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From January 2017 to June 2018 more than 7000 measles cases were reported in Italy, of which more than 400 among unvaccinated healthcare workers. We described a measles outbreak occurred in Western Liguria, Italy, characterized by a high involvement of healthcare workers and hospital visitors. Suspected measles cases and data regarding vaccination status and clinical management of the patients were collected by reviewing 3 different surveillance systems: the routine mandatory notification system, the National Integrated Surveillance System for Measles and Rubella and the regional reference laboratory for measles diagnosis. Thirty-six cases were reported, with a median age of 31 years and >95% in unvaccinated subjects. One death occurred, 15 cases were hospitalized. Hospital transmission was confirmed or suspected in 12 cases; amongst this cases, 5 were healthcare workers (a gynaecologist, an obstetric nurse, a radiologist, a physiotherapist and a nurse working in an infectious disease ward), all certified unvaccinated. Phylogenetic analysis revealed the circulation of a single B3 genotype variant. Our experience highlighted the key role of nosocomial transmission and the need for targeted strategies, in particular (i) to implement a measles catch-up immunization campaign in susceptible groups, especially in healthcare workers, (ii) to intensify the check of immunisation status of healthcare workers and to offer vaccination for those who need it, (iii) to improve timeliness and completeness of surveillance systems. Efforts are needed to guarantee the safety of the hospital and the reliability of the healthcare workers. Only high vaccination coverage among HCWs can prevent the diffusion of measles in the hospital setting. [ABSTRACT FROM AUTHOR]

The total burden of acute respiratory diseases in children is still not completely understood. Clinical and epidemiological surveillance of influenza (FLU) and other Acute Respiratory Infections (ARI) are currently a major objective of Public Health in order to approach “ad hoc” prevention strategies in pediatric population. The principal aim of our study was to describe the epidemiology of these diseases using an appropriate surveillance system. During 2000–2001 and 2001–2002 seasons, respectively 49 and 55 sentinel paediatricians monitored 10 Italian Regions (Liguria, Lombardy, Friuli Venezia Giulia, Tuscany, Umbria, Marche, Abbruzzo, Puglia, Calabria and Sicily) weekly notifying FLU, monitored as Influenza Like Illness (ILI), and ARI clinical cases. We calculated cumulative weekly morbidity rate×1000 subjects between 0 and 14 years during winter season (44th to 17th week). The FLU vaccinal status and the number of hospitalisations were also looked into. [Copyright &y& Elsevier]

• Healthcare workers are at high risk of both influenza and SARS-CoV-2 infections. • Influenza vaccines may exercise non-specific effects by inducing the trained immunity. • Higher SARS-CoV-2 testing frequency is associated with higher positivity rate. • Lower risk of SARS-CoV-2 was observed among recipients of influenza vaccines. • Influenza vaccination should be further encouraged among healthcare workers. Healthcare workers (HCWs) are a priority group for seasonal influenza vaccination (SIV). The 2020/21 SIV campaign was conducted during the second wave of the COVID-19 pandemic. Vaccines, including SIV, may exert non-specific protective effects on other infectious diseases which may be ascribable to the concept of trained immunity. The aim of this study was to explore the association between 2020/21 SIV and SARS-CoV-2 positivity in a cohort of Italian HCWs. In this observational study, a cohort of HCWs employed by a large (ca 5000 employees) referral tertiary acute-care university hospital was followed up retrospectively until the start of the COVID-19 vaccination campaign. The independent variable of interest was the 2020/21 SIV uptake. Both egg-based and cell culture-derived quadrivalent SIVs were available. The study outcome was the incidence of new SARS-CoV-2 infections, as determined by RT-PCR. Multivariable Cox regression was applied in order to discern the association of interest. The final cohort consisted of 2561 HCWs who underwent ≥1 RT-PCR test and accounted for a total of 94,445 person-days of observation. SIV uptake was 35.6%. During the study period, a total of 290 new SARS-CoV-2 infections occurred. The incidence of new SARS-CoV-2 was 1.62 (95% CI: 1.22–2.10) and 3.91 (95% CI: 3.43–4.45) per 1000 person-days in vaccinated and non-vaccinated HCWs, respectively, with an adjusted non-proportional hazard ratio of 0.37 (95% CI: 0.22–0.62). E -values suggested that unmeasured confounding was unlikely to explain the association. A lower risk of SARS-CoV-2 infection was observed among SIV recipients. [ABSTRACT FROM AUTHOR]

Background Screening of the natural HCV NS3 polymorphism Q80K is required prior to simeprevir administration due to the reduced susceptibility of genotype 1 viruses carrying this amino acid variant. A simple, rapid and robust test for Q80K screening would be advisable in routine diagnostic laboratories. Objectives The aim of this study was to evaluate a commercial NS3 Q80K real-time PCR kit (Q80K Polymorphism Kit, Clonit srl, Milan, Italy). Study design Forty-three plasma samples obtained from untreated HCV genotype 1a-infected patients and previously sequenced at a reference laboratory, were sent to two public clinical virology laboratories for blinded Q80K screening with the kit under evaluation. The sample panel included 25 cases with the wild type 80Q, 17 with the mutant 80K and 1 with the mutant 80L. Results Laboratory 1 identified 22/25 (88.0%) 80Q and 17/17 (100.0%) 80K cases. Laboratory 2 identified 23/25 (92.0%) 80Q and 16/17 (94.2%) 80K cases. All of the unidentified cases were scored as negative, with no mutant/wild type miscalling. The 80L variant was scored as indeterminate by Laboratory 1 and as negative by Laboratory 2. Overall, sensitivity and specificity for detection of 80K were 97.1% (95% C.I., 82.9–99.8%) and 100.0% (90.2–100.0%), respectively. However, the system did not provide any result for 6/84 cases (7.1% failure rate), not including the 80L variant which is not expected to be detected as stated in the kit package insert. Global inter-laboratory concordance was 93.0%. Conclusions Despite good specificity, this Q80K detection system needs improvements in amplification success rate and robustness. [ABSTRACT FROM AUTHOR]

Abstract: MF59 is already known to enhance the breadth of antibody response to mismatched influenza seasonal and avian strains. However, little is known on the effect of MF59 on immunogenicity of influenza vaccines when “apparent” good matching between circulating and vaccine strains exists. To this end, we compared the immune response elicited by MF59-adjuvanted or non-adjuvanted subunit vaccine, containing A/California/7/04(H3N2) strain, against circulating viruses isolated between 2004/2005 and 2006/2007 seasons, belonging to different clades. The advantage offered by MF59 in terms of higher immunogenicity, expressed as higher post-vaccination HI titres, is observable also against viruses showing antigenic and molecular pattern undistinguishable from vaccine strain, but it became even more evident as the antigenic and molecular distance between vaccine and circulating strains grew. These data show that seasonal influenza vaccine adjuvanted with MF59 can offer a stronger benefit as compared to non-adjuvanted vaccine in protecting against a broader range of virus strains circulating during the influenza season. [Copyright &y& Elsevier]

Abstract: Liguria was the first Italian Administrative Region, since 2003, to actively recommend free-of-charge immunisation, of all infants, with heptavalent Pneumococcal Conjugate Vaccine (PCV-7), within a research pilot-project. Vaccination coverage among infants rapidly increased from 42.8% in 2003 to 83.3% in 2004, progressively reaching levels of 93.4% in 2007. Two scientific projects have been carried out, aimed: (i) to assess the immunogenicity of PCV-7 and of a hexavalent vaccine Diphtheria-Tetanus-Trivalent Acellular Pertussis-Hepatitis B-Inactivated Polio Virus-Haemophilus influenzae type B (DTaP-HBV-IPV-Hib) when co-administered to healthy infants at 3, 5 and 11–12 months of age (routine schedule), and (ii) to evaluate the effect of the immunisation campaign in preventing pneumococcal-associated hospitalisations. Results in 151 infants showed the high immunogenicity of the vaccines, seroprotection rates, measured 1 month after the third dose, ranging between 97.3% (serotype 6 B) and 100% (serotypes 4 and 9 V) for PCV-7 and between 99.3% and 100% against common antigens of hexavalent vaccine. Monitoring nearly 70,000 children, aged 0–24 months, during the period 2000–2007, and comparing hospitalisation rates occurred in subjects belonging to birth cohorts before and after the introduction of widespread immunisation, a significant decline for all-cause and pneumococcal pneumonia and for acute otitis media was observed, with preventive fractions of 15.2%, 70.5% and 36.4%, respectively. [Copyright &y& Elsevier]

Abstract: Safety and efficacy of adjuvanted vaccines in autoimmune individuals raises growing clinical and scientific interest. Protection from influenza would bring particular benefits in these patients with common cardiac and respiratory impairment. This study evaluates efficacy, clinical safety and immune effects of the administration of a single dose of a virosomal flu vaccine in 46 scleroderma patients. The following parameters were evaluated before and after administration of Inflexal: clinical conditions, inflammation and autoimmunity parameters, humoral response, lymphocyte proliferation and cytokine production upon flu antigen stimulation by specific and non-specific cells. Inflexal was found effective in scleroderma patients. In no subject was worsening of clinical conditions, inflammation and immunological parameters observed. [Copyright &y& Elsevier]

Summary: Adjuvants enhance antibody response against vaccination. We compared the ability of MF59™-adjuvanted and non-adjuvanted subunit influenza vaccines, containing A/Wyoming/3/03(H3N2), to confer cross-protection against four consecutive drifted strains in the elderly. Neutralizing and haemagglutination-inhibiting antibody were measured. MF59™-adjuvanted vaccine induced a stronger booster response against A/Panama/2007/99(H3N2) than non-adjuvanted vaccine. A/Panama/2007/99(H3N2) circulated widely during the previous 5 years and was included in vaccines over four consecutive seasons. Broader serological protection against drifted strains that circulated 1 and 2 years after vaccination with A/Wyoming/3/03(H3N2) was observed with MF59™-adjuvanted vaccine. Thus, MF59™-adjuvanted vaccine confers greater immunogenicity than non-adjuvanted vaccines in vulnerable populations. [Copyright &y& Elsevier]