03400e26e53543bfa1791d3228a09f88 282295.pdf df32583125f8ef51633a4a2d5b3d11434fbd5567 282295.pdf c8d93bd32617361c7b5a5134a995b458100c03850350df253f7b940ac2799eac 282295.pdf Title: Epidemiological Characteristics and Spatio-Temporal Distribution of Hepatitis A in Spain in the Context of the 2016/2017 European Outbreak Subject: The aim of our study was to describe the results of the epidemiological surveillance of hepatitis A infections in Spain in the context of the 2016/2017 European outbreak, particularly of hepatitis A outbreaks reported in the MSM population, incorporating the results of a spatio-temporal analysis of cases. Hepatitis A cases and outbreaks reported in 2016–2017 to the National Epidemiological Surveillance Network were reviewed: outbreaks in which some of the cases belonged to the MSM group were described, and clusters of hepatitis A cases in men and women were analysed using a space–time scan statistic. Twenty-six outbreaks were identified, with a median size of two cases per outbreak, with most of the outbreak-related cases belonging to the 15–44 years-old group. Nearly 85% occurred in a household setting, and in all outbreaks, the mode of transmission was direct person-to-person contact. Regarding space–time analysis, twenty statistically significant clusters were identified in the male population and eight in the female population; clusters in men presented a higher number of observed cases and affected municipalities, as well as a higher percentage of municipalities classified as large urban areas. The elevated number of cases detected in clusters of men indicates that the number of MSM-related outbreaks may be higher than reported, showing that spatio-temporal analysis is a complementary, useful tool which may improve the detection of outbreaks in settings where epidemiological investigation may be more challenging. Keywords: hepatitis A virus; epidemiological surveillance; MSM; outbreaks; space-time clustering; urban population Author: María Guerrero-Vadillo, Marina Peñuelas, Ángela Domínguez, Pere Godoy, Diana Gómez-Barroso, Nuria Soldevila, Conchita Izquierdo, Ana Martínez, Nuria Torner, Ana Avellón, Cristina Rius and Carmen Varela Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Dec 14 10:14:56 2022 CET ModDate: Wed Dec 14 10:31:31 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2836431 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XMESMT+VnURWPalladioL Type 1 Custom yes yes no 10 0 WAUDGG+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 JHAXGI+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 OXSKSW+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 OPETZR+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 74 0 CIDFont+F3 CID TrueType Identity-H yes no yes 80 0 CIDFont+F1 CID TrueType Identity-H yes no yes 88 0 CIDFont+F2 CID TrueType Identity-H yes no yes 96 0 CIDFont+F3 CID TrueType Identity-H yes no yes 113 0 CIDFont+F1 CID TrueType Identity-H yes no yes 121 0 CIDFont+F2 CID TrueType Identity-H yes no yes 129 0 CIDFont+F3 CID TrueType Identity-H yes no yes 144 0 CIDFont+F1 CID TrueType Identity-H yes no yes 152 0 CIDFont+F2 CID TrueType Identity-H yes no yes 160 0 CIDFont+F3 CID TrueType Identity-H yes no yes 175 0 CIDFont+F1 CID TrueType Identity-H yes no yes 183 0 CIDFont+F2 CID TrueType Identity-H yes no yes 191 0 CIDFont+F3 CID TrueType Identity-H yes no yes 206 0 CIDFont+F1 CID TrueType Identity-H yes no yes 214 0 CIDFont+F2 CID TrueType Identity-H yes no yes 222 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 234 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-10-05 02:30:50 CEST RepresentationInformation: 282295.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-10-04 10:32:41 CEST Size: 2836431 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 377 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Study Area Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Data Sources Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Hepatitis A Outbreaks Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Hepatitis A Cases Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Children: Item: Title: Temporal Trends Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Space Time Cluster Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Statistical Analyses Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Children: Item: Title: Outbreaks Related to MSM Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Temporal Trends and Male-to-Female Ratio Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Space Time Cluster Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@6121c9d6 Info: Title: Epidemiological Characteristics and Spatio-Temporal Distribution of Hepatitis A in Spain in the Context of the 2016/2017 European Outbreak Author: María Guerrero-Vadillo, Marina Peñuelas, Ángela Domínguez, Pere Godoy, Diana Gómez-Barroso, Nuria Soldevila, Conchita Izquierdo, Ana Martínez, Nuria Torner, Ana Avellón, Cristina Rius and Carmen Varela Subject: The aim of our study was to describe the results of the epidemiological surveillance of hepatitis A infections in Spain in the context of the 2016/2017 European outbreak, particularly of hepatitis A outbreaks reported in the MSM population, incorporating the results of a spatio-temporal analysis of cases. Hepatitis A cases and outbreaks reported in 2016 2017 to the National Epidemiological Surveillance Network were reviewed: outbreaks in which some of the cases belonged to the MSM group were described, and clusters of hepatitis A cases in men and women were analysed using a space time scan statistic. Twenty-six outbreaks were identified, with a median size of two cases per outbreak, with most of the outbreak-related cases belonging to the 15 44 years-old group. Nearly 85% occurred in a household setting, and in all outbreaks, the mode of transmission was direct person-to-person contact. Regarding space time analysis, twenty statistically significant clusters were identified in the male population and eight in the female population; clusters in men presented a higher number of observed cases and affected municipalities, as well as a higher percentage of municipalities classified as large urban areas. The elevated number of cases detected in clusters of men indicates that the number of MSM-related outbreaks may be higher than reported, showing that spatio-temporal analysis is a complementary, useful tool which may improve the detection of outbreaks in settings where epidemiological investigation may be more challenging. 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