NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems.

No abstract

The Andalusian Regional Ministry of Health is implementing an Alert Integrated System (SIA) in order to improve the health protection of the population by means of the appropriate response to the sanitary alerts. <> is a service aimed both to catastrophic situations and to the other ones needing intervention and multisectorial coordination. Theses functions make possible their collaboration with the SIA, furnishing it with information about a series of environmental incidents. A study has been carried out in order to characterize the information received and to evaluate it systematic inclusion in the SIA, which include alerts from january to August 2003. The number of incidents communicated to 112 were 656, rank between months from 45 to 117. It is appropriate to underline the frequency of incidences related to Natural Hazards (50.15%) and Environmental Pollution (26.07%). The 67.55% of incidences happened between 15.00 p.m. and 8.00 a.m. hours of the following day. By provinces, Sevilla reported 24.5%, and the higher rate belongs to Huelva with 4.74 incidences/100 000 inhabitants. Incidents related to health care, environmental problems, risks to alimentary and occupational health, and epidemiological alerts are of great interest to the SIA; that is why it is necessary to consider the integration of the information systems of the emergency centres in the Public Health Surveillance.

We present our reflections on the management of an acute gastroenteritis outbreak in a public school, which caused a public health crisis, and the conclusions drawn from this experience. The methodology of strengths, weaknesses, opportunities, and threats (SWOT) analysis was used. This article describes the epidemiology of the incident and the policy decisions made, but focuses on operational aspects of outbreak management. The experience of the outbreak control team, liaison with other organizations, and data management are discussed. The difficulties encountered by the outbreak team related to delay in declaring in the outbreak, lack of training in some of the entities involved, and incorrect use of the surveillance circuits. Current protocols and specific action plans for the management of outbreaks should be improved through self-evaluation and updating of resources and knowledge.