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2014, Number 6

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Rev Med Inst Mex Seguro Soc 2014; 52 (6)

Experience on the management of a hepatitis A outbreak in a children daycare center

Cabrera-Gaytán DA, Nava-Martínez ML, Ontiveros D, Niebla-Fuentes MR, Grajales-Muñiz C, Rojas-Mendoza T

Language: Spanish
References: 22
Page: 330-336
PDF size: 125.51 Kb.


ABSTRACT

Background: Since hepatitis A virus is transmitted via the fecal-oral route, outbreaks in nurseries are favored by constant diaper changes and failures in hygienic measures. The purpose of this investigation was to describe an outbreak of hepatitis A between November 2012 and February 2013 at a nursery in Mexicali, Baja California, as well as the measures adopted for its control.
Methods: A descriptive study was conducted on the outbreak and the control measures, calculating the rates of attack and establishing proportions using the Wilson’s scale. Pupils, workers or family members with symptoms consistent with hepatitis A were considered to be suspected cases. First-occurrence hepatitis A records were reviewed on the Weekly Disease Surveillance Report at the involved medical units and on the nursery’s infi rmary records.
Results: The global attack rate was 13.1 %, and in those captive in the nursery, 9.5 %. Jaundice, biliuria and abdominal pain were the most important clinical data. There were no deaths or hospitalizations. The outbreak lasted 86 days. Control measures were based on epidemiological surveillance reinforcement and preventive hygienic measures.
Conclusions: The outbreak showed a spreading trend, it affected mainly children and showed the importance of health education and epidemiological surveillance maintenance, extensive to the familial setting.


REFERENCES

  1. González-Ayala SE, Cecchini DM. Módulo 4. Enfermedades virales transmitidas por alimentos. Enfermedades producidas por priones transmitidas por alimentos. En: Organización Panamericana de la Salud. Diagnóstico e investigación epidemiológica de las enfermedades transmitidas por alimentos. Argentina: Organización Panamericana de la Salud; [s. f.]. Disponible en http://publicaciones.ops.org.ar/publicaciones/ publicaciones%20virtuales/libroETAs/ modulo4/modulo4c.html

  2. Mauss S, Berg T, Rockstroh J, Sarrazin C, Wedemeyer H, editores. Hepatology 2013. A clinical textbook. Fourth edition. Germany: Flying Publisher; 2013.

  3. Dakic Z, Musa S. Hepatitis A outbreak in Bijeljina, Bosnia and Herzegovina, August 2012-April 2013. Euro Surveill. 2013;18(21).pii:20486. Texto libre en http://www.eurosurveillance.org/images/dynamic/ EE/V18N21/art20486.pdf

  4. Arce-Arnáez A, Rodero-Garduño I, Íñigo-Martínez J, Burgoa-Arenales M, Guevara-Alemany E. Brote de hepatitis A en una escuela infantil y transmisión intrafamiliar de la infección. An Pediatr. 2004;60(3): 222-7.

  5. Pelletier AR, Mehta PJ, Burgess DR, Bondeson LM, Carson PJ, Rea VE, et al. An Outbreak of hepatitis A among primary and secondary contacts of an International adoptee. Public Health Rep. 2010;125(5): 642-6.

  6. Rump BO, Visser O, Te Wierik MJ, Vennema H, Fanoy EB. Use of PCR for detection of faecal HAV as a screening tool in an outbreak of hepatitis A in daycare centres. Epidemiol Infect. 2013;141(3):549-55.

  7. Servicio Municipal de Salud de la Región de Murcia. Protocolo de actuación frente a la hepatitis A. Murcia, España: Consejería de Sanidad. Dirección de General de Salud Pública; 2008. Texto libre en https://www.murciasalud.es/recursos/fi cheros/134557 -hepatitisA.pdf

  8. Torner N, Broner S, Martínez A, Tortajada C, García- de Olalla P, Barrabeig I, et al. Factors associated to duration of hepatitis A outbreaks: Implications for control. PLoS One. 2012;7(2):e31339.

  9. Grupo de Vigilancia y Control de Factores de Riesgo Ambiental. Protocolo de vigilancia y control de hepatitis A. INT-R02.002.4040-003. Versión No. 00. Colombia: Instituto Nacional de Salud, Subdirección de Vigilancia y Control en Salud Pública; 2009.

  10. Vernon AA, Schable C, Francis D. A large outbreak of hepatitis a in a day-care center association with non-toilet-trained children and persistence of IgM antibody to hepatitis A virus. Am J Epidemiol. 1982; 115(3):325-31.

  11. Zhang LJ, Wang XJ, Bai JM, Fang G, Liu G, Zhang Y, et al. An outbreak of hepatitis A in recently vaccinated students from ice snacks made from contaminated well water. Epidemiol Infect. 2009;137(3):428-33.

  12. Rizzo C, Alfonsi V, Bruni R, Busani L, Ciccaglione A, De Medici D, et al. Ongoing outbreak of hepatitis A in Italy: preliminary report as of 31 May 2013. Euro Surveill. 2013;18(27).pii:20518. Texto libre en http:// www.eurosurveillance.org/images/dynamic/EE/V18 N27/art20518.pdf

  13. Nordic Outbreak Investigation Team C. Joint analysis by the Nordic countries of a hepatitis A outbreak, October 2012 to June 2013: Frozen strawberries suspected. Euro Surveill. 2013;18(27).pii:20520. Texto libre en http://www.eurosurveillance.org/images/dynamic/ EE/V18N27/art20520.pdf

  14. Norma ofi cial mexicana NOM-201-SSA1-2002, productos y servicios. Agua y hielo para consumo humano, envasados y a granel. Especifi caciones sanitarias. México: Secretaría de Salud; 2002. Texto libre en http:// www.salud.gob.mx/unidades/cdi/nom/201ssa12.html

  15. Norma ofi cial mexicana NOM-093-SSA1-1994, bienes y servicios. Prácticas de higiene y sanidad en la preparación de alimentos que se ofrecen en establecimientos fi jos. México: Secretaría de Salud; 1995. Texto libre en http://www.salud.gob.mx/ unidades/cdi/nom/093ssa14.html

  16. Koff RS. Hepatitis A. Lancet. 1998;351(9116):1643-9.

  17. Hepatitis A associated with child care, Juneau. State of Alaska Epidemiol Bull. 1984 Jul 13;(12):[s.p.]. Texto libre en http://www.epi.hss.state.ak.us/bulletins/docs/ b1984_ 12.pdf

  18. Staes CJ, Schlenker TL, Risk I, Cannon KG, Harris H, Pavia AT, et al. Sources of infection among persons with acute hepatitis A and no identifi ed risk factors during a sustained community-wide outbreak. Pediatrics. 2000;106(4):E54.

  19. Centers for Disease Control and Prevention. [Sitio web]. Hepatitis A FAQs for Health Professionals. Hepatitis A information for health professionals. Atlanta, GA: Centers for Disease Control and Prevention; 2013. Disponible en http://www.cdc.gov/ hepatitis/HAV/HAVfaq.htm#D1

  20. Aszkenasy OM. A community outbreak of hepatitis A in a religious community in Indiana: Failure of immune serum globulin to prevent the spread of infection. Epidemiol Infect. 2000;124(2):309-13.

  21. Zamir C, Rishpon S, Zamir D, Leventhal A, Rimon N, Ben-Porath E. Control of a community-wide outbreak of hepatitis A by mass vaccination with inactivated hepatitis A vaccine. Eur J Clin Microbiol Infect Dis. 2001;20(3):185-7.

  22. Taliani G, Gaeta GB. Hepatitis A: Post-exposure prophylaxis. Vaccine. 2003;21(19-20):2234-7.




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