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Coppeta L, Ferrari C, Somma G, Giovinazzo V, Buonomo E, Trabucco Aurilio M, Treglia M, Magrini A. Serological Evaluation for Measles among Italian and Foreign Medical Students in a University Hospital in Rome. Vaccines (Basel) 2023; 11:1256. [PMID: 37515071 PMCID: PMC10384754 DOI: 10.3390/vaccines11071256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Measles infection in the hospital setting is a major issue. Despite the availability of an effective vaccine, measles outbreaks continue to occur in some European countries. We aimed to evaluate the immunological status of medical students attending the Tor Vergata Polyclinic (PTV). METHODS Measles antibodies titers were assessed by venipuncture on a sample of 2717 medical students who underwent annual health surveillance visits from January 2021 to March 2023. Subjects showing serum IgG values above 1.0 S/CO were considered serologically protected. Personal data, country of origin, and main demographic characteristic were also collected. RESULTS 66.7% (1467 Italian and 346 foreign) of medical students showed protective IgG antibodies levels. Female students were serologically immune more frequently than males (68.6% vs. 63.3%; p < 0.01 at Chi2). The mean antibody titer was 1.72 S/CO, significantly higher in females than males (1.67 vs. 1.75, respectively; p < 0.05), and significantly related to age (p < 0.01). Albanian students, who were the largest foreign population in our study, showed a low serological protection rate (40/90: 44.4%). CONCLUSIONS The proportion of serologically non-immune students is high, raising concerns about the possible risk of hospital transmission. Substantial differences in the rate of immunity have been found between subjects coming from different parts of Europe and the world. Pre-training assessment of all medical students and vaccination of susceptible individuals is highly recommended, particularly for those from low immunization rate countries.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Faculty of Medicine, University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Viola Giovinazzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Faculty of Medicine, University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Michele Treglia
- Forensics Department, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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Torner N, Mercader S, Dominguez A, Martinez A, Costa J, Sowers SB, Abernathy ES, Bellini WJ, Hickman CJ. Etiological analysis of discarded measles in the context of a measles outbreak among a highly immunized population. Pediatr Int 2023; 65:e15430. [PMID: 36461709 PMCID: PMC10107150 DOI: 10.1111/ped.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Measles can lead to serious complications and remains an important cause of morbidity and mortality worldwide. In this study we aimed to assess the etiological diagnosis of discarded measles cases in the context of an outbreak among a highly immunized population. METHODS We conducted a retrospective observational study of discarded measles cases from an outbreak that occurred from October 2006 to July 2007 in Catalonia. A confirmed case was defined as having a positive measles serum IgM result and/or a positive result by RT-PCR in urine and/or nasopharyngeal swab; or an epidemiological link to a confirmed case. Serum specimens were tested by a commercially available indirect-format and by an in-house capture-format measles IgM enzyme immunoassays. RESULTS Testing of 89 samples discarded for measles determined the etiologies for 10 (11.2%), including one rubella, three human herpes virus 6, and six measles infections. Of 381 confirmed cases in the outbreak, 10% had received at least one dose of the measles-mumps-rubella vaccine versus 54% of the discarded for measles (OR: 0.09; 95% CI: 0.06, 0.14; p < 0.001). CONCLUSIONS Highly sensitive surveillance systems are critical to identifying cases, responding to outbreaks and verifying progress towards measles elimination. Molecular tools for measles detection and differential diagnosis, and collection of appropriate specimens for molecular and serological testing are essential to correctly diagnose suspected measles infection.
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Affiliation(s)
- Nuria Torner
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Department of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Sara Mercader
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Angela Dominguez
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Department of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Ana Martinez
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Public Health Agency of CataloniaBarcelonaSpain
| | - Josep Costa
- Virology Unit, Centre de Diagnòstic BiomèdicHospital ClínicBarcelonaSpain
| | - Sun B. Sowers
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Emily S. Abernathy
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - William J. Bellini
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Carol J. Hickman
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
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3
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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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4
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Han SB, Park SH, Yi Y, Ji SK, Jang SH, Park MH, Lee JE, Jeong HS, Shin S. Measles seroprevalence among healthcare workers in South Korea during the post-elimination period. Hum Vaccin Immunother 2021; 17:2517-2521. [PMID: 33689571 DOI: 10.1080/21645515.2021.1888623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
During the measles epidemic in 2019, in-hospital transmission of measles contributed to more than two-thirds of measles cases in South Korea, where measles is declared eliminated. This study aimed to examine measles seropositivity among healthcare workers (HCWs) in South Korea to help develop an effective measles prevention strategy for hospital settings. Measles IgG titer was tested in 1,579 HCWs working in a university-affiliated hospital and the measles-containing vaccine (MCV) immunization records of 870 HCWs were identified. The overall seropositivity was 92.0%, but the seropositivity and antibody titers were significantly low among HCWs aged 20-25 years (78.6%) and among one-dose vaccine recipients (86.7%). Among two-dose recipients, seropositivity was lower among young HCWs who received two doses during their childhood than among those who received the catch-up vaccination as part of job requirements (70.3% vs. 98.0%). Among 87 seronegative HCWs who received two-dose MMR vaccination, the seroconversion rate was 98.9%. A considerable proportion of young HCWs were potentially susceptible to measles despite receiving the two-dose vaccination during childhood because of the waning immunity against measles in a country with measles-eliminated status. Serological screening for measles of newly employed HCWs and MCV immunization of seronegative HCWs appears to be an effective prevention strategy.
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Affiliation(s)
- Seung Beom Han
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,The Catholic University of Korea, Daejeon, Republic of Korea
| | - Sun Hee Park
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yunmi Yi
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seul Ki Ji
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - So Hee Jang
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Min Hee Park
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Ji Eun Lee
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Hye Sook Jeong
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Soyoung Shin
- Infection Control Unit, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.,Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Baccolini V, Sindoni A, Adamo G, Rosso A, Massimi A, Bella A, Filia A, Magurano F, Marzuillo C, Villari P, De Vito C. Measles among healthcare workers in Italy: is it time to act? Hum Vaccin Immunother 2020; 16:2618-2627. [PMID: 32209017 PMCID: PMC7746257 DOI: 10.1080/21645515.2020.1737458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/27/2020] [Indexed: 12/22/2022] Open
Abstract
Vaccination of healthcare workers (HCWs) against measles is strongly recommended in Europe. In this study, we examined the impact of measles on Italian HCWs by systematically and quantitatively analyzing measles cases involving HCWs over time and by identifying the epidemiological characteristics of the respective measles outbreaks. We retrieved data on measles cases from the Italian national integrated measles and rubella surveillance system from January 2013 to May 2019. Additionally, we performed a systematic review of the literature and an analysis of the measles and rubella aggregate outbreaks reporting forms from 2014 to 2018. Our review suggests that preventing measles infection among HCWs in disease outbreaks may be crucial for the elimination of measles in Italy. National policies aiming to increase HCW immunization rates are fundamental to the protection of HCWs and patients, will limit the economic impact of outbreaks on the institutions affected and will help achieve the elimination goal.
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Affiliation(s)
- Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giovanna Adamo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Annalisa Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Local Health Unit Roma 2, Rome, Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Fabio Magurano
- Department of Infectious Parasitic and Immune-mediated Diseases, National Institute of Health, Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Coppeta L, Ferrari C, Iannuzzi I, D’Alessandro I, Balbi O, Pietroiusti A, Trabucco Aurilio M. Rubella Immunity among Italian Female Healthcare Workers: A Serological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217992. [PMID: 33143150 PMCID: PMC7663519 DOI: 10.3390/ijerph17217992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 11/24/2022]
Abstract
Rubella, also known as German measles or three-day measles, is an infectious disease caused by virus of the genus Rubivirus, which may be prevented by vaccination. The infection is potentially dangerous for non immune subjects, although 20–50% of infected subjects are asymptomatic. Healthcare workers (HCWs) have an increased potential exposure to rubella in comparison to the general population, putting them and their patients at risk of infection and its complications. In 2019, 20 cases of rubella have been reported in Italy. According to the Italian National Immunization and Prevention Plan, HCWs should provide a written certification of vaccination for rubella or serological evidence of protective antibodies. The aim of the study was to evaluate the rubella immunization status in female HCWs of the teaching hospital Policlinic Rome Tor Vergata (PTV) of childbearing age. For this purpose, we retrospectively checked the serologic values of rubella-specific IgG antibodies analyzing the clinical records of the HCWs of undergoing the occupational health surveillance program from January 1st to June1st 2020. Five hundred fourteen HCWs with a mean age of 23.19 (range 19–37, DS: 2.80) were included: 90.3% (464) showed a protective antibody titre. The mean value of the anti-rubella IgG was 49.59 IU/mL. Our study shows a non-protective anti rubella IgG titre in a substantial percentage of HCWs (9.7%). As vaccine protection decreases over the years and the risk of congenital rubella syndrome (CRS) in vaccinated subjects should not be underestimated, we suggest routine screening of the immunological status followed by the administration of a third dose of vaccine if the antibody titre becomes non-protective.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- Correspondence: (L.C.); (M.T.A.)
| | - Cristiana Ferrari
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Ilaria Iannuzzi
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Iacopo D’Alessandro
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Ottavia Balbi
- School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (C.F.); (I.I.); (I.D.); (O.B.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Correspondence: (L.C.); (M.T.A.)
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7
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Coppeta L, D'Alessandro I, Pietroiusti A, Somma G, Balbi O, Iannuzzi I, Magrini A. Seroprevalence for vaccine-preventable diseases among Italian healthcare workers. Hum Vaccin Immunother 2020; 17:1342-1346. [PMID: 33017204 DOI: 10.1080/21645515.2020.1818523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Healthcare workers (HCWs) have an increased risk to be exposed to infectious diseases compared to the general population. For this reason, according to the National Immunization and Prevention Plan, all HCWs should have demonstrable evidence of immunity to measles, mumps, rubella, varicella and Hepatitis B. Earlier studies have already shown that a large percentage of Italian operators lacked immune protection for one or more of those pathogens.The aim of this study was to evaluate the immunization status for vaccine-preventable diseases of HCWs in a large Italian teaching hospital. We retrospectively evaluated clinical records and serological data of HCWs who followed the occupational health surveillance program between January 1 and December 31 2019. We reviewed the clinical records of 1,017 HCWs: 393 males and 624 females with a median age of 35.69 y (range: 19-67). Protective IgG antibody values were documented in the 88.0%, 75.7%, 90.3%, 87.4% and 85.7% of the HCWs screened, respectively, against measles, mumps, rubella, varicella and Hepatitis B. Age was significantly related to serological protection against measles, mumps and varicella but was not significantly related to protective IgG levels for rubella and HBV.Female gender was significantly related to a higher protection rate against Hepatitis B (87.8 vs 82.4%; p < .01) whereas males were significantly more protected against varicella (92-4 vs 84.1%; p < .01).Our study shows suboptimal levels of protection among Italian HCWs and a consequent increased risk of infection for them and their patients. Public health policies should be focused on improving preventive strategies, including serological screening and workplace vaccination of nonimmune individuals.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Iacopo D'Alessandro
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | | | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Ottavia Balbi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Ilaria Iannuzzi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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8
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Bianchi FP, Mascipinto S, Stefanizzi P, de Nitto S, Germinario CA, Lopalco P, Tafuri S. Prevalence and management of measles susceptibility in healthcare workers in Italy: a systematic review and meta-analysis. Expert Rev Vaccines 2020; 19:611-620. [DOI: 10.1080/14760584.2020.1791091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Simona Mascipinto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Sara de Nitto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | | | - Pierluigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Coppeta L, Somma G, Di Giampaolo L, Bizzarro G, Ippoliti L, Borelli F, Balbi O, Perrone S, Pietroiusti A. Persistence of antibodies for measles among vaccinated medical students in Italy. Infect Dis (Lond) 2020; 52:593-595. [PMID: 32484374 DOI: 10.1080/23744235.2020.1772498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Luca Di Giampaolo
- Department of Occupational Medicine, University of Chieti, G. D'Annunzio, Chieti, Italy
| | - Giuseppe Bizzarro
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Lorenzo Ippoliti
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Francesco Borelli
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Ottavia Balbi
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Stefano Perrone
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
| | - Antonio Pietroiusti
- Department of Occupational Medicine, University of Rome, Tor Vergata, Rome, Italy
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10
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Coppeta L, Biondi G, Perrone S, Pietroiusti A. Susceptibility to measles among healthcare workers: a cross-sectional serological study. Infect Dis (Lond) 2020; 52:443-445. [PMID: 32178557 DOI: 10.1080/23744235.2020.1739746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Giorgia Biondi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Stefano Perrone
- Department of Occupational Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Antonio Pietroiusti
- Department of Occupational Medicine, University of Rome Tor Vergata, Roma, Italy
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Coppeta L, Biondi G, Lieto P, Pietroiusti A. Evaluation of Immunity to Measles in a Cohort of Medical Students in Rome, Italy. Vaccines (Basel) 2019; 7:vaccines7040214. [PMID: 31847140 PMCID: PMC6963665 DOI: 10.3390/vaccines7040214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Measles is a highly contagious viral disease with serious complications. Currently, in Italy, measles vaccination is not mandatory for health care workers (HCWs) and medical students, and the free offer of the Measles Mumps Rubella (MMR) vaccine is the only national prevention measure to increase the coverage rate among these subjects. Aims: The aim of our study was to evaluate the impact on vaccination rate of the National Plan of Vaccine Prevention (NPVP) implemented in 2017. Material and Methods: This is a retrospective observational study that evaluated the measles-specific IgG immunity status of medical students at the University Tor Vergata of Rome, which underwent occupational health surveillance from 1 January to 31 December 2018. Results: In 2018, 84 of 319 students (26.30%) were serologically non-immune to measles; among these, 16 (19%) had previously been vaccinated, and 35 of the remaining 68 students accepted the MMR vaccine. Therefore, 33 out of 319 students did not undergo vaccination in 2018. These data are similar to those obtained in the previous year. In the 2017 screening, 84/314 (26.75%) students tested negative at the serological screening, whereas 15/85 (17.8%) among them documented a previous vaccination with two doses of the MMR vaccine; 69 students tested as unprotected. Vaccine compliance was 51.44%. Conclusions: No change in vaccination coverage occurred after the introduction of the last NPVP. Further efforts are needed to sensitize target populations about the relevance of vaccination; providing pre-employment screening for measles and free vaccine might be useful for this purpose.
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Coppeta L, Morucci L, Pietroiusti A, Magrini A. Cost-effectiveness of workplace vaccination against measles. Hum Vaccin Immunother 2019; 15:2847-2850. [PMID: 31339463 DOI: 10.1080/21645515.2019.1616505] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Measles is one of the most contagious infectious diseases. Measles vaccine, which has been introduced in Italy in 1979, is highly effective in preventing the disease (two-dose vaccine effectiveness is 99%). In 2017, Italy was the second country of EU for number of cases of measles. A study conducted in the same year showed that 22.3% of measles infection happened in hospital settings and 6.6% of cases occurred in HCWs. This risk group showed low rates of adhesion to the vaccination campaign. For this reason, we hypothesized that workplace vaccination could lead to better vaccination rates in HCWs. Moreover, we focused the vaccination campaign on a specific target group composed of HCWs not serologically immune and previously not vaccinated. We analyzed the clinical records of measles-specific IgG antibodies of 2,940 HCWs, that underwent occupational health surveillance between 1 January 2017 and 31 December 2017. 15.3% (450) was seronegative for measles, especially in the age group under 35 years. We compared the costs related to strategies with and without serological screening. Our study confirmed that immunization strategy with pre-vaccination screening was cost-effective compared to the vaccination without screening. In our sample, in fact, administration of two dose vaccine only susceptible HCWs determine a saving of 146,262 €. The vaccination of HCWs remains a topical issue in preventing the transmission of infectious disease in the hospital setting. Due to the cost-effectiveness evaluation, we recommend extending the pre-vaccination screening to identify the real susceptible workers.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luca Morucci
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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