Factors contributing to suboptimal vaccination against influenza: results of a nationwide telephone survey of persons with cardiovascular disease.

Vaccination against influenza averts cardiovascular events and is recommended for all patients with coronary heart disease. Because data were unavailable regarding vaccination rates among such patients' household contacts, we sought to estimate the rate of influenza vaccination in persons with cardiovascular disease and their contacts. In 2004, we conducted a random, nationwide telephone survey of 1,202 adults (age, > or = 18 yr) to ascertain knowledge, attitudes, and behaviors regarding influenza vaccination. Of the interviewees, 134 (11.1%) had histories of heart disease or stroke. Of these 134, 57% were men, and 45% were > or = 65 years of age. Overall, 57% were inoculated against influenza in 2003-2004, and 68% intended the same during 2004-2005. Vaccination rates increased with age: 48% (ages, 18-49 yr), 68% (ages, 50-64 yr), and 75% (age, > or = 65 yr). Forty of 69 respondents (58%) reported that their spouses were vaccinated, and 7 of 21 (33%) reported the inoculation of children < or = 17 years old in their household. Only 65% of the 134 patients considered themselves to be of high-risk status. Chief reasons for remaining unvaccinated were disbelief in being at risk and fear of contracting influenza from the vaccine. Although seasonal influenza vaccination is recommended for all coronary heart disease patients and their household contacts, the practice is less prevalent than is optimal. Intensified approaches are needed to increase vaccination rates. These findings suggest a need to increase vaccination efforts in high-risk subjects, particularly amidst the emerging H1N1 pandemic.

First-trimester prenatal screening for the common 35delG GJB2 mutation causing prelingual deafness.

OBJECTIVE: This study evaluates the prevalence of 35delG GJB2 mutation, the most common genetic mutation causing prelingual deafness, and its screening feasibility and acceptability in pregnant women undergoing first-trimester CVS for chromosomal abnormality investigation. METHODS: Samples were taken from 5786 pregnant women who requested CVS for chromosomal analysis. The samples were split into two aliquots for chromosome and DNA analysis, respectively. The results of foetal karyotyping were provided 7 days after sampling, at which time the fully informed couple decided whether or not to undergo DNA testing. RESULTS: Of the 5449 eligible candidates, 2997 (55.0%) chose to undergo 35delG testing. Among them, 67 proved to be carriers of the mutation, resulting in a prevalence rate of 1:44.7 (2.23%). There were no homozygous foetuses, but two double heterozygous foetuses were found, and in one case the couple chose to terminate the pregnancy. CONCLUSIONS: The results confirm the high frequency of 35delG mutation in the Italian population. The study shows that prenatal screening for GJB2 mutations in pregnant women with no retrospective risk for deafness appears to be feasible and highly acceptable. Consequently, given evidence that early evaluation and treatment significantly improve speech and language skills, as well as social and emotional well-being in affected children, 35delG mutation analysis in pregnant women booking CVS primarily for chromosomal investigation could be considered a useful addition to more comprehensive population screening strategies.