24 de septiembre&#46; En el an&#225;lisis de uno de los m&#243;dulos de la prisi&#243;n se obtuvo resultados similares a la muestra aleatoria&#46; En una muestra de salpic&#243;n de marisco se aislaron <span class="elsevierStyleItalic">Clostridium perfringens&#44; Bacillus cereus</span> y <span class="elsevierStyleItalic">Escherichia coli</span>&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Se confirm&#243; un brote de gastroenteritis por varios pat&#243;genos&#46; Tanto los s&#237;ntomas como el per&#237;odo de incubaci&#243;n corresponden a los pat&#243;genos aislados&#46; La preparaci&#243;n de los alimentos en centros penitenciarios debe cumplir los est&#225;ndares m&#237;nimos de seguridad&#44; que incluya la refrigeraci&#243;n y la educaci&#243;n de los manipuladores&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">On September 25 2005&#44; more than 100 inmates &#40;almost 5&#37; of the 1&#44;800 prison population&#41; experienced sudden onset gastroenteritis&#46; This outbreak was the largest foodborne outbreak described in a prison population in Spain&#46; Our objective was to confirm the outbreak&#44; identify risk factors&#44; implement control measures&#44; and provide recommendations&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We conducted a cohort analysis of a stratified random sample of all the inmates&#44; a cohort analysis of the one of the prison blocks&#44; and an environmental investigation&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 221 inmates were selected&#44; of which 196 were interviewed&#46; Twenty-eight percent had gastroenteritis and the main symptoms were abdominal pain &#40;85&#37;&#41; and diarrhea &#40;71&#37;&#41;&#46; All foods consumed caused similar attack rates&#46; Factors associated with the risk of illness were eating the entire portion of seafood cocktail at lunch or all of the fried shrimp at dinner on September 24 &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; 95&#37; CI&#44; 1&#46;1-3&#46;8&#44; and RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#59; 95&#37; CI&#44; 1&#46;1-3&#46;1&#41;&#46; Analysis of one of the prison blocks yielded results similar to those of the random sample&#46; <span class="elsevierStyleItalic">Clostridium perfringens&#44; Bacillus cereus</span> and <span class="elsevierStyleItalic">Escherichia coli</span> were isolated from a sample of the seafood cocktail&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">A gastroenteritis outbreak caused by several pathogens was confirmed&#46; Both the reported symptoms and the calculated incubation periods corresponded to the pathogens isolated&#46; Preparation of food in prison facilities should meet minimum safety standards&#44; including refrigeration and training of food handlers&#46;</p>"
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Vol. 21. Núm. 6.
Páginas 452-457 (noviembre - diciembre 2007)
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Vol. 21. Núm. 6.
Páginas 452-457 (noviembre - diciembre 2007)
Originales
Open Access
Investigación de una toxiinfección alimentaria en un centro penitenciario de alta ocupación
Investigation of a foodborne intoxication in a high-density penitentiary center
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Victoria Hernandoa,
Autor para correspondencia
vhernando@isciii.es

Correspondencia: Victoria hernando. Instituto de la Salud Carlos III. Sinesio Delgado, 8. Pabellón 3. 28029 Madrid. España.
, Lou Narot Arranza, Susana Catalánb, Pilar Gómezb, Cristina Hidalgoc, Alicia Barrasaa, Dionisio Herreraa
a Programa de Epidemiología Aplicada de Campo, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
b Subdirección General de Sanidad Penitenciaria, Dirección General de Instituciones Penitenciarias, Madrid, España
c Servicio de Salud Pública del Área V de la Comunidad de Madrid, Madrid, España
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Resumen
Introducción

El 25 de septiembre de 2005 más de un centenar de reclusos presentaron síntomas de gastroenteritis, casi un 5% de los 1.800 reclusos de una prisión. El objetivo del estudio fue confirmar la existencia de un brote, identificar los factores de riesgo, implementar medidas de control y establecer recomendaciones.

Métodos

Se realizó un análisis de cohortes de una muestra aleatoria estratificada de todos los internos, un análisis de cohortes de uno de los módulos de la prisión y una investigación medioambiental.

Resultados

Se seleccionaron 221 internos de toda la prisión, de los cuales se entrevistó a 196. Un 28% eran casos, cuya sintomatología principal fue dolor abdominal (85%) y diarrea (71%). Todos los alimentos consumidos presentaron tasas de ataque similares. Se asoció con la enfermedad el hecho de comer toda la ración de salpicón de marisco de la comida (riesgo relativo [RR]=2; intervalo de confianza [IC] del 95%, 1,1-3,8) o toda la ración de gambas rebozadas en la cena (RR=1,8; IC del 95%, 1,1-3,1) del día 24 de septiembre. En el análisis de uno de los módulos de la prisión se obtuvo resultados similares a la muestra aleatoria. En una muestra de salpicón de marisco se aislaron Clostridium perfringens, Bacillus cereus y Escherichia coli.

Conclusión

Se confirmó un brote de gastroenteritis por varios patógenos. Tanto los síntomas como el período de incubación corresponden a los patógenos aislados. La preparación de los alimentos en centros penitenciarios debe cumplir los estándares mínimos de seguridad, que incluya la refrigeración y la educación de los manipuladores.

Palabras clave:
Brote
Prisión
Clostridium perfringens
Bacillus cereus
Gastroenteritis
Abstract
Background

On September 25 2005, more than 100 inmates (almost 5% of the 1,800 prison population) experienced sudden onset gastroenteritis. This outbreak was the largest foodborne outbreak described in a prison population in Spain. Our objective was to confirm the outbreak, identify risk factors, implement control measures, and provide recommendations.

Methods

We conducted a cohort analysis of a stratified random sample of all the inmates, a cohort analysis of the one of the prison blocks, and an environmental investigation.

Results

A total of 221 inmates were selected, of which 196 were interviewed. Twenty-eight percent had gastroenteritis and the main symptoms were abdominal pain (85%) and diarrhea (71%). All foods consumed caused similar attack rates. Factors associated with the risk of illness were eating the entire portion of seafood cocktail at lunch or all of the fried shrimp at dinner on September 24 (RR=2; 95% CI, 1.1-3.8, and RR=1.8; 95% CI, 1.1-3.1). Analysis of one of the prison blocks yielded results similar to those of the random sample. Clostridium perfringens, Bacillus cereus and Escherichia coli were isolated from a sample of the seafood cocktail.

Conclusion

A gastroenteritis outbreak caused by several pathogens was confirmed. Both the reported symptoms and the calculated incubation periods corresponded to the pathogens isolated. Preparation of food in prison facilities should meet minimum safety standards, including refrigeration and training of food handlers.

Key words:
Outbreak
Prison
Clostridium perfringens
Bacillus cereus
Gastroenteritis
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Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
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