Present situation and new perspectives for vaccination against Neisseria meningitidis in Tuscany, Central Italy

Background. In Italy one third of bacterial meningitis are caused by Neisseria meningitidis. In March 2005, the Regional Health Authority of Tuscany included the meningococcal serogroup C conjugate (MCC) vaccine in the recommended vaccination pro- gram with a schedule of three doses to all newborns at 3, 5 and 13 months of age (from 2008 amended to a single dose at 13 months) and a single catch-up dose until age 6. Objective. To evaluate the impact of the current national and regional immunization strategies against N. meningitidis and to highlight new perspectives for meningococcal disease prevention with the existing tetravalent meningococcal vaccine (ACWY) and with the future incoming meningococcal B vaccines. Methods. Meningitis incidence rates in Italy and in Tuscany were calculated for the period 1994-2011 and 2005-2011,respectively. Immunization coverage with MCC vaccine in Tuscany and vacci- nation status of meningitis cases were reported. Literature review on meningococcal conjugate vaccine use and recommendation was performed. Results. A decrease in incidence rates of meningococcal menin- gitis was observed in all age groups involved in the immunization campaign. Immunization coverage with MCC increased progres- sively year by year in Tuscany. A herd immunity effect was meas- ured in unvaccinated age groups. Since 2006 no cases of invasive meningococcal C infection in vaccinated subjects were observed in Tuscany. Conclusions. Implementation of MCC vaccination in Tuscany was effective in preventing meningococcal C disease, confirming the effectiveness of the vaccine. A new tetravalent (ACWY) con- jugate vaccine is now available and its use in all Italian Regions should be considered. The full article is free available on www.jpmh.or

Agronomic and Environmental Benefits of Cover Crops in Northern Italy

Cover crops have a number of benefits (reduction of nitrate leaching and of soil erosion, control of weed seed bank, increase of soil organic matter and increase of cash crop yield), but these were seldom quantified in cropping systems of Northern Italy. This experiment aimed to quantify some of these effects, by comparing cover crop species and their management techniques

Sexual behavior, use of contraceptive methods and risk factors for HPV infections of students living in Central Italy: implications for vaccination strategies

The most frequent risk factors related to the infection/persistence of HPV in the population are an early start of sexual activity, the number of sexual partners, smoking, and the utilization of some contraceptive methods. In Italy, HPV vaccine is offered free of charge to all 12 year-old female adolescents, with a possible extension to other age groups according to Regional policies. In order to value the suitability of the current HPV vaccination strategies in Italy, an epidemiological study on sexual habits in adolescents and young adults was organized. An anonymous questionnaire on sexual behavior and risk factors for HPV infection was administered to 2300 students aged 13-24 years attending secondary schools and universities in Tuscany during 2008-09. About 12% of the sample declared to be foreign citizen. The results highlight the early start of sexual activity among young students. Particularly, more than half of the interviewed students declared to be already sexually active. The mean and the median age of the first sexual intercourse was 15.4 ± 1.4 years and 15 years (25th and 75th percentiles = 14-16), respectively. More than 77% of students at age 16 years declared they already had the first sexual intercourse, compared with 0.3% of those inf. 12 years. Generally, females aged 13-16-years, if sexually active, had sexual contacts with a single partner. Most students declared to know common contraceptive methods (male condom and contraceptive pill). However, only half of them declared a regular use of male condom. These data confirm the importance of vaccination against HPV for young females before their sexual debut. In addition, the current multi-cohort strategy of HPV vaccination in Tuscany (free of charge in the age range 12-16 years) allows also to catch up those girls that have not yet had their first sexual experiences before 16 years (21.5% according to our study) but also to those girls already sexually active, who very rarely are already infected by all vaccine types at 16 years. Our results also show the importance of sexual health education and of promotion of correct behaviours in schools

Non-familial paid caregivers as potential flu carriers and cause of spread: the primary prevention of flu measured through their adhesion to flu vaccination campaigns—A Florentine experience

Introduction: Influenza vaccination is recommended for caregivers of elderly people. In a study aimed at assessing the level of health literacy (HL) in a sample non-familial caregivers in the Florence Health District (Tuscany), data were collected regarding access and adherence to the flu vaccination campaigns. Methods: The sample consists of 47 non-familial paid caregivers. We collected information regarding socio-demographic characteristics, services provided and daily work time, whether or not influenza vaccination was administered for the 2016/2017 season and in the previous three years. The level of HL was assessed through the Newest Vital Sign. Results: 63.8% of non-familial caregivers have not joined the flu campaigns over the last four years, 14.9% have been vaccinated only sometimes (in some epidemic seasons), and 21.3% have received a flu shot in all the seasons investigated. Most of the non-familial caregivers who do not get vaccinated (27.7%) do not perceive that they are in direct contact with a person at-risk; those who get the vaccine regularly (12.8%) reported they want to protect the assisted person as motivation for vaccine uptake. Vaccination was not associated with HL. Conclusion: Adhesion to anti-flu vaccination campaigns for these homecare workers has been resulted rather poor. Coverage does not seem to be related with HL level. It seems appropriate to promote extensively flu vaccination among family carers by actively offering the vaccination in appropriate forms, places and times, to avoid serious consequences on elderly people with higher risk of comorbidity and frailty