@Prevention: a website project for prevention in the healthcare setting.

In the field of prevention, Internet websites and their related instruments constitute valuable tools for healthcare facilities, and particularly for Local Healthcare Authorities (LHA). As yet, however, their undoubted potential remains largely unexploited. Many LHA websites currently operating in Italy are organized in such a way that they fail to make adequate use of this precious resource. Indeed, communication regarding prevention is all too often limited to the simple reproduction of information and indications in a static and heterogeneous manner, so much so that it resembles a mere "online notice-board". The aim of the present research was to analyze the current situation and the various innovative proposals that have been made, in order to construct a more effective website model that could be used nationwide. To this end, the research was carried out through a two-pronged approach: on the one hand, all 190 LHA websites in Italy were analyzed; on the other, a questionnaire was administered to a sample of habitual users of the most modern and widespread social network, Facebook. Analysis and elaboration of the data gathered led to the creation of the model "@Prevention". This project is intended to introduce an innovative perspective into the field of online communication for healthcare prevention by providing a highly useful tool for the LHA, healthcare workers and, obviously, citizens.

Molecular epidemiology and case-control approaches for management of an outbreak of hepatitis A in Liguria, Italy.

INTRODUCTION AND METHODS: Hepatitis A remains an important public health problem in low endemicity areas, because of the social and economic high burden of cyclical outbreaks. In this study we described an outbreak of HAV infection occurred in the city of Genoa and in its proximity and the viral circulation in the post-epidemic period. In order to identify risk factors associated to the illness and to determine the source of infection and the dynamics of virus evolution, we conducted an epidemiological and molecular investigation by a case-control study and by sequence analysis of high variable regions of the genome. RESULTS: From May to October 2005, 58 HAV hepatitis cases were notified. The case-control study showed that beach establishment attending is strongly associated with HAV hepatitis (OR = 24.5, p-value < 0.01), at multivariate analysis. The profile of epidemic curve, the clinical onset of primary cases who occurred in few weeks and the geographic distribution of cases clearly indicated a common exposure to a point source: the outbreak can be probably associated with a contaminated food product dispensed in the affected area. The outbreak has been mainly caused by a single variant, confirming the common exposure to a point source; this variant previously circulated within homosexual man (MSM) network in Northern Europe. During the outbreak and in the following months, different variants originating from Southeast Asia, Southern America and Northern Africa, have co-circulated: all these cases were related to international travel and none of these had determined secondary cases. DISCUSSION: The epidemiological picture of hepatitis A in Liguria is characterized by a wide heterogeneity of circulating HAV strains. This pattern could be associated with the increase of imported cases and transmission within network of persons with similar risk factors. Molecular approach coupled to descriptive and analytical epidemiological studies appeared un-replaceable tools for management and control of HAV outbreaks, because of their capacity to recognize infection origin, transmission patterns and dynamics of virus evolution.