Malattie infettive del viaggiatore: principali aspetti epidemiologici e preventivi.

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Object oriented influence diagram fo cost effectiveness analysis of influenza vaccination in the elderly population.

nfluenza infection is a major cause of illness, morbidity and mortality throughout the world, mainly amongst the elderly. Since vaccination has proven to be effective in the reduction of all acute complications, deciding whether to implement a vaccination campaign and which vaccine to prescribe is an important task. The aim of this review is to build a decision model, which allows the decision makers to evaluate the possible results under different scenarios, and to choose the decision associated with the highest expected utility. The analysis is based on Bayesian networks methodology. Vaccination is more effective in the long run and is cost saving compared with the null option. Moreover, the innovative MF59 adjuvanted flu vaccine proves to be cost effective with respect to standard vaccine

AIDS ed epatiti virali in odontoiatria: aspetti preventivi

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Response of influenza vaccines against heterovariant influenza virus strains in adults with chronic diseases

The ability of influenza vaccination to provide cross-protection against heterovariant influenza strains was evaluated in a double-blind, randomized, trial in north-east Italy during the winter of 2005-2006. Of 238 adult subjects with underlying chronic diseases, 120 received MF59-adjuvanted subunit vaccine (Sub/MF59) and 118 received a conventional subunit vaccine (Subunit). Immunogenicity was measured for A/H3N2 and B influenza strains against both the homologous vaccine strains (A/New York/55/2004 and B/Jiangsu/10/2003), and the heterovariant strains recommended for the 2006-2007 season (A/Wisconsin/67/2005 and B/Malaysia/2506/2004). Although both vaccines conferred serological protection against the homologous vaccine strains and the 2006-2007 heterovariant A/H3N2 strain for a majority of subjects, the antibody response was highest in the Sub/MF59 vaccine group. For example, MF59-adjuvanted vaccination conferred significantly greater (P = 0.002) protection against the heterovariant A/H3N2 strain than the conventional subunit vaccine (79.2% vs. 61.0% of subjects, respectively). In conclusion, these results demonstrate that protection provided by influenza vaccination in adults affected by chronic diseases is lower against heterovariant strains than for homologous strains. However, addition of MF59 adjuvant to a subunit vaccine enhances immunogenicity against the A/H3N2 heterovariant strain, conferring broader protection than a conventional subunit vaccine in this population, who are at higher risk of influenza-related complications