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The frequent occurrence of Legionnaires' disease outbreaks in many countries, including Italy, highlights the importance of epidemiological investigations on this disease. For this purpose, an active surveillance programme of pneumonia patients was carried out in a large hospital in Apulia (Italy) from March 2001 to December 2003. A total of 612 patients were tested for Legionella pneumophila infection by urinary antigen detection and evaluation of antibodies titre. Culture of respiratory specimens was performed on 117 patients. Thirty-seven patients (6%) tested positive for legionellosis: 10 resulted nosocomial cases and 27 as community-acquired. Only 9 cases di Legionella pneumophila infection were reported from Apulia to the routine surveillance system between 1996 and 2000. The results of our study denote the level of underestimation of this disease in Apulia.

An investigation about N. meningitidis carriers was carried out in Apulia (Italy) among teen-agers. 85 healthy carriers were identified (1.4%): the 81.2% of isolates resulted polyagglutinable, 3.5% autoagglutinable and 1.2% were not classifiable with antisera. The other strains belonged to serogroup B (9.4%), W135 (2.3%), Y (1.2%) and 29E (1.2%). Some Authors report that non-groupable strains are usually isolated from healthy carriers pharynx. The most recent molecular methods permit to subdivide these bacteria in serotype and serosubtype by membrane protein antigens, too. So, today the only identification as serogroup is not able to study N. meningitidis epidemiology.

A pilot study on environmental surveillance of poliovirus included one hundred ninety-six samples (drinking water, surface water, seawater and sewage), collected between 1996 and 1998 in different regions of Italy. Samples were screened for the presence of poliovirus and other enteric viruses. Twelve polioviruses, 35 non polio enteroviruses (NPE) and 51 enteric non entero (NE) viruses were isolated. All poliovirus isolates, namely four type 1, four type 2 and four type 3, were characterised as Sabin-like strains. Thirty-one Coxsackie B and 4 Echo viruses were also detected. The presence of Sabin-like polioviruses in the environment is not unexpected since immunization with only oral poliovirus vaccine was performed in Italy until May 1999, when a sequential schedule consisting of two doses of inactivated polio vaccine (IPV) and two of oral polio vaccine (OPV) was adopted; in July 2002 a schedule consisting of four doses of IPV was adopted. Although this is only a pilot study and the number of samples analysed is limited, so far data from this study so far supports once again evidence of lack of circulating wild poliovirus and is in line with results from AFP surveillance in Italy and stool survey on healthy children.

Salmonellosis is one of the most common forms of foodborne infection. An outbreak of gastroenteritidis associated with a wedding party was investigated, even to value the costs falling on individuals, the health services and society as a whole. One hundred and fifty nine wedding guests were interviewed by phone. Multivariate analysis was used to assess which food were significantly associated with infection. One hundred and thirteen cases were identified; ten stool samples were culture positive for Salmonella enteritidis. Handmade ice-cream and babà (a typical Italian pastry) were significantly associated with infection. The cost of a case was estimated to be between US $ 74 (for non hospitalised patients) and US $ 1,896 (for hospitalised patients). The outbreak was caused by a strain of Salmonella enteritidis and the vehicle of infection were unpasteurised eggs used to prepare the ice-cream. The economic impact of this outbreak was considerable and mainly due to the hospitalisation.