Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review

Abstract Background Measles is a vaccine-preventable infectious disease and it remains one of the leading causes of infant mortality globally. The World Health Organization (WHO) has adopted the goal of eliminating measles and rubella. Detection and control of communicable diseases would not be possible without accurate laboratory results regarding when and where a particular disease circulates. Methods WHO/Europe therefore works with all Member States to steadily improve the quality of the laboratory data in order to determine the Region's progress towards measles and rubella elimination. For this purpose coordinates the European Measles and Rubella Laboratory Network (MR LabNet). National labs in this network undergoes regular external quality assessment through an annual accreditation programme. Results In Italy, a Sub-national Reference Laboratories Network for measles and rubella (MoRoNET) has been developed since March 2017 and currently includes 15 laboratories. MoRoNet was developed following the indications of the MR LabNet. It is accreditate, coordinated and supervised by the National Reference Laboratory. Conclusions Strengthening the role of national laboratories in overseeing the performance of subnational laboratories has become a critical need in order to properly monitor the Region's measles and rubella elimination efforts. MoRoNet permits to Italy to develop a country-specific work plan for establishing national networks and oversight mechanism, including preliminary monitoring and evaluation indicators compliant with MR LabNet standards. This is very significant not only to optimize the participation in national and regional processes to verify disease elimination, but also to strengthen the quality of vaccine-preventable disease surveillance. MoRoNet Group: A Amendola; F Baldanti; MR Capobianchi; M Chironna; MG Cusi; P D'Agaro; P Lanzafame; T Lazzarotto; K Marinelli; A Orsi; E Pagani; G Palù; F Pittaluga, A Sacchi; F Tramuto. Key messages MoRoNet has permitted to Italy to develop a country-specific work plan for establishing national networks and oversight mechanism, compliant with WHO MR LabNet standards. MoRoNet network has permitted to optimize the participation in processes to verify disease elimination, but also to strengthen the quality of vaccine-preventable disease surveillance.

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From epidemiology to public health decision making: analysis on IMD & vaccination strategy in Italy

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1451 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Igidbashian ◽

F Caracci ◽

P Bonanni ◽

P Castiglia ◽

M Conversano ◽

...

Keyword(s):

Public Health ◽

Decision Making ◽

Adult Population ◽

Vaccination Strategy ◽

Healthcare Services ◽

Steady Increase ◽

Vaccine Preventable Disease ◽

Preventable Disease ◽

Italian Regions ◽

Age Range

Abstract Introduction Invasive Meningococcal Disease (IMD) is one of the most severe vaccine-preventable disease, with high fatality rate and severe sequelae in up to 20% of survivors. MenB, MenC and MenACWY vaccines are available in Italy, but recommendations vary among Italian regions in terms of type of vaccines and targeted age groups. The aim of the study is to describe epidemiology of IMDs in order to provide the best vaccination strategy. Methods IMDs surveillance data in the period 2011-2017 from the Italian National Health Institute were explored. Excel was used to present trend analysis, stratifying by age and serogroups. Results In Italy, during the period 2011-2017, IMDs overall incidence increased from 0.25 cases/100,000 inhabitants in 2011 to 0.33 in 2017. Most cases after 2013 were caused by non-B serogroups (52%, 52%, 66%, 64%, 59% from 2013 to 2017). Although incidence is highest in 1 years old children, the number of cases is highest in the age range 25-64. The number of cases in this age-range had a steady increase after 2013 (36 cases in 2011, 79 in 2017), with serogroups C, W and Y present in more than 65% of cases in 25+ age ranges after 2012. Conclusions IMD is a rare but severe vaccine-preventable disease. The key role of public health is to monitor disease serogroups, trends and outbreaks and strengthen methodological evidence-based tools for decision-making processes, public health policies, planning of healthcare services and intervention measures, including immunization. The increase in incidence shown in the period 2011-2017 in Italy, although probably due to better surveillance, highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population. Based on our analysis we believe that anti-meningococcal vaccination plan in Italy should include the highest number of preventable serogroups and be aimed to the whole population through a multicohort strategy, including boosters in children and in adults. Key messages Anti-meningococcal vaccination plan in Italy should include all the preventable serogroups and be aimed to the whole population with a multicohort strategy including boosters in children and in adults. The increase in incidence of IMD in the period 2011-2017 in Italy highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population.

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