Control de un brote escolar de enfermedad meningocócica serogrupo B mediante quimioprofilaxis con azitromicina y ciprofloxacino
Control of a school outbreak of meningococcal b infection through chemoprophylaxis with azithromycin and ciprofloxacin
A. González de Aledo Linos
, J. García Merino
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Sección de Promoción de la Salud. Dirección General de Sanidad de Cantabria. Santander
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"apellidos" => "González de Aledo Linos" "email" => array:1 [ 0 => "aaledo@cantabria.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "García Merino" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección de Promoción de la Salud. Dirección General de Sanidad de Cantabria. Santander" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*." "correspondencia" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Correspondencia</span></span>: Valdenoja, 46, 7.° 39012 Santander (Cantabria)." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Control of a school outbreak of meningococcal b infection through chemoprophylaxis with azithromycin and ciprofloxacin" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-01-01" "fechaAceptado" => "2000-07-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186499" "palabras" => array:4 [ 0 => "<span class="elsevierStyleItalic">Meningococcus</span>" 1 => "<span class="elsevierStyleItalic">Chemoprophylaxis</span>" 2 => "<span class="elsevierStyleItalic">Azithromycin</span>" 3 => "<span class="elsevierStyleItalic">Ciprofloxacin</span>" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186498" "palabras" => array:4 [ 0 => "<span class="elsevierStyleItalic">Meningococo</span>" 1 => "<span class="elsevierStyleItalic">Quimioprofilaxis</span>" 2 => "<span class="elsevierStyleItalic">Azitromicina</span>" 3 => "<span class="elsevierStyleItalic">Ciprofloxacino</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comprobar la efectividad de la azitromicina como medicamento quimioprofiláctico de la enfermedad meningocócica en preescolares, y la seguridad del ciprofloxacino en niños de 6 a 16 años.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En un brote escolar de enfermedad meningocócica, ante el fallo previo de la rifampicina, se realizó un segundo ciclo de quimioprofilaxis con azitromicina en educación infantil (99 niños de 3 a 5 años) y con ciprofloxacino en educación primaria y secundaria (795 niños de 6 a 16 años) y en los 58 adultos del centro. La eficacia de la quimioprofilaxis se comprobó mediante los registros de ingresos por enfermedad meningocócica, el sistema EDO y las bajas escolares, y la seguridad del ciprofloxacino mediante encuestas dirigidas a los padres y a los pediatras de la zona de influencia del colegio, destinadas a recoger la incidencia de efectos adversos osteoarticulares.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El brote se controló con la quimioprofilaxis establecida. Se recogieron 764 encuestas (tasa de respuesta, 89,5%). La incidencia de artralgias tras ciprofloxacino fue del 0,9% en los niños y del 3,3% en adultos. Todas fueron leves y autolimitadas sin tratamiento, menos un caso (en el grupo de adultos) en que persistían un mes tras la quimioprofilaxis pero de naturaleza tan leve que no había consultado a su médico. Sólo 3 niños habían realizado consulta médica por las artralgias, por lo que la incidencia detectada por el sistema habitual de farmacovigilancia hubiera sido de 0,4% en los niños y 0% en los adultos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La azitromicina fue eficaz en el control del brote en los niños de 3-5 años. El ciprofloxacino fue seguro y eficaz, sin ningún efecto osteoarticular grave o persistente en niños, y con una incidencia de artralgias menor que en los adultos.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the efficacy of azithromycin as a chemoprophylactic agent in meningococcal disease in pre-school aged children, and the safety of ciprofloxacin in children aged 6-16 years old.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">After classic chemoprophylaxis with rifampicin failed to control a school outbreak of meningococcal disease in Cantabria (Spain), a second cycle of chemoprophylaxis was administered in the school. Azithromycin was administered in the nursery level (99 children, aged 3-5 years old) and ciprofloxacin was administered in the primary and secondary levels (795 children, aged 6-16 years old) and in the school's adult personnel (58 persons). The efficacy of chemoprophylaxis was studied through records of cases of meningococcal disease, the mandatory disease reporting system, and the school's absences. The safety of ciprofloxacin was studied using a questionnaire designed to determine the incidence of adverse osteoarticular effects, which was distributed to parents, school personnel and pediatricians within the school's area.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The chemoprophylaxis administered controlled the outbreak. We collected 764 questionnaires (response rate: 89.5%). The incidence of arthralgia after ciprofloxacin was 0.9% in children and 3.3% in adults. All were mild and self-limiting without specific treatment, except in one patient (in the adult group) in whom arthralgia was present 1 month after prophylactic treatment. However, the arthralgia was so mild that the patient had not consulted her physician. Only three children had sought medical advice for arthralgia. Consequently, the incidence that would have been detected by the Spanish pharmacovigilance system would have been 0.4% in children and 0% in adults.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Azithromycin was effective in controlling the outbreak in children aged between 3 and 5 years. Ciprofloxacin was safe and effective, with no serious or persistent osteoarticular effects in children. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 11 | 15 |
| 2024 Octubre | 37 | 55 | 92 |
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| 2024 Mayo | 50 | 43 | 93 |
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| 2023 Noviembre | 32 | 40 | 72 |
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| 2023 Septiembre | 19 | 28 | 47 |
| 2023 Agosto | 21 | 17 | 38 |
| 2023 Julio | 37 | 36 | 73 |
| 2023 Junio | 26 | 35 | 61 |
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| 2023 Marzo | 17 | 33 | 50 |
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| 2023 Enero | 16 | 24 | 40 |
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| 2022 Marzo | 29 | 42 | 71 |
| 2022 Febrero | 21 | 36 | 57 |
| 2022 Enero | 27 | 37 | 64 |
| 2021 Diciembre | 21 | 47 | 68 |
| 2021 Noviembre | 27 | 48 | 75 |
| 2021 Octubre | 37 | 63 | 100 |
| 2021 Septiembre | 24 | 56 | 80 |
| 2021 Agosto | 45 | 27 | 72 |
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| 2021 Junio | 19 | 36 | 55 |
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| 2021 Marzo | 52 | 16 | 68 |
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| 2020 Diciembre | 44 | 17 | 61 |
| 2020 Noviembre | 15 | 8 | 23 |
| 2020 Octubre | 10 | 6 | 16 |
| 2020 Septiembre | 12 | 6 | 18 |
| 2020 Agosto | 12 | 12 | 24 |
| 2020 Julio | 9 | 12 | 21 |
| 2020 Junio | 26 | 14 | 40 |
| 2020 Mayo | 20 | 16 | 36 |
| 2020 Abril | 19 | 9 | 28 |
| 2020 Marzo | 29 | 9 | 38 |
| 2020 Febrero | 22 | 8 | 30 |
| 2020 Enero | 17 | 15 | 32 |
| 2019 Diciembre | 23 | 16 | 39 |
| 2019 Noviembre | 21 | 5 | 26 |
| 2019 Octubre | 11 | 11 | 22 |
| 2019 Septiembre | 15 | 19 | 34 |
| 2019 Agosto | 14 | 14 | 28 |
| 2019 Julio | 22 | 23 | 45 |
| 2019 Junio | 29 | 34 | 63 |
| 2019 Mayo | 17 | 51 | 68 |
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| 2019 Marzo | 11 | 12 | 23 |
| 2019 Febrero | 16 | 8 | 24 |
| 2019 Enero | 18 | 7 | 25 |
| 2018 Diciembre | 17 | 14 | 31 |
| 2018 Noviembre | 13 | 19 | 32 |
| 2018 Octubre | 21 | 12 | 33 |
| 2018 Septiembre | 10 | 10 | 20 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Junio | 2 | 0 | 2 |
| 2018 Mayo | 3 | 0 | 3 |
| 2018 Abril | 5 | 0 | 5 |
| 2018 Marzo | 3 | 0 | 3 |
| 2018 Febrero | 8 | 0 | 8 |
| 2018 Enero | 6 | 0 | 6 |
| 2017 Diciembre | 7 | 0 | 7 |
| 2017 Noviembre | 11 | 0 | 11 |
| 2017 Octubre | 9 | 0 | 9 |
| 2017 Septiembre | 10 | 0 | 10 |
| 2017 Agosto | 2 | 0 | 2 |
| 2017 Julio | 10 | 1 | 11 |
| 2017 Junio | 18 | 6 | 24 |
| 2017 Mayo | 15 | 6 | 21 |
| 2017 Abril | 19 | 2 | 21 |
| 2017 Marzo | 13 | 14 | 27 |
| 2017 Febrero | 7 | 3 | 10 |
| 2017 Enero | 12 | 4 | 16 |
| 2016 Diciembre | 13 | 4 | 17 |
| 2016 Noviembre | 19 | 9 | 28 |
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