[Retrospective survey on epidemiologic monitoring of accidents due to professional exposure to biological agents in A.O.U. "G. Martino" of Messina, Italy)]. / Indagine retrospettiva sul monitoraggio epidemiologico degli infortuni biologici da esposizione professionale nel- i'A.O.U. "G. Martino" di Messina.

The management of healthcare professionals exposed to biological material which may potentially be contaminated with HIV HBVand HCV viruses, is of vital importance in acquiring precise epidemiological data regarding the type and means of exposure, and the efficacy or failure to apply recommended preventive measures. This will make it possible to assess over time which measures need to be implemented or improved. For these reasons we decided to analyze cases of occupational exposure to biological risk occurring in the University Hospital in Messina between 1998 and 2002. Our study highlighted in particular that the most frequently affected category was that of professional nurses (46.74%) and that only 31.72% of the healthcare workers who tested negative for HBsAb were administered vaccine prophylaxis also after the accident. Moreover, it emerged that there is the need to increase the amount and quality of information made available, by changing report forms, with the aim of identifying problems and risky behavior and procedures, and thus make ways to ensure the continued improvement of the accident prevention and management programmes. In fact, in the accident reporting procedure used, it was not possible to specify the precise way in which the accidents happened.

[Water quality and microbiological status of the distribution system: traditional parameters and emerging parameters]. / Qualità dell'acqua e stato microbiologico alla distribuzione: parametri tradizionali e parametri emergenti.

Most pollution of drinking water is caused by inadequacy of the uptake and distribution systems, by insufficient upkeep of the sewage system and by defects or breaks in the disinfection processes. This may be the cause of waterborne epidemic outbreaks and therefore it is necessary carry out routine controls by simple and rapid tests for the detection of intestinal organisms. In the light of minor hepatitis A epidemics occurred in the town of Messina, we have carried out a study to determine the drinking water quality. To this end, in addition to the traditional tests recommended by CEE and required by the 8/2/1985 DPCM (37 degrees C and 20 degrees C viable count, total and faecal coliforms and faecal streptococci), we have carried out P. aeruginosa, coliphages and gram-negative endotoxins tests, in 74 water samples drawn on way in and way out of the tanks and along the piping system. Only 12.5% of the sixteen water samples drawn on way in (before disinfection system) was in compliance with the law. 75% of these samples showed positivity for faecal streptococci. The water quality was lower in the fourteen water samples drawn on way out of the tanks (7.1% was in compliance with the law). The percent of positivity along the piping system for total and faecal coliforms and for faecal streptococci was 34.1, 15.9 and 59.1 respectively. Coliphages were always absent. P. aeruginosa was almost always present in way in water (93.7%). Moreover this microorganism was recovered in 85.7% of the samples drawn on the way out and in 77.3% along the piping system. In the same drawing places endotoxins were present at high percentage (100%, 85.7% and 90.9%). These values come from high test sensitivity and poor water quality. Finally we have pointed out the importance of all the parameters examined. The significance of coliform bacteria is known, but we consider very important, as organisms indicative of pollution, the enterococci, since they P. aeruginosa may survive long time in fresh water though it is not autoctone, but, in general, of faecal origin. Several soluble antigens of this microorganism as well as enterococci show positive LAL tests (1-5-6). The endotoxin content in fresh water reflects the degree of bacterial contamination. We believe, therefore, it is needed to fix an upper limit to endotoxins in drinking water. Coliphages concentrations could be correlated with enteric virus concentrations but the ratio of coliforms to coliphages is about 100:1. Therefore this indicator of viral pollution is helpful only for highly polluted surface waters.

[A few viral infections in the recent epidemiological evolution (author's transl)]. / Alcune infezioni virali nella piu' recente evoluzione epidemiologica.

In the study we presented a few infections of viral etiology that showed evident epidemiological evolutions during the last ten years. We refered of a disease nearly eradicated, of one that can be eradicated, and of a group of infections that at present cannot be eradicated. The first is poliomyelitis, the second is measles, the third is represented by viral infections connected with the respiratory tract. As for the first disease, the sistematic immunoprophilaxis applyed in different countries of the world on one hand stopped the transmission of wild polioviruses and on the other created an immunological barrier in those countries where polio vaccination is maintained, as demonstrated by statistics revealing the absence or low incidence of this disease. As for the epidemiological evolution of measles, after considering the incidence due to age, environment, social-hygienic conditions, mortality etc..., we refered in particular of a vaccination that took place in USA where the disease decreased with 1968 then rised next year a pause of the vaccination program. A second cycle of vaccinations against measles revealed in 1972 a decrease of the disease this signifying the importance of the vaccination in stopping, reducing or modifying the epidemiology of measles. The epidemiological conditions of respiratory infections are completely different due to the variety of the etiological factors, the difficulty in preparing aspecific vaccines, and the impossibility in recognising clinical forms caused by these viruses. All these factors, impede, actually, a complete eradication.