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Molecular techniques for the identification of enteric viruses in marine waters

Abstract The RNAs extracted from 28 high spin pellets of clarified lysates from BGM cells, previously infected by concentrated Adriatic Sea water samples, were analyzed by a dot-blot test. We used a 32 P-labeled cDNA probe ( BamH I 220–670 ) from the 5′ non-coding end of the cloned poliovirus I (Mahoney) genome. The probe was selected for its broad range of genetic specificities. Based on the density of the hybridization signals on the autoradiograph, our dot-blot results showed a high degree of reactivity of the probe to homologous (poliovirus 1) and heterologous (echovirus 6 and coxsackievirus B3) reference RNA, as predicted by a computer analysis of their sequences, and a low reactivity to that of the samples leading us to exclude the presence of enteroviruses like the reference strains. In order to understand if there were other enteroviral serotypes or not, dot-blot tests were supplemented with Northern-blot hybridization assays. Results from the Northern-blot showed a series of fragments ranging from 4.3 to 1.2 kb but no signal corresponding to 7.5 kb (as did the positive control RNAs). These features suggested that the tested RNAs might derive from viruses of the Reoviridae family, which includes members with segmented genome. Traditional PAGE analysis showed clearly the 10-fragments pattern characteristic of reoviruses. Twenty-three out of the twenty-eight samples tested showed the presence of viruses, and this confirms the previously noted cytopathic effect (CPE) of the samples on the BGM cells.

Towards the eradication of HPV infection through universal specific vaccination

BackgroundThe Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies.DiscussionA panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations’ intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men.SummaryThe reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.

Immune response of the elderly to rabies vaccines

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.

Immunity status against poliomyelitis in persons 13–14 years old living in Rome

The immunity against poliomyelitis in 1000 subjects 13-14 years old was evaluated. Neutralizing antibodies against poliovirus type 1, 2 and 3 were detected in 97.6%, 95.8% and 70% of samples, respectively. 3/1000 (0.3%) subjects were simultaneously seronegative to the three types. WHO does not suggest a protective level of International Units (IU), but our data indicate that such level is 0.45 IU for polio type 1, 0.65 IU for the type 2 and 0.138 for the type 3. A booster dose of vaccine in adolescence to ensure personal and herd immunity is recommended.

The future of immunization policies in Italy and in the European Union: The Declaration of Erice

On December 2014 the Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) of the European Union adopted the Council Conclusions on “Vaccinations as an effective tool in public health,” a crucial step to strengthen EU action supporting Member States (MS) to implement effective immunization policies and programs. As a contribution to the ongoing pan-European discussion and to the Italian commitment to stay at the forefront of promoting vaccination polices, the Erice Declaration was drafted by Italys best experts in the field of immunization to transpose to the national level the goals set by the EPSCO Conclusions. The aim of the current letter is to present to the broader international audience the Italian perspective as a case study to assess different immunization policy models, challenges and priorities.

Prevalence survey of nosocomial infections in a paediatric hospital

A prevalence survey of nosocomial and community infections in a childrens hospital was carried out in the wards of the Bambino Gesù Hospital, Rome, Italy. The overall prevalence of hospital-acquired infection (HAI) was 5.1%, with higher rates in surgical units and among children aged 1 to 5 years. The proportion of community-acquired infections was 9.2%, with higher rates in the infectious disease and internal medicine units and among children aged 6 to 11 years. The most frequent type of HAI was respiratory tract infection, with only a small number of urinary tract infections.

Communication about vaccination: A shared responsibility.

ABSTRACT Vaccine hesitancy is an important issue to be addressed, due to the risk of decrease of vaccination coverage and consequent control of preventable diseases. While it is not considered a specific determinant, poor or inadequate communication can contribute to vaccine hesitancy and negatively influence vaccination uptake. As a contribution to the ongoing discussion regarding this theme and in the perspective of the implementation of the upcoming national vaccination plan in Italy, the Erice Declaration was drafted by experts in the field of immunization following a 5-day residential, independent workshop regarding communication topics in vaccinology. The aim of the current letter is to present to the broader international audience such a contribution, proposing the identification of the main actions that should be taken into account and prioritized in order to improve communication in the domain of vaccination.

Can Hexavalent Vaccines Be Simultaneously Administered with Pneumococcal or Meningococcal Conjugate Vaccines

Background Local immunization programs may include hexavalent and conjugate pneumococcal or meningococcal vaccines administered in the same vaccination visit. Information based on evidence is necessary for correctly planning schedules and for parents who often fear the administration of too many vaccines. We reviewed the available literature to assess the effects on immunogenicity and safety of simultaneous administration of hexavalent and conjugate pneumococcal and meningococcal C vaccines in healthy children. Methods We searched for papers including a comparison of coadministration and single administration of hexavalent with conjugate pneumococcal or meningococcal C vaccines. Data sources included Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. Immunogenicity and safety results were extracted and compared. We calculated the absolute risk increase of being a non responder to any antigen and of experiencing common adverse events. Results Four relevant articles were included in the review. Immunogenicity of components included in the hexavalent vaccines was maintained with coadministration of conjugate pneumococcal and meningococcal C vaccines. However individuals who received hexavalent vaccine with conjugate pneumococcal vaccines were 18% more likely to have anti-PRP < 1 μg/mL after the third dose although this difference disappeared after the fourth dose, and titres against meningococcal C antigens were higher when vaccines were administered separately. Children who received simultaneous administration of hexavalent vaccines with conjugate pneumococcal vaccines had a 13-17% additional risk of experiencing fever compared with single administration. Conclusion Few studies deal with coadministration of vaccines. Hexavalent and conjugate pneumococcal or meningococcal vaccines may however be administered simultaneously without noteworthy negative effects on immunogenicity or safety profile. Parents of vaccinees should be appropriately informed on the effects of coadministration to improve their compliance. Studies on vaccine coadministration should be promoted and unpublished studies realized for vaccine registration should be made available.

Home hygiene and the prevention of infectious disease in developing countries: a responsibility for all

Infectious disease remains a serious global threat to health, the most significant proportion of these diseases occurring in developing countries. Prevention of infectious disease through integrated programmes relating to water supply, sanitation, food quality and community and home hygiene practice are key factors in controlling infectious disease. There is evidence that provision of sanitation services and hygiene education along with safe drinking water could reduce diarrhoeal mortality by 65% and the related morbidity by 30%. In India and in other developing regions, experience now shows that if the health benefits from public-funded community programmes relating to water supply, sanitation, food quality, etc. are to be commensurate with the investment made, they must be better integrated with the promotion of hygiene practice within the community, in the home and its immediate surroundings. Promoting hygiene education and developing community-based projects will empower communities and enable individuals to take more responsibility for their health in terms of hygiene in the home and its environment. This is most relevant in regions where governmental organisations may be less able to provide a standard of public health services, including Community Water Supply and Sanitation (CWSS), that is common in developed countries. The responsibility for health education and hygiene promotion needs to be shared by all stakeholders, including the private sector, interested in improving the hygienic status of the domestic and peri-domestic environment, individually or in partnerships. With this in mind, the International Scientific Forum on Home Hygiene (IFH), in partnership with the London School of Hygiene and Tropical Medicine, Sulabh International Social Service Organisation, the Indian Public Health Association (IPHA), the Institution of Public Health Engineers (IPHE), and the Indian Association of Preventive and Social Medicine, organised an international conference entitled ‘Home Hygiene and the Prevention of Infectious Disease in Developing Countries: A Responsibility for All’. This conference took place in New Delhi, India, in April 2002 and was attended by around 150 delegates from around the world. The main conference objective was to stimulate discussion and share experience on the issues of integrated hygiene interventions related to the domestic setting. The conference covered all the main hygiene areas related to domestic and peri-domestic settings, including water, sanitation, food hygiene, handwashing and hygiene practice. A further objective of the conference was to evaluate the important and interdependent responsibilities of government, non-government and inter-government organisations, and the corporate world for developing and promoting home and environmental hygiene in areas of the world where the threat of infectious disease is high and where improved hygiene practices can bring very significant health benefits at affordable costs. International Journal of Environmental Health Research 13, S5 – S8 (June 2003)

Enterovirus surveillance of Italian healthy children.

Surveillance of acute flaccid paralysis (AFP) is the golden strategy recommended by the WHO to verify the condition of polio eradication in a country. Because of the difficulty to detect all of the expected AFP cases and to reach the target incidence of 1/100,000 requested by WHO, the surveillance of enteroviruses in the population has been adopted by several countries as an important additional method to verify the absence of wild-poliovirus circulation. To complete the results of AFP surveillance set up in Italy in 1996, we have conducted a wild poliovirus surveillance by examining stool samples from 1551 healthy children aged less than 5 years, collected during the period January 1997 to January 1998. The children were from three cities (Parma, Rome and Bari) located in northern, central and southern Italy. Thirty-nine polioviruses, 72 non-polio enteroviruses and 50 enteric, non-entero (NE), viruses were isolated from stool specimens. Polioviruses identified were nine type 1, seven type 2 and twenty-three type 3. Characterization of isolates by both antigenic and molecular methods showed that all polioviruses were of vaccine origin. As expected, most polioviruses, especially types 2 and 3, presented retromutations known to be associated with loss of the Sabin attenuated phenotype. The results of this study support the data obtained from the active AFP surveillance conducted in Italy in the same period – on the absence of paralytic disease due to wild poliovirus – and altogether demonstrate the effectiveness of the vaccination program.