In Europe the influence spread in France, Great Britain, Italy and Spain, interfering on the battle-fields with the military operations during the First World War.The official communications of the health authorities worldwide gave certainty about the etiology of influenza, but from laboratories it was not always possible to isolate the famous Pfiffer bacillus. The Spanish flu hit different ages with a so-called "W- trend": the two typically more susceptible age spikes were the children and the elderly, added by the healthy young adults.The first official preventive measures implemented in August 1918 included the notification need of suspected cases, and the surveillance of communities such as schools, barracks and boarding schools.The identification of the ill through surveillance, voluntary and legally enforced quarantine, or isolation had also permitted to limit Sanish flu widespread.In order to not impress the public opinion, moreover, several hygiene local offices refused to provide the numbers of people affected and deads.The influenza pandemic of 1918 killed more than 50 million people worldwide.Virological and bacteriological analysis of preserved samples of infected soldiers who died in 1918 during the pandemic period is a main step in order to better understand and prepare to future pandemics.
Fin dai tempi antichi, il rimedio più frequentemente prescritto per il trattamento della tubercolosi era una permanenza in un clima temperato. Dalla metà del XIX secolo alla metà del XX, l'Europa ha visto lo sviluppo di sanatori, dove i pazienti hanno potuto beneficiare di passeggiate all'aria aperta, esercizio fisico e una dieta equilibrata. Inoltre, l'istituzionalizzazione e l'isolamento dei pazienti ritenuti contagiosi rimane una delle misure più efficaci per il controllo di questo tipo di infezione.Il primo sanatorio aperto in Germania nel 1854, mentre in Italia i primi esperimenti furono condotti all'inizio del 20 ° secolo. A quel tempo, era opinione diffusa in Italia che la tubercolosi polmonare potesse migliorare in un clima marino. Al contrario, lo studioso Biagio Castaldi ha descritto gli effetti salubri dell'aria di montagna e ha documentato una minore incidenza di tubercolosi tra le popolazioni montane, che ha sostenuto l'ipotesi di una predisposizione ereditaria alla malattia. Nel 1898 furono fondati diversi comitati locali (Siena, Pisa, Padova) per combattere la tubercolosi. L'anno seguente, questi hanno dato origine alla Lega Italiana (Lega Italiana) con il patrocinio del Re d'Italia, che ha contribuito a promuovere l'intervento statale nella costruzione di sanatori.The pioneer of the institution of dedicated facilities for the treatment of tuberculosis was Edoardo Maragliano in Genoa in 1896. A few years later, in 1900, the first specialised hospital, with a capacity of 100 beds, was built in Budrio in a non-mountainous area, the aim being to treat patients within their habitual climatic environment. In the following years, institutes were built in Bologna, Livorno, Rome, Turin and Venice. A large sanatorium for the treatment of working-class patients was constructed in Valtellina by the fascist government at the beginning of the century, in the wake of studies by Eugenio Morelli on the climatic conditions of the pine woods in Sortenna di Sondalo, which he deemed to be ideal. In December 1916, the Italian Red Cross inaugurated the first military sanatorium in the "Luigi Merello" maritime hospice in Bergeggi (SV) to treat soldiers affected by curable tuberculosis. In 1919, a specific law mandated a 10-fold increase in funding for the construction of dispensaries and sanatoria. As a result, the Provincial Anti-tuberculosis Committees were transformed into Consortiums of municipal and provincial authorities and anti-TB associations, with the aim of coordinating the action to be undertaken. In 1927, the constitution of an Anti-tuberculosis Consortium in every province became a legal obligation.Nonostante questa crescita delle misure sociali e sanitarie, la tubercolosi in Italia ha continuato a costituire un grave problema di salute pubblica fino all'avvento degli antibiotici negli anni '50. Fino a quel momento, il sanatorio ha svolto un ruolo di primo piano nel trattamento della tubercolosi in Italia, come nel resto d'Europa.
Influenza vaccination is a fundamental tool for the prevention of influenza in healthcare settings and its administration to healthcare workers (HCWs) is recommended in more than 40 countries including United States of America and many countries of the European Union. Despite these recommendations, the compliance of HCWs to influenza vaccination is largely inadequate in Italy. Since 2005/06 season, a comprehensive multifaceted intervention project aimed at increasing the seasonal influenza vaccination coverage rates among HCWs was performed at the IRCCS AOU San Martino IST teaching hospital in Genoa, Italy, the regional tertiary adult acute-care reference center with a 1300 bed capacity. Despite almost a decade of efforts, the vaccination coverage rates registered at our hospital steadily remain unsatisfactory and very distant by the minimum objective of 75% defined by the Italian Ministry of Health. During the last influenza season (2013/14), vaccination coverage rates by occupation type resulted 30% among physicians, 11% among nurses and 9% among other clinical personnel.
