Trasmissione autoctona di dengue nel territorio di ATS Milano: misure di sanità pubblica e analisi dei parametri epidemiologici dell'epidemia

La dengue rappresenta un emergente problema di sanità pubblica in Europa e in Italia. L'obiettivo del presente lavoro è quello di descrivere l'evoluzione del primo focolaio autoctono di dengue verificatosi in Lombardia, a Castiglione d'Adda (Lodi), a partire da agosto 2023, e le relative misure di sanità pubblica attuate, tra cui l'educazione e formazione della comunità e degli operatori sanitari, le attività di monitoraggio entomologico e di lotta al vettore

Asimmetria interemisferica durante il sonno come biomarcatore dell'esposizione a radiazioni ionizzanti: studio elettroencefalografico in una popolazione di cardiologi interventisti

Le radiazioni in ambito sanitario sono la più grande fonte artificiale di esposizione alle radiazioni ionizzanti nei paesi occidentali, con una dose efficace media di 3,0 mSv pro capite l’anno. Tra le categorie professionali quella degli emodinamisti si contraddistingue per l’elevata esposizione a radiazioni ionizzanti, che può portare, nell’arco di una vita lavorativa, al raggiungimento di una dose efficace cumulativa di circa 100 mSv (sotto al grembiule di piombo) e a valori di dose equivalente alla testa di circa 2-3 Sv, con una dose equivalente al cervello che corrisponde approssimativamente al 20-25% della dose esterna. Inoltre, le relazioni spaziali tra il posizionamento dell’emodinamista e del paziente rispetto alla sorgente di radiazioni ionizzanti fanno sì che le stime di esposizione del cranio a sinistra siano due volte superiori rispetto a destra. Nonostante il tessuto nervoso sia stato a lungo considerato un tessuto radioresistente secondo la legge di Bergoniè e Tribondeau, a causa della sua bassa attività mitotica e l’elevata differenziazione, studi effettuati su pazienti sottoposti alla radioterapia craniale (>1 Sv) hanno evidenziato un rischio significativo, tra i sopravvissuti, di danno cerebrale e disfunzioni cognitive. Inoltre, per quanto gli effetti cerebrali dell’esposizione a basse dosi di radiazioni ionizzanti siano ad oggi ancora poco conosciuti, recenti studi hanno dimostrato come anche l’esposizione a basse dosi possa portare, a lungo termine, oltre ad un aumento dell’incidenza di neoplasie, anche ad alterazioni significative delle funzioni cognitive, in particolare delle performance mnemoniche e attentive, delle funzioni vascolari cerebrali, nonché ad una disfunzione olfattiva per disordini neurodegenerativi. Sulla base di quanto emerso in letteratura e in considerazione della necessità di ulteriori dati sugli effetti dell’esposizione a dosi medio-basse di radiazioni ionizzanti sull’encefalo, il presente studio si pone l’obiettivo di indagare possibili alterazioni della funzionalità elettrica del cervello indotte dalle radiazioni, mediante l’identificazione e l’applicazione di un indice elettroencefalografico di asimmetria interemisferica (Interhemispheric Asymmetry Index o IAI).Tale indice, utilizzato come possibile biomarcatore dell’esposizione cumulativa a basse dosi di radiazioni ionizzanti, è stato studiato durante il sonno e la veglia, in una popolazione di cardiologi interventisti

HCV micro-elimination in two prisons in Milan, Italy: a model of care

People in prison represent a high-risk population for HCV infection control. With the advent of new direct antiviral agents (DAAs) HCV micro-elimination in prison setting became a feasible strategy. We assessed the impact of an intervention for HCV testing and treatment in 2017 and 2018 in a jail (San Vittore,SV) and a prison for sentenced individuals (Opera,OP). A dedicated protocol was applied and implemented over the two years. We collected data on demographics, HCV testing and treatment on all inmates present on October 31st 2017 and 2018. In the two facilities there were 2,366 and 2,369 inmates in 2017 and 2018 respectively; the majority were men (95.6%; 96.4%) and Italians (57.0%; 61.9%) with a median age of 41 years. Prevalence of lifetime reported drug use remained high (46.5%; 44.2%). HCV screening coverage was 89% in both years, while HCV-RNA test coverage increased (90.6%; 99.0%). HCV sero-prevalence remained stable (10.1%; 9.2%). In 2017 among inmates with HCV chronic infection 90 (42.4%) individuals had started DAAs treatment and 106 (54.6%) in 2018; of whom 38 (17.9%) and 74 (38.1%) achieved the SVR. The viremic pool decreased significantly over time (SV,24.4%; 15.4%;OP, 16.1%;<1%). Among inmates with HCV-positive serology in 2018, 121 (81.0%) were never linked to care before incarceration. Our study showed how a targeted and well-implemented HCV test-and-treat intervention in prison was feasible and effective in achieving micro-elimination. Viral hepatitis elimination agenda may help drawing interest onto this neglected population and bringing prison health higher up in the global public health agenda

Increased Risk of Acquisition of New Delhi Metallo-Beta-Lactamase-Producing Carbapenem-Resistant Enterobacterales (NDM-CRE) among a Cohort of COVID-19 Patients in a Teaching Hospital in Tuscany, Italy

We describe the epidemiology of New Delhi Metallo-Beta-Lactamase-Producing Carbapenem-Resistant Enterobacterales (NDM-CRE) colonization/infection in a cohort of COVID-19 patients in an Italian teaching hospital. These patients had an increased risk of NDM-CRE acquisition versus the usual patients (75.9 vs. 25.3 cases/10,000 patient days). The co-infection significantly increased the duration of hospital stay (32.9 vs. 15.8 days)

HCV micro‐elimination in two prisons in Milan, Italy: A model of care

People in prison represent a high-risk population for HCV infection control. With the advent of new direct antiviral agents (DAAs) HCV micro-elimination in prison setting became a feasible strategy. We assessed the impact of an intervention for HCV testing and treatment in 2017 and 2018 in a jail (San Vittore,SV) and a prison for sentenced individuals (Opera,OP). A dedicated protocol was applied and implemented over the two years. We collected data on demographics, HCV testing and treatment on all inmates present on October 31st 2017 and 2018. In the two facilities there were 2,366 and 2,369 inmates in 2017 and 2018 respectively; the majority were men (95.6%; 96.4%) and Italians (57.0%; 61.9%) with a median age of 41 years. Prevalence of lifetime reported drug use remained high (46.5%; 44.2%). HCV screening coverage was 89% in both years, while HCV-RNA test coverage increased (90.6%; 99.0%). HCV sero-prevalence remained stable (10.1%; 9.2%). In 2017 among inmates with HCV chronic infection 90 (42.4%) individuals had started DAAs treatment and 106 (54.6%) in 2018; of whom 38 (17.9%) and 74 (38.1%) achieved the SVR. The viremic pool decreased significantly over time (SV,24.4%; 15.4%;OP, 16.1%;<1%). Among inmates with HCV-positive serology in 2018, 121 (81.0%) were never linked to care before incarceration. Our study showed how a targeted and well-implemented HCV test-and-treat intervention in prison was feasible and effective in achieving micro-elimination. Viral hepatitis elimination agenda may help drawing interest onto this neglected population and bringing prison health higher up in the global public health agenda

Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years’ Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient’s safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+ 230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season

A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022.

Following the report of a non-travel-associated cluster of monkeypox cases by the United Kingdom in May 2022, 41 countries across the WHO European Region have reported 21,098 cases and two deaths by 23 August 2022. Nowcasting suggests a plateauing in case notifications. Most cases (97%) are MSM, with atypical rash-illness presentation. Spread is mainly through close contact during sexual activities. Few cases are reported among women and children. Targeted interventions of at-risk groups are needed to stop further transmission