Influenza vaccine effectiveness in Italy: Age, subtype-specific and vaccine type estimates 2014/15 season.

The 2014/15 influenza season in Europe was characterised by the circulation of influenza A(H3N2) viruses with an antigenic and genetic mismatch from the vaccine strain A/Texas/50/2012(H3N2) recommended for the Northern hemisphere for the 2014/15 season. Italy, differently from other EU countries where most of the subtyped influenza A viruses were H3N2, experienced a 2014/15 season characterized by an extended circulation of two influenza viruses: A(H1N1)pdm09 and A(H3N2), that both contributed substantially to morbidity. Within the context of the existing National sentinel influenza surveillance system (InfluNet) a test-negative case-control study was established in order to produce vaccine effectiveness (VE) estimates. The point estimates VE were adjusted by age group (<5; 5-15; 15-64; 65+ years), the presence of at least one chronic condition, target group for vaccination and need help for walking or bathing. In Italy, adjusted estimates of the 2014/15 seasonal influenza VE against medically attended influenza-like illness (ILI) laboratory-confirmed as influenza for all age groups were 6.0% (95%CI: -36.5 to 35.2%), 43.6% (95%CI: -3.7 to 69.3%), -84.5% (95%CI: (-190.4 to -17.2%) and 50.7% (95% CI: -2.5 to 76.3%) against any influenza virus, A(H1N1)pdm09, A(H3N2) and B, respectively. These results suggest evidence of good VE against A(H1N1)pdm09 and B viruses in Italy and evidence of lack of VE against A(H3N2) virus due to antigenic and genetic mismatch between circulating A(H3N2) and the respective 2014/15 vaccine strain.

Travelers With Chikungunya Virus Infection Returning to Northwest Italy From the Caribbean and Central America During June-November 2014.

Chikungunya virus (CHIKV) has recently emerged in the Caribbean. In Italy, CHIKV vector is documented in the Po river valley; therefore, a risk for autochthonous outbreaks is present. We report a case series of seven imported CHIKV infections in travelers returning from the Caribbean and Latin America occurring between June and November 2014, in the area of Turin, Northwest Italy, 3 years after the last imported cases were reported. These cases are a reminder of the need to always consider CHIKV infection in travelers from these epidemic areas as well as the importance of a prompt diagnosis.

Risk perception about zoonoses in immigrants and Italian workers in Northwestern Italy.

OBJECTIVE: To assess factors associated with a low risk perception of zoonoses and to identify the gaps in knowledge about transmission and prevention of zoonoses in immigrant and Italian workers. METHODS: A cross-sectional study with 175 workers in the agro-livestock and agro-food industry in Piemonte, Italy, was carried out. Data were collected with a semi-structured questionnaire based on knowledge, attitudes and practices (KAP) survey. We calculated proportions and used chi-square tests and odds ratios to assess associations. Eight individual interviews with key informants on immigration and public health in Piemonte were carried out. RESULTS: Participants were 82 (47%) Italians and 93 (53%) immigrants. Immigrants were from Romania, Morocco, Albania, India, China, Argentina, Peru, Macedonia, Ivory Coast, Ukraine and Colombia. The study revealed significant differences in risk perception at work (p = 0.001). We found associations between "not having correct knowledge about zoonoses" and the following variables: i. "being immigrant" OR = 4.1 (95%CI 1.7;9.8 p ≤ 0.01); ii. "working in the livestock industry" OR = 2.9 (95%CI 1.2;15.4 p = 0.01); and iii. "being an unqualified worker" OR = 4.4 (95%CI 2.9;15.4 p ≤ 0.01). Another strong association was found between being immigrant and having a low job qualification OR = 6.7 (IC95% 2.9 - 15.4 p ≤ 0.01). Asian immigrants were the group with the highest frequency of risky behaviours and the lowest level of knowledge about zoonoses. CONCLUSIONS: Our results indicate that there were differences in risk perception of zoonoses between the groups participating in our study. These results suggest that immigrant status can be considered a risk factor for having lower risk perception and lower level of knowledge of zoonoses at work. There is a relationship between this specific knowledge of zoonoses and lack of training and instruction among migrant populations. Our results stress the need for developing education programs on zoonoses prevention among the immigrant population in Piemonte, Italy.

Risk perception about zoonoses in immigrants and Italian workers in Northwestern Italy / Percepção de risco sobre zoonoses em trabalhadores imigrantes e italianos no Noroeste da Itália / Percepción de riesgo de zoonosis en trabajadores inmigrantes e italianos en el noroeste de Italia

OBJETIVO: To assess factors associated with a low risk perception of zoonoses and to identify the gaps in knowledge about transmission and prevention of zoonoses in immigrant and Italian workers. MÉTODOS: A cross-sectional study with 175 workers in the agro-livestock and agro-food industry in Piemonte, Italy, was carried out. Data were collected with a semi-structured questionnaire based on knowledge, attitudes and practices (KAP) survey. We calculated proportions and used chi-square tests and odds ratios to assess associations. Eight individual interviews with key informants on immigration and public health in Piemonte were carried out. RESULTADOS: Participants were 82 (47%) Italians and 93 (53%) immigrants. Immigrants were from Romania, Morocco, Albania, India, China, Argentina, Peru, Macedonia, Ivory Coast, Ukraine and Colombia. The study revealed significant differences in risk perception at work (p = 0.001). We found associations between "not having correct knowledge about zoonoses" and the following variables: i. "being immigrant" OR = 4.1 (95%CI 1.7;9.8 p ≤ 0.01); ii. "working in the livestock industry" OR = 2.9 (95%CI 1.2;15.4 p = 0.01); and iii. "being an unqualified worker" OR = 4.4 (95%CI 2.9;15.4 p ≤ 0.01). Another strong association was found between being immigrant and having a low job qualification OR = 6.7 (IC95% 2.9 - 15.4 p ≤ 0.01). Asian immigrants were the group with the highest frequency of risky behaviours and the lowest level of knowledge about zoonoses. CONCLUSÕES: Our results indicate that there were differences in risk perception of zoonoses between the groups participating in our study. These results suggest that immigrant status can be considered a risk factor for having lower risk perception and lower level of knowledge of zoonoses at work. There is a relationship between this specific knowledge of zoonoses and lack of training and instruction among migrant populations. Our results stress the need for developing education programs on zoonoses prevention among the immigrant population in Piemonte, Italy.

OBJECTIVE: Analisar fatores associados à baixa percepção de risco de zoonoses e identificar as lacunas no conhecimento sobre a transmissão e prevenção de zoonoses em trabalhadores imigrantes e italianos. METHODS: Estudo transversal com 175 trabalhadores da indústria agropecuária e agroalimentar em Piemonte, Itália. Os dados foram obtidos por meio de questionário semiestruturado baseado em estudo sobre conhecimentos, atitudes e práticas. Foram calculadas proporções, com uso de teste qui-quadrado e odds ratio para estimar associações. Oito entrevistas individuais com informantes-chave em matéria de imigração e saúde pública foram realizadas. RESULTS: Cerca de 47% dos trabalhadores eram italianos e 53%, imigrantes, provenientes da Romênia, Marrocos, Albânia, Índia, China, Argentina, Peru, Macedônia, Costa do Marfim, Ucrânia e Colômbia. Houve diferenças significativas na menor percepção do risco no trabalho (p = 0,001). Observou-se associação entre falta de conhecimentos corretos sobre zoonoses e ser imigrante (OR = 4,1; IC95% 1,7;9,8; p ≤ 0,01), trabalhar na indústria pecuária (OR = 2,9; IC95% 1,2;6,8; p = 0,01) e ser um trabalhador não qualificado (OR = 4,4; IC95% 1,2;15,4; p = 0,01). Outra forte associação ocorreu entre ser imigrante e ter emprego de baixa qualificação (OR = 6,7; IC95% 2,9;15,4; p ≤ 0,01). Maior frequência de comportamentos de risco e menor nível de conhecimento sobre zoonoses foram encontrados no grupo dos imigrantes asiáticos. CONCLUSIONS: Foram observadas diferenças na percepção de risco de zoonoses entre os grupos participantes. O status de imigrante pode ser considerado fator de risco para ter baixa percepção de risco e menor nível de conhecimento das zoonoses no trabalho. Existe relação entre esse conhecimento específico de zoonoses e falta de formação e instrução entre as populações migrantes. É necessário desenvolver programas de educação sobre a prevenção de zoonoses entre a população imigrante.

OBJETIVO: Analizar factores asociados a la baja percepción de riesgo de zoonosis e identificar los vacíos de conocimiento sobre la transmisión y prevención de zoonosis en trabajadores inmigrantes e italianos. MÉTODOS: Estudio transversal con 175 trabajadores de la industria agropecuaria y agroalimentaria en Piemonte, Italia. Los datos fueron obtenidos por medio de cuestionario semi-estructurado basado en estudio sobre conocimientos, actitudes y prácticas. Se calcularon proporciones y usó la prueba de Chi-cuadrado y odds ratio para estimar asociaciones. Se realizaron ocho entrevistas individuales con informantes clave en materia de inmigración y salud pública. RESULTADOS: Cerca de 47% de los trabajadores eran italianos y 53%, inmigrantes provenientes de Rumania, Marruecos, Albania, India, China, Argentina, Perú, Macedonia, Costa de Marfil, Ucrania y Colombia. Hubo diferencias significativas en la menor percepción del riesgo en el trabajo (p = 0,001). Se observó asociación entre falta de conocimientos correctos sobre zoonosis y ser inmigrante (OR=4,1; IC95% 1,7;9,8;p ≤ 0,01), trabajar en la industria pecuaria (OR = 2,9; IC95% 1,2;6,8;p = 0,01) y ser un trabajador no calificado (OR = 4,4; IC95% 1,2;15,4;p = 0,01). Otra fuerte asociación ocurrió entre ser inmigrante y tener empleo de baja calificación (OR = 6,7; IC95% 2,9;15,4;p ≤ 0,01). Se encontró mayor frecuencia de conductas de riesgo y menor nivel de conocimiento sobre zoonosis en el grupo de los inmigrantes asiáticos.

The effectiveness and safety of hepatitis A vaccine: a systematic review.

We report on the conduct of a systematic review to assess the efficacy and the safety of hepatitis A vaccines in adults and children. We identified, retrieved, and assessed all trials evaluating the effects of hepatitis A vaccines on prevention of cases of hepatitis A, death from hepatitis A, and assessing nature and frequency of adverse events. We included eight randomised trials, four containing efficacy outcomes, three containing only safety outcomes and a single study containing efficacy and adverse events outcomes. Combined inactivated vaccine effectiveness was 86% (95% CI: 63-95%). Combined attenuated vaccine effectiveness was 95% (95% CI: 81-99%). Inactivated vaccine effectiveness in the prevention of HAV secondary cases, compared to non-intervention was 82% (95% CI: 23-96%). Safety profile of vaccines was similar to that of their comparators. Despite poor design and reporting of trials, we found convincing evidence of the effectiveness and safety of inactivated HAV vaccines.