Description of two measles outbreaks in the Lazio Region, Italy (2006-2007). Importance of pockets of low vaccine coverage in sustaining the infection

<p>Abstract</p> <p>Background</p> <p>Despite the launch of the national plan for measles elimination, in Italy, immunization coverage remains suboptimal and outbreaks continue to occur. Two measles outbreaks, occurred in Lazio region during 2006-2007, were investigated to identify sources of infection, transmission routes, and assess operational implications for elimination of the disease.</p> <p>Methods</p> <p>Data were obtained from several sources, the routine infectious diseases surveillance system, field epidemiological investigations, and molecular genotyping of virus by the national reference laboratory.</p> <p>Results</p> <p>Overall 449 cases were reported, sustained by two different stereotypes overlapping for few months. Serotype D4 was likely imported from Romania by a Roma/Sinti family and subsequently spread to the rest of the population. Serotype B3 was responsible for the second outbreak which started in a secondary school. Pockets of low vaccine coverage individuals (Roma/Sinti communities, high school students) facilitated the reintroduction of serotypes not endemic in Italy and facilitated the measles infection to spread.</p> <p>Conclusions</p> <p>Communities with low vaccine coverage represent a more serious public health threat than do sporadic susceptible individuals. The successful elimination of measles will require additional efforts to immunize low vaccine coverage population groups, including hard-to-reach individuals, adolescents, and young adults. An enhanced surveillance systems, which includes viral genotyping to document chains of transmission, is an essential tool for evaluating strategy to control and eliminate measles</p

ICONA 2003: Indagine nazionale sulla copertura vaccinale infantile

Lo studio ICONA è un insieme di indagini campionarie di copertura vaccinale condotte simultaneamente nel primo semestre 2003 in tutte le Regioni e Province Autonome italiane, utilizzando la tecnica del campionamento a cluster. Complessivamente sono state intervistate le famiglie di 4.602 bambini di età compresa tra i 12 e i 24 mesi di vita. A livello nazionale, la proporzione di bambini vaccinati con tre dosi di poliomielite, difterite, tetano, epatite virale B e pertosse varia dal 95% al 96%, mentre la copertura per Haemophilus influenzae tipo b è dell'87%. La proporzione di bambini tra 16 e 24 mesi vaccinati contro morbillo, rosolia e parotite è del 77%. Anche se i risultati regionali evidenziano un incremento delle coperture rispetto alla precedente indagine condotta nel 1998, permangono notevoli differenze tra regioni, indicando che non tutti i bambini italiani hanno le stesse opportunità di prevenzione

ICONA 2008: Indagine di COpertura vaccinale NAzionale nei bambini e negli adolescenti

Lo studio ICONA 2008 è un insieme di indagini campionarie di copertura vaccinale condotte simultaneamente in 17 Regioni e nella Provincia Autonoma di Trento utilizzando la tecnica del campionamento a cluster. Complessivamente sono state intervistate le famiglie di 3.806 bambini di età compresa tra i 12 e i 24 mesi e le famiglie di 3.804 adolescenti nel loro sedicesimo anno di vita. Oltre il 96% dei bambini tra i 12-24 mesi ha completato il ciclo primario di vaccinazione contro polio, difterite, tetano, pertosse, epatite B e Haemophilus influenzae tipo b ma solo l’86,5% del campione è stato vaccinato contro morbillo, parotite, rosolia. Tra gli adolescenti oltre il 96% è risultato completamente vaccinato per polio ed epatite B ed ha effettuato 4 dosi di vaccino per difterite e tetano ma solo il 52,9% ha ricevuto la quinta dose di richiamo di vaccino difto-tetanico. La copertura vaccinale per tre dosi di pertosse è del 45,6% e quella per una dose di Morbillo Rosolia Parotite /Morbillo è pari al 78,1%, mentre per due dosi è del 53,9%

An outbreak of acute hepatitis A among young adult men: clinical features and HIV coinfection rate from a large teaching hospital in Rome, Italy

Objectives: Italy is a low-incidence region for hepatitis A; however, during the last 2\ua0years an increase in the incidence of hepatitis A virus (HAV) infection was reported in Europe. The aim of this study was to describe this recent outbreak. Methods: We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio (INR) and the presence or absence of anti-HIV-1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the \u3c72 test and Mann\u2013Whitney U-test. Results: A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88\ua0mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5\ua0days. In 2016-2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20-39\ua0years compared with older (2010-2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV-positive, four of whom represented new diagnoses. HIV-positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV-negative patients. Conclusions: In 2016\u20132017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged