Letter to the editor: Measles outbreak linked to an international dog show in Slovenia - primary cases and chains of transmission identified in Italy, November to December 2014

In the letter epidemiological and virological investigations on Italian measles cases associated to a measles outbreak in Slovenia, linked to an international dog show from 8 to 9 November 2014, are described

Flexible membranes anchored to the ground for slope stabilisation: Numerical modelling of soil slopes using SPH

An alternative modelling for flexible membranes anchored to the ground for soil slope stabilisation is presented using Smoothed-Particle Hydrodynamics to model the unstable ground mass in a soil slope, employing a dynamic solve engine. A regression model of pressure normal to the ground, qsim, and also membrane deflection, fsim, have been developed using Design of Experiment. Finally, a comparison between the pressure obtained from numerical simulation and from a limit equilibrium analysis considering infinite slope has been carried out, showing differences in the results, mainly due to the membrane stiffness.The realization of this research paper has been possible thanks to the funding of the following entities: SODERCAN (Sociedad para el Desarrollo de Cantabria), Consejería de Obras Públicas del Gobierno de Cantabria, Iberotalud S.L., Malla Talud Cantabria S.L. and Contratas Iglesias S.L. The authors wish also to acknowledge the support provided by the GICONSIME Research Group of the University of Oviedo and the GITECO Research Group of the University of Cantabria. We also thank Swanson Analysis Inc. for the use of the ANSYS Academic program

Dengue virus infections among European travellers, 2015 to 2019

Background: Dengue is a disease with major impacts on public health in tropical and subtropical countries. In Europe, in the past decade, few autochthonous outbreaks were described. Aim: We aimed to identify factors associated with frequency of dengue virus infection among European travellers and at assessing how surveillance data could support preparedness against autochthonous outbreaks within Europe. Methods: We performed a descriptive analysis of travel-related dengue cases reported by European countries from 2015 through 2019. Using flight passenger data, we calculated travellers’ infection rates (TIR). We investigated the following associations: (i) between TIR and incidence rate in selected countries of infection and (ii) between number of travel-related cases and occurrence of autochthonous outbreaks within Europe. Results: There were 11,478 travel-related dengue cases and the TIR was 2.8 cases per 100,000 travellers. Most cases were infected in Asia (71%), predominantly in south-eastern Asia. The TIR was highest among travellers returning from Asia (6.1/100,000). There was an association between the incidence rate in the country of infection and the TIR but no association between the number of travel-related cases and occurrence of autochthonous outbreaks in Europe. Conclusions: The likelihood of infection in travellers is a function of the ongoing epidemiological situation in the country of exposure. The number of travel-related cases alone is not sufficient to estimate the likelihood of autochthonous outbreaks where vectors are present in Europe. Additional contributing factors such as adequate vectorial capacity and suitable environmental conditions are required.Peer Reviewe

congenital rubella still a public health problem in italy analysis of national surveillance data from 2005 to 2013

In accordance with the goal of the World Health Organization Regional Office for Europe, the Italian national measles and rubella elimination plan aims to reduce the incidence of congenital rubella cases to?less than?one case per 100,000 live births by the end of 2015. We report national surveillance data for congenital rubella and rubella in pregnancy from 2005 to 2013. A total of 75 congenital rubella infections were reported; the national annual mean incidence was 1.5/100,000 live births, including probable and confirmed cases according to European Union case definition. Two peaks occurred in 2008 and 2012 (5.0 and 3.6/100,000 respectively). Overall, 160 rubella infections in pregnancy were reported; 69/148 women were multiparous and 38/126 had had a rubella antibody test before pregnancy. Among reported cases, there were 62 infected newborns, 31 voluntary abortions, one stillbirth and one spontaneous abortion. A total of 24 newborns were unclassified and 14 women were lost to follow-up, so underestimation is likely. To improve follow-up of cases, systematic procedures for monitoring infected mothers and children were introduced in 2013. To prevent congenital rubella, antibody screening before pregnancy and vaccination of susceptible women, including post-partum and post-abortum vaccination, should be promoted. Population coverage?of two doses of measles-mumps-rubella vaccination of ≥?95% should be maintained and knowledge of health professionals improved

Evolution of occupational asthma: Does cessation of exposure really improve prognosis?

SummaryAimTo assess the evolution of occupational asthma (OA) depending on whether the patient avoids or continues with exposure to the offending agent.MethodsStudy in patients diagnosed with OA using a specific inhalation challenge. Patients underwent the following examinations on the same day: clinical interview, physical examination, forced spirometry, methacholine test and determination of total IgE. Clinical improvement, deterioration or no change were defined according to the changes seen on the GINA severity scale at the time of diagnosis.ResultsOf the 73 patients finally included, 55 had totally ended exposure and 18 continued to be exposed at work. Clinical improvement was observed in 47% of those who had terminated exposure and in 22% of those who remained exposed; clinical deterioration was observed in 14% and 17% respectively (p = 0.805). Logistical regression analysis, including the type of agent and the persistence or avoidance of exposure among the variables, did not show any predictive factors of clinical evolution. Similarly, the changes in FEV1 and in bronchial hyperresponsiveness were not associated with the avoidance or continuation of exposure to the causative agent.ConclusionsAvoiding exposure to the causative agent in patients with OA does not seem to improve prognosis in this disease. Despite these findings, there is insufficient evidence to recommend a change in current management guidelines

Towards elimination of measles and rubella in Italy. Progress and challenges

Introduction In the WHO European Region, endemic transmission of measles and rubella had been interrupted by 37 and 42 of the 53 member states (MSs), respectively, by 2018. Sixteen MSs are still endemic for measles, 11 for rubella and nine for both diseases, the latter including Italy. Elimination is documented by each country’s National Verification Committee (NVC) through an annual status update (ASU). Objective By analysing data used to produce the ASUs, we aimed to describe the advances made by Italy towards elimination of measles and rubella. Moreover, we propose a set of major interventions that could facilitate the elimination process. Methods A total of 28 indicators were identified within the six core sections of the ASU form and these were evaluated for the period 2013–2018. These indicators relate to the incidence of measles/rubella; epidemiological investigation of cases; investigation of outbreaks; performance of the surveillance system; population immunity levels; and implementation of supplemental immunization activities (SIAs). Results From 2013 to 2018, epidemiological and laboratory analyses of measles cases in Italy improved substantially, allowing timely investigation in 2017 and 2018 of most outbreak and sporadic cases and identification of the majority of genotypic variants. Moreover, since 2017, vaccination coverage has increased significantly. Despite these improvements, several areas of concern emerged, prompting the following recommendations: i) improve outbreak monitoring; ii) strengthen the MoRoNet network; iii) increase the number of SIAs; iv) reinforce vaccination services; v) maintain regional monitoring; vi) design effective communication strategies; vii) foster the role of general practitioners and family paediatricians. Conclusions The review of national ASUs is a crucial step to provide the NVC with useful insights into the elimination process and to guide the development of targeted interventions. Against this background, the seven recommendations proposed by the NVC have been shared with the Italian Ministry of Health and the Technical Advisory Group on measles and rubella elimination and have been incorporated into the new Italian Elimination Plan 2019–2023 as a technical aid to facilitate the achievement of disease elimination goals

Initial impact of SARS-Cov-2 vaccination on healthcare workers in Italy. Update on the 28th of march 2021

In Italy, the COVID-19 vaccination campaign started in December 2020 with the vaccination of healthcare workers (HCW). To analyse the real-life impact that vaccination is having on this population group, we measured the association between week of diagnosis and HCW status using log-binomial regression. By the week 22–28 March, we observed a 74% reduction (PPR 0.26; 95% CI 0.22–0.29) in the proportion of cases reported as HCW and 81% reduction in the proportion of symptomatic cases reported as HCW, compared with the week with the lowest proportion of cases among HCWs prior to the vaccination campaign (31 August-7 September). The reduction, both in relative and absolute terms, of COVID-19 cases in HCWs that started around 30 days after the start of the vaccination campaign suggest that COVID-19 vaccines are being effective in preventing infection in this group

A Statistical Inference Method for Interpreting the CLASP Observations

On 3rd September 2015, the Chromospheric Lyman-Alpha SpectroPolarimeter (CLASP) successfully measured the linear polarization produced by scattering processes in the hydrogen Lyman-$\alpha$ line of the solar disk radiation, revealing conspicuous spatial variations in the $Q/I$ and $U/I$ signals. Via the Hanle effect the line-center $Q/I$ and $U/I$ amplitudes encode information on the magnetic field of the chromosphere-corona transition region (TR), but they are also sensitive to the three-dimensional structure of this corrugated interface region. With the help of a simple line formation model, here we propose a statistical inference method for interpreting the Lyman-$\alpha$ line-center polarization observed by CLASP.Comment: Accepted for publication in The Astrophysical Journa

CLASP Constraints on the Magnetization and Geometrical Complexity of the Chromosphere-Corona Transition Region

The Chromospheric Lyman-Alpha Spectro-Polarimeter (CLASP) is a suborbital rocket experiment that on 3rd September 2015 measured the linear polarization produced by scattering processes in the hydrogen Ly-$\alpha$ line of the solar disk radiation, whose line-center photons stem from the chromosphere-corona transition region (TR). These unprecedented spectropolarimetric observations revealed an interesting surprise, namely that there is practically no center-to-limb variation (CLV) in the $Q/I$ line-center signals. Using an analytical model, we first show that the geometrical complexity of the corrugated surface that delineates the TR has a crucial impact on the CLV of the $Q/I$ and $U/I$ line-center signals. Secondly, we introduce a statistical description of the solar atmosphere based on a three-dimensional (3D) model derived from a state-of-the-art radiation magneto-hydrodynamic simulation. Each realization of the statistical ensemble is a 3D model characterized by a given degree of magnetization and corrugation of the TR, and for each such realization we solve the full 3D radiative transfer problem taking into account the impact of the CLASP instrument degradation on the calculated polarization signals. Finally, we apply the statistical inference method presented in a previous paper to show that the TR of the 3D model that produces the best agreement with the CLASP observations has a relatively weak magnetic field and a relatively high degree of corrugation. We emphasize that a suitable way to validate or refute numerical models of the upper solar chromosphere is by confronting calculations and observations of the scattering polarization in ultraviolet lines sensitive to the Hanle effect.Comment: Accepted for publication in The Astrophysical Journal Letter