hepatitis a outbreak in italy 2013 a matched case control study

Between January and May 2013 a hepatitis A (HA) incidence increase was detected in Italy, signalling an outbreak. A retrospective matched case-control study was conducted to identify the source of infection. A case was defined as a resident of any of five regions (Apulia, autonomous province of Bolzano, Emilia-Romagna, Friuli-Venezia-Giulia and autonomous province of Trento), who had symptom onset between 1 January and 31 May2013 as well a positive test for anti-HA virus IgM. We compared each case with four age-and neighbourhood-matched controls. Overall 119 cases and 419 controls were enrolled. Berries were found as the main risk factor for HA (adjusted odds ratio (ORadj): 4.2; 95% confidence interval (CI): 2.5-7.0) followed by raw seafood (ORadj: 3.8; 95% CI: 2.2-6.8; PAF: 26%). Sequencing the virion protein (VP)1-2a region from 24 cases yielded a common sequence (GenBank number: KF182323). The same sequence was amplified from frozen mixed berries consumed by some cases as well as from isolates from Dutch and German HA patients, who had visited some of the affected Italian provinces during the outbreak. These findings suggested berries as the main source of the Italian outbreak. Control measures included voluntary recall of the confirmed frozen mixed berry batches and a trace-back investigation was initiated. The Ministry of Health website recommends frozen berries to be cooked for two minutes before eating.

Respiration, hydrogen peroxide levels and antioxidant enzyme activities during cold storage of zucchini squash fruit

Steady-state levels of hydrogen peroxide and activities of catalase and peroxidase were measured in the peel and pulp of zucchini squash (Cucurbita pepo L., cv., Giambo) during storage at 10 \ub0C or 0 \ub0C for two weeks. No visible damage occurred during this storage time; epidermal brown pits become visible later, at day 20 in fruit stored at 10 \ub0C and at day 15 in those stored at 0 \ub0C. In order to analyze the early effects of the chilling-induced oxidative stress during zucchini storage, rates of succinate oxidation, alternative oxidase activity, membrane fluidity and phospholipid composition were also measured in mitochondria isolated from the zucchini pulp. A decrease in hydrogen peroxide levels, an increase in the activity of detoxifying enzymes, a recovery of chilling-induced mitochondrial membrane fluidity and an increase in alternative oxidase (AOX) activity were detected in the early stages of zucchini storage at 10 \ub0C. The peroxidase and the AOX activities of the pulp of zucchini stored at 0 \ub0C were also found to increase but to a lesser extent and later during storage, suggesting that these fruit can also activate these ROS regulatory systems, possibly preventing the occurrence of early visible damage in the peel but not the occurrence of cold stress

L’andamento epidemiologico della tubercolosi nella regione Emilia-Romagna: dati dal report regionale 1999-2020

Introduzione La tubercolosi (Tb) rappresenta una delle dieci principali cause di morte nel mondo. L’Italia è un Paese a bassa endemia con incidenza inferiore a 10 casi/100.000 abitanti. Questo lavoro espone i dati più significativi dell’aggiornamento epidemiologico sulla sorveglianza della Tb nella regione Emilia-Romagna (RER). Materiali e metodi L’aggiornamento epidemiologico 2020 analizza i casi di Tb notificati secondo i DM 15/12/1990 e 29/07/1998, rilevati dal sistema di sorveglianza previsto dalla Circolare Regionale n. 9 del 26/04/2005 riguardanti residenti e domiciliati in RER nel periodo 1999-2020 con focus negli anni 2016-2020. Risultati Analogamente ai dati nazionali, la RER ha registrato una diminuzione del tasso di incidenza (11,6 casi/100.000 abitanti nel 2012 vs 7,3 nel 2020) ad eccezione del 2017 in cui si è verificato un lieve aumento (9,3 casi/100.000 abitanti). Il calo ha riguardato anche l’incidenza delle forme polmonari (4,8 casi/100.000 abitanti nel 2020). L’età media dei casi è calata (53,9 anni nel 1999 vs 42,2 nel 2020) con rapporto maschi/ femmine di 1,5:1 nel periodo 2016-2020. La prevalenza è maggiore nei nati all’estero (27,9% nel 1999 vs 69,6% nel 2020). La mediana del ritardo diagnostico è superiore nei nati in Italia rispetto ai nati all’estero (45 gg vs 39 gg); in questi ultimi il ritardo diagnostico è maggiore in chi viveva in Italia da più di tre anni rispetto a chi vi risiedeva da meno tempo (40 gg vs 36 gg). Nel 2014 si è osservata una lieve flessione della percentuale di esiti favorevoli di fine trattamento; tuttavia, per la coorte dei casi 2019 è emerso il risultato migliore dal 2016 (68,5%) nonostante l’anno di sorveglianza coincidesse con il primo anno di pandemia. Nel periodo 2016-2020, nell’8% dei nuovi casi per i quali era disponibile il saggio di sensibilità ai farmaci anti-Tb di prima linea, è stata rilevata almeno una resistenza farmacologica e nell’1,7% sono stati individuati ceppi MDR. Conclusioni Il calo dell’incidenza di Tb e delle forme polmonari rappresenta un successo delle politiche di prevenzione e controllo della rete territoriale e dai Dipartimenti di Sanità Pubblica della RER. Rimane necessario prestare attenzione alla popolazione italiana e straniera più giovane per ridurre ritardo diagnostico e potenziale diffusione ai contatti, migliorare follow-up ed esito di malattia. La creazione di percorsi formativi destinati agli operatori sanitari, prevista dal Piano Regionale della Prevenzione 2021-2025, si propone di potenziare comunicazione e counseling rivolti alla popolazione straniera e favorire accessibilità ai servizi sanitari e adesione terapeutica

Hepatitis A outbreak in Italy, 2013: a matched case–control study

Between January and May 2013 a hepatitis A (HA) incidence increase was detected in Italy, signalling an outbreak. A retrospective matched case–control study was conducted to identify the source of infection. A case was defined as a resident of any of five regions (Apulia, autonomous province of Bolzano, Emilia-Romagna, Friuli–Venezia-Giulia and autonomous province of Trento), who had symptom onset between 1 January and 31 May2013 as well a positive test for anti-HA virus IgM. We compared each case with four age-and neighbourhood-matched controls. Overall 119 cases and 419 controls were enrolled. Berries were found as the main risk factor for HA (adjusted odds ratio (ORadj): 4.2; 95% confidence interval (CI): 2.5–7.0) followed by raw seafood (ORadj: 3.8; 95% CI: 2.2–6.8; PAF: 26%). Sequencing the virion protein (VP)1-2a region from 24 cases yielded a common sequence (GenBank number: KF182323). The same sequence was amplified from frozen mixed berries consumed by some cases as well as from isolates from Dutch and German HA patients, who had visited some of the affected Italian provinces during the outbreak. These findings suggested berries as the main source of the Italian outbreak. Control measures included voluntary recall of the confirmed frozen mixed berry batches and a trace-back investigation was initiated. The Ministry of Health website recommends frozen berries to be cooked for two minutes before eating

Il profilo di salute per il nuovo Piano della Prevenzione della Regione Emilia-Romagna, 2014-2018

Profilo di salute della Regione Emilia-Romagna per il PRP 2014-201