Unusual Domestic Source of Lead Poisoning.

Non-occupational lead poisoning is not rare, mainly occurring in domestic situations in children, but also in adults. Lead poisoning was observed in a 65 years-old woman non-exposed to risk that caught our attention with a diagnostic suspicion of acute intermittent porphyria according to recurrent episodes of abdominal pain and neuropathy of upper limbs. Acute intermittent porphyria was excluded by a laboratory investigation that showed instead severe lead poisoning. After several thorough examinations of the domestic environment, the source of intoxication has been detected in some cooking pots that released high concentrations of lead. Ethylenediamine tetracetic acid disodium calcium therapy (three cycles) reduced consistently blood lead concentration and, after one year, neuropathy was almost entirely recovered.

Varicella seroepidemiology and immunization in a cohort of future healthcare workers in the pre-vaccination era.

OBJECTIVES: The goal of this study was to establish the seroprevalence of positive antibodies against varicella and compliance with varicella vaccination in the pre-vaccination era. METHODS: A cohort of 10 683 Italian students from Padua University Medical School (from 2004 to 2019) were enrolled and classified as unvaccinated, vaccinated once, or vaccinated twice against varicella, according to their vaccination certificate. The antibody titre was measured and the seroprevalence of positive subjects was determined. Subjects with negative or equivocal antibodies were invited for vaccination, and then the antibody titre was retested. RESULTS: Unvaccinated students were mostly seropositive (95.6%), compared with vaccinated students who were less seropositive (68.0% after one dose and 78.6% after two doses) and had significantly lower antibody titres (p < 0.0001). The post-test vaccination had a positive response rate of 85.4%: 67.4% after one dose and 91.4% after two doses. CONCLUSIONS: In the pre-vaccination era, only 3.3% of future healthcare workers were vaccinated against varicella (1.1% once and 2.2% twice). Vaccination or revaccination of negative and equivocal individuals could reduce the number of susceptible people. Implementation of varicella vaccine (two doses) in healthcare workers is of primary importance to reduce the risk of transmission.

Significance of anti-HB levels below 10 IU/L after vaccination against hepatitis B in infancy or adolescence: an update in relation to sex.

Hepatitis B vaccination (three-dose series) induces long-term immunity, but it is not uncommon to find antibody levels below 10 IU/L long after vaccination. However, the majority of the subjects with low antibody levels have a prompt response to a booster dose. A population of 10,294 students at Padua University Medical School, who were subjected to hepatitis B vaccination during infancy or adolescence according to the law, was tested for the presence of anti-HBs, usually during the first year of matriculation. Among the students offered a booster dose, 1,030 were vaccinated, and the antibody titre was re-tested. The present research provides further evidence from a larger number of students (1,030) that an anti-HB level higher than 2 IU/L is predictive of a prompt response to a booster. There are also differences related to sex. The results clearly confirm that an antibody titre equal to or greater than 2 IU/L is enough to prompt a response after a booster dose, even several years after the initial vaccination cycle, and to predict effective immune protection. The length of the interval between the booster/post-booster analyses increases the probability of finding a low response to the booster; furthermore, females show a more rapid response to the booster than males. The importance for healthcare workers of measuring the antibody titre four weeks after a booster is highlighted, and the results suggest that females have a better response than males to booster vaccination.