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Robin C, Redjoul R, Terrade A, Deghmane AE, Cabanne L, Cordonnier C, Taha MK. Immunogenicity and safety of the meningococcal B recombinant (4CMenB) vaccine in allogeneic hematopoietic cell transplantation recipients. Clin Microbiol Infect 2022; 28:1609-1614. [PMID: 35803542 DOI: 10.1016/j.cmi.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Despite a high risk of invasive meningococcal (Men) disease, there is no published data on any MenB vaccine after hematopoietic cell transplantation (HCT). We investigated the immunogenicity and safety of the 4CMenB recombinant vaccine (Bexsero®) in adult HCT recipients. METHODS Patients were eligible from 6 months post-HCT to receive 2 4CMenB doses at 2 months interval. Sera were collected at baseline, 1 month after the second dose, and 12 months after enrollment. The serum bactericidal activity (SBA) using human complement (hSBA) was assessed against fHbp, NadA, PorAP1.4 and NHBA antigens. The vaccine response was defined by one criteria for one vaccine antigen: (1) In patients with a hSBA titer < 4 at baseline: a titer > 4; (2) In patients with a hSBA titer > 4 at baseline: at least a x4 increase. RESULTS 40 patients were included at a median of 2.14 (0.57-13.03) years post-transplant. At baseline, most patients (32/40 80%) had hSBA titers < 4 for all vaccine antigens. After 2 vaccine doses, the proportion of patients with a titer > 4 was significantly increased for fHbp (23/40 57.5%), NadA (25/40 62.5%), and PorA (31/40 77.5%) but not for NHBA for which only 6/40 (15%) patients responded. 36/40 (90%) patients were responders to > 1 antigen. However, 9 months later, only 23/37 (62.2%) patients were still seroprotected. No severe adverse event was observed. CONCLUSION The response rate of 90% for >1 vaccine antigen and our safety data supports the 4CMenB vaccination of HCT recipients from 6 months after transplant with 2 doses. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov, NCT03509051.
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Affiliation(s)
- Christine Robin
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France; University Paris-Est-Créteil, Créteil, France.
| | - Rabah Redjoul
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Aude Terrade
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
| | - Ala-Eddine Deghmane
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
| | - Ludovic Cabanne
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Catherine Cordonnier
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France; University Paris-Est-Créteil, Créteil, France.
| | - Muhamed-Kheir Taha
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
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Gattini V, Napoletano M, Bonotti A, Mignani A, Cosentino F, Guglielmi G, Fallahi P, Cristaudo A, Foddis R. Antimeningococcal Vaccination Coverage Among Healthcare Workers in an Italian University Hospital. Front Public Health 2021; 9:651100. [PMID: 33981667 PMCID: PMC8109265 DOI: 10.3389/fpubh.2021.651100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Following an outbreak of meningococcal epidemic in 2015 and 2016 in Tuscany, we registered a higher demand for antimeningococcal vaccination (anti-Men ACWY) by Healthcare Workers of the University Hospital of Pisa [Azienda Ospedaliero Universitaria Pisana (AOUP)]. The purpose of this work is to analyze and discuss data on vaccination coverage resulting from this vaccination campaign. Materials and Methods: We conducted a monocentric study about anti-Men vaccination in the healthcare workers of the AOUP following the outbreak of meningococcal meningitis that occurred mainly in the population of the Tuscan provinces of Pisa, Pistoia, Prato, and Florence. The variables under examination were age, sex, educational qualification, and job profile. Department healthcare workers were vaccinated with two types of conjugated tetravalent vaccines for the A, C, Y, and W135 strains. Data were analyzed using the SPSS software. Results: The total population of the workers in AOUP was 7,188 subjects; the population considered in the study was 5,889. Between 2015 and 2017, a total of 2,423 subjects (41.1%) underwent anti-Men vaccination. Women, older HCWs, those with a lower educational qualification, doctors, and the HCWs of the maternal and child department, and imaging department recorded a statistically significant better vaccine compliance. Discussion: The AOUP, implementing the program of the Tuscany Region of vaccination against Neisseria meningitidis, has contributed to reduce the incidence of invasive meningococcal disease. Some critical issues remain in the compliance of some sections of the population, despite the high level of adherence recorded in this case, probably also due to the great media coverage of the event.
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Affiliation(s)
- Vittorio Gattini
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Napoletano
- School of Specialization in Occupational Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Bonotti
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Aldo Mignani
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Francesca Cosentino
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Giovanni Guglielmi
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Alfonso Cristaudo
- U. O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Rudy Foddis
- School of Specialization in Occupational Medicine, University of Pisa, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Deghmane AE, Haeghebaert S, Hong E, Jousset A, Barret AS, Taha MK. Emergence of new genetic lineage, ST-9316, of Neisseria meningitidis group W in Hauts-de-France region, France 2013-2018. J Infect 2020; 80:519-526. [PMID: 32032620 DOI: 10.1016/j.jinf.2020.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The epidemiology of invasive meningococcal disease (IMD) is continuously changing in incidence, age distribution and/or the expansion of new strains of Neisseria meningitidis. The epidemiology of IMD due to group W (IMDW) has changed recently at a global level with the emergence of isolates belonging to the clonal complex ST-11 (CC11) derived from the South America-UK strain. A more recent change has been detected in France with the emergence of a new genotype distinct from CC11 that we aimed to analyse. METHODS Epidemiological and microbiological surveillance data in France were used in combination with whole genome sequencing (WGS) to detect emerging phenotypes and genotypes of IMD causing strains, and their susceptibility to immunity induced by the 4CMenB vaccine. Transgenic mice expressing the human transferrin were used to analyse the virulence of emerging strain isolates by direct comparison with CC11 isolates. FINDINGS Our data showed a local increase of IMDW isolates in north France since 2013. The isolates belonged to ST-9316 and few were ST-11 isolates. WGS clustered ST-9316 isolates together and were distantly separated from the isolates of the clonal complex ST-11 (CC11). Unlike cases due to W/CC11 isolates, cases due to W/ST-9316 isolates were mostly observed amongst infants under the age of 1 year but with lower mortality compared to W/CC11 cases. Genomic comparison showed that the W/ST-9316, unlike W/CC11 isolates, lacked the hmbR gene encoding the haemoglobin receptor that is a virulence factor involved in the acquisition of iron from haemoglobin. W/ST-9316 further showed lower virulence in mice compared to W/CC11 isolates. INTERPRETATION We report the emergence of a novel sequence type (ST-9316) mostly associated with serogroup W, and exhibiting a lower virulence and a distinct age specific incidence profile than W/CC11 isolates. Surveillance requires powerful approaches combining WGS and pathophysiological analysis to adapt control measures.
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Affiliation(s)
- Ala-Eddine Deghmane
- Institut Pasteur, National Reference center for meningococci and Haemophilus influenzae, F-75724 Paris, France
| | - Sylvie Haeghebaert
- Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France
| | - Eva Hong
- Institut Pasteur, National Reference center for meningococci and Haemophilus influenzae, F-75724 Paris, France
| | - Améliane Jousset
- Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France
| | - Anne-Sophie Barret
- Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France
| | - Muhamed-Kheir Taha
- Institut Pasteur, National Reference center for meningococci and Haemophilus influenzae, F-75724 Paris, France.
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Thabuis A, Tararbit K, Taha MK, Dejour-Salamanca D, Ronin V, Parent du Chatelet I, Spaccaferri G. Community outbreak of serogroup B invasive meningococcal disease in Beaujolais, France, February to June 2016: from alert to targeted vaccination. ACTA ACUST UNITED AC 2019; 23. [PMID: 30017022 PMCID: PMC6152148 DOI: 10.2807/1560-7917.es.2018.23.28.1700590] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In February and March 2016, four cases of serogroup B invasive meningococcal disease (IMD) occurred over 3 weeks in a small area north of Lyon in the Auvergne-Rhône-Alpes region, France. There were no deaths but two cases had sequelae. This community outbreak was caused by a rare meningococcal strain of the clonal complex ST-32, covered by the 4CMenB/Bexsero vaccine. The incidence rate for serogroup B IMD in this area was 22.5 per 100,000 inhabitants, which is above the epidemic threshold (10/100,000). The number of cases observed was significantly higher than expected in the age group of 0–24 year-olds (standardised incidence ratio: 96). These results suggested the potential emergence of this invasive strain in this sub-population. In accordance with French recommendations, it was decided to vaccinate the population aged between 2 months and 24 years, living, working or studying in the epidemic area. The vaccination campaign took place from April to September 2016. Vaccination coverage was estimated at 47% for one dose and 40% for two doses. The lowest coverage estimations were observed for the age groups younger than 3 and 15–19 years. Enhanced epidemiological and microbiological surveillance reported a fifth case in June 2016, outside the epidemic area.
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Affiliation(s)
- Alexandra Thabuis
- Santé publique France, French national public health agency, Cellule d'intervention en région Auvergne-Rhône-Alpes, Saint-Maurice, France
| | - Karim Tararbit
- Agence régionale de santé Auvergne-Rhône-Alpes, Regional health agency, Lyon, France
| | - Muhamed-Kheir Taha
- Institut Pasteur, National Reference Centre for Meningococci, Paris, France
| | | | - Vincent Ronin
- Agence régionale de santé Auvergne-Rhône-Alpes, Regional health agency, Lyon, France
| | - Isabelle Parent du Chatelet
- Santé publique France, French national public health agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Guillaume Spaccaferri
- Santé publique France, French national public health agency, Cellule d'intervention en région Auvergne-Rhône-Alpes, Saint-Maurice, France
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Bouza E, Ancochea-Bermúdez J, Campins M, Eirós-Bouza JM, Fargas J, García Rojas A, Gracia D, Gutiérrez Sánchez A, Limia A, López JA, Magro MC, Mirada G, Muñoz P, Olier E, Ortiz de Lejarazu R, Urbiztondo L, Palomo E. The situation of vaccines for the prevention of infections in adults: An opinion paper on the situation in Spain. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:333-364. [PMID: 31345005 PMCID: PMC6719651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/23/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022]
Abstract
The childhood immunization schedule is well known and generally well implemented in developed countries. For various reasons, the same is not true of vaccines aimed at preventing infections in adults, in which vaccination coverage is incomplete and generally very deficient. In order to assess the situation of adult vaccination in Spain, the Fundación de Ciencias de la Salud has brought together a series of experts in different fields, including doctors, nurses, representatives of patient associations, health managers and economists, health authorities and journalists to deal with this issue. The format was that of a round table in which a series of questions previously formulated by the coordinators were to be answered and debated. The document presented is not an exhaustive review of the topic, nor is it intended to make recommendations, but only to give a multidisciplinary opinion on topics that could be particularly debatable or controversial. The paper reviews the main vaccine-preventable adult diseases, their clinical and economic impact, the possibilities of reducing them with vaccination programmes and the difficulties in carrying them out. The role of nursing, pharmacy services, patient associations and the health administration itself in changing the current situation was discussed. Prospects for new vaccines were discussed and we speculated on the future in this field. Finally, particularly relevant ethical aspects in decision-making regarding vaccination were discussed, which must be faced by both individuals and states. We have tried to summarize, at the end of the presentation of each question, the environment of opinion that was agreed with all the members of the table.
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Affiliation(s)
- E Bouza
- Emilio Bouza, Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Palomo
- Esteban Palomo. Director. Fundación de Ciencias de la Salud. C/ Severo Ochoa, 2, 28760 Tres Cantos. Madrid, Spain. Phone +34 91 3530150
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Giuliani AR, Mattei A, Appetiti A, Pompei D, Di Donna F, Fiasca F, Fabiani L. Spontanuous Demand For Meningococcal B Vaccination: Effects On Appropriateness And Timing. Hum Vaccin Immunother 2018; 14:2075-2081. [PMID: 29927693 PMCID: PMC6150011 DOI: 10.1080/21645515.2018.1466015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
When the meningococcus B vaccine was introduced into Italy in 2017, it was recommended for newborns based on national epidemiological data indicating that they were at greater risk. However, the vaccination service of the local health authority of L'Aquila had already been receiving spontaneous parental requests to provide vaccination for children in lower-risk age groups from the beginning of 2016. We therefore decided to use a self-administered questionnaire in order to investigate the parents’ socio-demographic data; their children's history of other recommended vaccinations (against measles, mumps and rubella, varicella, meningococcus C and, for females, human papilloma virus); the information sources concerning meningococcal vaccination; and the timing of its administration. The questionnaire was completed by 565 parents, and the results showed that the requests mainly came from the parents of children aged 5–11 years. The children whose mothers had received a high school education and were >35 years old were more likely to have received the first dose after the age of one year and to have perceived pain at the inoculation site, and less likely to have experienced mild general reactions. The requests were mainly trigged by the recommendations of healthcare professionals, and the overloading of the vaccination service led to delays in the administration of the doses after the first. The delays (reported by 74.07% of the parents) were mainly due to organisational problems in the service itself, which led 61.52% of the doses being more appropriately administered by staff working as private physicians inside public health facilities, albeit at extra cost. These findings indicate that organisational factors and excessive demand had a considerable impact on both the efficacy of the immunisation and its appropriateness.
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Affiliation(s)
- A R Giuliani
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
| | - A Mattei
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
| | - A Appetiti
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
| | - D Pompei
- b Abruzzo Regional Department of Prevention (ASL1) , L'Aquila , Italy
| | - F Di Donna
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
| | - F Fiasca
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
| | - L Fabiani
- a Department of Life , Health and Environmental Sciences, University of L'Aquila , Italy
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Riccò M, Vezzosi L, Odone A, Signorelli C. Invasive Meningococcal Disease on the Workplaces: a systematic review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:337-351. [PMID: 29083344 DOI: 10.23750/abm.v88i3.6726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 01/08/2023]
Abstract
Background and aims of the work: Invasive Meningococcal Disease (IMD) represents a global health threat, and occupational settings have the potential to contribute to its spreading. Therefore, here we present the available evidences on the epidemiology of IMD on the workplaces. METHODS The following key words were used to explore PubMed: Neisseria meningitidis, meningococcus, meningococcal, invasive meningococcal disease, epidemiology, outbreaks, profession(al), occupation(al). RESULTS We identified a total of 12 IMD cases among healthcare workers (HCW), 44 involving biological laboratory workers (BLW), 8 among school personnel, and eventually 27 from other settings, including 3 large industrial working populations. Eventual prognosis of BLW, particularly the case/fatality ratio, was dismal. As clustered in time and space, data about school cases as well as industrial cases seem to reflect community rather than occupational outbreaks. In general, we identified a common pattern for HCW and BLW, i.e. the exposure to droplets or aerosol containing N meningitidis in absence of appropriate personal protective equipment (PPE) and/or microbiological safety devices (MSD) (e.g. cabinets). Post-exposure chemoprophylaxis (PEC) was rarely reported by HCW (16.7%) workers, and never by BLW. Data regarding vaccination status were available only for a case, who had failed requested boosters. CONCLUSIONS The risk for occupational transmission of IMD appears relatively low, possibly as a consequence of significant reporting bias, with the exception of HCW and BLW. Improved preventive measures should be implemented in these occupational groups, in order to improve the strict use of PPE and MSD, and the appropriate implementation of PEC.
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio Emilia V.le Amendola n.2 - 42122 RE Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL) Dip. di Prevenzione.
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Riccò M, Vezzosi L, Odone A, Signorelli C. Invasive Meningococcal Disease on the Workplaces: a systematic review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88. [PMID: 29083344 PMCID: PMC6142849 DOI: 10.23750/abm.v%vi%i.6726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background and aims of the work: Invasive Meningococcal Disease (IMD) represents a global health threat, and occupational settings have the potential to contribute to its spreading. Therefore, here we present the available evidences on the epidemiology of IMD on the workplaces. METHODS The following key words were used to explore PubMed: Neisseria meningitidis, meningococcus, meningococcal, invasive meningococcal disease, epidemiology, outbreaks, profession(al), occupation(al). RESULTS We identified a total of 12 IMD cases among healthcare workers (HCW), 44 involving biological laboratory workers (BLW), 8 among school personnel, and eventually 27 from other settings, including 3 large industrial working populations. Eventual prognosis of BLW, particularly the case/fatality ratio, was dismal. As clustered in time and space, data about school cases as well as industrial cases seem to reflect community rather than occupational outbreaks. In general, we identified a common pattern for HCW and BLW, i.e. the exposure to droplets or aerosol containing N meningitidis in absence of appropriate personal protective equipment (PPE) and/or microbiological safety devices (MSD) (e.g. cabinets). Post-exposure chemoprophylaxis (PEC) was rarely reported by HCW (16.7%) workers, and never by BLW. Data regarding vaccination status were available only for a case, who had failed requested boosters. CONCLUSIONS The risk for occupational transmission of IMD appears relatively low, possibly as a consequence of significant reporting bias, with the exception of HCW and BLW. Improved preventive measures should be implemented in these occupational groups, in order to improve the strict use of PPE and MSD, and the appropriate implementation of PEC.
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Affiliation(s)
- Matteo Riccò
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento, Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN),Local Health Unit of Reggio Emilia - Regional Health Service of Emilia Romagna, Department of Public Health, Service for Health and Safety in the Workplace, Reggio Emilia (RE),Correspondence: Dr. Matteo Riccò Local Health Unit of Reggio Emilia Via Amendola, 2 - 42122 Reggio Emilia (RE) Tel. 0039.3392994343 - 0039.522.837587; E-mail: ;
| | - Luigi Vezzosi
- University of Campania “Luigi Vanvitelli”, Department of Experimental Medicine, Napoli (NA)
| | - Anna Odone
- University “Vita-Salute San Raffaele”, Milan (MI),University of Parma, Department of Medicine and Surgery, Parma (PR)
| | - Carlo Signorelli
- University “Vita-Salute San Raffaele”, Milan (MI),University of Parma, Department of Medicine and Surgery, Parma (PR)
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