31 research outputs found
Epidemiological and molecular approaches for management of a measles outbreak in Liguria, Italy
Since March 2010 a measles outbreak has been occurred in Genoa, Liguria, an administrative Region in Northern Italy. Epi- demiological and molecular data on the outbreak, obtained from the passive mandatory notification system, the laboratory surveillance and an innovative syndrome surveillance system, were investigated. Overall 39 cases were reported in the urban area. Information about demography, vaccination status, hospitalization and geographic distribution of measles cases are available. 19 cases (48.7%) were laboratory-confirmed and were characterized by sequence analysis: 18 strains belonged to genotype D8, so identifying a new measles variant within the Liguria population. Adopted control measures seem to have limited viral circulation. The outbreak allowed to test the efficacy of the 3 surveillance systems active in Liguria, highlighting their advantages and some important limitations. More efforts are needed to collect and integrate any epidemiological and virological available data in order to better describe the local measles transmission dynamics
Molecular epidemiology of measles in Liguria, Italy: a tool for the elimination of the infection
no Abstrac
Molecular epidemiology and case-control approaches for management of an outbreak of hepatitis A in Liguria, Italy
Introduction and methods. Hepatitis A remains an important
public health problem in low endemicity areas, because of the
social and economic high burden of cyclical outbreaks. In this
study we described an outbreak of HAV infection occurred in the
city of Genoa and in its proximity and the viral circulation in the
post-epidemic period. In order to identify risk factors associated to
the illness and to determine the source of infection and the dynamics
of virus evolution, we conducted an epidemiological and molecular
investigation by a case-control study and by sequence analysis of
high variable regions of the genome.
Results. From May to October 2005, 58 HAV hepatitis cases were
notified. The case-control study showed that beach establishment
attending is strongly associated with HAV hepatitis (OR = 24.5,
p-value inf. 0.01), at multivariate analysis. The profile of epidemic
curve, the clinical onset of primary cases who occurred in few
weeks and the geographic distribution of cases clearly indicated
a common exposure to a point source: the outbreak can be probably
associated with a contaminated food product dispensed in
the affected area.
The outbreak has been mainly caused by a single variant, confirming
the common exposure to a point source; this variant previously circulated
within homosexual man (MSM) network in Northern Europe.
During the outbreak and in the following months, different variants
originating from Southeast Asia, Southern America and Northern
Africa, have co-circulated: all these cases were related to international
travel and none of these had determined secondary cases.
Discussion. The epidemiological picture of hepatitis A in Liguria is
characterized by a wide heterogeneity of circulating HAV strains.
This pattern could be associated with the increase of imported
cases and transmission within network of persons with similar risk
factors. Molecular approach coupled to descriptive and analytical
epidemiological studies appeared un-replaceable tools for management
and control of HAV outbreaks, because of their capacity
to recognize infection origin, transmission patterns and dynamics
of virus evolution
Strumenti per il raggiungimento delle coperture vaccinali, verifica della qualità delle prestazioni e valutazione dei programmi vaccinali
Epidemiologia molecolare del morbillo: uno strumento verso l'eliminazione del virus in Liguria
Malignancy after kidney transplantation: results of 400 patients from a single center
Abstract: Background: Post-transplant malignancies (PTM) occur in a percentage as high as 50% in patients followed 20 yr and have become a main cause of mortality and are expected to be the first cause of death
within the next 20 yr in kidney transplant recipients.
Patients and methods: We analyzed the PTM incidence in our kidney transplant recipients, and its main risk factors. The records of 400 patients (min follow up = one yr) have been retrospectively reviewed and categorized
into three groups: patients without any tumor, with a non-melanoma skin cancer and with a solid or hematologic cancer. A cancer-free multivariate survival study was performed stratified by age, sex, immunosuppressive
therapy, time on dialysis, body mass index (BMI), smoke, diabetes and nephropathy.
Results: Thirty patients developed PTM: 12 non-melanoma skin cancer,three lymphomas and 15 solid malignancies (seven genitourinary, three lung, two breast, two gastrointestinal and one sarcoma). The mean age at
diagnosis was 55 yr, with a mean time from transplant of 27 months. We observed six deaths and two graft losses. Non-melanoma skin cancer-free survival and the solid/hematologic cancer-free survival was 99.5% and
98.5% at one yr, and 95.2% and 94.6% at five yr, respectively. At univariate analysis, age and induction therapy were significant risk factors for
both types of PTM, while only recipient age significantly increased the risk of all PTM, and anti CD25 significantly reduced the risk of non-melanoma skin cancer at the multivariate study.
Conclusions: These data confirm the role of age and induction strategies in modulating the risk of neoplasia. To look for which strategies might reduce the PTM risk, including a personalized therapy to minimize the effects of
chronic immunosuppressant, will be a crucial goal
Prophylactic perioperative plasmapheresis does not prevent rebound of permeability factors in patients with focal segmental glomerulosclerosis (FSGS) who undergo kidney transplant.
Prophylactic perioperative plasmapheresis does not prevent rebound of permeability factors in patients with focal segmental glomerulosclerosis (FSGS) who undergo kidney transplant
No abstract avaibl
Epidemiological and molecular approaches for management of a measles outbreak in Liguria, Italy
Since March 2010 a measles outbreak has been occurred in Genoa, Liguria, an administrative Region in Northern Italy. Epi- demiological and molecular data on the outbreak, obtained from the passive mandatory notification system, the laboratory surveillance and an innovative syndrome surveillance system, were investigated. Overall 39 cases were reported in the urban area. Information about demography, vaccination status, hospitalization and geographic distribution of measles cases are available. 19 cases (48.7%) were laboratory-confirmed and were characterized by sequence analysis: 18 strains belonged to genotype D8, so identifying a new measles variant within the Liguria population. Adopted control measures seem to have limited viral circulation. The outbreak allowed to test the efficacy of the 3 surveillance systems active in Liguria, highlighting their advantages and some important limitations. More efforts are needed to collect and integrate any epidemiological and virological available data in order to better describe the local measles transmission dynamics