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The COVID-19 pandemic has drastically changed our daily lives. One of the sectors most affected was tourism and travel – and, more specifically, cruises, given the prolonged time passengers spend with others within the small spaces of the cruise ship. While finding well-organised entertainment opportunities on cruises is possible, emergency conditions may cause panic. On such occasions, reactions can be highly stressful or even traumatic. This research explores the events and emotions experienced by passengers during a cruise ship quarantined for COVID-19. The empirical materials consist of interviews with 15 passengers. The analyses show four thematic areas: fear of contagion, feelings of discrimination, cooperation between passengers and relationship with the crew. The problems during a cruise ship quarantine presented by the passengers in this study reveal the need for psychological preparation for the crew and security personnel. Finally, we suggest that telemedicine and telepsychology are key elements to improve the efficiency of behavioral control on cruise ships and to mitigate the COVID-19 effects on tourists' well-being during a quarantine. © 2023 by the author.
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Introduction: Vaccination against Bordetella pertussis is recommended by the Italian Ministry of Health starting from the 28th week of pregnancy. However, data about vaccine coverages are unknown and sharing good practices is necessary to increase adherence to vaccine programs implemented at local level. Here we present data on epidemiology and vaccine coverage of Pertussis in Tuscany from 2012 to 2021 and data on Pertussis vaccine coverage in pregnant women in the Health District of urban area of Pisa for the period 2017 to September 2022. Materials and methods: Data on pertussis cases and pertussis vaccine coverage were retrieved form the Regional Health Agency that made available data on Infectious Diseases Epidemiology in Tuscany on a public report. The diphteria, tetanus, pertussis (dTpa) vaccination in pregnant women were extracted from the vaccination registry from 2017 to 30 September 2022 and adjusted new births from 1st April to 30th March of the following year were considered as denominator. For the current year we assumed that the monthly trend of the absolute number of vaccinations is maintained (+45.3 vaccinations/month) and that the number of new-borns is the same as in 2021. Results: In Tuscany, a progressive increase in the number of cases has been observed since 2012, peaking in 2017 with 115 infections concentrated mainly in children under one year of age. After a significant reduction in the three-year period 2018-2020, with values between 25 and 39 infections per year, no cases of the disease were notified in 2021. Most likely due to the actions taken to counteract the transmission of SARS-CoV-2. Notably, from 2017 to 30 September 2022, a significant increase in vaccination coverage for dTpa in pregnant women was observed, with an average annual increase from 2018 onwards of 39% (range 18%-63%). Discussion and conclusions: Even if the vaccine coverage calculation has some limitations, the availability of a free access services for pregnant women and their contacts has improved adherence to the vaccination against pertussis. However, to achieve an active recruitment strategic to overcome cultural, linguistic and hesitancy barriers it is crucial to improve active call of the pregnant women.
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This article discussed the evolution of the InfluNet surveillance system in Italy, which was originally developed in 1999-2000 for monitoring flu-like syndromes and the circulation of influenza viruses. After the 2009-2010 subtype A/H1N1pdm09 influenza pandemic, InfluNet became an integrated surveillance system, including epidemiological and virological surveillance, as well as other sources of data to monitor the impact of influenza. The system proved to be a useful tool for assessing vaccine efficacy and preventing serious and severe forms of flu, especially in frail subjects. The SARS-CoV-2 pandemic introduced further innovations in InfluNet surveillance, and starting from the 2020-2021 season, InfluNet became a respiratory virus surveillance system. The article also described the trends of the 2021-2022 influenza season, with a low incidence of ILI and limited circulation of influenza viruses compared to seasons prior to 2020, as well as the impact of RSV. The article emphasized the importance of vaccination programs and the need for integrated surveillance systems to prevent the spread of respiratory diseases and deal with future pandemics.
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Background: Each decade since 2000, the French College of General Hospital Pulmonologists (CPHG) conducts a real-life nationwide prospective epidemiological, observational, multicenter study on lung cancer (LC). In 2020, the CPHG constituted the third cohort, KBP-2020-CPHG. We reported here the data on one-month and three-month mortality among general population of this cohort and compared them with 2010 cohort. Methods: Collection of all consecutive LC histologically or cytologically confirmed between 01/01 and 12/31/2020 in non-academic public hospital pulmonology or oncology units in France. A Scientific Committee controlled inclusion exhaustivity and quality in each center. Results: 82 centers collected 8,999 patients in 2020. One-month mortality was 8.8% (734/8,999) and 9.7% (680/7,051) in 2010. Three-month mortality was 21.5% (1,771/8,999) in 2020 and 23.3% (1,624/7,051) in 2010 (Table 1). According to sex, mortality at one and three months mainly affected men (525/734;71.5% and 1,259/1,771;71.1% respectively). Mean age at diagnosis was older than in the cohort population (67.8 y-o);respectively 69.9 and 69.8 at one and three months. At diagnosis, patients were in poorer ECOG mainly grade 2 (211/697;30.3%) or 3 (194/697;27.8%) for one-month and mainly grade 1 (549/1,703;32.2%) or 2 (547/1,703;32.1%) for three-month mortality. Among ECOG grade 3 and 4, 34.8% (194/557) and 57.1% (93/163) were dead at one month respectively;63.5% (350/551) and 83.4% (136/163) respectively were dead at three months. According to histology, adenocarcinoma was the most common (308/734;42%), followed by small cell lung cancer (170/734;23.2%) at one-month;adenocarcinoma was also the most common (822/ 1,771;46.4%), followed by squamous cell carcinoma (380/1771;21.5%) at three-month mortality. Most patients who died early were stage 4, metastatic/disseminated (respectively 625/702;89% and 1,488/1,715;86.8% for one- and three-month mortality). In patients with COVID19 infection (n=547), mortality at one and three months was respectively 36.4% (174/478) and 46.7% (228/ 488). Conclusions: Early mortality has not improved over the two decades and remains high. KBP- 2020-CPHG study was performed during COVID-19 pandemic, which may have generated delays in diagnosis and limited access to care and hospital. Early mortality at one and three months concerned mostly men, mean age nearly 70 y-o, adenocarcinoma, metastatic disease and frail patients. This confirms the potential value of LC screening program in a targeted population.
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Introduction: The European Joint Action on Vaccination (EU-JAV) is a European project that aims at spurring long-lasting European cooperation against vaccine-preventable diseases. In the context of the EU-JAV's Work Package 8, the Italian National Institute of Health, in collaboration with the Bambino Gesu Children's Hospital (Rome, Italy), developed a web platform designed to monitor vaccination discourse on the web and on social media. Materials and methods: We collected data on vaccine-related content from Twitter, Reddit, Wikipedia and Google Trends, through validated keyword filters, in Italian, French and Spanish. The platform's analysis layer included two machine learning-based algorithms: the influencer analysis, aimed at identifying the most influential users involved in the vaccine discourse;and the early-signal detection, used to identify new hashtags emerging in the conversation.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination plays a crucial role as pivotal strategies to curb the coronavirus dis-ease-19 (COVID-19) pandemic. Despite the mass-scale vaccination, literature data about the incidence of disease fares in IIM patients are still not reported as well as the immunological condition. Objectives: The present study aimed to describe the clinical status of patients affected by IIM after vaccination against COVID19 in order to assess the number of relapses or immune-mediated reactions in a cohort of Italian patients with such disease. Methods: We included all patients affected by IIM and followed by Myositis Clinic, Rheumatology and Respiratory Diseases Units, Siena University Hospital, Bari University Hospital, Policlinico Umberto I, Sapienza University, Rome, and Policlinico Paolo Giaccone, Palermo. Inclusion criteria were a recent (<3 months) clinical and serological assessment before the survey and a defnite diagnosis of dermatomyosi-tis, polymyositis and anti-synthetase syndrome. All patients underwent a telephone survey in order to establish their clinical status and potential relapses after vaccination. Results: A total of 119 IIM patients (median, IQR 58 (47-66) years;32 males) were consecutively enrolled. Fifty had a diagnosis of DM, 39 had PM and 30 had ASS. The median months of disease duration was 79.62±83.98. According to number of organs involvement, forty-two had only one, 45 had two organs involvement, 20 had three, 11 had four and one had five. The majority of them received two doses of COVID-19 vaccine, except four patients who refused the vaccination: 94 (78.9%) Cominarty, 16 (13.4%) Moderna, 5 (0.04%) AZ. Seven (0.06%) patients had fare after vaccination, the majority of them were mild except one major with three organs involved and one life-threatening with systemic involvement. In order to understand or predict the effect of demographic and clinical features on the fare development after vaccination, a logistic regression analysis was performed. The goodness-of-ft statistics showed a Chi2 associated with the Log ratio (L.R.) of 0.045. From the probability associated with the Chi-square tests, the Type II analysis showed the variable that most influences the development of fare was the number of organs involved (p=0.047). Sixty-eight patients received the third dose of COVID-19 vaccination: 51 (75%) Cominarty and 17 (25%) Moderna. Only one (0.01%) patient (the same who had life-threatening fare with systemic involvement after two doses) had fare after third dose and eventually died. Conclusion: Vaccines against SARS-CoV2 have provided, both in registratory studies and in preliminary real-life evidence, an overall good efficacy and safety. Nevertheless, only scanty data are available for rheumatic patients in general and the ones affected by IIM in particular. To the best of our knowledge, ours represent the largest cohort of IIM patients in which immunogenicity of anti-SARS-CoV2 vaccine was assessed. In line with real-life data from other diseases, we found a non-statistically signifcant risk of relapse in our patients, which occurred seldom, usually mild and in patients with a more severe and aggressive course of disease.
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Introduction: Influenza and COVID-19 are high transmission pathologies which have a different median incubation period. Although the symptoms are similar, people are more likely to be affected by severe and/or critical COVID-19 infection than severe and/or critical influenza infection. It is well proven that school closure and personal protection measures (mask-wearing and social distancing) are effective in reducing the spread of infection. This study aims to highlight the impact of 2020-21 seasonal influenza on the Italian population during the COVID-19 pandemic and to identify possible reasons for that. Materials and methods: To describe the impact of influenza on the population, data from the Integrated Influence Surveillance InfluNet and vaccination coverage in Italy in the 2020-21 season were used. Influenza Like Illness (ILI) incidence rates per thousand patients and influenza vaccination coverage (%) were calculated on the total population and by age group.
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The pandemic crisis is upsetting the world. In this dramatically new world, medical science must face an unknown and particularly insidious epidemiological risk. But does a criminal risk also lie with the doctors facing the Coronavirus risk? And, in this age opened by the Covid-19, what should be the “future” of professional medical liability in criminal law? And what response should the legal system give to changes in the epistemological statute of medicine? © 2021 Pisa University Press. All rights reserved.
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Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers' (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey<sup> R</sup> and distributed the link through Facebook and Whatsapp closed groups. The research instrument was a 31 items questionnaire distributed using Facebook and Whatsapp. It was conducted in Italy from February to May 2020. The study participants were general practitioners, pediatricians and other health professionals. A total of 958 participants were included: 320 (33.4%) general practitioners, 248 (25.9%) pediatricians and 390 (40.7%) other health professionals. The highest response rate was from Northern Italy (48.1%), followed by Central Italy (29.9%) and Southern Italy (22.0%). Less than a half (46%) of respondents felt they had a good level of information of COVID-19 case definition and of national prevention guidelines. Respondents reported to have changed their clinical practice;particularly, they increased the use of masks (87.1%, p < 0.001), disinfection and sanitization of doctors' offices (75.8%, p < 0.001), the use of protective glasses (71.2%, p < 0.001), alcoholic hand solution (71.2%, p < 0.001), and hand washing (31.8%, p = 0.028). HCWs are at high risk of infection;less than a half of them felt adequately prepared to face COVID-19 pandemic, so they need extensive information and awareness of the disease to take adequate precautionary measures, and they are crucial to disseminate good practices.