Measles in Italy: Viral strains and crossing borders.

In 2017, Italy experienced one of the largest outbreaks of measles in recent years, with 5404 notified cases and 4347 confirmed cases. A further 2029 cases were notified during the first 6 months of 2018, and 1516 of them were laboratory-confirmed. The B3 and D8 genotypes were identified as those responsible for the outbreak. Possible transmission routes can be established by monitoring the circulating measles virus strains in support of the national health authorities to warn people and travellers

Dynamics and molecular evolution of HIV-1 strains in Sicily among antiretroviral na\uefve patients.

HIV-1 subtype B is the most frequent strain in Sicily. To date, there is no available data about the genetic diversity of HIV-1 viral strains circulating in Sicily among antiretroviral (ARV) na\uefve subjects and the role of immigration as potential determinant of evolutionary dynamics of HIV-1 molecular epidemiology. For this purpose, HIV-1 polymerase (pol) sequences obtained from 155 ARV na\uefve individuals from 2004 to 2009 were phylogenetically analysed. The overall rate of HIV-1 non-B infections was 31.0% (n = 48/155), increasing from 7.8% in 2004\u20132006 to 40.9% in 2009, and about one-third were identified as unique recombinant forms. CRF02_AG was the prevalent non-B clade (n = 28/48, 58.3%), while subtype C-related strains were responsible for about 30% HIV-1 infections. Non-B viruses strictly associated with heterosexual transmission (85.4%) and were mostly found among immigrants (77.1%). Phylogenetic analysis of non-B sequences found in foreign-born subjects was geographically correlated to the respective country of origin. Moreover, the detection of non-B viral variants in the autochthonous population may support an increasing genetic diversity in Sicily as well as a local circulation of HIV strains also uncommon in our country. In Sicily, HIV-1 epidemic is still mostly attributable to the B subtype. Nevertheless, migration and population movements are progressively introducing novel HIV-1 subtypes causing a continuous increase of HIV-1 molecular dynamic at local level. Molecular surveillance is needed to monitor the genetic evolution of HIV-1 epidemic

Trends of influenza B during the 2010–2016 seasons in 2 regions of north and south Italy: The impact of the vaccine mismatch on influenza immunisation strategy

Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012–2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population

Occurrence of a case of influenza A(H1N1)pdm09 and B co-infection during the epidemic season 2012–2013

We report the detection of one case of co-infection with influenza A(H1N1)pdm09 and B, occurred during the 2012–2013 influenza season in Sicily. The dual infection was identified in a 18-year-old boy, who was not covered by specific vaccination and who had no other pre-existing risk factors. He presented classical symptoms of influenza-like illness developing no respiratory complications. A(H1N1)pdm09 viral concen- tration was initially about 10-fold higher than B virus, whereas its clearance was more rapidly achieved than in the case of B virus infection. Although influenza co-infection appears to be a rare event, a contin- ued influenza surveillance activity is recommended, in order to evaluate diversity and evolution, but also to support public health prevention measures

Ischemic cardiovascular disease in workers occupationally exposed to urban air pollution – A systematic review

Introduction. Cardiovascular disease is the first cause of morbidity and mortality worldwide. Among several known risk factors, researchers also focus their attention on the chronic exposure to air pollution. There is much evidence that exposure to air pollution, especially to ultrafine particles, can damage the endothelium and can favour cardiovascular diseases in the general population. Occupational exposition could be an additive risk factor for the cardiovascular system. This article presents a scientific review of the linkage between occupational exposure to air pollution and ischemic heart disease. Materials and method. A scientific review was undertaken, followed by PRISMA Statements. Observational studies were selected from several scientific databases, likesuch as Pubmed, Google Scholar, Nioshtic-2 and Reserchgate, searching for selected key words: police workers, professional drivers, mail carriers, filling station attendants, road cleaners, garage workers, motor vehicles and engine maintenance. All the key words were combined with “Boolean Operators” with the following words: cardiovascular (or cardiac) disease, cardiovascular function, cardiovascular system, ischemic heart disease, coronary disease, myocardial infarction. During the systematic research, the focus was on retrospective and prospective studies from January 1990 – December 2014. Results. Both the retrospective and prospective studies showed an increased risk of ischemic heart disease in occupationally occupied people exposed to air pollution. Only one study presented a ly minor risk. Conclusions. The findings of this systematic review suggest a possible linkage between occupational exposure to urban air pollution, especially to motor exhaust and particulate, and ischemic heart disease

Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)

Introduction. A wastewater-based epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy with a population of 671 696 inhabitants, and to investigate the monthly variability of drug loads in wastewater from different areas of the city. A seven-months detection campaign was conducted at the two wastewater treatment plants of the city. Methods. Following a pre-treatment, 32 samples of wastewater were analyzed by liquid chromatography-tandem mass spectrometry. Results. We estimated a mean cocaine use in Palermo of 0.19 g/day/1000 people, corresponding to 1.90 doses/1000 people and cannabinoids use of 2.85 g/day/1000 people, corresponding to 35.62 doses/1000 people. Amphetamines residues in wastewater were always recovered in concentrations lower than the limit of quantification. Conclusion. Our findings showed that drugs consumption in Palermo is in line with those of other Italian cities and that no significant differences on prevalence on cocaine and cannabinoids consumption were recorded in the different months of the survey, except for the summer period in a wastewater treatment plant of the city

Ospedalizzazioni per Zoster e neuropatia post-erpetica in Sicilia: quali sono le comorbosit\ue0 pi\uf9 frequenti?

INTRODUZIONE L\u2019Herpes Zoster (HZ) e la Nevralgia Post-Erpetica (NPE) sono patologie frequenti nell\u2019adulto, specialmente in chi \ue8 affetto da comorbosit\ue0, e possono essere causa di ospedalizzazione. Oltre il 95% degli adulti italiani, avendo contratto la varicella, ne sono a rischio e l\u2019unica METODIca di prevenzione \ue8 la vaccinazione. MATERIALI \uc9 stato condotto uno studio retrospettivo osservazionale delle Schede di Dimissione Ospedaliera dei soggetti residenti in Sicilia dal 2007 al 2015 per analizzare le variabili socio- demografiche e sanitarie tra cui la presenza di comorbosit\ue0 dei ricoverati per HZ e PHN. I codici ICD9-CM utilizzati per identificare i casi HZ e NPE sono stati 053-053.9 presenti in almeno una delle 6 diagnosi. RISULTATI In totale 3.939 ricoveri per HZ/PHN sono stati registrati in Sicilia dal 2007 al 2015 in tutte le et\ue0 (3.199 nei soggetti >50 anni). L\u2019andamento delle ospedalizzazioni per et\ue0 dei ricoveri con un codice di HZ/NPE in una delle 6 diagnosi \ue8 stato di 8,7 per 100.000 (range 10,9-6,3). In tutto il periodo analizzato si \ue8 avuto un sostanziale incremento dei ricoveri a partire dai 55 anni, il sesso femminile \ue8 stato maggiormente ospedalizzato (M/F ratio=0,9) e la durata media del ricovero \ue8 stata di 7 giorni. I soggetti ricoverati con diagnosi di HZ/PHN, senza comorbosit\ue0, sono stati 689 (17,4%). Tra i soggetti con HZ e comorbosit\ue0 i maggiori tassi di ospedalizzazione si sono osservati in quelli affetti da HIV (725 per 100.000), LLC (530 per 100.000), MM (246 per 100.000) e BPCO (103 per 100.000). CONCLUSIONI La maggiore et\ue0 risulta essere uno dei principali fattori di rischio per HZ e NPH, presumibilmente per la riduzione dell\u2019immunit\ue0 cellulo-mediata virus specifica. Poich\ue8 le categorie a maggior rischio di contrarre una forma grave di HZ sono costituite dai soggetti ai quali \ue8 parzialmente controindicata la vaccinazione anti-zoster (HIV, MM e LLC) sarebbe opportuno valutare caso per caso l'eventuale vaccinazione di tali soggetti

Influenza vaccine effectiveness among high-risk groups: a systematic literature review and metaanalysis of case-control and cohort studies

Vaccination represents the most effective intervention to prevent infection, hospitalization and mortality due to influenza. This meta-analysis quantifies data reporting influenza vaccine effectiveness (VE) on influenza visits and hospitalizations of case-control and cohort studies among high-risk groups. A systematic literature review including original articles published between 2007 and 2016, using a protocol registered on Prospero with No. 42017054854, and a meta-analysis were conducted. For three high-risk groups (subjects with underlying health conditions, pregnant women and health care workers) only a qualitative evaluation was carried out. The VE quantitative analysis demonstrated a clear significant overall effect of 39% (95%CI: 32%-46%) for visits and 57% (95%CI: 30%-74%) for hospitalization among children. Considering the elderly influenza VE had a clear effect of 25% (95%CI: 6%-40%) for visits and 14% (95%CI: 7%-21%; p<0.001) for hospitalization. This study showed the high VE of influenza vaccination among high-risk groups, representing a tool for public health decision-makers to develop evidence-based preventive interventions to avoid influenza outcome