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

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

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

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

The molecular epidemiology and evolutionary dynamics of influenza B virus in two Italian regions during 2010-2015: The experience of Sicily and Liguria

Molecular epidemiology of influenza B virus remained poorly studied in Italy, despite representing a major contributor to seasonal epidemics. This study aimed to reconstruct the phylogenetic relationships and genetic diversity of the hemagglutinin gene sequences of 197 influenza B strains circulating in both Southern (Sicily) and Northern (Liguria) Italy between 2010 and 2015. Upper respiratory tract specimens of patients displaying symptoms of influenza-like illness were screened by real-time RT-PCR assay for the presence of influenza B virus. PCR-positive influenza B samples were further analyzed by sequencing. Neighbor-joining phylogenetic trees were constructed and the amino-acid alignments were analyzed. Phylogenetic analysis showed clusters in B/Victoria clade 1A/1B (n = 29, 14.7%), and B/Yamagata clades 2 (n = 112, 56.8%) and 3 (n = 56, 28.4%). Both influenza B lineages were found to co-circulate during the study period, although a lineage swap from B/Victoria to B/Yamagata occurred in Italy between January 2011 and January 2013. The most represented amino-acid substitutions were N116K in the 120-loop (83.9% of B/Yamagata clade 3 strains) and I146V in the 150-loop (89.6% of B/Victoria clade 1 strains). D197N in 190-helix was found in almost all viruses collected. Our findings provide further evidence to support the adoption of quadrivalent influenza vaccines in our country

Influenza vaccination of healthcare workers in Italy: could mandatory vaccination be a solution to protect patients?

Several studies have reported that influenza infections in healthcare workers (HCWs) can lead to nosocomial outbreaks. HCWs can potentially be infected with influenza every year, and may continue to work, encouraging the spread of the virus. Different strategies, such as informative interventions on influenza and influenza vaccination, ‘onsite’ vaccination weeks, communicative strategies through dedicated web and social media pages, and mandatory informed dissent form, were organized for HCWs working at the University Hospital of Palermo, during previous influenza seasons. However, the increased vaccination rates observed among HCWs still remain far from the 75% recommended by Public Health Authorities. The level of coverage observed in countries with mandatory vaccination policies for HCWs, could suggest the adoption of this strategy for increase influenza vaccination adherence in Italy

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

Molecular Epidemiology and Genetic Diversity of Human Respiratory Syncytial Virus in Sicily during Pre- and Post-COVID-19 Surveillance Seasons

Human respiratory syncytial virus (hRSV) is an important pathogen of acute respiratory tract infection of global significance. In this study, we investigated the molecular epidemiology and the genetic variability of hRSV over seven surveillance seasons between 2015 and 2023 in Sicily, Italy. hRSV subgroups co-circulated through every season, although hRSV-B mostly prevailed. After the considerable reduction in the circulation of hRSV due to the widespread implementation of non- pharmaceutical preventive measures during the COVID-19 pandemic, hRSV rapidly re-emerged at a high intensity in 2022–2023. The G gene was sequenced for genotyping and analysis of deduced amino acids. A total of 128 hRSV-A and 179 hRSV-B G gene sequences were obtained. The phylogenetic analysis revealed that the GA2.3.5a (ON1) and GB5.0.5a (BA9) genotypes were responsible for the hRSV epidemics in Sicily.; only one strain belonged to the genotype GB5.0.4a. No differences were observed in the circulating genotypes during pre- and post-pandemic years. Amino acid sequence alignment revealed the continuous evolution of the G gene, with a combination of amino acid changes specifically appearing in 2022–2023. The predicted N-glycosylation sites were relatively conserved in ON1 and BA9 genotype strains. Our findings augment the understanding and prediction of the seasonal evolution of hRSV at the local level and its implication in the monitoring of novel variants worth considering in better design of candidate vaccines