Pertussis epidemiology in Australia over the decade 1995-2005--trends by region and age group

Important changes have occurred in the National Immunisation Program for pertussis during the decade 1995-2005, including the introduction of acellular pertussis vaccine for all doses, removal from the schedule of the booster dose at 18 months, and the introduction of a booster dose for adolescents. In addition, the coverage of pertussis vaccine at 12 and 24 months has substantially increased as recorded by Australian Bureau of Statistics surveys and the Australian Childhood Immunisation Register. There were 75,458 notifications nationally between 1995 and 2005, with little change in the annual number of notifications at the national level but with periodic and dramatic changes in the age distribution of notified cases. Pertussis is well controlled in the 1-4 and 5-9 year age groups, and the highest annual notification rates continue to be in infants under 6 months of age. Adolescents aged 10-19 years had high notification rates in all states and territories, over this period, but 63% of notifications are now in the 20-59 year age range. Following the introduction of a fifth dose for adolescents, the current focus should be on protecting infants too young to be vaccinated and further defining the true morbidity of the disease in the elderly population.     

Review of the 2008-2009 pertussis epidemic in NSW: notifications and hospitalisations

In 2008 and 2009 increased numbers of pertussis notifications were reported in NSW. During the epidemic period, the pertussis notification rate was 2.7 times higher than the previous 5-year average. Rates of pertussis notifications and hospitalisations were highest among infants aged less than 1 year across all years studied. Compared to previous years, the notification rate for children aged 1-4 years increased dramatically and was particularly striking for children aged 3 years with notifications exceeding those for infants in 2009. Changes in testing practices during the epidemic period, including a significant increase in the use of polymerase chain reaction, may account for some of the relative increase in size of the 2008-2009 outbreak compared with previous outbreak years.     

Epidemiology of measles,mumps and rubella in Italy

A serosurvey for measles, mumps and rubella was conducted in Italy; incidence based on statutory notifications over the last three decades was also calculated. In Italy the diseases followed an endemic-epidemic pattern, with an incidence peak every 2-4 years, and had a limited reduction of incidence attributable to childhood immunization. Lower notification rates were observed in the Southern regions. This is possibly related to greater under notification in the South and is confirmed by our seroprevalence data. Incidence of measles and rubella and proportion of cases among young adults increased significantly in the three decades considered, but not for mumps. Serological data confirmed that these infections are still very frequent in Italy, without significant geographic variation in the country. In the age groups 2-4 and 5-9 years the percentage of individuals still susceptible to each virus was higher than 30%. The proportion of susceptible subjects older than 15 years was similar for the three infections (6.1, 11.7 and 8.8% for measles, mumps and rubella, respectively). The low vaccine coverage for rubella and measles in Italy has so far only partially affected the occurrence of the diseases. No impact of mumps vaccination is visible. The average number of deaths, for each disease, has decreased during the three study periods. Today the priority in Italy is to halt the progressive increase of the mean age of acquisition of the three infections, to eliminate differences in coverage among regions and to conform to European standards. This will be achieved through a combination of increasing MMR vaccine coverage before 2 years of age, implementing vaccination campaigns for low seroprevalence age groups, and/or introducing a second dose of MMR, depending on the level of current MMR coverage.     

Changes in tuberculosis notification rates in the white ethnic group in England and Wales between 1953 and 1983.

Since the early 1960s notification rates for tuberculosis in England and Wales for the whole population have been influenced by high rates in certain ethnic groups. Using data based on country of birth from the British (Thoracic and) Tuberculosis Association surveys of 1965 and 1971, and based on ethnic origin from the Medical Research Council surveys in 1978/79 and 1983, rates for the white ethnic group have been estimated at those four times, and compared with the published rates for the whole population in 1953, when only a very small proportion was of non-white ethnic origin. Between 1953 and 1983 the notification rate for the white ethnic group fell from 122.2 to 11.3 per 100,000 for males, an annual decline of 7.7%, the corresponding rates for females being 90.1 and 5.8, an annual decline of 8.8%. The greatest annual declines occurred between 1953 and 1965, 9.4% for males and 11.2% for females. The annual declines in the most recent period, 1978/79 to 1983, were 6.9% for males and 7.3% for females. In both sexes the decline was greatest in the 15-24 year age group and least in the oldest age group, and this has led to a change in the age pattern of annual notification rates. The highest rates in both sexes occurred in young adults in 1953 but in the oldest age groups in 1983. There is however no evidence of any cohort experiencing an increase in notification rate with increasing age.     

Communicable Diseases Network Australia National Arbovirus and Malaria Advisory Committee annual report, 2006-07

This report describes the epidemiology of mosquito-borne disease in Australia for the mosquito-borne disease season 1 July 2006 to 30 June 2007, which was moderately low compared to previous seasons. Ross River virus (RRV) infections (55%), Barmah Forest virus (BFV) infections (29%) and overseas acquired malaria (11%) were the most common mosquito-borne diseases reported in 2006-07. The number, proportion and rate of national BFV notifications were the second highest on record since 1998-99. The Northern Territory reported the highest BFV notification rate this season. BFV notification rates were the highest in the 40-59 year age groups when compared to other age groups. The number, proportion and rate of RRV notifications were moderately low this season compared with previous seasons. The highest RRV rate was reported by Western Australia from the Kimberley region. The highest age-specific RRV notification rate was observed in the 40-59 year age groups. Locally acquired dengue virus notifications were low this season compared to previous seasons, with a small outbreak of dengue serotype 3 in 39 cases confined to the greater Townsville region. There were 640 notifications of malaria in 2006-07 of which none were reported as locally acquired. This was the third highest number of malaria notifications since 2001. Plasmodium falciparum was reported as the infecting species in 47% of the malaria notifications and Plasmodium vivax for 40% of cases. Young adolescents and adults in the 15-29 year age group had the highest number of cases accounting for 32% of notifications. Sentinel chicken surveillance data for flaviviruses and sentinel pig surveillance data for Japanese encephalitis virus are also reported.     

Chlamydia trachomatis in Tasmania 2001–2007: rising notification trends

Objectives: To investigate trends in notification rates of Chlamydia trachomatis in Tasmania, Australia, by population sub‐groups, from 1 January 2001 to 31 December 2007. Methods: An enhanced surveillance dataset was used to supplement case notifications. Rates based on age group were analysed by sex, geographic region, indigenous status, sexual exposure, reason for testing and healthcare provider. Results: In all age groups, the notification rate increased steeply. The highest rates were seen in the ages 15–24 years; this age group represented 15% of the population but accounted for 74% of the chlamydial notifications. The increased rates in females aged 15–24 years and males 15–19 years in Tasmania were larger than the increases observed nationally. Rates were consistently higher in urban areas. Females were more likely to have been tested as a result of screening, and males were more likely to have been tested when presenting with symptoms or as a result of contact tracing. The majority of cases reported sexual exposure with opposite sex partners only. Conclusions: This study highlights the increasing significance of chlamydial infection as a public health issue, the gender differences in health‐seeking behaviour, and the discrepancies in testing patterns. These findings will assist with the design of health promotion programs.     

Communicable Diseases Network Australia: National Arbovirus and Malaria Advisory Committee annual report 2004-05

This report describes the epidemiology of mosquito-borne disease in Australia for the mosquito-borne disease season 1 July 2004 to 30 June 2005. Ross River virus (RRV) infections (45%), Barmah Forest virus (BFV) infections (30%) and malaria (19%) were the most common mosquito-borne diseases reported in 2004-05. The Northern Territory had the highest rate of RRV notifications and the peak notification rate (in February 2005) was 54 per cent less than the previous season. The Northern Territory also reported the highest BFV notification rate this season, peaking in April 2005, which was the second highest reported BFV notification rate since 1998. National RRV and BFV notification rates were highest in the 45-49 year age group. There were 799 notifications of malaria in 2004-05 of which none were reported as locally acquired. This was the third highest reporting season for malaria notifications since 1998. In contrast to previous years in which Plasmodium vivax was the predominant species, Plasmodium falciparum was reported as the infecting species in 57 per cent of the malaria notifications and Plasmodium vivax for 34 per cent of cases. Children in the 5-9 year age group had the highest number of cases compared to previous years in which the peak number of cases tended to be in young adult age groups. There were four cases of Kunjin virus (KUNV) and two cases of Murray Valley encephalitis virus (MVEV) reported in 2004-05. Sentinel chicken surveillance data for flaviviruses and sentinel pig surveillance data for Japanese encephalitis virus are reported. There were 188 notifications of dengue virus infection (DENV) in 2004-05, of which 46 per cent (n=86) were reported as having been acquired overseas. Dengue serotype 4 was the most frequently reported type, accounting for 32 per cent of cases (n=60).     

The effects of the scheme for BCG vaccination of schoolchildren in England and Wales and the consequences of discontinuing the scheme at various dates.

The aims of this paper were to estimate the numbers of tuberculosis notifications in young white adults which will be prevented in the next 25 years by the schools BCG vaccination scheme, and to assess the numbers of additional notifications if the scheme were to be discontinued. Assuming that in the white ethnic group in England and Wales the decline in tuberculosis notification rates (8-10% per year for ages less than 45 years) and efficacy of BCG vaccination (75-80%) are maintained, it is estimated that the scheme for BCG vaccination of schoolchildren with its present coverage will prevent 217 notifications in those aged 15-29 years in 1993, 119 in 1998, and 69 in 2003. The epidemiological consequences of stopping the BCG in schools scheme, whenever this occurs, would be a substantial slowing of the rate of decline of tuberculosis notifications, confined almost entirely to the 15-29 years age group, for a period of about 15 years, after which the steeper decline would resume. If the scheme stopped at the end of 1991 the annual number of additional notifications would slowly increase to a maximum of just over 80 about 15 years later, and then decrease. For stopping at the end of 1996 the maximum annual number of additional notifications would be about 50.     

Communicable Diseases Network Australia National Arbovirus and Malaria Advisory Committee annual report, 2005-06

This report describes the epidemiology of mosquito-borne disease in Australia for the mosquito-borne disease season 1 July 2005 to 30 June 2006, in which the second largest number of notifications since 1995-96 was reported. Ross River virus (RRV) infections (66%), Barmah Forest virus (BFV) infections (23%) and malaria (9%) were the most common mosquito-borne diseases reported in 2005-06. National RRV notifications were the fifth largest on record. The Northern Territory had the highest rate of RRV notifications and the peak notification rate (in January 2006) was the third highest since 2000. National BFV notification rates were the highest on record. The Northern Territory also reported the highest BFV notification rate this season, peaking in February-March 2006, which was the highest reported BFV notification rate on record. BFV notification rates were significantly higher in teenagers compared to previous seasons. There were 731 notifications of malaria in 2005-06 of which none was reported as locally acquired. This was the third highest reporting period for malaria notifications since 2000. In contrast to previous years in which Plasmodium vivax was the predominant species, Plasmodium falciparum was reported as the infecting species in 45 per cent of the malaria notifications and Plasmodium vivax for 42 per cent of cases. Young adults in the 20-24 year age group had the highest number of cases and children in the 5-9 year age group accounted for 22 per cent of notifications. There were two cases of Kunjin virus (KUNV) infection and one case of Murray Valley encephalitis virus (MVEV) infection reported in 2005-06, all from Western Australia. Sentinel chicken surveillance data for flaviviruses and sentinel pig surveillance data for Japanese encephalitis virus are reported. There were 200 notifications of dengue virus (DENV) infection in 2005-06, of which 46 per cent (n = 92) was reported as having been acquired overseas. Dengue serotypes 2 and 3 were detected in two outbreaks of locally-acquired dengue in Queensland this season.     

上海市1990-2006年风疹流行病学特征分析

目的了解1990—2006年上海市风疹流行病学特征。方法用描述流行病学方法分析1990—2006年上海市传染病报告疫情数据库，数据采用Excel整理与分析。结果1990—2006年上海市风疹报告发病率为0．15110万～451．57／10万；1993年上海市发生风疹大流行，是风疹发病最高的年份，共报告风疹病例58104例，1998年是风疹发病的最低年份，共报告19例；1990—1994年（疫苗使用前）年平均报告发病率为93．00/10万，在疫苗使用前，风疹发病有明显的季节性特征，每年发病高峰集中在3—6月；风疹病例主要集中在儿童和青少年人群，即以5～9岁和10～14岁年龄组为主。1995年开始在上海市大规模使用风疹联合疫苗（MMR）后，全市MMR接种率达85％以上。风疹发病率呈逐渐下降趋势，每年报告风疹发病数除1995年外均〈100例，风疹的发病得到有效控制。但疫苗使用后，风疹发病的年龄构成有所改变，0～4岁发病年龄构成增加，占总发病数的21．00％，且发病年龄有逐年后移趋势，20岁以上年龄组发病占总发病数的31．62％，1995—2006年25～29岁年龄组和30～34岁年龄组风疹发病率均高于疫苗使用前（除1993年）相同年龄组的发病率。结论上海市风疹发病年龄后移。     

Evaluation of the measles,mumps and rubella immunisation programme in Spain by using a sero-epidemiological survey

In Spain, measles, mumps and rubella vaccination was introduced in 1981, with one dose at the age of 15 months and another at the age of 11 years being administered since 1995. Reported disease incidence was less than one case per 100,000 people for measles and rubella, and 23 cases per 100,000 people for mumps. A seroepidemiological survey was undertaken to estimate the frequency of susceptible individuals by age and environment; and vaccination coverage and efficacy of the vaccines administered. A population-based cross-sectional study was then conducted, covering the population aged 2–39 years, residing in Spain (excluding Catalonia). The sample was stratified by age and rural/urban environment and informed consent obtained to take blood specimens from subjects attending blood-extraction centres. The final sample totalled 3932 persons. IgG antibodies were detected by an enzyme-linked immunosorbent assay. Estimated vaccination coverage was 96% for children aged 2–5 years; vaccine efficacies were 96.7% for measles, 97.2% for rubella and 79.3% for mumps. Immunity was the lowest in the 6–9 year age group for measles (90.8%) and in males aged between 15 and 24 years for rubella (86 and 89.8%, respectively). In the case of mumps, this proved the lowest in the 2–5 year age group (76.7%) and in those autonomous regions in which only the Rubini strain had been administered. The incidence of measles has enabled the National Measles Elimination Plan to be implemented by which the elimination of congenital rubella syndrome could now be initiated. A possible explanation for the higher susceptibility observed for mumps might lie in the Rubini strain's low efficacy.     

Suicide in the elderly 60 years of age and over in the south-east part of Serbia

Some previous investigations indicated that economic crisis (inflation in Serbia 1993/94) have great influence on increasing suicide rates in Serbia. After that suicide decreased, despite the war and bombing in 1999, specially among the elderly people. A total of 453 suicides were registered on the territory of south-eastern Serbia during 1995-2001 years. Of them 295 (65.1%) were aged over 60 years. Generally linear trends of suicide among both genders from 1995 to 2001 decreased, but the slope of decreasing was grater among males than among females. The highest rates among the both genders were registered in the years with the maximum number of suicides, but the linear trends of rates have statistically important correlation with time (r>0.5). Average annual suicide rate among males was 42.5, and among women it was 18.7. The highest average annual suicide rate among men was observed in the age group 75 years and over (93.3), and the lowest in the age group 65-69 (20.6). Among males, in the all age group linear trends of suicide rates decreased, with the highest slope among 75 years and over and the lowest among 65-69 years. The highest suicide rate among females was registered in age group 75 years and over (25.6), the lowest in the age group 65-69 (13.5). The linear trends are similar as among males: downward trend was observed among all aged groups, with the highest slope among women 75 years and over. The most common way of suicide among men was hanging up (63%), poisoning and by firearms. There were no statistical differences between way of suicide and age groups. The most frequent way of suicide among females was hanging up (55%), poisoning (25%) and drowning (12%). There were statistically significant differences in drowning between age groups, 70-74 and 75 and over (p<0.05), and between poisoning and age groups 60-64 years and 75 years and over. Poisoning and drowning are statistically more frequent among women than among men.     

Tetanus in Italy 2001–2010: A continuing threat in older adults

Despite being a completely preventable disease, tetanus cases continue to occur in Italy and notification and hospitalization rates have been reported to be higher with respect to European and other industrialized countries. We examined statutory notification, hospitalization, mortality and seroprevalence data to describe tetanus epidemiology in Italy from 2001 to 2010. A total of 594 tetanus cases were notified, with an average annual incidence of 1.0/1,000,000 population. Most cases were unvaccinated or incompletely vaccinated. Eighty percent of cases occurred in subjects aged >64 years and a higher proportion of females with respect to males were reported in this age group. The annual number of hospital admissions was 1.4–1.7 times greater than the number of notifications in the same year. The mean annual number of reported deaths was 21. Seroprevalence data show progressively higher susceptibility levels with increasing age. Over 50% of persons aged 45–64 years and over two thirds of subjects ≥65 years had tetanus antibody levels <0.01 IU/ml. Results show that tetanus is a continuing problem in Italy and, as in other countries, most cases occur in older adults, especially elderly women. The observed differences in notification and hospitalization rates suggest underreporting by physicians. In recent years, Italy has accounted for most cases reported annually in the European Union (EU) but different case definitions are used. In Italy, a confirmed case is one that meets the clinical case definition while the EU case definition classifies confirmed cases as those with laboratory confirmation of disease. The incidence of clinical tetanus in Italy is ten-fold higher than in other industrialized countries, like Australia and Canada, likely due to higher susceptibility levels in Italy. In view of the low prevalence of tetanus antibodies in adults ≥45 years, strategies to improve vaccine uptake in this population group need to be implemented.     

Is the major increase in notified campylobacteriosis in New Zealand real?

Notifications of campylobacteriosis by New Zealand medical practitioners have increased steadily in the last two decades. To determine if this increase is real, as opposed to a surveillance artefact, we examined both available notification (1980-2003) and hospitalization data (1995-2003). The similarity in the temporal pattern of increasing hospitalizations for campylobacteriosis, with that of notifications, is suggestive that this increase is indeed real. Although some risk factors for this disease have been identified (e.g. uncooked poultry consumption) it is unclear what the likely causes of the increasing rates are. The overall disease burden is also high compared with other developed countries (an annual notification rate of 396 cases per 100000 population in 2003), with highest rates in children aged 1-4 years, males, Europeans, and those living in urban areas. Given the large disease burden, further research and intervention studies should be public health priorities in this country.     

The prevalence of severe leptospirosis among humans on Barbados

Leptospirosis was confirmed by the Leptospira Laboratory in 138 hospital patients on Barbados between early November 1979 and the end of 1982 (annual average 43.6 cases). These were the great majority of severe cases occurring on the island during that time. The crude incidence rate ranged between 15 and 23 per 100,000 population per year (average 17.6). 26 of the patients died (15 males, 11 females), giving an over-all case fatality rate of 18.8%, and an average of 8.2 deaths per year. 68% of all cases were in males. The highest percentages of cases were in males aged 20 to 24 and females aged 55 to 59, but the incidence of the disease in both sexes increased with age up to 60 years. Previous figures recorded on the island by the Ministry of Health for 1975-79 were considerably lower, with a mean of 23.6 cases per year and a crude annual incidence of 9.5 per 100,000. 15 of the patients died (13 males, 2 females), giving an over-all case fatality rate of 12.7% and an average of 3 deaths per year. 74% of all cases were in males. The highest percentages of cases were in the 20 to 29 and 50 to 59 year age groups for males and females, respectively, i.e., similar to those in the present series. In both sexes the incidence of leptospirosis increased with age up to 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)     

Interruption of rubella virus transmission in Australia may require vaccination of adult males: evidence from a Victorian sero-survey.

Prior to the introduction of rubella vaccine to Australia in 1970 rubella was primarily a disease of primary school aged children. Vaccination programs have subsequently altered rubella age and sex susceptibility. Between July 2001 and June 2002, 85 per cent of the 32 laboratory-confirmed cases of rubella ascertained from enhanced surveillance in Victoria were males aged 20-42 years. This study aimed to determine rubella susceptibility by age group and sex in Victoria and to examine the implications of susceptibility for the interruption of circulating rubella virus. Rubella immunoglobulin G concentrations were determined for 934 residual diagnostic sera stored at the Victorian Infectious Diseases Reference Laboratory using a standard commercial enzyme immunoassay. Susceptibility was analysed by age groups defined by previous and current Australian rubella immunisation schedules. Among all subjects aged 1-55 years, males were more susceptible to rubella infection than females (10.2% vs 2.6%, p < 0.0001). Although this sex difference occurred in all age groups, it was unlikely to be explained by sampling variation in sera from subjects aged 23-44 years, for whom rubella vaccine had been recommended only for girls aged 10-14 years and rubella susceptible women post-partum. Australia's past rubella immunisation policies have resulted in a susceptible cohort of adult males. If rubella virus transmission is to be interrupted in Australia, consideration needs to be given to a rubella vaccination program targeting men aged 17-44 years. A campaign, targeting both men and women in a similar age group has recently been successful in Costa Rica.     

Persistence of antibodies in 4-8 year old Austrian children after vaccination with hexavalent DTaP-HBV-IPV/Hib and MMR vaccines

To determine the proficiency of the Austrian childhood vaccination schedule to induce long lasting seroprotection against vaccine preventable diseases a seroepidemiological study in 348 children between four and eight years of age was conducted. Antibodies against diphtheria, tetanus, pertussis, hepatitis B, measles, mumps and rubella antigens were assessed in children, who had been vaccinated with hexavalent DTaP-HBV-IPV/Hib vaccines at three, four, five months and in the second year of life and/or MMR vaccines in the second year of life at least once, but mostly twice.High seroprotection rates (SPRs) were detected for tetanus (96%) and measles (90%). SPRs regarding diphtheria and mumps were 81% and 72%, respectively. Rubella-SPRs were 68% in females and 58% in males. Hepatitis B-antibody levels ≥10 mIU/mL were present in 52%; antibodies against pertussis were detected in 27% of the children. SPRs for measles and rubella depended on the interval since last vaccination; mumps-antibodies were significantly lower after one MMR-vaccination only. Antibodies against diphtheria, tetanus and pertussis depended on the interval since last vaccination while HBs-antibodies did not. The low levels of antibodies 1-7 years after vaccination against pertussis, rubella and mumps after only one vaccination should be considered when recommending new vaccination schedules.     

Mumps and the media: changes in the reporting of mumps in response to newspaper coverage

OBJECTIVE: To determine the links between national newspaper coverage of mumps after a press release and increased reports of clinical mumps cases. DESIGN AND SETTING: A cross sectional study involving people aged 15-24 years in the West Midlands, and England and Wales. Reported mumps cases were obtained from statutory notifications of infectious diseases to the Health Protection Agency and reports to the Royal College of General Practitioners Weekly Returns Service. Data on newspaper coverage was obtained by retrospectively reviewing the Health Protection Agency press archives. MAIN OUTCOME MEASURE: The effect of newspaper coverage was assessed by examining the 4 weeks before the press release (weeks 15-18 of the year), a 2-week period that included the week of the press release (weeks 19-20) and 4 weeks after the press release (weeks 21-24). MAIN RESULTS: Mumps notification rates were declining before increased newspaper coverage. Significant increases in national (from 28.3/100 000 population (95% CI 26.5 to 30.1) in weeks 18 to 42.8 (95% CI 40.6 to 45) in week 20) and local (from 9.8 (95% CI 7.4 to 12.1) to 21.2 (95% CI 17.7 to 24.6)) notification rates were seen after increased newspaper coverage. Reports rapidly declined after decreased media interest. CONCLUSIONS: The reported incidence rate of mumps seems to be markedly influenced by the level of newspaper coverage. This has implications for surveillance activities.     

Hepatitis A in Australia in the 1990s: future directions in surveillance and control.

The national notification data from 1952 to 1997 was examined in order to characterise hepatitis A virus (HAV) infection in Australia in the 1990s, and to determine whether currently available surveillance data are sufficient to inform disease control strategies and vaccination policies. Hepatitis A annual notification rates declined dramatically from a high of 123 notifications per 100,000 persons in 1961, to 3 per 100,000 in 1989. During 1991-97, the hepatitis A notification rate was 12 per 100,000 persons per year, although rates varied substantially between States and Territories. The Northern Territory had the highest notification rate of 52 per 100,000 persons per year. Seventy-six per cent of cases were adults, although in most regions notification rates were significantly higher in children than adults. Nationally, the male to female ratio was 1.7:1 (p < 0.001). The Northern Territory was the only area with no significant difference in notifications between the sexes. Large outbreaks were detectable through the notification system but risk factors for transmission could only be inferred from age and sex distribution of notifications, and from previous outbreak reports. National hepatitis A surveillance would be improved by collecting basic risk factor data, which identify cases as food-borne, sporadic, related to another case, or travel related. In addition, a population based serosurvey to measure age-specific hepatitis A susceptibility would assist vaccination policy development. Serosurveillance data are also needed, in conjunction with enhancements of the notification data, to provide baseline information against which the impact of changes in vaccination policy can be assessed.     

Prevalence of childhood exanthematic disease antibodies in paramedical students: need of vaccination

The immunity to common childhood exanthematic diseases such as varicella, rubella, mumps and measles was evaluated in 1024 students of the degree courses of health professions at Padua University Medical School. Subjects were subdivided according to gender and age (25 years old or less, and older than 25 years). Results showed that the prevalence of positive antibodies (IgG) to varicella and rubella (94.1 and 94.5%, respectively) was significantly higher (p<0.001) than mumps (78.6%) and measles (86.3%). In addition, measles showed a significant higher prevalence than mumps (p<0.001). Prevalence of positive antibodies to rubella in females (97.4%) was significantly higher (p<0.001) than males (87.5%), but only if aged 25 years or less. Furthermore, males older than 25 years were significantly more immune (p<0.001) to measles (93.0%) than younger ones (84.3%). A vaccination strategy was applied but compliance was less than 50%; in addition, about 40.0% of vaccinated subjects eluded control after vaccination. Seroconversion after vaccine appeared high for rubella, mumps and measles (92.3, 88.9 and 88.1%, respectively), but low for varicella (43.8%).