Primary series COVID-19 vaccine effectiveness among healthcare workers in Albania, February–December 2021

Background: Healthcare workers have experienced high rates of morbidity and mortality from coronavirus disease 2019 (COVID-19). Methods: A prospective cohort study was conducted in three Albanian hospitals between 19 February and 14 December 2021. All participants underwent polymerase chain reaction (PCR) and serological testing at enrolment, regular serology throughout, and PCR testing when symptomatic. Vaccine effectiveness (VE) against COVID-19 and against all severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections (symptomatic or asymptomatic) was estimated. VE was estimated using a Cox regression model, with vaccination status as a time-varying variable. Findings: In total, 1504 HCWs were enrolled in this study; 70% had evidence of prior SARS-CoV-2 infection. VE was 65.1% [95% confidence interval (CI) 37.7–80.5] against COVID-19, 58.2% (95% CI 15.7–79.3) among participants without prior SARS-CoV-2 infection, and 73.6% (95% CI 24.3–90.8) among participants with prior SARS-CoV-2 infection. For BNT162b2 alone, VE was 69.5% (95% CI 44.5–83.2). During the period when the Delta variant was predominant, VE was 67.1% (95% CI 38.3–82.5). VE against SARS-CoV-2 infection for the full study period was 36.9% (95% CI 15.8–52.7). Interpretation: This study found moderate primary series VE against COVID-19 among healthcare workers in Albania. These results support the continued promotion of COVID-19 vaccination in Albania, and highlight the benefits of vaccination in populations with high levels of prior infection

Retrospective Analysis of Six Years of Acute Flaccid Paralysis Surveillance and Polio Vaccine Coverage Reported by Italy, Serbia, Bosnia and Herzegovina, Montenegro, Bulgaria, Kosovo, Albania, North Macedonia, Malta, and Greece

Here we analyzed six years of acute flaccid paralysis (AFP) surveillance, from 2015 to 2020, of 10 countries linked to the WHO Regional Reference Laboratory, at the Istituto Superiore di Sanità, Italy. The analysis also comprises the polio vaccine coverage available (2015–2019) and enterovirus (EV) identification and typing data. Centralized Information System for Infectious Diseases and Laboratory Data Management System databases were used to obtain data on AFP indicators and laboratory performance and countries’ vaccine coverage from 2015 to 2019. EV isolation, identification, and typing were performed by each country according to WHO protocols. Overall, a general AFP underreporting was observed. Non-Polio Enterovirus (NPEV) typing showed a high heterogeneity: over the years, several genotypes of coxsackievirus and echovirus have been identified. The polio vaccine coverage, for the data available, differs among countries. This evaluation allows for the collection, for the first time, of data from the countries of the Balkan area regarding AFP surveillance and polio vaccine coverage. The need, for some countries, to enhance the surveillance systems and to promote the polio vaccine uptake, in order to maintain the polio-free status, is evident

Genital Human Papillomavirus infection and genotype prevalence among Albanian women. A cross sectional study.

International audience“High Risk” HPV types have different geographical distribution and evidence suggests their respective prevalence may vary in different areas and regions. Accurate description of High Risk HPV circulation is a key feature for the rational design of prevention and screening campaigns. A cross-sectional, virological study was conducted on adult Albanian women living either in the Tirana area or in the Duress prefecture. Clinical and gynaecological evaluations were done according to current standard criteria. HPV detection and typing were carried out by a combined MY09/MY11 and GP5+/GP6+ PCR followed by direct sequencing of generated amplicons. Virological data could be obtained from 402 out of 452 patients enrolled between January 2004 and December 2007. Sixtyone patients (15.1% of the cohort) were found to be infected with a genital HPV. As expected viral prevalence was higher among women younger than 30years of age (25.2%) in comparison to those aged 30 or older (13.6%). HPV 16 was found to be the most frequent type (41% of cases), followed by HPV 53, (roughly 7.2%) HPV 31 (5.8%) and HPV 18 (4.3%). HPV 81 and HPV 84, were the most prevalent low risk types detected with prevalences of 11.6 and 5.8 %. No difference was noted in any type specific prevalence between young and mature women. The circulation of HPV types is far more complex than assumed generally. The detailed knowledge of HPV type circulating patterns in specific local geographical areas is essential for appropriate implementation of screening, prevention and surveillance campaigns

Crimean-Congo hemorrhagic fever with hepatic impairment and vaginal hemorrhage: a case report

Abstract Background Crimean-Congo hemorrhagic fever is a tick-borne disease described in more than 30 countries in Europe, Asia, and Africa. Albania is located in the southwestern part of the Balkan Peninsula. In 1986, the first case of Crimean-Congo hemorrhagic fever was registered, and cases of patients with hemorrhagic fever are rising, and most of them present in a serious condition, when the mortality rate is very high. In districts like Mirdite, Lezhe, Gjirokaster, Skrapar, Erseke, and Kukes, there is delineated human-to-human transmission. Case presentation We report the case of a 32 year-old Albanian woman from a rural area of Albania. She was hospitalized at the Infectious Diseases Service, for a severe influenza-like illness of 4 days duration. Our patient had been bitten by a tick while working in her garden. She presented with nausea, vomiting, headache and muscle pain. A physical examination found a high fever of 40 °C, an enlarged liver, petechia, and vaginal bleeding; flapping tremor and fetor hepaticus were found as a sign for hepatic encephalopathy; and confusion and disorientation were observed in her neurological examination. Her platelet and white blood cell counts were very low, while her aspartate aminotransferase and alanine aminotransferase levels were very high. She was transferred to the intensive care unit because of her worsening condition. Serological and C-reactive protein test results for Crimean-Congo hemorrhagic fever were positive. She was treated with oral ribavirin and discharged with normal parameters. Conclusions People in high-risk professions in the endemic areas should be informed and trained on the risk of Crimean-Congo hemorrhagic fever as a matter of urgency. Vaginal bleeding is not always a gynecological problem. In Albania, these places are the mountainous areas, so people who have traveled to these areas and who have symptoms after a tick bite are advised to contact their doctors

Detection of Leishmania infantum and a Novel Phlebovirus (Balkan Virus) from Sand Flies in Albania

WOS: 000390243200012PubMed ID: 27788062Objective: To organize entomological campaigns to trap sand flies in selected regions of Albania and to test them for the presence of existing or new phleboviruses and for leishmania DNA. Methods: Sand flies were collected in 14 locations from May to October 2014 using three different types of traps. Pools with a maximum of 30 individuals were prepared according to gender, trapping site, and trapping date; they were tested for the presence of (1) phlebovirus RNA with three different PCR systems (2) and Leishmania DNA using two different real-time PCR assays. Results: A total of 972 sand flies (568 females, 404 males) were aliquoted to 55 pools. Three pools (in two different regions) were positive for Leishmania infantum. Two pools (Kruje region) were positive for phlebovirus RNA and a 575-nucleotide (nt) colinearized sequence of a novel virus most closely related to but clearly distinct from Tehran virus (16% and 3% divergence at nt and amino acid levels). Next generation sequencing analysis indicated that this virus might be transmitted by either Phlebotomus neglectus, Phlebotomus tobbi, or both vectors. Conclusions: Visceral leishmaniasis has been clinically recognized in Albania for at least 80 years; however, this is the first time that L. infantum, detected by molecular means, has been reported in sand flies in Albania. At the outset of this study, only Adria virus (Salehabad species) was recognized in Albania. A novel virus, Balkan virus, was identified and genetic analysis revealed that it belongs to the Sandfly fever Naples virus group containing human pathogens.EUEuropean Union (EU) [FP7-261504 EDENext]; European UnionEuropean Union (EU) [653316]; Fondation Infectiopole Sud, Marseille, FranceThis work was supported through funds received from (1) the EU grant FP7-261504 EDENext and this article is catalogued by the EDENext Steering Committee as EDENext449 (www.edenext.eu), (2) the European Virus Archive goes Global (EVAg) project in the European Union's Horizon 2020 research and innovation program under grant agreement No 653316 (http://global.european-virus-archive.com). N. A. was supported by a PhD funding from Fondation Infectiopole Sud, Marseille, France. The work of R.N. Charrel was carried out under the framework of the EurNegVec (TD1303) COST Action

Detection of a Novel Phlebovirus (Drin Virus) from Sand Flies in Albania

Phlebotomine sand flies are generalist vectors with significant implications for public health. They are able to transmit phleboviruses that cause sand fly fever, headaches, or meningitis in humans. Albania is a country in Southeast Europe with a typical Mediterranean climate which provides convenient conditions for the presence of sand flies. Hence, the circulation of phleboviruses, such as the Toscana and Balkan viruses, has been recently described in the country. We followed a virus discovery approach on sand fly samples collected in 2015 and 2016 in seven regions of Albania, with the aim to investigate and characterize potentially circulating phleboviruses in phlebotomine sand flies. A presumed novel phlebovirus was detected in a pool consisting of 24 Phlebotomus neglectus males. The virus was provisionally named the Drin virus after a river near the locality of Kukës, where the infected sand flies were trapped. Genetic and phylogenetic analysis revealed that the Drin virus is closely related to the Corfou (CFUV) virus, isolated in the 1980s from Phlebotomus major sand flies on the eponymous island of Greece, and may also be involved in human infections because of its similarity to the sand fly fever Sicilian virus. The latter justifies further studies to specifically address this concern. Together with recent findings, this study confirms that Albania and the Balkan peninsula are hot spots for phleboviruses

Nucleotide variation in Sabin type 3 poliovirus from an Albanian infant with agammaglobulinemia and vaccine associated poliomyelitis

Vaccine-associated paralytic poliomyelitis (VAPP) and immunodeficient long-term polio excretors constitute a significant public health burden and are a major concern for the WHO global polio eradication endgame