Monitoraggio sugli operatori sanitari risultati positivi a COVID-19 dall’inizio dell’epidemia fino al 30 aprile 2020: studio retrospettivo in sette regioni italiane

Il documento affronta il tema del contagio tra il personale sanitario che, fin dalle primissime fasi, ha svolto un ruolo cruciale nella gestione dell'epidemia sia per la cura in prima linea dei pazienti infetti, con il conseguente maggior rischio di esposizione, sia nell’assicurare la piena implementazione delle misure di prevenzione e controllo per il contenimento del contagio. Questo ha determinato un'elevata diffusione di contagi tra gli operatori sanitari con percentuali molto elevate rispetto ai casi registrati nella popolazione generale

Tularemia Outbreak Investigation in Kosovo: Case Control and Environmental Studies

A large outbreak of tularemia occurred in Kosovo in the early postwar period, 1999-2000. Epidemiologic and environmental investigations were conducted to identify sources of infection, modes of transmission, and household risk factors. Case and control status was verified by enzyme-linked immunosorbent assay, Western blot, and microagglutination assay. A total of 327 serologically confirmed cases of tularemia pharyngitis and cervical lymphadenitis were identified in 21 of 29 Kosovo municipalities. Matched analysis of 46 case households and 76 control households suggested that infection was transmitted through contaminated food or water and that the source of infection was rodents. Environmental circumstances in war-torn Kosovo led to epizootic rodent tularemia and its spread to resettled rural populations living under circumstances of substandard housing, hygiene, and sanitation

Focolaio di COVID-19 in un campo estivo nella Regione Piemonte (2021): descrizione, lezioni apprese e raccomandazioni per futuri campi estivi

COVID-19 outbreak at a summer camp in Piedimont region in 2021: description, lessons learned and recommendations for future summer camps Introduction In August 2021, an outbreak of coronavirus disease 2019 (COVID-19) occurred in a summer camp in Piedmont region, Italy, affecting primarily campers aged ≤16 years. We conducted a retrospective cohort study among campers and personnel (attendees) to determine the attack rate (AR), evaluate possible factors associated with transmission and propose recommended measures for the organization of future summer camps. Materials and methods A de-identified database including demographic, role of attendees, cohorting, means of transportation to the camp, inter-camper interactions, SARS-CoV-2 testing results and symptomatology was used. All analysis data came from a collection of data carried out by the organizing private company and the information related to the mitigation protocol put in place was provided by the health care personnel. All campers were asked to have an antigen/molecular test within 72 hours before departure. Nine dedicated buses departed from different Italian regions towards the camp. All travellers wore a surgical mask during the trip. Upon arrival, regardless of the bus used, the campers were divided into 11 subgroups with no further contact between them unless they were blood relatives. No SARS-CoV-2 screening tests were scheduled for campers after arrival and during the camp period. On the other hand, personnel had a screening test at each shift change. During the camp period, antigen tests were performed at cases with symptoms suggestive of infection. Only attendees enrolled in the private company and those who received at least one test since arrival at the camp were considered in the study. We calculated overall AR and relative risk (RR) along with specific, transmission-focused risk factors. Results Among the 187 study participants, the median age was 14 years (range: 6-45). Seven days after arrival at the camp, 8 campers developed symptoms and tested positive. The overall AR was 33.7% (63 out of 187), and 34.2% (50/146) for campers and 31.7% (13/41) for staff, respectively. Among those with available symptoms information, 72% (36/50) were asymptomatic at the time of testing. Only 17.1% of campers had direct contact with blood relatives from other subgroups. The AR of participants using a bus was 36.2% (59/163) with an RR of 1.18 (95% CI = 0.51-2.73,) and the AR of those belonging to a subgroup was 35% (62/177) with an RR of 3.5 (95% CI = 0.54-22.7). For personnel, participation to a subgroup gave an AR of 38.7% (12/31) and an RR of 3.87 (95% CI = 0.57-26.18). All but four subgroups had a high AR (>33,3). Conclusions Getting tested prior to traveling and campers separation into low-contact subgroups was not sufficient enough to avoid a high number of infections in this summer camp. Analysis did not allow the identification of an index case or helped to understand whether the outbreak originated from the attendees who travelled on the same bus. The high AR observed in all subgroups suggest that there was frequent contact between attendees belonging to different subgroups. Sharing of common areas such as the canteen and contact between attendees are possible factors that have contributed to the spread of the outbreak. The experience gained by the analysis of this data was used for the review of measures for the organization of summer camps in 2022

Impatto della vaccinazione e della pregressa diagnosi sul rischio di infezione e di malattia severa associata a SARS-CoV-2. Un’analisi dei casi diagnosticati nel mese di ottobre 2022

In Italia, l’epidemia di infezioni da SARS-CoV-2 nel corso del 2022 è stata influenzata dalla predominanza della variante Omicron, caratterizzata da alta trasmissibilità, e dalla progressiva eliminazione di quasi tutte le misure non farmacologiche di prevenzione. La combinazione di questi due elementi ha determinato una notevole circolazione virale di SARS-CoV-2 con oltre 24,5 milioni di casi da inizio epidemia. Dato l’alto numero di persone che ha superato almeno una infezione da SARS-CoV-2 e l’alta copertura vaccinale nella popolazione è necessario stimare il ruolo protettivo dell’immunità associata sia al vaccino che all’infezione pregressa nel prevenire l’infezione e la malattia severa da COVID-19. Il presente rapporto fornisce una stima del rischio di infezione e di malattia grave, per il mese di ottobre 2022, sulla base della vaccinazione e della precedente infezione. La massima protezione contro la diagnosi di infezione da SARS-CoV-2 e la malattia severa si realizza attraverso una immunità ibrida (l’effetto combinato della vaccinazione e della pregressa infezione) mentre livelli di rischio più alto si riscontrano sempre tra le persone non vaccinate e senza una precedente diagnosi di infezione. A parità di fascia di età e di pregressa infezione, si osserva una tendenza alla riduzione del rischio di malattia severa associata alla vaccinazione, in particolare se recente

Risk factors for death from invasive pneumococcal disease, europe, 2010

We studied the possible association between patient age and sex, clinical presentation, Streptococcus pneumoniae serotype, antimicrobial resistance, and death in invasive pneumococcal disease cases reported by 17 European countries during 2010. The study sample comprised 2,921 patients, of whom 56.8% were men and 38.2% were >65 years of age. Meningitis occurred in 18.5% of cases. Death was reported in 264 (9.0%) cases. Older age, meningitis, and nonsusceptibility to penicillin were signifcantly asso ciated with death. Non-pneumococcal conjugate vaccine (PCV) serotypes among children 65 years of age, risk did not differ by serotype. These fndings highlight differences in case-fatality rates between sero types and age; thus, continued epidemiologic surveillance across all ages is crucial to monitor the long-term effects of PCVs

Introduction of new and reinforcement of existing compulsory vaccinations in italy: First evaluation of the impact on vaccination coverage in 2017

In June 2017, a decree-law to increase the number of mandatory vaccinations from 4 to 10 for minors up to 16-years-old was issued in Italy. The vaccination coverage for 2017 showed a positive impact for all the vaccines, particularly for the measles, mumps and rubella vaccine at 91.6% for the year 2017, showing a 4.4% increase compared with 2016 (87.2%). Continued monitoring is needed to evaluate the medium to long-term effects of the law

The Impact of the First Wave of the COVID-19 Pandemic on Healthcare Workers: An Italian Retrospective Study

Healthcare workers (HCWs) played an essential role in managing the COVID-19 pandemic. The Italian Workers’ Compensation Authority (INAIL) and the Italian National Institute of Health (ISS) developed a retrospective study to analyze and understand trends and characteristics of infections among HCWs during the first wave of the pandemic. Between May and September 2020, Italian Regions retrospectively collected anonymous data regarding HCWs infected from the beginning of the pandemic until 30 April 2020 from their administrative sources through a questionnaire asking for socio-demographic and occupational information about the characteristics of contagion and disease outcome. Almost 16,000 valid questionnaires were received. Logistic regression was performed to ascertain the effect of age, gender, geographical macro area, profession, and pre-existing health conditions on the likelihood of HCWs developing more severe forms of COVID-19 (at least hospitalization with mild symptoms). All predictor variables were statistically significant. HCWs at higher risk of developing a more severe disease were males (OR: 1.90; 95% CI: 1.44–2.51), older than 60 years of age (OR: 6.00; 95% CI: 3.30–10.91), doctors (OR: 4.22; 95% CI: 2.22–9.02), working in Lombardy (OR: 55.24; 95% CI: 34.96–87.29) and with pre-existing health conditions (OR: 1.90; 95% CI: 1.43–2.51). This study analyses the main reasons for the overload put on the National Health Service by the first wave of the pandemic and the risk of infection for HCWs by age, gender, occupational profile and pre-existing health conditions. Improved knowledge, availability of personal protective equipment (PPE) and a tight vaccination campaign for HCWs strongly changed the trend of infections among HCWs, with substantial elimination of serious and fatal cases