Biomedical subjects
Publications and source records attributed to M G Pompa.
Three clusters of measles cases occurred between June and September 2006, in the Roma/Sinti populations in three different Italian regions: the Bolzano-South Tyrol in northern Italy; Lazio in central Italy; and the island of Sardinia in the southwest.
An initiative of active prevention, to promote an influenza vaccination programme, has been carried out in the Ministry of Health of Rome, Directorate General of Health Prevention: during October 2004 influenza vaccine has been actively offered to all the employees; 46 out of the 129 workers (about 36% of the total) accepted to be vaccinated. Afterward, the propensity to get influenza of the vaccinated has been compared with that of a control group, operating in the same setting, but not vaccinated. Taking into account that the groups in question is far too small, the statistical results showed that influenza vaccination of healthy working adults did not reduce the rates of influenza-like-illness (ILI), in addition, the difference between average duration of disease in unvaccinated persons was not statistically significant.
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In 1994, the Italian Ministry of Health implemented a National Surveillance System to obtain data on the incidence of bacterial meningitis and its causative agents, including Haemophilus influenzae type b (Hib). As a consequence, case reporting of Hib meningitis is increasing year by year; in 1996, there were 126 notifications, of which 73% were in children under 2 years of age. Although underreporting still exists, parallel prospective or retrospective epidemiological surveys conducted in some Italian Regions allowed for partial correction of the incidence of Hib meningitis (up to 18.5/100,000 population in 1994).
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During 1994, 603 cases of bacterial meningitis were reported in Italy. Seventy-five percent of cases with determined etiology was due to three agents: Neisseria meningitidis (33.4%), Streptococcus pneumoniae (23.4%) and Haemophilus influenzae (18.6%). The majority of cases due to N. meningitidis and H. influenzae occurred in subjects below five years of age (35.7% and 84.8%, respectively) while S. pneumoniae accounted for 52.8% of meningitis cases in subjects older than 44 year of age. The estimated incidence of N. meningitidis on the national population in 1994 was 0.27 per 100,000. Serogroup B accounted for 62.5% of the serotyped isolates, group C for 23.1%, group A for 7.2%, group W135 for 3.6%, group Y for 1.8%. All tested meningococcal strains were susceptible to penicillin as well as to rifampin. Incidence of meningococcal meningitis in 1994 has been low suggesting that its relative importance compared to other bacteria causing meningitis is likely to change in the future. Therefore, extended surveillance on bacterial meningitis by other etiological agents has to be maintained and implemented in order to undertake the appropriate control measures and evaluate their effect.
A serological study has been performed to detect the antibody response to full schedules of two anti-rabies vaccines (PDEV and HDCV). Subjects aged > 50 years, compared with subjects 11-25 years, showed significantly lower titres after the 4th dose (and, to a lesser extent, after the 5th dose), suggesting that, among the elderly, the 6th dose is strongly desirable.
A seroepidemiological survey of a group of drug abusers has been carried out to determine the prevalence of hepatitis C virus and hepatitis B virus, hepatitis D virus, hepatitis A virus infection markers in sera, as well as to evaluate the role of potential risk factors. A total of 645 symptomless subjects with a history of injecting heroin were recruited as volunteers from methadone maintenance centres in Rome. For all hepatitis viruses the total figures showed high prevalence rates giving considerable viral circulation in this group. Among heroin addicts the prevalence was 63.4% for HCV, 65% for HBV, 13.3% for HDV and 50.9% for HAV. Anti-HCV prevalence correlated with serological evidence of HBV infection. A significant correlation was also found between presence of HCV antibodies and exposure time to drug addiction > 5 years earlier. The data reveal the important role played by needle sharing in the spreading of multiple infections among intravenous drug abusers (IVDA).
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Severe clinical conditions are due to invasive diseases that are not routinely reported in a routine surveillance system, in Italy. Nevertheless we can estimate the incidence of invasive diseases considering the surveillance system of bacterial meningitis, the Hospital Discharge Registry and the laboratory-based surveillance, this is useful to outline the trend of S. pneumoniae infections. We report the results of some Italian studies on the pneumococcal infections together with some international studies.
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Meningococcal disease is the only bacterial meningitis able to cause an epidemic and the mortality due to this disease is all but negligible; therefore the active immunization induced by a vaccine that includes a large portion of Neisseria meningitidis serogroups responsible for the immunization of subjects at risk. Tetravalent vaccine containing polysaccharides of the serogroups A, C, Y, W135 has given good results both for tolerability and immune response. Considering the epidemic situation in Italy, this vaccine could be an excellent strategy "to behead" possible epidemics and/or hyperendemics due to a known serogroups.
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The notification of the cases of meningitis admitted to the Hospital Cotugno of Naples in the period 1987-91 were analyzed by a retrospective study: aim of the study was to outline the epidemiological trend of meningitis and to evaluate the quality of the data around the change of the reporting system, which took place in 1991. We examined 566 clinical charts, selecting only the cases whose agents were identified. Our data agree with the national and international literature, with the exception that the majority of cases were produced by S. pneumoniae. Moreover, the data about tuberculous meningitis still show that the highest incidence occur in youth, while other Authors noticed a trend toward older ages. Further studies are in progress to improve the knowledge of tuberculous meningitis in our Country.