Monkeypox outbreak predominantly affecting men who have sex with men,Madrid, Spain, 26 April to 16 June 2022

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18–67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.     

Cultural interpretations of contagion

Anthropological research in recent years has examined how single diseases such as Aids, tuberculosis, measles, malaria and leprosy are conceptualized by laypersons in non-Western societies. But how is disease transmission itself interpreted in other cultures? Data from ethnographical studies in Côte d'Ivoire and the Afro-Brazilian culture in Bahia, Brazil show that the interpretations of contagion and preventive practices cut across society involving five main relationships: empirical and analogical thinking, symbolic factors and social organization, the concept of person and body elements, natural and supernatural powers and individual and contextual factors. There is not a general theory, such as Pasteur's theory of germs. Instead,contagion presents itself as a transversal, multidimensional concept crossing and interconnecting society and culture. Public health programmes aimed at controlling infectious diseases need first to understand how contagion is conceptualized by laypersons, the extent to which diseases are considered infectious and the relation between perceptions and preventive practices. This would help in implementing infectious disease control programmes within local contexts based on meaningful community participation.     

绩效考核在城市社区公共卫生服务管理中的应用效果分析

目的观察实施绩效考核在城市社区公共卫生服务管理中的效果。方法以辖区内7个社区卫生服务中心为研究对象,把健康档案、预防接种、儿童保健、妇女保健、老年保健、高血压、糖尿病、重性精神病患者管理等作为观察指标,通过查阅资料和现场调查,对比实施绩效考核办法前及实施3年后基本公共卫生服务项目组织管理、资金筹集、服务实施等方面的差异。结果上述社区卫生服务中心实施绩效考核办法3年后基本公共卫生服务组织管理项目健全,监督指导进一步加强;在资金筹集情况、健康档案建立率和电子建档率、高血压和糖尿病管理率、重性精神病患者管理率等方面与实施绩效考核办法前比较,管理水平和效果有了显著的提高。结论城市实施基本公共卫生服务项目绩效考核,应用于公共卫生项目的管理可取得较大的成效。     

Thyrotoxicosis in Iceland 1980–1982

ABSTRACT A nationwide survey of the incidence of clinical thyrotoxicosis in Iceland was made during the three-year period 1980–1982. An annual incidence of 23.6 per 100 000 inhabitants was found, females outnumbering males by 4.2: 1; 72% of all patients were aged 20–49. Graves' disease was considered the cause in 83.3% of the patients.