Legionella pneumonia has increased in Navarra, Spain in recent weeks

The incidence of acute gastroenteritis remains high, with 306 cases last week

Cases of Legionella pneumonia have increased in Navarra this fall, as they have in previous years. The Institute of Public and Occupational Health of Navarra (ISPLN) noted in its epidemiological report that there have been 43 possible cases of infection in the autonomous community so far this year, with 13 confirmed in the past four weeks. Week of October 2-8.

In all cases, environmental studies were conducted to identify possible sources of exposure, but no evidence of a common source was found in the cases. Some infections were acquired at holiday resorts, others due to contamination of domestic hot water installations, and still others the source could not be determined after community risk had been ruled out.

Reasons for the increase in cases include: the seasonality of Legionnaires’ disease, which “tends to be highest in the autumn”; an increase in vulnerable groups due to advanced age or immunodeficiency; or keeping domestic hot water tanks below 60°C, which favors Legionella of reproduction.

“While confirmation of the etiology of pneumonia is not critical for appropriate treatment, it is recommended to rule out a diagnosis of Legionnaires’ disease by measuring Legionella antigens in urine. This is an easily accessible, non-invasive sample that can be used in healthcare The request to public health authorities stressed: “Detection of Legionella can study and control possible outbreaks that could lead to more cases. “

In cases where the presence of Legionnaires’ disease is confirmed by antigens in urine, “it is important to perform a sputum culture to be able to draw conclusions about the similarity of Legionella detected in patient and environmental samples.”

Likewise, it recommends keeping domestic hot water tanks and circuits at high temperatures (>60°) to prevent bacterial growth, purifying water circuits after periods of non-use, and performing “good maintenance” on facilities. Also avoid or reduce tobacco consumption, as it increases your risk of getting sick from exposure to Legionella bacteria.

Cases of acute gastroenteritis remain high

The number of acute gastroenteritis cases remains high, with 306 cases reported in primary care last week. The incidence rate was “within the range recorded for the same period in other years.”

The causative factors are diverse. The biggest increase was in viruses, particularly norovirus, which causes “temporary symptoms that are often unconfirmed.” Bacteria and parasites are associated with longer-lasting symptoms. Cryptosporidiosis cases have declined for the fourth consecutive week.

Recommendations for preventing and controlling gastroenteritis include practicing good hand hygiene regularly and always after using the toilet and before eating or handling food.

Children with symptoms of acute gastroenteritis should not go to day care until their symptoms have completely resolved. People with symptoms of acute gastroenteritis should avoid handling food or cooking for others until symptoms completely resolve.

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The Public Health Department recalls that in September there was an outbreak of cryptosporidiosis associated with drinking water in Tarasana (Aragón). In the eight municipalities of Navarra that belong to the same water community, an incidence of acute gastroenteritis was observed that was “consistent with what has been recorded in other municipalities of Navarra”. In recent weeks, there have been no confirmed cases of cryptosporidiosis in these eight cities.

respiratory tract infection

On the other hand, the number of presentations for acute respiratory infections in primary care remained stable last week, with Covid-19 cases falling and influenza syndrome increasing.

The rate is 542 cases per 100,000 inhabitants, including 9 influenza syndrome cases per 100,000 inhabitants and 57 COVID-19 cases per 100,000 inhabitants.

Sixteen people have been hospitalized with covid-19 and one has died. A case of influenza A (H1N1) was confirmed this week and required hospitalization. No cases of respiratory syncytial virus have been confirmed this week. High circulation of rhinovirus, and to a lesser extent other viruses such as adenovirus and parainfluenza virus, is found in patients with acute respiratory infections.

“Different respiratory viruses can spread throughout the year,” says ISPLN, which recommends maintaining preventive measures to avoid severe illness in vulnerable people due to advanced age or chronic illness.

Overall mortality rate in Navarra

There were 95 deaths recorded in the week of September 25 to October 1 (complete data was available last week), a value “within what would be expected for this time of year”.

Preliminary estimates for the week of October 2-8 suggest that the death toll remains at a similar figure. So far this year, the cumulative death rate is below the median of the previous five years.

The death toll is estimated to be around 130 fewer than expected, due to a “mild” respiratory virus season and the “moderate impact” of the heatwave.