Epidemiological and molecular approaches for management of a measles outbreak in Liguria, Italy

Since March 2010 a measles outbreak has been occurred in Genoa, Liguria, an administrative Region in Northern Italy. Epi- demiological and molecular data on the outbreak, obtained from the passive mandatory notification system, the laboratory surveillance and an innovative syndrome surveillance system, were investigated. Overall 39 cases were reported in the urban area. Information about demography, vaccination status, hospitalization and geographic distribution of measles cases are available. 19 cases (48.7%) were laboratory-confirmed and were characterized by sequence analysis: 18 strains belonged to genotype D8, so identifying a new measles variant within the Liguria population. Adopted control measures seem to have limited viral circulation. The outbreak allowed to test the efficacy of the 3 surveillance systems active in Liguria, highlighting their advantages and some important limitations. More efforts are needed to collect and integrate any epidemiological and virological available data in order to better describe the local measles transmission dynamics

Improving the protection against Streptococcus pn with the new generation 13-valent pneumococcal conjugate vaccine

The wide use of the 7-valent Pneumococcal Conjugate Vaccine (PCV7) determined, during the last decade, a dramatic decline in the incidence of Invasive Pneumococcal Diseases (IPD) in infants and children, and also among the non-vaccinated popu- lation through the phenomenon known as ?herd protection?. Furthermore a significant reduction of some non-IPD, such as Community Acquired Pneumonia (CAP) and Acute Otitis Media (AOM) was reported among the pediatric population. At the same time, the high vaccination coverage rates reached with PCV7 contributed to modify the ecology of Streptococcus pneumoniae (Sp), favoring the emergence of some serotypes not included in PCV7 and involved in IPD (replacement phenomenon), thus par- tially affecting the positive effects of the pediatric immunization programs. To remedy these shortcomings, a new generation of conjugate vaccines, with an enlarged antigenic spectrum of activ- ity than PCV7, has been available since 2010. In particular, the 13-valent Pneumococcal Conjugate Vaccine (PCV13) has been authorized for active prevention of IPD, CAP and AOM in infants and children aged between 6 months and 5 years. More recently, in September 2011, the European Medicine Agency extended the indication for its use to include active immunization of adults aged ? 50 years for the prevention of IPD, thus opening new interesting opportunities to improve the control of pneumococcal disease among the entire population. The most interesting results from clinical trials using PCV13 in both children and adults are reported and discussed in details. The full article is free available on www.jpmh.or

Influenza vaccination in the elderly: why are the overall benefits still hotly debated?

The exact magnitude of the benefit of influenza vaccine among elderly individuals is subject of considerable debated. Existing vaccine effectiveness estimates come mostly from observational studies, which may be biased because of difficulties in identifying and adjusting for confounders. In this paper, we examine the potential sources of bias in observational studies of influenza vaccine effectiveness in the elderly and we discuss available evidence regarding the efficacy and effectiveness of licensed influenza vaccines. Although several methodological criticisms among the available analyses on seasonal vaccines for elderly were identified, overall seasonal influenza vaccines showed relevant efficacy/effectiveness in reducing the risk of influenza and its complications in the elderly, considering different measure of outcome