Research on mesophilic aerobic microorganisms and Enterobacteriaceae in cultivated and commercialized Agaricus bisporus.

BACKGROUND: Production and consumption of fresh mushrooms reached high levels in recent years but only a few data regarding microbiological quality of these products are available, although their potential microbial load is expected to be high. EU and Italian legislation have not set a limit on microbial counts in these products and label information is often unclear. This study investigates the microbial quality of samples of fresh cultivated mushrooms sold in Tuscany so that both food business operators and legislators can obtain data about potential microbial risk for consumers and debate about the opportunity of realizing an update on fresh mushrooms labels that should include information to protect consumers' health. STUDY DESIGN: This study reports the microbial load in samples of cultivated and commercialized Agaricus bisporus. Samples were obtained from different shops in Florence, chosen among those products whose labels did not indicate how the product should be consumed. METHODS: From March through May 2014, 20 couples of samples of A. bisporus were acquired in Florence. Microbiological analysis included the quantification of the microbial counts for mesophilic aerobic microorganisms and Enterobacteriaceae, as indicators of hygienic practices during cultivation and manufacturing. The analyses were carried out at two subsequent stages: one immediately (T0) and one at the end of the shelf life (T1), i.e. close to the expiry date stated on the label. RESULTS: The high microbial load observed exceeds the reference values set as acceptable for raw foods in Tuscany and is worse than the ones reported in other studies on this subject. The results are particularly alarming in light of the fact that A. bisporus is usually consumed raw and there is no mandatory specification on the label that informs consumers that the product must be cooked before being consumed. CONCLUSION: This research highlights the importance of adequate and complete information on fresh mushrooms labels, that should include information about the need for sanitization before the consumption, the appropriate storage temperature, and the maximum duration of shelf life. Data obtained could also be useful for food business operators to gather information about the microbial quality of fresh cultivated commercialized mushrooms in order to implement quality controls of the production process and storage conditions.

Budget impact analysis of universal rotavirus vaccination in the Local Health Unit 11 Empoli, Tuscany, Italy.

BACKGROUND: Rotavirus (RV) infection is the first cause of acute viral gastroenteritis in children under five years of age all over the world; it mainly affects children between six and 24 months of age and can cause serious acute diarrhoea and dehydration. The aim of this study is to perform the budget impact analysis of universal rotavirus vaccination in the Local Health Unit (LHU) 11 Empoli, Tuscany, Italy. METHODS: An ad hoc mathematical simulation model was developed to evaluate the budget impact analysis of 5-years universal rotavirus vaccination. Particularly, incidence of rotavirus gastroenteritis (RVGE), hospitalizations, nosocomial diarrhoea, medical consultations, prescriptions and accesses to emergency department were taken into account in the analysis. The direct medical costs due to RV diarrhoea and the costs of vaccination campaign were considered as the main outcome measures in the study. RESULTS: The adoption of universal rotavirus vaccination campaign for five years in the LHU 11 Empoli would result in relevant savings due to the health cares avoided. These savings would overlapped the costs of vaccination yet from the second year after the introduction of vaccination. The saving for the Health Service would be 1.5 million Euro after five years of campaign. CONCLUSIONS: Universal vaccination against rotavirus results clinically and economically favourable for both the Health Service and the Society perspectives.

Surveillance of adverse events following immunization with meningococcal group C conjugate vaccine: Tuscany, 2005-2012.

INTRODUCTION: Post-licensure vaccine safety studies are essential to identify uncommon events that may be difficult to assess during pre-licensure studies. The aim of our study was to evaluate the safety of serogroup C meningococcal conjugate (MCC) vaccine in Tuscany from 2005 to 2012. METHODS: All adverse events (AEs) to MCC vaccine notified from 2005 to 2012 were obtained from the regional health authority. RESULTS: Following 451,570 doses administered, 110 suspected AEs were notified (mean annual reporting rate: 2.8/10,000 doses). The most frequently AE reported was fever (60%), followed by swelling at the injection site (11%) and febrile seizures (10%). Overall, 77.3% of cases were not severe, while 21.8% required hospitalization. Almost four months after the receipt of the vaccine, a one-year-old infant was diagnosed with a pervasive developmental disorder with disturbance of speech, but any link with the vaccinations received was refuted. Most AEs (80.9%) occurred after co-administration with other vaccines, especially with MMR or MMRV vaccines (42.7%) or the DTPa-HBV-IPV/Hib vaccine (33.7%). DISCUSSION: Our study confirmed the high level of safety of MCC vaccine in Tuscany: AEs proved rare and all cases had only temporary and self-resolving consequences. As usually only the most severe suspected AEs are reported, the true proportion of AEs requiring hospitalization was most probably overestimated, and it is plausible that most of these cases were in fact only temporally related.