Two cases are adults, not vaccinated, among the other deaths from measles. Two other cases (in Sicily) that, added to the previous ones, raise the number to six deaths in 2018 from this disease. This was reported by the latest bulletin on the disease of the Higher Institute of Health, which also made known the ages of the victims. It is a person of 51 years and one of 29. “In all cases – we read in the official document – the cause of death was a severe respiratory failure or a cardiovascular arrest. All cases were unvaccinated at the time of infection. We commented on the news with Dr. Elena Azzolini, medical assistant of the Medical Directorate of Humanitas.
The cases
From 1 January to 31 August 2018, 2,248 cases of measles were reported in Italy: 126 in July and 66 in August 2018. 88.5% of the cases occurred in 7 Regions, led by Sicily (1,116 cases), which reported the highest incidence (333 cases per million inhabitants). The median age of the cases was 25 years. There were 429 cases reported in children under 5 years of age, 138 of whom were under 1 year old. 91.1% of the cases were unvaccinated at the time of infection, 5.5% had only one dose. 48.9% of the cases developed at least one complication, the document continues, and 59.4% of the total cases were hospitalized. There were 98 reported cases among health professionals, 52 of which developed complications (53.1%).
Grillo: “The obligation get vaccinated is not enough to prevent”
“The measles epidemic in progress in our country shows that forcing vaccinations may be necessary, but it is not enough for prevention purposes. This was stated by the Minister of Health, Giulia Grillo, at the question time in the Senate. “In fact – stressed the minister – the increase in coverage that the obligation has produced in the generations of newborns has not stopped the spread of the disease. According to Grillo, this is because the elimination of measles requires the implementation of complex interventions, described in a Plan already available and that was however “guiltily forgotten” since 2011, as well as not funded. In short, according to the government, to stop the epidemic, vaccination must be promoted among health workers to ensure opportunities for contact with health services and social communication must be greatly enhanced.
New measures
The intention of the Minister of Health is now to rapidly update the “Measles Plan” and propose to the Government and the Regions to make concrete commitments, transforming the recommendations of the Plan into financed and verifiable actions. It is hoped that concrete initiatives will be envisaged: to strengthen vaccination services, to make the national registry office operational, to monitor coverage and adverse events and to adequately finance expenditure.
The opinion and actions of Humanitas
“The Sicilian cases do not surprise us – commented Dr. Azzolini: it is not an emergency, but an acute problem already widely announced, in which Italy is reaching almost a world record in terms of cases and deaths. Lombardy has for years been among the top 5 regions that report the majority of cases in Italy (Dato Epicentro). Until recently, at Humanitas it was not possible to quickly verify the immune status of health personnel without a capillary mapping of the vaccination status of our employees or active surveillance with the execution of serological tests. Therefore, tested by the 2017 epidemic in which we handled 37 cases that in turn generated hundreds of exposures both among patients and among health care personnel, we developed a new procedure for the active surveillance of suspected cases of measles and planned a surveillance plan to identify surgeons likely to become infected with measles and to offer vaccination to prevent intra-hospital transmission, in accordance with regional and ministerial provisions. First we mapped the critical areas, first aid and onco-hematology, then from May 15, 2018 an awareness campaign was launched that extended the screening to all other health personnel, as well as staff who during their work may come into contact with our patients, such as the team beds, the staff of the restaurant, the Pink Cross.
“The result? – continued the specialist – Since the activation of the surveillance plan we have mapped over 3000 workers, of which about 10% were not immune. Starting from the areas most at risk, the susceptible workers were then offered vaccination against measles. To date, almost all workers have been vaccinated.
We can therefore say that our healthcare staff is almost 100% mapped and that this incredible result meant that, at the last suspected case of measles last August, we were able to verify the immune status of the staff exposed in a few minutes and to proceed to administer the vaccine for those at risk within 24 hours. It ‘s a very satisfactory result, for which we thank the Laboratory Analysis and the Service of Preventive Medicine for the great effort and all the staff who have made themselves available. Obviously the activity does not end here and we will continue with the surveillance for all newly hired staff and with training activities on the infectious and biological risk and on the proper use of personal protective equipment.
