An update on the epidemiology of hepatitis A in Italy 2015-2019. Data from the surveillance of acute viral hepatitis SEIEVA

BACKGROUND: hepatitis A is an infective disease whose global diffusion appears to be variable and strictly related to socioeconomic status, hygiene conditions, and access to potable water. During last twenty years, Italy registered a constant decrease of new cases with recurrent epidemic outbreaks. OBJECTIVES: to outline the hepatitis A epidemiological situation in Italy in the five-year period 2015-2019. DESIGN: descriptive study based on cases reported to the National Surveillance System for Acute Viral Hepatitis (SEIEVA). SETTING AND PARTICIPANTS: hepatitis A cases reported to SEIEVA from 2015 to 2019. MAIN OUTCOME MEASURES: hepatitis A incidence, percentages of cases exposed to known risk factors, distribution of cases by vaccination status. RESULTS: during the whole observational period, SEIEVA registered 4,929 type A hepatitis cases. The epidemic curve initially showed a trend with a low incidence level interrupted in August 2016 with the onset of a large epidemic, in the period between August 2016 and December 2017, involving 3,428 cases mostly adult men exposed to homosexual intercourses (MSM). Since January 2018, the trend of the cases has been decreasing even though its level is still higher than the pre-epidemic period. Based on the analysis of the epidemic curve, three periods characterized by different trends in the monthly number of notified cases were identified: January 2015-July 2016 (pre-epidemic period), August 2016-December 2017 (epidemic period), January 2018-December 2019 (post-epidemic period). In the last observation period, cases show different characteristics compared to the previous periods. They are mainly males under 18 years (p=0.026), subjects travelling to Morocco (8.9% vs 15.9%; p< 0.001) or being in contact with an infected person (p<0.001). The multivariate analysis confirmed a significantly higher probability for cases notified in the post-epidemic period, compared to the pre-epidemic, to be secondary cases or to have traveled to Morocco. Compared to the pre-epidemic period and the epidemic period, there was a higher percentage of subjects who received a single dose of anti-hepatitis A vaccine (p=0.001). Taking into account only secondary cases reported in the third period, the percentage of cases with incomplete vaccination rises to 31%; in this group, a single dose of the vaccine was administered at a median of 11.5 days before the onset of symptoms. CONCLUSIONS: vaccination is of paramount importance for the prevention of hepatitis A in all risk groups, including adult males exposed to same-sex sexual intercourse and travelers to areas at high-medium endemic level, especially children, as the timeliness in the vaccination of contacts is fundamental and crucial for interrupting the chains of infection. The observed increase in secondary cases and the delay in the administration of doses lead to a reflection on the need for greater promotion of vaccination, but also highlight the critical issues in the organization of vaccination services, mainly in the areas that have reported the greatest number of cases

Quantum efficiency measurement system for large area CsI photodetectors

A proximity focusing freon/CsI RICH detector has been built for kaon physics at Thomas Jefferson National Accelerator Facility (TJNAF or Jefferson Lab), Hall A. The Cherenkov photons are detected by a UV photosensitive CsI film which has been obtained by vacuum evaporation. A dedicated evaporation facility for large area photocathodes has been built for this task. A measuring system has been built to allow the evaluation of the absolute quantum efficiency (QE) just after the evaporation. The evaporation facility is described here, as well as the quantum efficiency measurement device. Results of the QE on-line measurements, for the first time on large area photocathodes, are reported

Hepatitis E in Italy : 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016

Increasing numbers of hepatitis E cases are being reported in several European countries, including Italy, but the burden of hepatitis E virus (HEV) infection is largely unknown in the latter. To gain a better understanding of HEV epidemiology at national level in Italy, we piloted a strengthened and integrated human (epi-demiological and virological) and environmental HEV surveillance system between 2012 and 2016. Over the 5-year period, 169 confirmed hepatitis E cases were identified, with a national annual incidence of 0.72 cases per 1,000,000. Of 65 HEV-RNA positive samples of sufficient quality for molecular analysis, 66% were genotype HEV3, 32% HEV1 and 1% HEV4. The most frequent risk factor reported by all HEV3 infected cases, was the consumption of undercooked pork and sausage. For the environmental surveillance, 679 urban sewage samples were collected from 53 wastewater treatment plants and HEV-RNA was detected in 38/679 of the samples. Among these, 25 (66%) were genotype HEV3 and the remaining were HEV1. We demonstrate that autochthonous transmission and environmental circulation of genotype HEV3 is adding to travel-related HEV transmission in Italy. We recommend the \u2018One Health\u2019 approach to integrated surveillance, and to include HEV-related messages within health information campaigns focussing on food security

Gestione automatizzata degli appuntamenti nella conduzione di studi epidemiologici longitudinali

Within a research quality promotion program, an automatic procedure called "MEMO-PC" was developed. It promotes data management during the phases of recruitment and follow-up of a clinical tests. This procedure is composed of several consecutive steps such as: data entry, agenda, searching/updating, full list of participants, analysis, printing of full list of participants and backup. Its output is standardized information which aggregate all relevant information necessary for the secretarial staff to contact all study participants and to survey the appointments during the phases of the study. MEMO-PC can be a powerful tool for those interested in conducting epidemiological studies which entail the recruitment of subjects who will be recalled in regular preestablished intervals of time. Since there are not many publications on this matter, a full description of the above mentioned procedure was considered to be usefulConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome Istituto Superiore di Sanita' - Viale Regina Elena, 299, Rome / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Controllo di qualit nella trascrizione dei dati su computer, in ambiente DBIII Plus, e sua utilit negli studi epidemiologici

Consiglio Nazionale delle Ricerche. Biblioteca Centrale / CNR - Consiglio Nazionale delle RichercheSIGLEITItal