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Resultados de la vigilancia de las enfermedades transmisibles notificadas a la Red Nacional de Vigilancia Epidemiológica (RENAVE) en 2024
La Red Nacional de Vigilancia Epidemiológica (RENAVE) presenta los resultados de la vigilancia de las enfermedades transmisibles para el año 2024 realizada por los servicios de vigilancia de las comunidades y ciudades autonómicas.
ENFERMEDADES TRANSMISIBLES, RENAVE, VIGILANCIA
Copyright (c) 2025 Rocio Amillategui Dos Santos, Carmen Martín Mesonero, Rosa Cano Portero https://creativecommons.org/licenses/by-nc-sa/4.0
Foodborne outbreaks associated with bacterial toxins in Spain, 2015-2023
Introduction: Foodborne outbreaks caused by bacterial toxins are a frequent cause of intoxication. Although these outbreaks are usually self-limiting, they may lead to hospitalizations and deaths, and their investigation is key to establish preventive measures. This study assesses, for the first time at the national level, the bacterial toxin-related outbreaks impact reported to the Spanish National Surveillance Network (RENAVE). Method: A descriptive study was conducted on foodborne outbreaks associated with B. cereus, C. perfringens and S. aureus reported to RENAVE between 2015 and 2023. Results: A total of 380 outbreaks resulting in 8853 cases were reported. Annually, there were between 13 (2020, coinciding with the COVID-19 pandemic) and 67 (2023) outbreaks. 63 hospitalizations (0.71%) and 7 deaths were recorded. S. aureus was the most frequent agent (176 outbreaks) and was associated with the highest hospitalisation rate (1.88%), whereas C. perfringens caused the largest outbreaks (mean: 41.4 cases) and the highest number of cases (5,428). Outbreaks due to S. aureus occurred more frequently in summer, those caused by B. cereus increased in spring and C. perfringens outbreaks declined during holiday periods. The most frequently associated foods were meat and meat products, and the most common setting was food service establishments. Discussion: The COVID-19 pandemic led to a decrease in the reporting of these outbreaks, but it has subsequently increased. The characteristics of these outbreaks were similar to those described internationally, although they were larger in Spain. Conducting targeted epidemiological studies to better characterize these outbreaks would support the implementation of the most appropriate control measures.
Copyright (c) 2025 Miguel Gallego-Munuera, María Guerrero-Vadillo, Carmen Varela https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological situation of leprosy in Spain, 2015-2024
Introduction: Leprosy is a chronic, infectious, neglected tropical disease caused by Mycobacterium leprae or M. lepromatosis. In Spain, it is a notifiable disease. The aim of this study was to describe the characteristics of reported cases between 2015 and 2024. Method: Retrospective descriptive study of leprosy cases reported to the National Epidemiological Surveillance Network (RENAVE) from 2015 to 2024. Sociodemographic and clinical variables were analyzed, as well as the temporal and geographical distribution of cases. Results: Between 2015 and 2024, 97 cases of leprosy were reported (47 in men and 50 in women), with a median age of 38 years. The trend over time was relatively stable, with a peak in 2022. Most cases were imported (n=86), primarily from Brazil and Paraguay. Differences were observed by country of birth: cases born in Spain were older and predominantly female. In the last two years, the reported cases were imported and originated in another country. Conclusions: The number of reported cases has remained relatively stable, with a peak in 2022, likely related to the impact of the COVID-19 pandemic on surveillance systems. Most cases were imported and/or foreign-born, with sociodemographic differences identified based on country of origin. Despite improvements in the overall control of this disease, it remains crucial that healthcare professionals maintain a high level of clinical suspicion, along with adequate training and awareness, in patients from countries where the disease remains endemic.
Copyright (c) 2025 Lorena Simón Méndez, Álvaro Roy Cordero, María Sastre García, Beatriz Fernández-Martínez, Rosa Mª Estévez-Reboredo, Zaida Herrador-Ortiz https://creativecommons.org/licenses/by-nc-sa/4.0
Increase in imported dengue cases in Spain in 2024: analysis by region of exposure and evolution since 2016
Introduction: Dengue is a viral disease transmitted by Aedes mosquitoes. It is not endemic in Europe, and reported cases are mainly imported. The aim of this study is to describe in greater detail the cases imported into Spain in 2024 according to the place of exposure, in relation to those reported since 2016. Method: Retrospective descriptive study of imported dengue cases reported to the National Epidemiological Surveillance Network (RENAVE) in 2024, according to place of exposure and their evolution since 2016. Sociodemographic variables, place of exposure, reason for stay abroad, hospital admission and death. Results: Between 2016 and 2024, 3,451 imported dengue cases were reported, with a historic high in 2024 (1,113 cases; 32.3% of the total). In 2024, an atypical increase in cases was observed in January-April, in addition to the July-October peak of previous years. The Americas (73.0%) was the main region of exposure in 2024, and also in the months of January-April (86.0%), mainly Argentina and Paraguay. In 2024, family visits also predominated (52.8%) and no increase in hospitalisations was observed. Discussion: The unprecedented increase in imported cases in 2024 reflects the transmission situation in endemic areas and the international mobility patterns of travellers from our country. These findings reinforce the need to strengthen epidemiological and entomological surveillance, as well as prevention strategies aimed at travellers and residents with family ties in endemic areas, especially in areas where Aedes albopictus is present, due to the risk of autochthonous outbreaks.
Copyright (c) 2025 Juan Miguel Guerras, Álvaro Roy Cordero, Rosa Mª Estévez-Reboredo, Zaida Herrador Ortiz, Beatriz Fernández Martínez https://creativecommons.org/licenses/by-nc-sa/4.0
World Rabies Day: reflections on a forgotten disease
Como todos los años, el 28 de septiembre se celebra el Día Mundial contra la rabia, una enfermedad por muchos olvidada, pero que no deja de ser una amenaza constante en nuestras fronteras y a la que conviene prestar atención.
Copyright (c) 2025 Rosa Mª Estévez-Reboredo, Juan Emilio Echevarría https://creativecommons.org/licenses/by-nc-sa/4.0
A year of data: SiViEs Plus usage and statistics from the first year
Las estadísticas de uso de la aplicación SiViEs Plus, herramienta para la gestión de los datos de la vigilancia de las enfermedades transmisibles en España, reflejan su uso activo y un compromiso creciente por parte de sus usuarios…
Copyright (c) 2025 María Sastre García, Cristina Cabezas, David Olivares, Rosa Cano https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological Analysis of Human Q fever in Spain (2020-2024)
Introduction: Q fever is caused by Coxiella burnetii, a highly infectious and resistant bacterium. Spain notifies the highest number of cases in Europe. Method: A descriptive analysis of autochthonous cases notified to RENAVE in the 2020-2024 period. Variables of person, place and time were analysed by calculating frequencies, percentages and notification rates (NR). Disease maps were generated. Results: In 2024, 544 cases were notified (NR= 1.12), both maximum values for the period 2020-2024. Seasonality shifted, with increased cases in January and February. Andalusia notified the highest number of cases and Navarre the highest NR. Discussion: The increase of cases is likely related to improved disease notification. Men over 45 years old are occupationally at-risk. A One Health approach is recommended.
Copyright (c) 2025 Daniel Cifo, Diana Gómez-Barroso, David González-Barrio, Esteban Aznar-Cano, Laura Santos-Larrégola, Rosa M. Estévez-Reboredo https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological situation of Tularaemia in Spain. Period 2015-2024
Introduction: Tularaemia is a zoonosis caused by Francisella tularensis. Humans can contract the disease through direct or indirect contact with sick animals, mainly hares, moles and rodents. The aim of this study was to describe the epidemiological situation of tularaemia in Spain in the period 2015-2024. Methods: A descriptive analysis of tularaemia cases reported to the National Epidemiological Surveillance Network (RENAVE) was performed. We analysed the sociodemographic variables age, sex and autonomous community (AC) of residence. Absolute and relative frequencies, notification rates (NR) and ratio of NR per 100,000 inhabitants were calculated. Results: 445 cases of tularaemia were reported in Spain in the period 2015-2024, with significant increases in cases in 2019 and 2024 (80% of all cases in the period). The majority of cases were in men (76.1%) and aged between 45 and 64 years. The Autonomous Community with the highest number of cases and NT in 2024 was Castilla y León. Of the 9 deaths reported in the period, all corresponded to the year 2024, resulting in a case fatality of 5.3% in that year, although this variable was reported in 7.6% of the cases in the period. Conclusions: Although tularaemia is a rare disease in Spain, the increase in cases in 2024 indicates that the risk of outbreaks in endemic areas persists. To prevent future cases, it is essential to strengthen surveillance, particularly in high-risk regions, and to implement strategies based on the One Health approach.
Copyright (c) 2025 María Elena Cantera Garde, Ana Mª Ruiz-Tornero, Lorena Muñoz Martínez, Rocío Carmona, Juan Miguel Guerras, Raquel Escudero Nieto, Rosa Mª Estévez-Reboredo https://creativecommons.org/licenses/by-nc-sa/4.0
Invasive meningococcal disease in Spain, 2024
Introduction: The invasive meningococcal disease (IMD) is a serious infectious disease under mandatory surveillance in Spain. The objective is to describe the epidemiology of IMD in Spain during 2024 and to compare it to previous years. Methods: A descriptive epidemiological analysis was conducted on IMD cases reported to the National Epidemiological Surveillance Network (RENAVE) in 2024. Variables analysed included sex, age group, symptom onset date, reporting autonomous community or city, death, clinical manifestation, and serogroup. Results: In 2024, 336 cases of IMD were reported (53.0% female) with a cumulative incidence rate (AIR) of 0.68. The highest incidence rate in 2024 were observed in children under 1 year of age. The presentation of cases followed the typical seasonal pattern of this disease, with a higher number in autumn and winter. The most frequent clinical manifestation was sepsis accounting the 36.7% of the reported cases. The case fatality rate (9.23%) was lower than the observed in 2023. The serotype of 5.1% of the reported cases of IMD was unknown. Of the cases in which this information was recorded, 59.2% corresponded to serogroup B. Discussion: an increasing of incidence rate of IMD occurred in 2024 compared to the previous period (2020-2023), reaching the pre-COVID-19 pandemic levels. Improved reporting of microbiological characterization and vaccination data is crucial for conducting IMD surveillance and for the evaluation of the vaccination program.
Invasive Meningococcal Disease; Neisseria meningitidis; Spain; Epidemiological analysis; 2024
Copyright (c) 2025 Josefa Masa Calles, Alexandra Martín-Sánchez Alexandra Martín Sánchez, Javier del Águila Mejía, Marina Acosta Gutiérrez , Marta Soler Soneira, Rosa Cano Portero https://creativecommons.org/licenses/by-nc-sa/4.0
Emerging infectious diseases: a global challenge from a One Health perspective
El concepto Una Salud surge a principios del siglo XXI, aunque sus bases ya fueron definidas por Rudolf Virchow (1821-1902), que defendía la integración en una salud única a las disciplinas humana y veterinaria. Según la Organización Mundial de Sanidad Animal (antigua Oficina Internacional de Epizootías) y la OMS, al menos un 75% de las enfermedades infecciosas emergentes en el ser humano son de origen zoonótico y su abordaje eficaz exige un planteamiento integrado y multidisciplinar…
Copyright (c) 2025 Zaida Herrador Ortiz, Beatriz Fernández Martínez, Juan Miguel Guerras, Álvaro Roy Cordero, Rosa Mª Estévez-Reboredo https://creativecommons.org/licenses/by-nc-sa/4.0
Behavioural risk factors in adults with chronic diseases in Spain
Introduction: To describe the prevalence of the main modifiable risk factors in adults with chronic diseases in Spain. Method: Data come from 67,451 individuals aged ≥15 years participating in the National Health Survey 2017 and European Health Surveys 2014 and 2020. Prevalences of tobacco use, alcohol consumption, fruit and vegetable consumption, and leisure-time physical activity were estimated in individuals with a history of myocardial infarction (n=1,530), stroke (n=1,382), diabetes (n=6,309), chronic obstructive pulmonary disease (COPD, n=2,831), asthma (n=3,078), and cancer (n=3,086). Results: Current tobacco use ranged from 22.5% in people with COPD to 13.4% with a history of heart attack. The highest prevalence of high-risk drinking was observed in the population with asthma and COPD (11.6% and 11.5%), and the lowest in people with stroke (5.9%). Consumption <3 times/day of fruit and/or vegetables ranged from 61.8% in those with asthma to 49.8% in people with cancer. Finally, the highest prevalence of leisure-time sedentary lifestyle was observed in people with a history of stroke (55.8%), and the lowest in individuals with asthma (41.8%). Conclusions: The study reveals a high prevalence of risk factors in individuals with chronic diseases, with a predominance of sedentary lifestyles and insufficient fruit and vegetable consumption. In the framework of secondary and tertiary prevention, these results underline the need to implement intervention strategies that effectively address these behaviours to improve the control of these diseases.
chronic diseases; tobacco; alcohol; diet; sedentarism; secundary and tertiary prevention;
Copyright (c) 2025 Cristina María Ortiz Burgos, Iñaki Galán Labaca, Jose Luis Peñalvo https://creativecommons.org/licenses/by-nc-sa/4.0
Diphtheria surveillance. Cases reported to the National Epidemiological Surveillance Network (RENAVE) in Spain from 2014 to 2024
Introduction: Diphtheria is a bacterial disease that primarily affects the upper respiratory tract, with a lethality rate of up to 10%. It is a vaccine-preventable disease. In Spain, the DTP (diphtheria, tetanus and pertussis) vaccine was introduced in 1965, maintaining coverage rates above 95% since 1999. In Spain, diphtheria is extremely infrequent but in the European Union, an increase in the number of diphtheria cases has been registered in recent years, in males mainly associated with migrant reception centres. Method: A descriptive epidemiological study of diphtheria cases reported to the National Epidemiological Surveillance Network (RENAVE) from 2014 to 2024 was carried. The variables included were: age, sex, country of birth, country of importation, strain, clinical manifestation, vaccination status, mortality and contact tracing. Results: In Spain, from 2014 to 2024, 15 cases of diphtheria were reported to the RENAVE. 73,3% were men; 33,3% aged 25 to 44 years, 73,3% caused by C. diphtheriae and 33,3% imported. Hospitalization was required in the 53,3% of the cases, and one death occurred. Discussion: Diphtheria is infrequent in Spain, thanks to high vaccination coverage rates. The data presented show mild cases and a significant number of imported cases. The most common causative agent is C. diphtheriae; however, cases of C. ulcerans of zoonotic origin have been reported. Is crucial to maintain high vaccination coverage rates, updated protocols and active surveillance systems, including reception plans for migrant people.
Diphtheria; surveillance; epidemiology. Spanish Epidemiological Surveillance Network
Copyright (c) 2025 Ivonne Torres-Jiménez, Silvia Herrera-León , Laura Herrera-León , Josefa Masa Calles https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological characteristics of non-food borne outbreaks in Spain, 2018-2022
Introduction: Outbreaks are a major public health problem. Early outbreak detection and investigation are key to implement the most effective measures. This study aims to describe the non-foodborne outbreaks reported to the Spanish National Surveillance System in the 2018-2022 period. Method: A descriptive study was conducted by disease group and causative agent of non-foodborne outbreaks (excluding healthcare associated infections and COVID-19 outbreaks) between 2018 and 2022. Results: A total of 3,858 outbreaks were reported, with 45,140 associated cases, 2,205 hospitalizations and 181 deaths. The main diseases causing outbreaks were gastrointestinal diseases (n=1,076 outbreaks), followed by vaccine-preventable diseases (n=795) and infestations (scabies and lice) (n=734). The highest number of hospitalizations was due to respiratory diseases and legionellosis (872 and 428, respectively). The number of reported outbreaks decreased in 2020, but a progressive increase was observed from 2021 onwards, approaching the pre-COVID-19 pandemic levels, with important differences depending on the disease. The main exposure setting was the household (1,507 outbreaks), followed by nursing homes (816 outbreaks). The Autonomous Regions did not report outbreaks uniformly during the study period. Discussion: Analysis of the data shows the disruption of epidemiological surveillance caused by the COVID-19 pandemic. Outbreak surveillance helps guide prevention and control measures and it makes possible to assess the epidemiological situation of some diseases for which case-based surveillance is not implemented.
outbreaks; non-foodborne outbreaks; Epidemiological analysis; Spain
Copyright (c) 2025 María Guerrero, Marina Peñuelas, Rosa Cano Portero, Carmen Varela https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological study of sporadic legionellosis in Spain (2011-2023)
Introduction: Legionnaires’ disease is an infectious disease caused by inhalation of aerosols of water contaminated with the bacterium Legionella pneumophila. Although most cases are sporadic and community-acquired, its origin is usually unknown. The aim of the study was to describe the spatiotemporal distribution of autochthonous, sporadic and community-acquired cases in Spain between 2011 and 2023. Method: A descriptive spatiotemporal analysis of confirmed cases of legionellosis reported to RENAVE between 2011 and 2023 was performed, excluding imported, nosocomial, outbreak or travel-associated cases and Pontiac fevers. Incidence, mortality and case fatality rates were calculated at national level and by sex, age and province of residence of the patient. Results: 13,037 cases were reported. The average annual incidence rate was 2.17 per 100,000 inhabitants, with a predominance in men (71.9%) and over 65 years of age. An annual increase of 8.96% in incidence and 11.19% in mortality was observed, with marked seasonality between June and November. The provinces with the highest incidence were Gipuzkoa, Huesca and Cantabria. The case fatality rate was 6.18%. Discussion: There is an increase in the incidence and mortality rates of sporadic and community-acquired cases of legionellosis. The highest rates are concentrated in the northeastern region of the country, which may indicate an origin associated with environmental factors such as meteorology or land use. Differences in diagnosis and reporting between the different regions should be considered as a limitation of the study.
Legionellosis; Legionella pneumophila; Epidemiological monitoring
Copyright (c) 2025 Javier Chaves-Cordero, María Guerrero-Vadillo, Rosa Cano-Portero, Carmen Varela-Martínez, Jesús Roche-Royo, Diana Gómez-Barroso https://creativecommons.org/licenses/by-nc-sa/4.0
International Vaccination Centres: protecting health in a globalised world
Los Centros de Vacunación Internacional son esenciales en la estrategia de prevención de enfermedades en un mundo cada vez más interconectado. Sus esfuerzos en la educación y protección durante los viajes no solo reducen los riesgos personales, sino que contribuyen a la seguridad sanitaria de toda la comunidad. Invertir en la mejora y expansión de estos centros es una medida clave para garantizar que España siga siendo un ejemplo de prevención eficaz frente a enfermedades globales
Copyright (c) 2025 María Elena González-Sancho, Francisco Borja de Isasa Martínez , Elisa Gallego, Juan Miguel Guerras https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiology of acute respiratory infections in in Spain during the 2023-2024 season
Introduction: The Spanish Acute Respiratory Infections surveillance system (SiVIRA) was set up in the 2020-21 season with gradual implementation in Spanish autonomous communities and cities. We here present the results of SiVIRA for the 2023-24 season. Method: Within syndromic surveillance, all cases who presented with acute respiratory infection in primary care (ARI) or were admitted for severe ARI (SARI) in hospitals were collected, allowing calculation of weighted weekly incidence rates. A systematic and representative sample of syndromic cases was selected for microbiological study, allowing calculation of positivity rates for influenza, SARS-CoV-2 and respiratory syncytial virus (RSV). Results: ARI and SARI incidence rates reached their maximum, respectively, in week 52/2023 (968.7 cases per 100,000 inhabitants), and week 01/2024 (38.7 cases per 100,000). The influenza epidemic was characterized by predominant circulation of influenza A, and developed between weeks 50/2023 and 04/2024, peaking in week 52/2023 or 01/2024, depending on which indicator. Two COVID-19 epidemic waves were observed, one with a peak incidence in week 51/2023 with predominance of the BA.2.86* variant (same week in which the RSV epidemic peaked) and the other one peaking in week 26/2024 coinciding with the increase of the K.P.3* variant. Discussion: In the 2023-24 season, the epidemic waves of influenza, COVID-19 and RSV coincided, and, while ARIs rates were similar to the 2022-23 season, SARI rates were considerably higher. The intensity of the seasonal epidemic was lower than the previous season for RSV, higher for influenza and similar for COVID-19.
acute respiratory infection; severe acute respiratory infection; influenza; COVID-19; RSV; surveillance
Copyright (c) 2025 Ana Maria Puerto Sanz https://creativecommons.org/licenses/by-nc-sa/4.0
Varicella in Spain, 1997-2023. Impact of the routine vaccine schedule in childhood. Preliminary Analysis
Introduction: varicella vaccine is available in Spain since 1998; initially was recommended for high-risk groups and their contacts. In 2005, it was recommended for susceptible adolescent, too. Since 2016, varicella vaccine is part of the childhood vaccination schedule with two doses. Method: All varicella cases reported to the National Epidemiological Surveillance Network (RENAVE) between 1997 and 2023 has been analysed. Incidence rate has been calculated for different regions, sex and age group. Vaccination history of varicella cases were analysed. Results: The varicella incidence rate ranged from 300 to 600 cases per 100,000 inhabitants before 2016. After universal childhood vaccination, incidence rate fell to 160 cases per 100,000 inhabitants. Since 2020, this figure has remained below 20 cases per 100,000 inhabitants per year. The most affected age group continues to be children between 1 and 4 years old. Overall, 6.0% of varicella reported cases had received at least one dose of the vaccine (16.3% of all the cases reported from 2017 onwards). Discussion: The universal childhood varicella vaccination has decreased varicella incidence rate. Children between 1 and 4 years of age have been most impacted. As the varicella vaccination program is consolidated, the percentage of varicella cases with a history of vaccination increases.
Copyright (c) 2025 Maria de Viarce Torres de Mier, Josefa Masa Calles https://creativecommons.org/licenses/by-nc-sa/4.0
Surveillance of tuberculosis in Spain, 2023
Introduction: The objective of this study was to describe the epidemiological situation of tuberculosis (TB) in Spain during the year 2023 and its temporal evolution since 2015. Method: Descriptive analysis of TB cases reported by the CCAA to the National Epidemiological Surveillance Network (RENAVE). The variables analysed were: sex, age, Autonomous Community, country of birth, date of case, location, co-infection with HIV, treatment outcome, death and antituberculostatic resistance. Notification rates were calculated and a time-space study was carried out based on these rates. Results: In 2023, a total of 3,944 autochthonous TB cases were reported (notification rate of 8.2 per 100,000 population). The % of cases was higher in men (2,575 cases, 65.3%) and the main location was pulmonary (n=2,721.69%). In 78.6% of the cases in which the treatment outcome was reported to be satisfactory. The ratio born in Spain/born in another country showed a progressive decrease between 2015 and 2023 (from 2.2 to 1.1, respectively). There was a 7% increase in notification rates compared to 2022 and a 22.5% decrease compared to 2015.This decreasing trend in rates was observed in most of the CCAA. The decrease was more pronounced for pulmonary forms. Discussion: The profile of cases shows no significant variation, except in relation to country of birth. The TB notification rate declined from 2015 to 2023, especially in pulmonary forms, although the rate of decline does not seem sufficient to reach the targets defined in the WHO End TB Strategy.
Copyright (c) 2025 Zaida Herrador https://creativecommons.org/licenses/by-nc-sa/4.0
Intersectoral collaboration in the response to tuberculosis in Spain.
This editorial presents the current situation of the strategic approach to tuberculosis in Spain and highlights the value of intersectoral collaboration in the prevention and control of tuberculosis.
Copyright (c) 2025 Christine Schwarz, Héctor Sánchez-Herrero, Ivana Gallego, Pedro Valdivia-Prieto, Javier Gómez-Castellá, Berta Suárez-Rodríguez, Julia del Amo https://creativecommons.org/licenses/by-nc-sa/4.0
Q fever in Spain: Comparison between epidemiological notification and hospital discharge (2016-2022)
Introduction: Q fever is a zoonotic disease caused by Coxiella burnetii, a highly infectious pathogen known for its resistance to harsh environmental conditions and its wide range of animal reservoirs. Human transmission occurs primarily through inhalation of pseudospores. Method: A comparative analysis of human Q fever between cases notified to the Spanish National Epidemiological Surveillance Network (RENAVE) and cases compiled in the Specialized Healthcare Activity Registry – Minimal Basic Data Set (RAE-CMBD) in Spain from 2016 to 2022 was performed. Individual, time and space variables were analyzed. Frequencies, percentages and notification/hospitalization rates (NR/HR) per 100,000 inhabitants were calculated. Results: A total of 2,429 cases were reported to RENAVE (NR = 0.74), while 2,991 hospitalizations were recorded in RAE-CMBD (HR = 0.91). Men accounted for 72% of the cases and mean age was 47 (RENAVE) and 54 (RAE-CMBD) years. Communities with the highest number of notifications to RENAVE were Canary Islands, Andalucia and Basque Country; those with higher RAE-CMBD registries were Andalucia, Canary Islands and Madrid Community. The highest NR/HR were observed in the Canary Islands (NR = 3.95, HR = 2.95). Conclusions: Q fever is an endemic disease in Spain, where an increasing trend is observed in the number of cases in recent years. The analysis suggests underreporting to RENAVE, highlighting the need for improved data quality and collection and enhanced surveillance efforts.
Copyright (c) 2025 Izaskun Miyar, Juan Miguel Guerras, Rosa M. Estévez-Reboredo, Diana Gómez-Barroso, David González-Barrio, Isabel Jado, Daniel Cifo https://creativecommons.org/licenses/by-nc-sa/4.0
The importance of the daily mortality surveillance system in Spain (MoMo)
El sistema de monitorización de la mortalidad diaria por todas las causas (MoMo) fue desarrollado en 2004 en el Centro Nacional de Epidemiología (CNE) del Instituto de Salud Carlos III (ISCIII), en el marco del «Plan Nacional de Acciones Preventivas contra los Efectos del Exceso de Temperaturas sobre la Salud», coordinado por el Ministerio de Sanidad, para reducir el impacto sobre la salud de la población como consecuencia del exceso de temperatura, durante los meses estivales. El objetivo era identificar las desviaciones de mortalidad diaria observada con respecto a la esperada según las series históricas de mortalidad y comunicar al Ministerio de Sanidad los resultados para su investigación o para la puesta en marcha de las medidas de control. En 2009 se amplió a todo el año para estimar de forma indirecta el impacto de cualquier evento de importancia en salud pública. Durante estos 20 años MoMo ha estimado el impacto de las olas de calor y frio, el impacto de otros eventos no relacionados con la salud, como por ejemplo los atentados del 11-M del 2011 en Madrid, o el accidente de metro en Valencia en el 2006 o, recientemente durante este año, la Dana ocurrida en esta misma provincia. Durante la pandemia de Covid-19 MoMo se consolidó como una herramienta esencial de vigilancia a tiempo real, para realizar estimaciones del impacto del Covid en la mortalidad. MoMo se convirtió en el primer sistema que ofrecía información adicional a tiempo real, que complementaba los datos de defunciones por COVID-19 obtenidas de los sistemas de Vigilancia Epidemiológica, y dando una idea del impacto de la pandemia en la mortalidad de la población española. Entre marzo y mayo de 2020, MoMo estimó un exceso de mortalidad por todas las causas sin precedentes en España (45.010 excesos de defunciones por todas las causas). Dicho exceso fue considerablemente mayor que las defunciones confirmadas por COVID-19 notificadas a la Red Nacional de Vigilancia Epidemiológica (RENAVE) en el marco del sistema universal de vigilancia de COVID-19. Dicha diferencia se explica por la limitada capacidad diagnóstica de SARS-CoV-2 en España durante la primera ola pandémica. Además Momo es un sistema complementario a otros sistemas de vigilancia como el sistema de la Vigilancia de la Gripe en España (SVGE) o el Sistema de Vigilancia de Infección Respiratoria Aguda (SiVIRA). Su principal fuente de información son las defunciones diarias por todas las causas procedentes de los registros civiles informatizados, que se reciben en el CNE desde el Ministerio de Justicia. Actualmente se recibe información de 4.128 registros civiles, con representación de todas las provincias españolas y que corresponden al 94% de la población. Otras fuentes de información son la mortalidad diaria por todas las causas, con cobertura nacional, y la población ambas procedentes del Instituto Nacional de Estadística (INE). Además, MoMo incluye información de temperaturas que obtiene de la Agencia Estatal de Meteorología (AEMET). En conclusión, MoMo constituye una herramienta esencial de vigilancia a tiempo real, como sistema de alerta temprana para la acción en salud pública, y para realizar estimaciones del impacto de diferentes eventos de salud en la mortalidad de la población.
Copyright (c) 2024 Inmaculada Le´on-Gómez, Lucía Pérez-Marín, Diana Gomez-Barroso https://creativecommons.org/licenses/by-nc-sa/4.0
Invasive meningococcal disease in Spain 2023
Introduction: Description of the epidemiological analysis of invasive meningococcal disease (IMD) in Spain during 2023 and its comparison with previous years. Methods: Descriptive epidemiological analysis of cases of IMD reported to the National Epidemiological Surveillance Network (RENAVE) in 2023 was conducted. The variables analysed were: sex, age group, date of onset of symptoms, reporting community or autonomous city, death, clinical manifestation and serogroup. Results: In 2023, 265 cases of IMD (51.7% men) were reported with an incidence rate (IR) of 0.58. The highest incidence rates in 2023 were seen in children younger than 1 year old, followed by the 1- to 4-year-old age group. During this year, the typical seasonal pattern of this disease was recovered, with a higher number of cases of IMD in autumn and winter. The most frequent clinical manifestation was meningitis with 38.5% of the reported cases. The case fatality rate was slightly higher than that observed in the last 12 years (13.2). The serogroup of 12.9% of reported cases of IMD is unknown. Of the 231cases for which this information was recorded, 60% corresponded to infections with serogroup B. Discussion: In 2023 there is an increase in IR compared to the years 2020-2022 without reaching pre-pandemic levels. Improved reporting of microbiological characterization and vaccination data is crucial for conducting surveillance for this disease and for evaluating the vaccination program.
Copyright (c) 2024 Marta Soler Soneira, Ainhoa Alcaide-Jimenez, Lorena Muñoz-Martinez, Carol Castellares-González, Rosa Cano-Portero https://creativecommons.org/licenses/by-nc-sa/4.0
Communicable diseases data reported to the National Epidemiological Surveillance (RENAVE) in 2023
La Red Nacional de Vigilancia Epidemiológica (RENAVE) tiene entre sus funciones la recogida sistemática de la información epidemiológica, su análisis e interpretación y la difusión de los resultados. Se presentan los resultados de la vigilancia de las enfermedades transmisibles para el año 2023 realizada por los servicios de vigilancia de las comunidades y ciudades autonómicas (a partir de ahora autonomías). El Centro de Coordinación de Alertas y Emergencias (CCAES) del Ministerio de Sanidad coordina el sistema de vigilancia y la gestión de la información la realiza el Centro Nacional de Epidemiología (CNE) del Instituto de Salud Carlos III de acuerdo a los protocolos de la RENAVE.
Copyright (c) 2024 Rocío Amillategui-Dos-Santos, Rosa Cano Portero, Carmen Martín Mesonero, Marta Soler-Soneira https://creativecommons.org/licenses/by-nc-sa/4.0
Implications for Spain of a Marburg Virus Disease Outbreak in Rwanda, September-November 2024
En este trabajo, revisamos las repercusiones para España de la identificación de un brote de fiebre hemorrágica en una región endémica, centrándonos en el reciente brote de virus Marburgo que ocurrió en Ruanda durante el otoño de este año. A raíz de esta situación, describimos el proceso de evaluación rápida del riesgo llevado a cabo en nuestro país
Copyright (c) 2024 Raquel Escuredo Campos, Bernardo Guzman Herrador, Gabriela Saravia-Campelli, María de Salomón-Arroyo, Miguel Dávila-Cornejo, Gloria González-Díaz, Rocío Palmera-Suárez, Rocío Ruíz-Huertas, Concepción Sánchez-Fernández, Inma Vera-Gil, Juan Miguel Guerras, Rosa María Estévez-Reboredo, Anabel Negredo, María Paz Sánchez-Seco, Ana Vázquez, María José Sierra-Moros https://creativecommons.org/licenses/by-nc-sa/4.0
Leptospirosis in Spain: Epidemiological Situation and Historical Context (2015-2023)
Introduction: Leptospirosis is a zoonotic infectious disease caused by spirochete bacteria Leptospira interrogans and transmitted to humans through direct or indirect contact with infected animals, especially rodents. The objective was to describe the epidemiology of leptospirosis in Spain during 2023 within the context of the 2015-2023 period. Method: A descriptive analysis of leptospirosis cases in Spain from 2015 to 2023 was conducted using the Spanish National Epidemiological Surveillance Network (RENAVE). The variables analysed were: sex, age, Autonomous Community, hospitalisation and death. Results: In 2023, 64 cases were reported to RENAVE with a notification rate (NR) = 0.13 From 2015 to 2023, 362 cases were reported (NR 0.09). NR peaked in 2018 (NR = 0.15). Throughout this period, the number of cases and NR were consistently higher in men (NR = 0.14) and reached their highest in the 25-34 age group (NR = 0.13). The most affected communities were Extremadura (NR = 0.39), the Basque Country and the Canary Islands (NR = 0.34). In the whole period, 62% of cases required hospitalisation and the case fatality rate was 0.84%. Conclusions: Between 2015-2023, leptospirosis NR has been relatively stable around 0.10 cases per 100,000 inhabitants. Despite this, it is important to continue implementing preventive and informative measures to avoid future outbreaks.
Copyright (c) 2024 María Alonso-Colón, Daniel Cifo, Raquel Escudero Nieto, Isabel Jado García, Juan Miguel Guerras, Rosa Mª Estévez-Reboredo https://creativecommons.org/licenses/by-nc-sa/4.0
españa Oropouche fever: A new threat to Global Health?
En febrero de 2024, la Organización Panamericana de la Salud (OPS) emitió una alerta epidemiológica debido al incremento de casos de fiebre de Oropouche en Brasil, Colombia y Perú…
Copyright (c) 2024 Juan Miguel Guerras, Rosa Mª Estévez-Reboredo, Zaida Herrador-Ortiz, Beatriz Fernández-Martínez https://creativecommons.org/licenses/by-nc-sa/4.0
Invasive Haemophilus influenzae disease. Spain 2023
Introduction: Epidemiological analysis of invasive Haemophilus influenzae disease (IHD) in Spain during 2023 and its comparison with previous years (2015-2022). Method: Descriptive epidemiological analysis of IHD cases reported to the National Epidemiological Surveillance Network (RENAVE) in 2023. The variables analyzed were: sex, age group, date of onset of symptoms, reporting region, death, clinical manifestation, and serotype. Results: In 2023, 674 cases of IHD were reported (54% men) with a cumulative incidence rate of 1.39 (number of cases per 100,000 inhabitants). The highest incidence rates in 2023 were observed in children under 1 year of age and in the population aged 85 years and over. During this year, the typical seasonal pattern of this disease was recovered, with a higher number of cases of IHD in autumn and winter. The most frequent clinical manifestation, regardless of age, was bacteremic pneumonia (27.9% of cases). 80.4% of deaths occurred in the 65-year-old age group. The serotype of most reported cases of HIE is unknown. Discussion: In 2023, the highest cumulative incidence in the last 9 years was recorded. Improved reporting of microbiological characterization data is crucial for conducting surveillance of this disease and for evaluation of the vaccination program.
Invasive disease by Haemophilus influenzae
Copyright (c) 2024 Marta Soler Soneira, Lorena Muñoz-Martinez, Ainhoa Alcaide-Jimenez, Virginia Arroyo-Nebreda, Rosa Cano-Portero https://creativecommons.org/licenses/by-nc-sa/4.0
The Importance of the Surveillance System in Spain SiViEs Plus
Vivimos en una época donde la Salud Pública enfrenta desafíos constantes, la implementación de sistemas de vigilancia epidemiológica es clave. Uno de estos sistemas es SiViEs Plus, el Sistema para Vigilancia en España, que se ha convertido en una herramienta fundamental para la descripción del patrón epidemiológico y control de las enfermedades transmisibles. Es una nueva plataforma versátil y atractiva que puede satisfacer de manera avanzada todas las necesidades relacionadas con el tratamiento, análisis y gestión de información epidemiológica en el nivel nacional, independientemente de la enfermedad. La flexibilidad de la plataforma radica en que el Centro Nacional de Epidemiología (CNE) es capaz de gestionar de manera independiente todo el sistema: creación de fichas para enfermedades nuevas, modificación de fichas para adaptar las enfermedades ya existentes a nuevos protocolos, creación de nuevos códigos, creación de periodos de consolidación, gestionar usuarios (altas, bajas, cambios en los datos de los usuarios). Además, los datos alojados y gestionados por SIVIES Plus se envían al Centro Europeo para la Prevención y el Control de Enfermedades (ECDC) a través del portal europeo de vigilancia de enfermedades infecciosas EpiPulse, siguiendo el calendario de recogida de datos que establece el ECDC, como centro coordinador de la vigilancia epidemiológica en la Unión Europea. Sin embargo, es importante recordar que el éxito de SiViEs Plus depende de la participación activa de sus usuarios. El trabajo conjunto del CNE, las comunidades y ciudades autónomas y los diferentes ministerios, es clave para mejorar la calidad de la información a la hora de notificar los casos de enfermedades que se vigilan en el ámbito nacional. Solo a través de un esfuerzo conjunto podremos fortalecer este sistema y garantizar una respuesta adecuada en las decisiones e intervenciones en el ámbito de la salud pública. En conclusión, SiViEs Plus representa un avance significativo en la vigilancia epidemiológica, pero su éxito depende de la colaboración y el compromiso de todos. El equipo de SiViEs quiere agradecer el trabajo y esfuerzo de todos los usuarios del sistema.
Copyright (c) 2024 María Sastre, Virginia Arroyo, Cristina Cabezas, David Olivares, Ana Puerto, Rosa Cano https://creativecommons.org/licenses/by-nc-sa/4.0
Evolution of hydatidosis in Spain since 2015 to 2023
Introduction: hydatidosis is a zoonosis typically diagnosed late and/or incidentally, caused by the parasite Echinococcus. The notification rate in Spain has been decreasing since it was included as a notifiable disease. The aim of this work is to describe the situation and evolution of human hydatidosis in Spain since 2015, with special emphasis in the last year 2023. Method: a descriptive analysis was conducted of the cases of hydatidosis reported to the National Epidemiological Surveillance Network (RENAVE) since 2015, with a special emphasis on the year 2023. Variables such as age, sex, autonomous community of residence, and exposure were analyzed. Frequencies, percentages, notification rates were calculated, and maps were created. Results: Between 2015 and 2023, 710 indigenous cases of hydatidosis were reported, with a peak in 2015 (154 cases) and decline until 2019, followed by a slight increase in 2021. In 2023, 71 indigenous cases were reported, of which 39.4% were hospitalizated, although no deaths were recorded. In 2023, the highest notification rates were observed in Extremadura, La Rioja, and C.F. Navarra, while the lowest rates were in the Comunitat Valenciana, País Vasco, and Cataluña. Discussion: a decrese in notification followed by an uptick suggests the effectiveness of control measures but also indicates persistent challenges. The presence of imported cases and regional variability reflects socioeconomic, cultural or environmental factors that must be considered in control and prevention strategies.
Hydatidosis; Zoonosis; Epidemiological surveillance
Copyright (c) 2024 Dan Rodríguez-Campelo, Juan Miguel Guerras, Beatriz Fernández-Martínez, Zaida Herrador-Ortiz, Rosa Mª Estévez-Reboredo https://creativecommons.org/licenses/by-nc-sa/4.0
Neglected Tropical Diseases, relevant epidemiological aspects and their surveillance in Spain
Introduction: neglected tropical diseases (NTDs) are a diverse group of diseases that are mainly prevalent in impoverished tropical communities. They are considered neglected because they do not receive enough resources to reduce their morbidity and mortality. The objective of this study was to improve our knowledge about NTDs´ situation in Spain, in terms of endemicity, occurrence and their emerging potential. Method: a two-phase review was performed. First, data sources (RAE-CMBD, BDCAP and National Epidemiological Surveillance Network) as well as official documents were consulted. If the information was scarce or limited after this search, a narrative search was done in the second phase by consulting the PubMed, EMBASE, Scopus and Google Scholar databases. Results: Chikungunya, dengue, leishmaniases, hydatidosis, leprosy and rabies are notifiable diseases at national level. Fascioliasis, scabies, snakebite poisoning and taeniasis are endemic, but non-reportable diseases. Chagas disease, schistosomiasis, soil-transmitted helminthiasis, African trypanosomiasis, mycetoma, onchocerciasis, lymphatic filariasis, tungiasis, yaws, trachoma, Buruli ulcer, dracunculiasis, chromoblastomycosis, sporotrichosis and paracoccidioidomycosis are non-endemic, non-reportable diseases. In this review, scabies, dengue and leishmaniases have been considered emerging due to the increase in the number of recent cases, and the geographical expansion of the Aedes albopictus vector, and leishmaniases. Discussion: Although NTDs are not a priority issue on the health agenda of high-income countries, they suppose a threat to global public health. Joining international efforts in response to the WHO’s 2021-2030 Roadmap for NTDs is the only way to mitigate risks that have no borders.
Copyright (c) 2024 María Sofia Juaneda-RuizFunes, María Blázquez-Arroyo, Lucía Higuera-Cabañes, Beatriz Fernández-Martínez, Juan Miguel Guerras, Álvaro Roy Cordero, Zaida Herrador https://creativecommons.org/licenses/by-nc-sa/4.0