Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.

Hepatitis A is the most common form of acute viral hepatitis in the world. Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development. The anti-hepatitis A virus (HAV) seroprevalence rate is presently decreasing in many parts of the world, but in less developed regions and in several developing countries, HAV infection is still very common in the first years of life and seroprevalence rates approach 100%. In areas of intermediate endemicity, the delay in the exposure to the virus has generated a huge number of susceptible adolescents and adults and significantly increased the average age at infection. As the severity of disease increases with age, this has led to outbreaks of hepatitis A. Several factors contribute to the decline of the infection rate, including rising socioeconomic levels, increased access to clean water and the availability of a hepatitis A vaccine that was developed in the 1990s. For populations with a high proportion of susceptible adults, implementing vaccination programs may be considered. In this report, we review available epidemiological data and implementation of vaccination strategies, particularly focusing on developing countries.

Overall, knowledge regarding influenza, implications during pregnancy and influenza vaccine was poor among pregnant women. In Italy, the National Vaccine Prevention Plan 2012-2014 recommends influenza vaccine during pregnancy, but only 18/309 were aware of this recommendation. These results suggest that in order to increase influenza vaccine acceptance it is necessary to improve pregnant women knowledge about influenza and to offer education to healthcare providers.

Rotavirus (RV) is worldwide considered as the most important viral agent of acute gastroenteritis in children less than 5 y. Since 2006, the availability of anti-RV vaccines has deeply modified the incidence and economic burden of RV infection. In Europe, some countries have introduced an anti-RV vaccination program in the last 10 y. Although community acquired RV (CARV) disease is the most studied condition of RV infection, recently some authors have highlighted the importance of nosocomial RV (nRV) disease as an emerging public health issue. The aim of this review is to summarize the epidemiology of both CARV and nRV, in order to discuss the difficulty of a clear evaluation of the burden of the disease in absence of comparable data. In particular, we focused our attention to European studies regarding nRV in terms of divergences related to definition, report of incidence rate and methodological issues.

A total of 213 subjects from a community in Italy of immigrants from Somalia and other NE African countries were enrolled in this study to evaluate the prevalence of HAV, HBV, HCV and HDV infections and to assess their possible risk factors. Of the subjects, 45 per cent (96) were female and 24 per cent (52) were under 12 years old. The age range was from 1 to 67 years and the mean age was 24 years. Eighty-three per cent (177 subjects) were born in Somalia, 10 per cent (21 subjects) in Ethiopia, and the rest in Djibouti, Egypt or Saudi Arabia. The 213 subjects were administered a questionnaire which covered socio-demographic characteristics and risk factors resulting from Western medical practice, traditional medicine, personal behaviour and living conditions. Blood was drawn from 209 subjects to ascertain the presence of HbsAg, HBeAg, anti-HAV, anti-HBc, anti-HBs, anti-HCV and anti-HDV. The results of this study show an HAV prevalence of 96 per cent (an 87.5 per cent prevalence in children under 12), and an HBV prevalence of 32 per cent (a 3.3 per cent prevalence of HBsAg carriers). No subject under 11 was HBV positive and no woman tested positive for HBeAg, confirming the extreme unlikelihood of vertical transmission of HBV. The prevalence of HBV is closely correlated with age (ranging from 2 per cent in those under 12 to 59 per cent in subjects over 39).(ABSTRACT TRUNCATED AT 250 WORDS)