Surveillance of infectious diseases in the Italian military as pre-requisite for tailored vaccination programme

Surveillance and control of infectious diseases in the Italian military inc lude prompt reporting of all occurring cases and prophylaxis through compul sory vaccination practices. The last mandatory immunisation programme in th e Italian military was launched in 1998 (more than 10 years after the previ ous programme was introduced in 1986 1987) and it was planned according to the epidemiological data herein reported. The incidence rates (number of ca ses x 100 000 subjects) of infectious diseases notified during the period 1 976-1980 were compared with the corresponding figures notified 15 years lat er (1991 - 1995). An increase of three airborne-transmitted viral diseases - varicella, rubella and measles - counterbalanced by a decrease of other i nfectious diseases, such as mumps, typhoid fever, tuberculosis. viral hepat itis, scabies. syphilis and gonorrhea. was observed. This may be related to improvements in the general hygienic conditions and more responsible sexua l behaviour among Italian military recruits. Moreover. incidence rates of c ases notified in the military were compared with those notified in the gene ral population of the same sex- and similar age-range (15-24 years) over a 12-year period (1986 - 1997). to monitor the epidemiological situation in r elation to (a) potential risk factors specifically linked to military life and (b) protective effects induced by specific vaccinations. Airborne-trans mitted viral diseases, such as varicella, rubella, measles and mumps - whic h are usually underreported among civilians - show higher incidence rates i n the military. Meningococcal meningitis: shows higher incidence rates in t he military in 1986 and 1987 (before the introduction of mandatory specific vaccination) as well as in 1995-1997 (main etiologic agent N. meningitidis serogroup B), similar rates were instead observed in the other years. Inci dence rates: for typhoid fever are generally lower in the military, despite the community life, probably reflecting the protective efficacy of specifi c vaccine. Hepatitis A and B show similar rates between military and civili an population. Finally, pulmonary tuberculosis generally show's higher rate s in the military. These data therefore allow the conclusion that the only infectious diseases, for which possible risk factors in the military life m ay be hypothesised, seem to be meningococcal meningitis and perhaps pulmona ry tuberculosis. Epidemiological surveillance of infectious diseases in the military as a pre-requisite for appropriate public health intervention str ategy represents a good model to be followed also in larger contexts. (C) 2 001 Published by Elsevier Science Ltd.