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Calzolari M, Angelini P, Finarelli AC, Cagarelli R, Bellini R, Albieri A, Bonilauri P, Cavrini F, Tamba M, Dottori M, Gaibani P, Natalini S, Maioli G, Pinna M, Mattivi A, Sambri V, Pierro A, Landini MP, Rossini G, Squintani G, Cinotti S, Varani S, Vocale C, Bedeschi E. Human and entomological surveillance of Toscana virus in the Emilia-Romagna region, Italy, 2010 to 2012. Euro Surveill 2014; 19:20978. [DOI: 10.2807/1560-7917.es2014.19.48.20978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.
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Affiliation(s)
- M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Bellini
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - A Albieri
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - F Cavrini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Gaibani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - S Natalini
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - G Maioli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Pinna
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina, Italy
| | - A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Squintani
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - S Cinotti
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - S Varani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - C Vocale
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - E Bedeschi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
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2
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Bellini R, Calzolari M, Mattivi A, Tamba M, Angelini P, Bonilauri P, Albieri A, Cagarelli R, Carrieri M, Dottori M, Finarelli AC, Gaibani P, Landini MP, Natalini S, Pascarelli N, Rossini G, Velati C, Vocale C, Bedeschi E. The experience of West Nile virus integrated surveillance system in the Emilia-Romagna region: five years of implementation, Italy, 2009 to 2013. ACTA ACUST UNITED AC 2014; 19. [PMID: 25394257 DOI: 10.2807/1560-7917.es2014.19.44.20953] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Predicting West Nile virus (WNV) circulation and the risk of WNV epidemics is difficult due to complex interactions of multiple factors involved. Surveillance systems that timely detect virus activity in targeted areas, and allow evidence-based risk assessments may therefore be necessary. Since 2009, a system integrating environmental (mosquitoes and birds) and human surveillance has been implemented and progressively improved in the Emilia-Romagna region, Italy. The objective is to increase knowledge of WNV circulation and to reduce the probability of virus transmission via blood, tissue and organ donation. As of 2013, the system has shown highly satisfactory results in terms of early detection capacity (the environmental surveillance component allowed detection of WNV circulation 3–4 weeks before human cases of West Nile neuroinvasive disease (WNND) occurred), sensitivity (capacity to detect virus circulation even at the enzootic level) and area specificity (capacity to indicate the spatial distribution of the risk for WNND). Strong correlations were observed between the vector index values and the number of human WNND cases registered at the province level. Taking into consideration two scenarios of surveillance, the first with environmental surveillance and the second without, the total costs for the period from 2009 to 2013 were reduced when environmental surveillance was considered (EUR 2.093 million for the first scenario vs EUR 2.560 million for the second). Environmental surveillance helped to reduce costs by enabling a more targeted blood unit testing strategy. The inclusion of environmental surveillance also increased the efficiency of detecting infected blood units and further allowed evidence-based adoption of preventative public health measures.
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Affiliation(s)
- R Bellini
- Centro Agricoltura Ambiente G.Nicoli , Crevalcore, Italy
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3
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Montaño-Remacha C, Ricotta L, Alfonsi V, Bella A, Tosti ME, Ciccaglione AR, Bruni R, Taffon S, Equestre M, Losio MN, Carraro V, Franchini S, Natter B, Augschiller M, Foppa A, Gualanduzzi C, Massimiliani E, Finarelli AC, Borrini BM, Gallo T, Cozza V, Chironna M, Prato R, Rizzo C, Central Task Force on Hepatitis C. Hepatitis A outbreak in Italy, 2013: a matched case–control study. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.37.20906] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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Affiliation(s)
- C Montaño-Remacha
- Istituto Superiore di Sanità (ISS), Rome, Italy
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - L Ricotta
- Dept. of Biomedical and Neuromotor Sciences, University of Bologna, Italy
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - V Alfonsi
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Bella
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - M E Tosti
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | | | - R Bruni
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - S Taffon
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - M Equestre
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - M N Losio
- Institute Experimental Zooprophylactic of Lombardy and Emilia Romagna, Italy
| | - V Carraro
- Prevention Dept., Province of Trento, Italy
| | | | - B Natter
- Prevention Dept., Province of Bolzano, Italy
| | | | - A Foppa
- Prevention Dept., Province of Bolzano, Italy
| | - C Gualanduzzi
- Public Health Service - Directorate General for Health and Social Policy - Emilia-Romagna Region, Italy
| | - E Massimiliani
- Public Health Service - Directorate General for Health and Social Policy - Emilia-Romagna Region, Italy
| | - A C Finarelli
- Public Health Service - Directorate General for Health and Social Policy - Emilia-Romagna Region, Italy
| | - B M Borrini
- Public Health Service - Directorate General for Health and Social Policy - Emilia-Romagna Region, Italy
| | - T Gallo
- Prevention Dept. - ASS4 Medio Friuli, Udine, Italy
| | - V Cozza
- Dept. of Medical and Surgical Sciences, University of Foggia, Italy
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - M Chironna
- Dept. of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - R Prato
- Dept. of Medical and Surgical Sciences, University of Foggia, Italy
| | - C Rizzo
- Istituto Superiore di Sanità (ISS), Rome, Italy
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4
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Pierro A, Landini MP, Gaibani P, Rossini G, Vocale C, Finarelli AC, Cagarelli R, Sambri V, Varani S. A model of laboratory surveillance for neuro-arbovirosis applied during 2012 in the Emilia-Romagna region, Italy. Clin Microbiol Infect 2013; 20:672-7. [PMID: 24329773 DOI: 10.1111/1469-0691.12436] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
Arboviruses with neuroinvasive potential are gaining more attention due to the increased number of cases of autochthonous and imported infections in the human host. Diagnosis of infection caused by these viruses in patients with central nervous system (CNS) diseases is still underestimated and these infections represent an emerging threat to public health. We describe a model suitable for the laboratory surveillance of neuro-arbovirosis that was applied in the Emilia-Romagna region, north-eastern Italy, during the 2012 summer season. One hundred and twenty cases of suspected neuroinvasive infection were tested for arboviral agents on the basis of clinical and laboratory signs and epidemiological data. The most common virus detected was Toscana virus (TOSV): anti-TOSV specific antibodies or viral components were detected in 28.3% of the cases; 79.4% of the TOSV cases were in the acute phase of infection. No cases resulted in acute phase for West Nile (WNV), Usutu (USUV), Chikungunya (CHIKV) or Dengue (DENV) virus infection. Conversely, two patients with a history of staying in a tick-borne encephalitis virus (TBEV) endemic area showed a probable TBEV infection. These results emphasize the importance of a complete and 'ready to act' laboratory diagnostic system to be implemented within the larger frame of a regional integrated surveillance system.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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5
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013. [DOI: 10.2807/1560-7917.es2013.18.28.20530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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Affiliation(s)
- S Varani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Cagarelli
- Public Health Authority Emilia-Romagna, Bologna, Italy
| | - F Melchionda
- Department of Pediatric Hematology and Oncology, St. Orsola Malpighi University Hospital, Bologna, Italy
| | - L Attard
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - C Salvadori
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - A C Finarelli
- Public Health Authority Emilia-Romagna, Bologna, Italy
| | - G A Gentilomi
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Tigani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Rangoni
- Public Health Department of Imola, Bologna, Italy
| | - R Todeschini
- Public Health Department of Casalecchio di Reno, Bologna, Italy
| | - A Scalone
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - T Di Muccio
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - M Gramiccia
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - L Gradoni
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - P Viale
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - M P Landini
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
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6
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013. [DOI: 10.2807/1560-7917.es2013.18.29.20530] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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7
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013; 18:20530. [PMID: 23929116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
An increased number of autochthonous visceral leishmaniasis (VL) cases has recently been reported in Bologna Province in northern Italy. Over six months from November 2012 to May 2013, 14 cases occurred, whereas the average number of cases per year was 2.6 (range: 0-8) in 2008 to 2012. VL was diagnosed in a median of 40 days (range: 15-120) from disease onset. This delay in diagnosis shows the need for heightened awareness of clinicians for autochthonous VL in Europe.
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Affiliation(s)
- S Varani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
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8
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Pierro A, Gaibani P, Spadafora C, Ruggeri D, Randi V, Parenti S, Finarelli AC, Rossini G, Landini MP, Sambri V. Detection of specific antibodies against West Nile and Usutu viruses in healthy blood donors in northern Italy, 2010-2011. Clin Microbiol Infect 2013; 19:E451-3. [PMID: 23663225 DOI: 10.1111/1469-0691.12241] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Neutralizing antibodies against West Nile (WNV) and Usutu (USUV) viruses were measured in 6000 samples collected, between 1 September 2010 and 30 June 2011, from blood donors living in different districts of Emilia-Romagna, northeastern Italy. On the basis of the microneutralization assay (MNTA), 47 (0.78%) subjects were positive for WNV and 14 (0.23%) for USUV. These results were compared with those obtained 2 years ago and suggest an increased circulation of USUV among humans in Emilia-Romagna.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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9
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Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012; 17:20257. [PMID: 22958609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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10
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Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.35.20257-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P Gaibani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - A C Finarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - A Pierro
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M P Landini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
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Rizzo C, Salcuni P, Nicoletti L, Ciufolini MG, Russo F, Masala R, Frongia O, Finarelli AC, Gramegna M, Gallo L, Pompa MG, Rezza G, Salmaso S, Declich S. Epidemiological surveillance of West Nile neuroinvasive diseases in Italy, 2008 to 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.20.20172-en] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - P Salcuni
- Ministry of Health, Department of Prevention and Communication, Rome, Italy
| | - L Nicoletti
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - M G Ciufolini
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - F Russo
- Regional Health Authority of Veneto, Italy
| | - R Masala
- Regional Health Authority of Sardinia, Italy
| | - O Frongia
- Local Health Authority of Oristano, Sardinia, Italy
| | | | - M Gramegna
- Regional Health Authority of Lombardy, Italy
| | - L Gallo
- Regional Health Authority of Friuli-Venezia Giulia, Italy
| | - M G Pompa
- Ministry of Health, Department of Prevention and Communication, Rome, Italy
| | - G Rezza
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Salmaso
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
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12
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Rizzo C, Salcuni P, Nicoletti L, Ciufolini MG, Russo F, Masala R, Frongia O, Finarelli AC, Gramegna M, Gallo L, Pompa MG, Rezza G, Salmaso S, Declich S. Epidemiological surveillance of West Nile neuroinvasive diseases in Italy, 2008 to 2011. Euro Surveill 2012; 17:20172. [PMID: 22642945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
We describe the geographical and temporal distribution of West Nile neuroinvasive diseases (WNND) cases in Italy from 2008 to 2011. The increasing number of confirmed human cases from eight in 2008 to 18 in 2009 and the occurrence of the virus in a larger geographical area in 2009 (moving from east to west) prompted the Ministry of Health to publish, in spring 2010, a national programme for WNND human surveillance, comprising veterinary and vector surveillance. Subsequently, in 2011, a new national plan on integrated human surveillance of imported and autochthonous vector-borne diseases (chikungunya, dengue and West Nile disease) was issued. Between 2008 and 2011, 43 cases of WNND were reported from five regions in Italy with a case fatality rate of 16%. The incidence of WNND during the entire study period was 0.55 per 100,000 population (range: 0.06–0.23 per 100,000). During 2011, two new regions (Friuli-Venezia Giulia and Sardinia) reported confirmed cases in humans. Integrated human, entomological and animal surveillance for West Nile virus is a public health priority in Italy and will be maintained during 2012.
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Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanita, ISS), Rome, Italy.
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13
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Moro ML, Grilli E, Corvetta A, Silvi G, Angelini R, Mascella F, Miserocchi F, Sambo P, Finarelli AC, Sambri V, Gagliotti C, Massimiliani E, Mattivi A, Pierro AM, Macini P. Long-term chikungunya infection clinical manifestations after an outbreak in Italy: a prognostic cohort study. J Infect 2012; 65:165-72. [PMID: 22522292 DOI: 10.1016/j.jinf.2012.04.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/12/2012] [Accepted: 04/08/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Following a Chikungunya (CHIKV) outbreak in Italy, a cohort study was conducted to describe the infection long-term clinical course and outcome. METHODS Persons identified through active and passive surveillance as confirmed or possible CHIKV cases during the outbreak were enrolled and interviewed by trained public health nurses, between 4-5 and 12-13 months following the acute stage. Patients reporting persistent clinical symptoms were evaluated by rheumatologists. Serum samples were obtained and anti-CHIKV specific IgG and IgM immune responses detected. Only confirmed cases who completed the follow-up were analysed. RESULTS Out of 250 patients, 66.5% still reported myalgia, asthenia or arthralgia (most frequent sign) after 12 months. Functional ability, measured by the ROAD index, was more impaired for lower extremities (3.75; Inter Quartile Range - IQR 4.4), and the activities of daily living (average 4.2; IQR 5). Variables independently associated with the presence of joint pain at 12-13 months were increasing age, and history of rheumatologic diseases). Elderly, females, and persons with history of rheumatologic diseases had higher anti-CHIKV IgG titres at 12-13 months. CONCLUSIONS This study confirms, in an unselected population, that the long-lasting burden of CHIKV infection is significant.
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Affiliation(s)
- M L Moro
- Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regione Emilia-Romagna, Viale Aldo Moro 21, Bologna, Italy.
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14
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Pierro A, Varani S, Rossini G, Gaibani P, Cavrini F, Finarelli AC, Macini P, Cagarelli R, Mattivi A, Angelini P, Landini MP, Sambri V. Imported cases of dengue virus infection: Emilia-Romagna, Italy, 2010. Clin Microbiol Infect 2011; 17:1349-52. [PMID: 21745260 DOI: 10.1111/j.1469-0691.2011.03544.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. In 2010, 83 serum samples from febrile travellers returning from dengue-endemic countries to a region in north-eastern Italy, densely infested with Aedes albopictus, were analysed for dengue virus (DENV). DENV RNA was detected in 20.5% of patients. By RT-PCR, DENV serotypes 1 and 3 were the most common. DENV must be identified early in symptomatic travellers returning from high-risk countries, to prevent outbreaks where potential vectors exist.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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15
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Angelini P, Tamba M, Finarelli AC, Bellini R, Albieri A, Bonilauri P, Cavrini F, Dottori M, Gaibani P, Martini E, Mattivi A, Pierro AM, Rugna G, Sambri V, Squintani G, Macini P. West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009. Euro Surveill 2010; 15:19547. [PMID: 20430000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.
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Affiliation(s)
- P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy.
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16
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Angelini P, Tamba M, Finarelli AC, Bellini R, Albieri A, Bonilauri P, Cavrini F, Dottori M, Gaibani P, Martini E, Mattivi A, Pierro AM, Rugna G, Sambri V, Squintani G, Macini P. West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009. Euro Surveill 2010. [DOI: 10.2807/ese.15.16.19547-en] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.
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Affiliation(s)
- P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Bellini
- Centro Agricoltura Ambiente “G Nicoli”, Crevalcore, Italy
| | - A Albieri
- Centro Agricoltura Ambiente “G Nicoli”, Crevalcore, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - F Cavrini
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Gaibani
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - E Martini
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A M Pierro
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - G Rugna
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - V Sambri
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - G Squintani
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - P Macini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
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17
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Rizzo C, Vescio F, Declich S, Finarelli AC, Macini P, Mattivi A, Rossini G, Piovesan C, Barzon L, Palù G, Gobbi F, Macchi L, Pavan A, Magurano F, Ciufolini MG, Nicoletti L, Salmaso S, Rezza G. West Nile virus transmission with human cases in Italy, August - September 2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.40.19353-en] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2009, to date 16 human cases of West Nile neuroinvasive disease (WNND) have been reported in Italy, in three regions: Veneto, Emilia-Romagna and Lombardia. The number of cases is higher compared with last year when nine cases were identified (eight cases of WNND and one case of West Nile fever) and the geographical distribution indicates spread from east to west.
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Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - F Vescio
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - P Macini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - G Rossini
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - C Piovesan
- Direction of Prevention, Veneto region, Venice, Italy
| | - L Barzon
- Regional Reference Centre for Infectious Diseases, Microbiology and Virology Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | - G Palù
- Regional Reference Centre for Infectious Diseases, Microbiology and Virology Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | - F Gobbi
- Department of Prevention, ULSS 20, Verona, Italy
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar (Verona), Italy
| | - L Macchi
- Regional Health Authority of Lombardy, Milan, Italy
| | - A Pavan
- Regional Health Authority of Lombardy, Milan, Italy
| | - F Magurano
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - M G Ciufolini
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - L Nicoletti
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Salmaso
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - G Rezza
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
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18
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Rizzo C, Vescio F, Declich S, Finarelli AC, Macini P, Mattivi A, Rossini G, Piovesan C, Barzon L, Palù G, Gobbi F, Macchi L, Pavan A, Magurano F, Ciufolini MG, Nicoletti L, Salmaso S, Rezza G. West Nile virus transmission with human cases in Italy, August - September 2009. Euro Surveill 2009; 14:19353. [PMID: 19822123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
In 2009, to date 16 human cases of West Nile neuroinvasive disease (WNND) have been reported in Italy, in three regions: Veneto, Emilia-Romagna and Lombardia. The number of cases is higher compared with last year when nine cases were identified (eight cases of WNND and one case of West Nile fever) and the geographical distribution indicates spread from east to west.
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Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanita, ISS), Rome, Italy.
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19
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Macini P, Squintani G, Finarelli AC, Angelini P, Martini E, Tamba M, Dottori M, Bellini R, Santi A, Loli Piccolomini L, Po C. Detection of West Nile virus infection in horses, Italy, September 2008. Euro Surveill 2008. [DOI: 10.2807/ese.13.39.18990-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Six confirmed and five suspected cases of West Nile virus infection in horses have been reported in the vicinity of Ferrara in Italy. To verify the diffusion of viral circulation and to prevent the spread of disease, the regional authorities of Emilia-Romagna adopted a special plan of West Nile fever surveillance.
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Affiliation(s)
- P Macini
- Servizio di Sanità Pubblica, Regione Emilia-Romagna, Bologna, Italy
| | - G Squintani
- Servizio Veterinario e igiene degli alimenti, Regione Emilia-Romagna, Bologna, Italy
| | - A C Finarelli
- Servizio di Sanità Pubblica, Regione Emilia-Romagna, Bologna, Italy
| | - P Angelini
- Servizio di Sanità Pubblica, Regione Emilia-Romagna, Bologna, Italy
| | - E Martini
- Servizio Veterinario e igiene degli alimenti, Regione Emilia-Romagna, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico sperimentale della Lombardia e dell’Emilia-Romagna, Italy
| | - M Dottori
- Istituto Zooprofilattico sperimentale della Lombardia e dell’Emilia-Romagna, Italy
| | - R Bellini
- Centro Agricoltura e ambiente “G. Nicoli” , Crevalcore (Bologna), Italy
| | - A Santi
- Servizio Veterinario e igiene degli alimenti, Regione Emilia-Romagna, Bologna, Italy
| | - L Loli Piccolomini
- Servizio Veterinario e igiene degli alimenti, Regione Emilia-Romagna, Bologna, Italy
| | - C Po
- Servizio di Sanità Pubblica, Regione Emilia-Romagna, Bologna, Italy
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20
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Macini P, Squintani G, Finarelli AC, Angelini P, Martini E, Tamba M, Dottori M, Bellini R, Santi A, Loli Piccolomini L, Po C. Detection of West Nile virus infection in horses, Italy, September 2008. Euro Surveill 2008; 13:18990. [PMID: 18822243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- P Macini
- Servizio di Sanita Pubblica, Regione Emilia-Romagna, Bologna, Italy
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21
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Puliti D, Miccinesi G, Collina N, De Lisi V, Federico M, Ferretti S, Finarelli AC, Foca F, Mangone L, Naldoni C, Petrella M, Ponti A, Segnan N, Sigona A, Zarcone M, Zorzi M, Zappa M, Paci E. Effectiveness of service screening: a case-control study to assess breast cancer mortality reduction. Br J Cancer 2008; 99:423-7. [PMID: 18665188 PMCID: PMC2527797 DOI: 10.1038/sj.bjc.6604532] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 06/20/2008] [Accepted: 06/30/2008] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was the evaluation of the impact of service screening programmes on breast cancer mortality in five regions of Italy. We conducted a matched case-control study with four controls for each case. Cases were defined as breast cancer deaths occurred not later than 31 December 2002. Controls were sampled from the local municipality list and matched by date of birth. Screening histories were assessed by the local, computerised, screening database and subjects were classified as either invited or not-yet-invited and as either screened or unscreened. There were a total of 1750 breast cancer deaths within the 50 to 74-year-old breast cancer cases and a total of 7000 controls. The logistic conditional estimate of the cumulative odds ratios comparing invited with not-yet-invited women was 0.75 (95% CI: 0.62-0.92). Restricting the analyses to invited women, the odds ratio of screened to never-respondent women corrected for self-selection bias was 0.55 (95% CI: 0.36-0.85). The introduction of breast cancer screening programmes in Italy is associated with a reduction in breast cancer mortality attributable to the additional impact of service screening over and above the background access to mammography.
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Affiliation(s)
- D Puliti
- Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, via San Salvi 12, Florence 50135, Italy
| | - G Miccinesi
- Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, via San Salvi 12, Florence 50135, Italy
| | - N Collina
- AUSL Bologna, Via del Seminario 1, S.Lazzaro di Savena, Bologna 40068, Italy
| | - V De Lisi
- Parma Cancer Registry, via Abbeveratoia 4, Parma 43100, Italy
| | - M Federico
- Modena Cancer Registry, via del Pozzo 71, Modena 41100, Italy
| | - S Ferretti
- Ferrara Cancer Registry, via Fossato di Mortara 64b, Ferrara 44100, Italy
| | - A C Finarelli
- Emilia-Romagna Region Health Department, viale Aldo Moro 21, Bologna 40127, Italy
| | - F Foca
- Romagna Cancer Registry, via Carlo Forlanini 34, Forlì 47100, Italy
| | - L Mangone
- Reggio Emilia Cancer Registry, via Amendola 2, Reggio Emilia 42100, Italy
| | - C Naldoni
- Emilia-Romagna Region Health Department, viale Aldo Moro 21, Bologna 40127, Italy
| | - M Petrella
- Epidemiology Unit ASL2, via XIV Settembre 79, Perugia 06100, Italy
| | - A Ponti
- Epidemiology Unit, CPO Piemonte, via S. Francesco da Paola 31, Torino 10123, Italy
| | - N Segnan
- Epidemiology Unit, CPO Piemonte, via S. Francesco da Paola 31, Torino 10123, Italy
| | - A Sigona
- Cancer Registry, A.O. ‘Civile M.P. Arezzo’, via Dante 109, Ragusa 97100, Italy
| | - M Zarcone
- Palermo Breast Cancer Registry, Piazzale N. Leotta 2, Palermo 90127, Italy
| | - M Zorzi
- Venetian Tumour Registry, Istituto Oncologico Veneto, via Gattamelata 64, Padua 35128, Italy
| | - M Zappa
- Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, via San Salvi 12, Florence 50135, Italy
| | - E Paci
- Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, via San Salvi 12, Florence 50135, Italy
| | - the IMPACT Working Group
- Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, via San Salvi 12, Florence 50135, Italy
- AUSL Bologna, Via del Seminario 1, S.Lazzaro di Savena, Bologna 40068, Italy
- Parma Cancer Registry, via Abbeveratoia 4, Parma 43100, Italy
- Modena Cancer Registry, via del Pozzo 71, Modena 41100, Italy
- Ferrara Cancer Registry, via Fossato di Mortara 64b, Ferrara 44100, Italy
- Emilia-Romagna Region Health Department, viale Aldo Moro 21, Bologna 40127, Italy
- Romagna Cancer Registry, via Carlo Forlanini 34, Forlì 47100, Italy
- Reggio Emilia Cancer Registry, via Amendola 2, Reggio Emilia 42100, Italy
- Epidemiology Unit ASL2, via XIV Settembre 79, Perugia 06100, Italy
- Epidemiology Unit, CPO Piemonte, via S. Francesco da Paola 31, Torino 10123, Italy
- Cancer Registry, A.O. ‘Civile M.P. Arezzo’, via Dante 109, Ragusa 97100, Italy
- Palermo Breast Cancer Registry, Piazzale N. Leotta 2, Palermo 90127, Italy
- Venetian Tumour Registry, Istituto Oncologico Veneto, via Gattamelata 64, Padua 35128, Italy
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22
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Angelini P, Macini P, Finarelli AC, Pol C, Venturelli C, Bellini R, Dottori M. Chikungunya epidemic outbreak in Emilia-Romagna (Italy) during summer 2007. Parassitologia 2008; 50:97-98. [PMID: 18693568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
During summer 2007, an outbreak due to the local transmission of CHIKV by Aedes albopictus mosquitoes occurred moreover in Italy, Emilia-Romagna Region, in the areas of Ravenna, Forli-Cesena, Rimini and Bologna cities. The original outbreak developed in Castiglione di Cervia and Castiglione di Ravenna, two small villages divided by a river. The first case was recorded on August 9th the epidemic outbreak then spread out, thus giving rise to smaller secondary outbreaks and further sporadic cases in the same area, for a total of 337 suspected cases, 217 of which confirmed by blood analysis. CHIKV has been isolated and characterized on both blood and mosquito samples.
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Affiliation(s)
- P Angelini
- Public Health Service of Emilia-Romagna Region, Bologna.
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23
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Seyler T, Rizzo C, Finarelli AC, Po C, Alessio P, Sambri V, Ciofi Degli Atti ML, Salmaso S. Autochthonous chikungunya virus transmission may have occurred in Bologna, Italy, during the summer 2007 outbreak. Euro Surveill 2008; 13. [DOI: 10.2807/ese.13.03.08015-en] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In Italy, a national surveillance system for chikungunya fever coordinated by the National Public Health Institute has been in place since August 2006. In summer 2007, an outbreak of chikungunya fever affected the Italian provinces of Ravenna, Cesena-Forli and Rimini [1-3]. As of 16 December 2007, health authorities identified 214 laboratory-confirmed cases with date of onset from 15 July to 28 September 2007. Most cases (161) occurred in the two neighbouring villages of Castiglione di Cervia and Castiglione di Ravenna, but limited local transmission also took place in the cities of Ravenna, Cesena, Cervia, and Rimini. In September 2007, two confirmed cases (two women aged 68 and 70) were reported among residents of the city of Bologna (373,026 inhabitants). Both had a history of travel in the affected areas (municipality of Cervia). No unusual increase in the density of Aedes albopictus mosquitoes in the Bologna area was noted at that time (September).
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Affiliation(s)
- T Seyler
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Communicable Disease Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità (National Public Health Institute, ISS), Rome, Italy
| | - C Rizzo
- Communicable Disease Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità (National Public Health Institute, ISS), Rome, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - C Po
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - P Alessio
- Azienda Unità Sanitaria Locale (Local Health Unit, AUSL) of Bologna, Department of Public Health, Bologna, Italy
| | - V Sambri
- University of Bologna, Azienda Ospedaliera Universitaria di Bologna, Microbiologia, Bologna, Italy
| | - M L Ciofi Degli Atti
- Communicable Disease Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità (National Public Health Institute, ISS), Rome, Italy
| | - S Salmaso
- National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità (National Public Health Institute, ISS), Rome, Italy
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24
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Rezza G, Nicoletti L, Angelini R, Romi R, Finarelli AC, Panning M, Cordioli P, Fortuna C, Boros S, Magurano F, Silvi G, Angelini P, Dottori M, Ciufolini MG, Majori GC, Cassone A. Infection with chikungunya virus in Italy: an outbreak in a temperate region. Lancet 2007; 370:1840-6. [PMID: 18061059 DOI: 10.1016/s0140-6736(07)61779-6] [Citation(s) in RCA: 988] [Impact Index Per Article: 58.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Chikungunya virus (CHIKV), which is transmitted by Aedes spp mosquitoes, has recently caused several outbreaks on islands in the Indian Ocean and on the Indian subcontinent. We report on an outbreak in Italy. METHODS After reports of a large number of cases of febrile illness of unknown origin in two contiguous villages in northeastern Italy, an outbreak investigation was done to identify the primary source of infection and modes of transmission. An active surveillance system was also implemented. The clinical case definition was presentation with fever and joint pain. Blood samples were gathered and analysed by PCR and serological assays to identify the causal agent. Locally captured mosquitoes were also tested by PCR. Phylogenetic analysis of the CHIKV E1 region was done. FINDINGS Analysis of samples from human beings and from mosquitoes showed that the outbreak was caused by CHIKV. We identified 205 cases of infection with CHIKV between July 4 and Sept 27, 2007. The presumed index case was a man from India who developed symptoms while visiting relatives in one of the villages. Phylogenetic analysis showed a high similarity between the strains found in Italy and those identified during an earlier outbreak on islands in the Indian Ocean. The disease was fairly mild in nearly all cases, with only one reported death. INTERPRETATION This outbreak of CHIKV disease in a non-tropical area was to some extent unexpected and emphasises the need for preparedness and response to emerging infectious threats in the era of globalisation.
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Affiliation(s)
- G Rezza
- Department of Infectious, Parasitic, and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
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Angelini R, Finarelli AC, Angelini P, Po C, Petropulacos K, Silvi G, Macini P, Fortuna C, Venturi G, Magurano F, Fiorentini C, Marchi A, Benedetti E, Bucci P, Boros S, Romi R, Majori G, Ciufolini MG, Nicoletti L, Rezza G, Cassone A. Chikungunya in north-eastern Italy: a summing up of the outbreak. ACTA ACUST UNITED AC 2007; 12:E071122.2. [PMID: 18053561 DOI: 10.2807/esw.12.47.03313-en] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- R Angelini
- Dipartimento Sanita Pubblica, Azienda Unita Sanitaria Locale (Department of Public Health, Local Health Unit), Ravenna, Italy
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Angelini R, Finarelli AC, Angelini P, Po C, Petropulacos K, Macini P, Fiorentini C, Fortuna C, Venturi G, Romi R, Majori G, Nicoletti L, Rezza G, Cassone A. An outbreak of chikungunya fever in the province of Ravenna, Italy. ACTA ACUST UNITED AC 2007; 12:E070906.1. [PMID: 17900424 DOI: 10.2807/esw.12.36.03260-en] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- R Angelini
- Department of Public Health, Local Health Unit, Ravenna, Italy
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Costa S, Sideri M, Syrjänen K, Terzano P, De Nuzzo M, De Simone P, Cristiani P, Finarelli AC, Bovicelli A, Zamparelli A, Bovicelli L. Combined Pap smear, cervicography and HPV DNA testing in the detection of cervical intraepithelial neoplasia and cancer. Acta Cytol 2000; 44:310-8. [PMID: 10833984 DOI: 10.1159/000328471] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The sensitivity of the Pap smear (PAP) continues to be the subject of debate. During the past several years, cervicography (CER) and HPV DNA testing have been suggested as optional tools in the screening of cervical cancer precursors. STUDY DESIGN The performance characteristics of PAP, CER and HPV DNA testing (hybrid capture test [HCT]) in all potential combinations were evaluated in a series of 1,030 women (aged 16-70, median, 33), subjected to colposcopy (COLPO) as the reference tool. RESULTS Of the 992 evaluable cases, 402/992 (41%) had positive COLPO (i.e., an abnormal transformation zone). Of them, 298 women underwent directed punch biopsy, while of the COLPO negative patients, 18/93 positive by at least one of the three tests had endocervical curettage. Of the 402 COLPO positive women, 146 (36%) remained negative on all tests, whereas 256 (64%) had at least one positive test. There were 84 cervical intraepithelial neoplasia (CIN) 2 and 3 lesions and 6 invasive carcinomas. Of the former, 10 were detected by PAP alone, 4 by CER alone and 3 by HCT alone. Three of the 6 carcinomas were HCT negative. The predictive value (PPV) of a positive test was 45% for PAP, 51% for CER and 48% for HCT. The combinations of PAP with CER (for PAP negative cases) and PAP with HCT were more sensitive for CIN 2 and 3 (95% and 94%, respectively) as compared with PAP alone but were associated with a significant decrease in specificity (44% and 46% vs. 57%, respectively). However, both combinations retained a PPV (43%) similar to that of PAP alone (45%). CONCLUSION The potential combinations of PAP with CER and with HCT were more sensitive in detecting CIN 2 and 3 as compared with PAP alone and retained a PPV similar to that of PAP.
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Affiliation(s)
- S Costa
- Department of Obstetrics and Gynecology, University of Bologna, Italy
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