scholarly journals Pneumococcal vaccination policy in Europe

2005 ◽  
Vol 10 (9) ◽  
pp. 11-12 ◽  
Author(s):  
R G Pebody ◽  
T Leino ◽  
H Nohynek ◽  
W Hellenbrand ◽  
S Salmaso ◽  
...  
Keyword(s):  
European Union ◽  
Herd Immunity ◽  
Clinical Manifestations ◽  
Pneumococcal Vaccination ◽  
Risk Groups ◽  
The Elderly ◽  
Vaccination Policy ◽  
Eu Member States ◽  
Serotype Replacement ◽  
Accession Countries

Infection due to Streptococcus pneumoniae (Pneumococcus) (Pnc) is an important cause of invasive clinical manifestations such as meningitis, septicaemia and pneumonia, particularly in young children and the elderly. A 23-valent polysaccharide Pnc vaccine (PPV) has been available for many years and a 7-valent conjugate Pnc vaccine (PCV) has been licensed since 2001 in Europe. As part of a European Union (EU) funded project on pneumococcal disease (Pnc-EURO), a questionnaire was distributed to all 15 EU member states, Switzerland, Norway and the 10 accession countries in 2003 to ascertain current pneumococcal vaccination policy. Twenty three of the 27 target countries, constituting the current European Union (plus Norway and Switzerland), completed the questionnaire. PPV was licensed in 22 of the 23 responding countries and was in the official recommendations of 21. In all the 20/21 countries for which information was available, risk groups at higher risk of infection were targeted. The number of risk groups targeted ranged from one to 12. At least 17 countries recommend that PPV be administered to all those >65 years of age (in three countries, to those over 60 years of age). Thirteen countries had developed national recommendations for PCV in 2003. No country recommended mass infant immunisation at that time, but rather targeted specific risk groups (between 1 and 11), particularly children with asplenia (n=13) and HIV infection (n=12). PCV use was restricted to children under two years of age in seven countries, and in four countries to children under five years of age. Future decisions on use of pneumococcal vaccines in Europe will be decided on the basis of several factors including: local disease burden; the predicted impact of any universal programme, particularly the importance of serotype replacement and herd immunity (indirect protection to the unvaccinated population); the effectiveness of reduced dose schedules, and vaccine cost. Indeed, at least one country, Luxembourg, has since implemented a universal infant PCV immunisation policy.

scholarly journals Pneumococcal Vaccination in High-Risk Individuals: Are We Doing It Right?

2016 ◽  
Vol 23 (5) ◽  
pp. 388-395 ◽  
Author(s):  
Ioanna Papadatou ◽  
Vana Spoulou
Keyword(s):  
High Risk ◽  
Cellular Response ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Primary Vaccination ◽  
Risk Groups ◽  
The Elderly ◽  
Polysaccharide Vaccine ◽  
Disease Epidemiology ◽  
Meta Analyses

ABSTRACTControversy exists regarding the optimal use of the 23-valent pneumococcal conjugate vaccine for the protection of high-risk individuals, such as children and adults with immunocompromising conditions and the elderly. The effectiveness and immunogenicity of 23-valent pneumococcal polysaccharide vaccine (PPV23) are limited in such high-risk populations compared to the healthy, with meta-analyses failing to provide robust evidence on vaccine efficacy against invasive pneumococcal disease (IPD) or pneumonia. Moreover, several studies have demonstrated a PPV23-induced state of immune tolerance or hyporesponsiveness to subsequent vaccination, where the response to revaccination does not reach the levels achieved with primary vaccination. The clinical significance of hyporesponsiveness is not yet clarified, but attenuated humoral and cellular response could lead to reduced levels of protection and increased susceptibility to pneumococcal disease. As disease epidemiology among high-risk groups shows that we are still in need of maximum serotype coverage, the optimal use of PPV23 in the context of combined conjugate/polysaccharide vaccine schedules is an important priority. In this minireview, we discuss PPV23-induced hyporesponsiveness and its implications in designing highly effective vaccination schedules for the optimal protection for high-risk individuals.

scholarly journals Influenza Vaccination in the Face of Immune Exhaustion: Is Herd Immunity Effective for Protecting the Elderly?

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Pierre Olivier Lang ◽  
Dimitrios Samaras ◽  
Nikolaos Samaras ◽  
Sheila Govind ◽  
Richard Aspinall
Keyword(s):  
Seasonal Influenza ◽  
Influenza Infection ◽  
Herd Immunity ◽  
Influenza Virus Infection ◽  
Chronically Ill ◽  
Risk Groups ◽  
The Elderly ◽  
Health Concern ◽  
World Population ◽  
The World

At the start of the 21st century, seasonal influenza virus infection is still a major public health concern across the world. The recent body of evidence confirms that trivalent inactivated influenza vaccines (TIVs) are not optimal within the population who account for approximately 90% of all influenza-related death: elderly and chronically ill individuals regardless of age. With the ever increasing aging of the world population and the recent fears of any pandemic influenza rife, great efforts and resources have been dedicated to developing more immunogenic vaccines and strategies for enhancing protection in these higher-risk groups. This paper describes the mechanisms that shape immune response at the extreme ages of life and how they have been taken into account to design more effective immunization strategies for these vulnerable populations. Furthermore, consideration will be given to how herd immunity may provide an effective strategy in preventing the burden of seasonal influenza infection within the aged population.

Case 26

2020 ◽  
pp. 173-178
Author(s):  
Hilary Humphreys
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Risk Groups ◽  
The Elderly ◽  
Altered Mental Status ◽  
Generation Cephalosporin ◽  
Polysaccharide Vaccine ◽  
Neck Stiffness ◽  
The Common ◽  
Low Sensitivity

Clinical signs suggestive of meningitis such as Kernig’s sign have low sensitivity in adults and fever, headache, neck stiffness, and altered mental status are the common clinical manifestations. Where possible, a sample of cerebrospinal fluid (CSF) should be taken and a combination of a third-generation cephalosporin and vancomycin started as empiric treatment. Amoxicillin should be added in the elderly or others at risk of listeriosis. Corticosteroids administered with antibiotics may reduce mortality from meningitis due to Streptococcus pneumoniae and severe hearing loss in children due to Haemophilus influenzae. Those over 65 years of age and patients in other risk groups should be vaccinated against invasive pneumococcal disease. Increasingly, there are recommendations that both the polysaccharide vaccine (PPV23) and conjugated vaccines (e.g. PCV13) should be used to maximize protection.

Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda
Keyword(s):  
High Risk ◽  
Psychiatric Disorders ◽  
Suicide Rate ◽  
Risk Groups ◽  
The Elderly ◽  
Female Ratio ◽  
Suicide Notes ◽  
Suicidal Intention ◽  
Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

A cost-effective preventative approach to potentially save lives in the coronavirus pandemic, jointly using Vitamin D, Curcumin, and Vitamin C. Authors Bakare T A and Soar J S

2020 ◽  
Author(s):  
Jagjit S Soar
Keyword(s):  
Vitamin D ◽  
Vitamin C ◽  
Cost Effective ◽  
Risk Groups ◽  
The Elderly ◽  
Pharmaceutical Drugs ◽  
Over The Counter ◽  
Literature Searches ◽  
Pharmaceutical Agents ◽  
And Control

he current COVID-19 pandemic now believed to be based on the mutation of the SARS-CoV virus (first reported in 2002) to SARS-CoV-2 emerging in 2019, is naturally causing extreme worry and concern around the world with sometimes mixed and incoherent messages on how to deal with it. There is a plethora of information from previous epidemics caused by other coronaviruses such as severe acute respiratory syndrome, SARS (2002) and Middle East respiratory syndrome MERS (2012) from which we can extrapolate guidance on how to deal with the current pandemic. In the current absence of specific pharmaceutical agents, we propose assessing the extended tools that we already possess in our biological armoury to combat, prevent and control the spread of this virus. Using a set of precise criteria to locate such possible contenders, we conducted literature searches to find compounds that met these criteria. We have now reduced this to a shortlist of three agents that may be the best candidates. We propose vitamin C, vitamin D and Curcumin fit our criteria well. These compounds are widely available to the general public. They are available online and over-the-counter as supplements. Otherwise healthy individuals are safely able to self-administer these agents as a prophylactic to protect themselves and to enhance their immune response. This would be especially desirable for the elderly and at risk groups. These agents can also be used as adjunct therapy, particularly for those who may have early symptoms. This preventative therapy could be implemented whilst awaiting specific pharmaceutical drugs to emerge as a treatment for COVID-19. Our suggested compounds are a highly cost-effective way to potentially reduce the mortality that is regretfully mounting as a result of COVID-19 infection. The biological mode of action and the dosing of these compounds are summarised.

Political aspects of security of the European Union Member States

2020 ◽  
pp. 97-105
Author(s):  
Aleksandra Kusztykiewicz-Fedurek
Keyword(s):  
European Union ◽  
Negative Impact ◽  
The European Union ◽  
Member States ◽  
Eu Member States ◽  
Political Security ◽  
New Institutions ◽  
The Stability ◽  
Key Aspects ◽  
The Eu

Political security is very often considered through the prism of individual states. In the scholar literature in-depth analyses of this kind of security are rarely encountered in the context of international entities that these countries integrate. The purpose of this article is to draw attention to key aspects of political security in the European Union (EU) Member States. The EU as a supranational organisation, gathering Member States first, ensures the stability of the EU as a whole, and secondly, it ensures that Member States respect common values and principles. Additionally, the EU institutions focus on ensuring the proper functioning of the Eurozone (also called officially “euro area” in EU regulations). Actions that may have a negative impact on the level of the EU’s political security include the boycott of establishing new institutions conducive to the peaceful coexistence and development of states. These threats seem to have a significant impact on the situation in the EU in the face of the proposed (and not accepted by Member States not belonging to the Eurogroup) Eurozone reforms concerning, inter alia, appointment of the Minister of Economy and Finance and the creation of a new institution - the European Monetary Fund.

The Southern Gas Corridor infrastructure project – implications for the energy security of the European Union

2019 ◽  
Vol 17 (4) ◽  
pp. 79-99
Author(s):  
Justyna Misiągiewicz
Keyword(s):  
European Union ◽  
Soviet Union ◽  
Energy Security ◽  
Energy System ◽  
Caspian Region ◽  
The European Union ◽  
Energy Field ◽  
Eu Member States ◽  
Infrastructure Project ◽  
The Eu

Nowadays, energy security is a growing concern in state foreignpolicy. Interdependency in the energy field is a very important dimensionof contemporary relations between states and transnational corporations.Energy security is becoming a key issue for the European Union (EU). TheUnion is one of the world’s fastest-growing energy markets and the biggestimporter of energy resources. For the foreseeable future, Europe’s energydependence will probably increase. Facing a shortage of energy, Europe isdependent on imports and the EU member states need to diversify their energysupplies. The Caspian region contains some of the largest undevelopedoil and gas reserves in the world. After the collapse of the Soviet Union, thenewly independent Caspian states became open to foreign investment. Thegrowing energy needs have given the EU a strong interest in developing tieswith energy-producing states in the Caspian region to build the necessarypipeline infrastructure. In this analysis, the pipeline infrastructure that exists orwill be built in the near future will be presented. The analysis will concentrateon routes transporting gas from the Caspian region and the most importantproblems and solutions in designing the midstream energy system in the region.The key aim of the article is to analyse the Southern Gas Corridor (SGC)infrastructure project, which will inevitably contribute to the EU’s energy securityinterest.

Polymyalgia Rheumatica - a Disease of the Elderly

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Clinical Aspects ◽  
Immune Disorder ◽  
Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

scholarly journals European Regional Inequalities: The Other Face of Development

2017 ◽  
Vol 9 (4) ◽  
pp. 163
Author(s):  
Celeste Perrucchini ◽  
Hiroshi Ito
Keyword(s):  
European Union ◽  
Empirical Evidence ◽  
Capita Income ◽  
Relevant Literature ◽  
Point Of View ◽  
The European Union ◽  
Per Capita Income ◽  
Member States ◽  
Eu Member States ◽  
Per Capita

Empirical evidence suggests an overall convergence in terms of GDP and per capita income occurring among the European Union (EU) Member States. Nevertheless, economic inequalities have been increasing at the regional level within European Union countries. Through the review of relevant literature, this study analyzes the increasing inequalities from an economical point of view, focusing on Italy and the UK as examples. First, a general overlook of the empirical evidence of the GDP and per capita income at national and sub-national levels will be presented. Second, an explanation of the possible causes of the results will be proposed through the use of economical and sociological theories. The findings of this research might uncover the relative inefficacy of EU Cohesion policies and point towards the necessity for deeper and more thoughtful measures to continue the convergence of Member States while preserving internal equilibria. This paper ends with discussions for the future directions of the EU.

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