Status of immunity against poliomyelitis: a study among european and extraeuropean young immigrants

From January 2001 to December 2003 blood specimens obtained from 323 European and extra-European young immigrants were collected for the determination of anti-polio antibody levels. They were sent to the Section of Hygiene, Department of Public Health, by the Local Health Authorities. A neutralization assay was performed to detect the anti-polio antibodies against serotypes 1, 2 and 3, using rhesus monkey kidney cells. The results showed 98.1% prevalence of anti-polio 1 antibodies (titre ?1:2), 99.1% of anti-polio 2, and 98.8% prevalence of anti-polio 3 antibodies. The seronegativity against only one or two serotypes (antibody titre <1:2) was found in 9 subjects (2.8%) while no subject was found totally seronegative against all 3 serotypes. According to the total amount of the analyzed samples, the estimated Geometric Mean Titre (GMT) resulted from moderate to low (GMT=29 of serotype 3; GMT=48.4 of serotype 2; GMT=56.5 of serotype 1) and it appeared to be similar to the results obtained in the previous years for all 3 serotypes; the GMT of serotype 3 was still the lowest. No difference was observed in the specimens with respect to the country of origin of the examined subjects and the data collected showed a good level of immunity

Acute respiratory infections in non-hospitalized children during flu epidemic season

BACKGROUND Among acute respiratory infections (ARI), influenza is the most important, but the circulation of other pathogens must not be underestimated especially in children. Given the common symptomatology, to obtain a rapid and precise etiological diagnosis, the molecular biology assays, allow to detect a wide variety of pathogens in a very short time with high sensitivity and specificity. The aim of the study was to evaluate the circulation of viral or bacterial pathogens, from October 2017 to January 2018. METHODS A pharyngeal swab was performed in non-hospitalized children with ARI-symptomatology at one primary care visit in Parma. Real-Time RT-PCR and Multiplex Real-Time PCR were used to identify influenza A and B viruses, Syncytial Respiratory Virus (RSV) A and B, human Metapneumovirus, human Rhinovirus/Enterovirus, Adenovirus, human Bocavirus, human Coronavirus, human Parainfluenza virus 1-4, Chlamydophila pneumoniae; Mycoplasma pneumoniae; Bordetella pertussis and Legionella pneumophila. The results were stratified by age groups and by surveillance weeks. RESULTS Of the 123 swabs analyzed, 110 (89.4%) were positive for one or more viruses: 54 (49.1%) for influenza B virus, 17 (15.5% ) for subtype A (H1N1) pdm09, 1 (0.9%) for subtype A (H3N2) and 38 (34,5%) for other respiratory viruses like RSV that was the most frequently found (26.40%), followed by Parainfluenza viruses (13.20%). 18.4% of children showed co-infection. No bacteria were identified. Children younger than 5 years showed the highest proportion of viral positive test and among them the highest prevalence of non-influenza respiratory viruses (81.6%) was found. These viruses were prevalent at the beginning of the flu season (44th-51th week) and continued to circulate also during the flu epidemic period. CONCLUSIONS The molecular biology assays showed the intense co-circulation, in the pediatric population, of several respiratory viruses together with flu viruses. A timely diagnosis would allow, in addition to a better description of the ARI's epidemiology, also to address the therapy, avoiding ineffective antibiotics being used to treat these viral forms

Poliovirus and non-polio-enterovirus environmental surveillance in Parma within the "Global Polio Eradication Program" (GPEI)

Introduzione: La sorveglianza ambientale per poliovirus svolge un ruolo essenziale nell’ambito del GPEI sia per il rilevamento della circolazione WTP e VDPV in aree endemiche sia per il monitoraggio della loro assenza nei paesi “polio-free”. Metodi: Dal 2005 al 2018, 642 campioni di acque reflue sono stati raccolti dai due impianti di trattamento di Parma, ed analizzati secondo le Linee Guida dell’OMS. Tutti i “sospetti poliovirus” isolati nel periodo sono stati caratterizzati presso il laboratorio di riferimento dell’ISS; invece la tipizzazione dei NPEV si riferisce solo al 2005-2016. Risultati: Il 68% dei campioni è risultato positivo senza differenze significative tra i due impianti. Sono stati rilevati 6 poliovirus (1,4%), tutti caratterizzati come Sabin-like: 4 polio 3 (66,7%) e 2 polio 1 (33,3%). L’85% dei NPEV sono risultati Coxsackievirus B di cui B4 il sierotipo più frequente (31%); tra gli Echovirus (15%) prevalgono Echo7 ed Echo11 (entrambi 23%). Conclusione: Poiché l’OPV non è utilizzato in Italia dal 2002, l’isolamento di poliovirus Sabin-like indica la possibilità di reintroduzione del poliovirus, considerando anche l’importante esposizione ai flussi migratori. Infine il monitoraggio della circolazione ambientale di NPEV potrebbe supplire alla mancanza di un sistema di sorveglianza delle infezioni da essi sostenute.Background: Environmental surveillance of poliovirus plays an essential role in GPEI both for the detection of WTP and VDPV circulation in endemic areas and for monitoring their absence in polio free countries. Methods: Since 2005 to 2018, in Parma, 642 wastewater samples were collected from the two wastewater treatment plants and analyzed according to the WHO Guidelines. All isolates supposed being poliovirus were sent to ISS reference laboratory for molecular characterization while NPEV only refer to samples up to 2016. Results: Positivity was obtained in 68% of samples without significant difference between the two treatment plants. Six polioviruses (1.4%) were detected, all characterized as Sabin-like: 4 of them (66.7%) were type 3 and 2 (33.3%) type 1. Coxsackieviruses B mainly recurred among NPEV (85%) while residual 15% was Echoviruses. B4 was the most frequent Coxsackie serotype isolated (31%) while, among Echovirus, Echo 7 and Echo 11 prevail (both 23%). Conclusion: As OPV isn’t used in Italy since 2002, recovery of Sabin-like polioviruses indicates the possibility of poliovirus reintroduction, considering also the important exposure to migratory flows. Finally, monitoring the environmental circulation of NPEV, could compensate for the lack of a surveillance system of the infections they cause

EFFICACIA SUL CAMPO DELLA VACCINAZIONE (VE) ANTINFLUENZALE DURANTE LA STAGIONE EPIDEMICA 2014/2015 IN EMILIA ROMAGNA

Introduzione.La VE dell’influenza dipende principalmente dalla prevalente circolazione di virus omologhi ai ceppi vaccinali e dall’età. L’epidemia del 2014/2015 è risultata tra le stagioni più intense degli ultimi anni. Obiettivo dello studio è stato stimare la VE nei confronti sia dell’influenza in generale sia verso ciascuno dei tre ceppi circolanti in Emilia Romagna (ER) attraverso l’attività del Centro di sorveglianza virologica dell’influenza, presso l’Unità di Sanità Pubblica dell’Università degli Studi di Parma. Metodi. Tra i tamponi faringei/nasali inviati da medici di medicina generale, pediatri di libera scelta e reparti ospedalieri eseguiti in soggetti con ARI (Acute Respiratory Illness) o ILI (Acute Influenza-like Illness), sono stati selezionati 1210 campioni in cui erano disponibili i dati di vaccinazione. La VE è stata stimata come 1-OR (IC95%). Risultati. Il 44,9% è risultato positivo per virus influenzale, il 46,2% per A/H3N2, il 40,7% per A/H1N1pdm2009 e il 13,1% per il tipo B. Tra i bambini (0-14 anni), che costituivano il 54,5% del campione, è stata osservata la percentuale più elevata di positività (49,6%). I virus A hanno co-circolato a partire dalla 52a settimana del 2014 mentre il tipo B è comparso successivamente. Il 19,2% aveva ricevuto il vaccino inattivato trivalente. La VE generale è risultata del 23% (IC95% -2,8-43) in accordo alla diffusa circolazione del sottotipo A/H3N2 mutato rispetto al ceppo vaccinale A/Texas/50/2012. La VE verso A/H1N1 è risultata del 64% (IC95% 41–78) e del 76% (IC95% 34–92) verso il tipo B. Tra i bambini, la VE è risultata maggiore (77% e 86% rispettivamente). Conclusioni.Bassi tassi di copertura vaccinale e virus circolanti variati, espongono la popolazione più fragile alle complicanze gravi dell’influenza. Il vaccino, invece, quando allineato ai ceppi circolanti dimostra grande efficacia. L’integrazione tra sorveglianza virologica ed epidemiologica risulta indispensabile strumento di prevenzione