Pertussis Immunization in Pregnancy: A Review

The pregnant woman has an altered immune response and, for some pathologies, is at increased risk of infection and of developing complications and serious outcomes. In addition, maternal infections can result in congenital anomalies, malformations or severe neonatal diseases. Vaccination of pregnant women can therefore have a double goal: to protect the mother from diseases that could have an impact on her health and to avoid infection/disease transmission to the fetus or the newborn. Despite the potential benefits of immunization in pregnant women, it is still evident reluctance and/or refusal of vaccinations by health professionals as well as by pregnant women, who are wary of the real advantages linked to vaccines. Concerning pertussis, immunization is strongly recommended in pregnancy and some data are already available in Europe as well as in other parts of the world. This review describes the rationale for this immunization and summarizes available data around the world

Evaluation of efficacy and effectiveness of live attenuated zoster vaccine

Herpes zoster (HZ) is a viral disease characterized by a dermatologic and neurologic involvement caused by the reactivation of the latent varicella zoster virus (VZV) acquired during primary infection (varicella). HZ incidence increases with age and is related to waning specific cell-mediated immunity (CMI). The most frequent complication of HZ is post-herpetic neuralgia (PHN) characterized by chronic pain lasting at least 30 days, with impact on patientsâ quality of life. Available treatments are quite unsatisfac- tory in reducing pain and length of the disease. The evaluation of the epidemiology, the debilitating complications (PHN), the suboptimal available treatments and the costs related to the diagnosis and clinical/therapeutic management of HZ patients have been the rationale for the search of an adequate preventive measure against this disease. The target of this intervention is to reduce the frequency and severity of HZ and related complications by stimulating CMI. Prevention has recently become possible with the live attenuated vaccine Oka/Merck, with an antigen content at least 10-fold higher than the antigen content of pediatric varicella vaccines. Clinical studies show a good level of efficacy and effectiveness, particularly against the burden of illness and PHN in all age classes. Accordingly to the summary of the characteristics of the product the zoster vaccine is indicated for the prevention of HZ and PHN in individuals 50 years of age or older and is effec- tive and safe in subjects with a positive history of HZ

Knowledge of preventive measures against occupational risks and spread of healthcare-associated infections among nursing students. An epidemiological prevalence study from Ferrara, Italy

Introduction. Exposure to biological agents is the most common occupational risk for nursing staff. This study verified changes in attitudes and knowledge occurred in the nursing students after the first year of degree. Methods. The survey was conducted in academic year 2006/07 among the students of the Professional Nursing Course at University of Ferrara (Italy) using a structured questionnaire. Students were 85 at the beginning and 80 at the end of the courses. Results. The rate of subjects using gloves for intramuscular injections and fingertip puncture was unsatisfactory. A high percentage of students performed recap of needles. The use of gloves in case of washing of surgical instruments was high. The compliance in the use of gloves in handling test tubes remained low. Only 2/3 of the students washes their hands coming in ward. Incorrect attitudes have been observed in changing or wearing gloves. The students considered vaccination against hepatitis-B necessary, vaccination against flu unnecessary. A high percentage of students had not performed any prophylaxis for tuberculosis. Discussion. Students intend the use of gloves mainly to perform self-protection. The concept of self-protection is contradicted by the large percentage of students that recap used needles. A significant percentage of students have not yet gained the criti- cal thinking necessary to consider the importance of universal precautions as a means not only of self-protection but also of prevention of hospital infections. Conclusions. Students consider the basic standard measures for the control of infectious diseases only like self-protection and not to prevent hospital infections

Assessment of seroprevalence against poliovirus among Italian adolescents and adults

In 2002, the WHO European Region was declared polio-free. Nonetheless global eradication has not yet been completed and the reintroduction from at risk areas is still possible. This seroprevalence study evaluated samples collected from each Italian region in the 12-50 years old age range to assess protection against Poliovirus (PV) 1, 2 and 3 among subjects immunised with different vaccination schedules. 1073 samples (50.5% females) were examined. WHO standardized microneutralization assay was used. Seroprotection rates were 92.9%, 96.2% and 83.4%, for PV1, PV2 and PV3, respectively. Geometric Mean Titres (GMTs) were higher for PV2 (52.8) and PV1 (41.1) than for PV3 (21.0). Increasing the age, a decreasing trend in seropositivity was observed, in particular for PV3. The 2017-2019 Italian National Immunisation Plan emphasises, as primary objective, the maintenance of the polio-free status and strongly validates the 2 + 1 schedule in the first year of life with IPV vaccine associated with the administration of booster doses at 6 years and during the adolescence. Surveillance system and high population immunity are crucial to ensure the maintenance of polio-free status

Viral Respiratory Infections in Hematological Patients

Viral infections of the respiratory system represent one of the most important complications in hematological patients in terms of both the severity of the clinical picture and its related impact on the duration of hospitalization, and of mortality. The most implicated viruses are those that commonly cause community-based respiratory diseases: respiratory syncytial virus, Influenza virus and rhinovirus. However, in some cases the clinical picture may be triggered by first infection with or reactivation of pathogens normally not responsible for clinically relevant diseases in immunocompetent subjects. This issue is currently being taken into greater consideration within the scientific community. However, the strong heterogeneity in the epidemiology and clinical expression of these infections and the lack of adequate therapeutic options imply that there is currently no uniform consensus on the best management of these patients. The main purpose of this review is to highlight which viruses are currently most implicated in the onset of these infections, what is their incidence in so heterogeneous and fragile patients and the factors that lead to disease's onset and evolution. Possible or available clinical management options, diagnostic and therapeutic tools, and preventive and prophylaxis measures are also discussed

Impact of Pertussis on the Italian population: Analysis of hospital discharge records in the period 2001–2014

Objectives: The study aimed to analyze and update the impact of pertussis on the Italian population by evaluating pertussis-related hospital admissions in the period 2001–2014. Design or methods: Hospital Discharge Records (HDR) were provided by the National Archive of HDR data of the Ministry of Health. Only hospitalizations included in the primary diagnosis were evaluated. Significant trends over the considered years were assessed as average annual percent changes (AAPC) applying the Joinpoint model. Results: A total of 7,102 hospital admissions for pertussis (main diagnosis) were registered; the trend of hospitalizations progressively decreased from >1/100,000 inhabitants in the years 2001-2004 to 0.64/100,000 inhabitants in 2014. A great part of hospitalizations (63.6%) involved subjects <1 year of life; almost 20% of cases were registered in the age class 5-14 years. The Joinpoint analysis showed a statistically significant variation in some age classes. Conclusions: Even if this study shows a decreasing trend in the number of pertussis-related hospitalizations, the impact of the disease in Italy in terms of hospital admissions continues to be relevant, especially in the <1 year age class. Pertussis therefore continues to be, in Italy as well as in other European countries, an important public health issue. Keywords: Pertussis, Burden, Vaccination, Pertussis-related hospitalization, Hospital discharge recor

Evaluation and review of preventive measures applied during COVID-19 pandemic: strategies adopted by European countries

The COVID-19 pandemic has greatly jeopardized the European continent and the spread of SARS-COV-2 has led European countries to implement a series of preventive interventions aimed at decreasing the incidence rate of the disease, in consideration of the lack of specific therapies and of a vaccine. Each European country has behaved in different ways and timing accordingly to the epidemiological trend and to different political strategies. The main purpose of preventive measures is to lower the incidence rate of the disease, avoiding the collapse of health systems and limiting the total number of severe cases and deaths. All these targets should fit with needs that go beyond scientific evidence such as economic interests, decisions of neighboring countries and specific socio-political factors for each country. The objective of this research is to clarify which preventive measures have been recommended and applied in different European countries

Trends in influenza coverage rates in five consecutive immunisation seasons in the Local Health Unit of Ferrara (North Italy).

Seasonal influenza epidemics yearly affects 5-15% of the world’s population, resulting in 3-5 million serious cases and up to 650,000 deaths. Elderly, pregnant women and individuals with underlying conditions are at increased risk of complications. According to the Italian National Immunization Prevention Plan 2017-2019, these categories benefit from free vaccination. Influenza coverage rate in Italy are not optimal. The study investigated the coverage rate in five consecutive influenza seasons (2010/2011-2014/2015) in Local Health Unit (LHU) of Ferrara (Italy). The amount of delivered vaccinations was not constant, with a decreasing trend. An increase in coverage with increasing age was observed, but in no immunisation seasons the 75% target of over-65 years old individuals immunised was achieved. As number of delivered doses and coverage rates decreased, the percentage of immunisations delivered by the General Practitioners (GPs) increased. The District with the lowest vaccination coverage was the Western District. In elderly, coverage rates in South-Eastern and North-Central District were higher with a statistically significant difference compared to Western District. Higher levels of immunisation were observed in South-Eastern District in the pediatric age and in North-Central District in adult age group with a statistically significant difference. The trend in the LHU of Ferrara was similar to regional and national data, conditioned in the 2014/2015 season by the spreading of worrying news, although unfounded, on the safety of the vaccine. The GPs were essential in ensuring vaccine uptake, growing the percentage of delivered doses and achieving as much as possible effective elderly immunisatio

Chronic diseases are strongly associated with sickness absences in a sample of Italian public employees

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Active surveillance of adverse events after immunization (AEFI) from the Local Health Unit of Ferrara, Italy

IntroductionVaccine vigilance implies the collection, evaluation, analysis and communication of adverse events following immunization (AEFI) and is a useful tool for vaccine monitoring allowing, even after approval and marketing, to check its safety/tolerability. The multiregional project "Active surveillance of adverse vaccine reactions", joined by the AUSL of Ferrara, is aimed at making parents of children, who have undergone at least one vaccination provided by the regional vaccination calendar in the first 24 months of life, aware of the reporting of any AEFI via mobile phone-SMS.MethodsAn analysis of the project data, collected in the period March 2018 - May 2019, was carried out, to evaluate the effectiveness of the reporting tool and the type and frequency of AEFI. Anonymized data were analyzed by number, gender, distribution by age, type of vaccine, adverse event, severity and outcome.ResultsA total of 1494 consents and 983 SMS messages were obtained from parents.The vaccine doses carried out were 1,984 (28.3% hexavalent, 28% PCV13, 17% anti-rotavirus, 14.3% Men-B). Almost all (99.5%) AEFI were classified as "not serious".Based on the Organ System Class (SOC), most reports are related to "General Disorders and Administration Site Conditions" (52.3%), followed by "Psychiatric Disorders" (26.5%) and "Metabolic and nutrition disorders" (12.5%).ConclusionsThe reported AEFI are in line with the ones reported in the literature.Reporting via SMS is a valid vaccine surveillance tool contributing to the qualitative and quantitative improvement of the information transmitted