rome and Measles

Topics: Adult; Aged; Aged, 80 and over; Cross Infection; Female; Hospitals, Teaching; Humans; Male; Measles; Measles-Mumps-Rubella Vaccine; Middle Aged; Rome; Vaccination Coverage; Workplace; Young Adult

To evaluate the effectiveness of the measles-mumps-rubella (MMR) vaccine in reducing hospitalizations for infectious disease, targeted and not targeted, as well as from respiratory diseases in children in Rome.. The cohort was recomposed through record linkage of 2 archives (vaccination register and hospital discharge records.. The analysis included 11,004 children. 20.9% did not receive the MMR vaccination, 49% and 30.1% received one and 2 doses. There were no hospitalizations for rubella, 2 for mumps, and 12 for measles. The vaccine was highly protective against measles and mumps hospitalizations (HR = 0.10; 95% CI: 0.03.0.34). Regarding all infectious diseases there were 414 hospitalizations, and the vaccine was protective (HR = 0.29; 95% CI: 0.25 to 0.34). Concerning respiratory diseases, there were 809 admissions (7.4%), and the vaccine was highly protective (HR: 0.18; 95% CI: 0.07 to 0.48).. MMR vaccination is effective for the primary prevention of target and not targeted infectious diseases and may also limit hospitalizations for respiratory diseases.

Topics: Child; Child, Preschool; Cohort Studies; Female; Hospitalization; Humans; Infant; Male; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Respiratory Tract Infections; Retrospective Studies; Rome; Rubella; Vaccination; Vaccines, Attenuated

Young infants with measles requiring respiratory support have a significant risk for death and long-term complications. Even in developed countries, the occurrence of spontaneous air-leaks and acute respiratory distress syndrome (ARDS) still represent the most severe clinical presentation in early childhood, with a high fatality rate. A clinical series review from a tertiary university paediatric intensive care unit (PICU) was undertaken. During the 2006-2007 outbreak in Rome, Italy, a young infant presented with ARDS/spontaneous air-leak and needed aggressive ventilatory management and haemodynamic support. Both nebulised iloprost and intravenous pentoxifylline were administered during the acute hypoxaemic phase; the role of this pharmacologic approach in critically ill patients is still under debate. We observed four further cases of respiratory impairment requiring a non-invasive approach. Clinical-radiological findings ranged from interstitial pneumonia to bronchiolitis-like pictures. All patients were imported cases, representing an important epidemiological factor and future medical issue, though they were not malnourished nor affected by chronic diseases. We conclude that early respiratory assessment and timely PICU referral is of mainstem importance in the youngest infants with measles-induced respiratory failure. The protean nature of clinical presentation and the possibility of rapid respiratory deterioration should be highlighted, and infants from immigrant families may represent a susceptible high-risk group.

Topics: Bronchiolitis; Child, Preschool; Disease Outbreaks; Female; Humans; Iloprost; Infant; Intensive Care Units, Pediatric; Lung Diseases, Interstitial; Male; Measles; Pentoxifylline; Platelet Aggregation Inhibitors; Radiography, Thoracic; Respiratory Distress Syndrome; Rome

Three clusters of measles cases occurred between June and September 2006, in the Roma/Sinti populations in three different Italian regions: the Bolzano-South Tyrol in northern Italy; Lazio in central Italy; and the island of Sardinia in the southwest.

Topics: Adolescent; Adult; Child; Child, Preschool; Cluster Analysis; Disease Outbreaks; Diseases in Twins; Female; Humans; Infant; Infectious Disease Transmission, Patient-to-Professional; Italy; Male; Measles; Measles Vaccine; Pregnancy; Pregnancy Complications, Infectious; Roma; Romania; Rome; Vaccination