COVID-19 emergency: from a general hospital to a covid hospital in one week, an Italian experience.

Abstract: Aim of this letter is to describe the reconversion process of our general hospital, in just one week, into a COVID-19 Hospital. The working strategy allowed to quickly find the spaces, identify the working group, reshape the hospital organizational structure, redesign the flows and patient/health workers pathways. The hospital provided for a progressive activation of COVID-19 beds following the philosophy of the intensity of care. The main results were on management, flows, PPE and hygiene areas. Although some problems came out in the beginning, this fast hospital reconversion model may be replicated in the future to face similar epidemic or pandemic outbreaks.

Unimmunized Gypsy populations and implications for the eradication of poliomyelitis in Europe.

The certification of poliomyelitis eradication in Europe will eventually require that countries demonstrate there is a minimal risk of wild poliovirus reintroduction and sustained transmission through unimmunized subpopulations such as ethnic minorities. A serologic survey among a Gypsy community in Italy found that despite only 26% documented immunization coverage, serum neutralizing antibodies to poliovirus types 1, 2, and 3 were detected in 81%, 94%, and 63% of the 86 persons studied. While the high level of immunity found in this community may have been due to secondary spread of vaccine virus, the possibility of unrecognized circulation of wild polioviruses cannot be excluded. Targeted immunization of such groups may be the most efficient means of eliminating the risk of importation-associated outbreaks.

[A seroepidemiological study on the level of immunological coverage in a nomadic population in Rome]. / Studio sieroepidemiologico sul livello di copertura immunitaria in una comunita nomade a Roma.

Immunization status to the three types of poliovirus, to tetanus, diphtheria and measles was evaluated in a Gypsy population living at a Roman camp. Information about demographic data and history of immunization was collected from 149 subjects and a blood sample was obtained from 86 individuals to determine antibody titres to the above mentioned infectious agents. Among the responders, only 20.8% had received at least one dose of oral polio vaccine (OPV), tetanus and diphtheria vaccine, while none was vaccinated against measles. In spite of a low immunization coverage, serological data showed high prevalence of antibodies to the three types of poliovirus (81.4% to polio type 1:94.2% to polio type 2:62.8% to polio type 3) and to measles (76.7%), while antibodies to tetanus and to diphtheria were detected respectively only in 3.5% and 0% of the individuals tested. High levels of antibodies to polio were found also among unvaccinated subjects. For these, a statistically significant positive correlation between age and number of "contact doses" from vaccinated family members was observed (r = 0.70; CI 95%: 0.27-0.90). In conclusion, this study uncovers very low levels of immunization to poliovirus, tetanus, diphtheria and measles in the study Gypsy population, and shows the effects of the secondary spread of the OPV, which probably contributed to reduce the risk of contracting the disease in unvaccinated individuals.

Tetanus: a rare but preventable cause of mortality among drug users and the elderly.

Forty deaths due to tetanus were reported in Lazio, Italy, during 1985-1994. Retired persons accounted for 48% of all deaths. Intravenous drug use was the most commonly identified risk factor among individuals aged less than 40 years. The frequent utilization of curative health services by drug users and the elderly should be used as an opportunity to update their immunization status.

Surveillance of meningococcal meningitis in the Latium region, Italy 1984-1985.

A surveillance system on meningococcal meningitis was set up in an Italian region in 1984, to monitor the trend and distribution of the disease, to acquire bacteriological data, to evaluate control measures. Results of the first two years show no overall increase in the incidence of the disease, on the other hand an increased incidence in the 15-24 age group, a high fatality rate, a prevalence of serogroup C and serotype 2a and widespread resistance to sulfonamides were observed. Features characteristic of an epidemic period are thus present in the context of an endemic setting.