Burden of pediatrics hospitalizations associated with Rotavirus gastroenteritis in Lombardy (Northern Italy) before immunization program

Aim. Rotavirus is recognized as the main cause of acute gastroenteritis in children under 5 years old, representing a considerable public health problem with a great impact on social and public health costs in developed countries. This study aims to assess the frequency and the epidemiological aspect of the hospitalization associated with Rotavirusgastroenteritis  in Lombardy, Northern Italy, from 2005 to 2011. Methods. The Lombardy Hospital Discharge Database was inquired from the official data of the Italian Ministry of Health and investigated for acute gastroenteritis (ICD9-CM code for bacteria, parasitic, viral and undetermined etiologic diarrhea) in primaryn and secondary diagnosis in children ≤ 5 years, between 2005 and 2011. Results. Out of the 32 944 acute-gastroenteritis hospitalizations reported in Lombardy, the 50.8% was caused by Rotavirus infection; of these, the 65.5% were reported in primary diagnosis. The peak of Rotavirus-gastroenteritis hospitalization was observed in February-March in children < 2 years old, with a cumulative prevalence of 64.5%. Patients admitted to hospital with diarrhea of undetermined etiology (about 14% of overall acute-gastroenteritis) showed epidemiological characteristics similar to the Rotavirusgastroenteritis, suggesting that the virus infection could also be involved in at least some of these. Conclusion. Our data confirm that Rotavirus are the most important agents involving in acute gastroenteritis hospitalizations. The use of Hospital Discharge Database had proved to be a simple tool to estimate the burden and to describe the epidemiological characteristics of Rotavirus gastroenteritis and could be used as a surveillance activity before and after the introduction of mass vaccination at national and regional level in Italy

Pp65 antigenemia, plasma real-time PCR and DBS test in symptomatic and asymptomatic cytomegalovirus congenitally infected newborns

<p>Abstract</p> <p>Background</p> <p>Many congenitally cytomegalovirus-infected (cCMV) neonates are at risk for severe consequences, even if they are asymptomatic at birth. The assessment of the viral load in neonatal blood could help in identifying the babies at risk of sequelae.</p> <p>Methods</p> <p>In the present study, we elaborated the results obtained on blood samples collected in the first two weeks of life from 22 symptomatic and 48 asymptomatic newborns with cCMV diagnosed through urine testing. We evaluated the performances of two quantitative methods (pp65 antigenemia test and plasma Real-time PCR) and the semi-quantitative results of dried blood sample (DBS) test in the aim of identifying a valid method for measuring viral load.</p> <p>Results</p> <p>Plasma qPCR and DBS tests were positive in 100% of cases, antigenemia in 81%. Only the latter test gave quantitatively different results in symptomatic versus asymptomatic children. qPCR values of 10³copies/ml were found in 52% of newborn. "Strong" DBS test positivity cases had higher median values of both pp65 positive PBL and DNA copies/ml than cases with a "weak" positivity.</p> <p>Conclusions</p> <p>As expected antigenemia test was less sensitive than molecular tests and DBS test performed better on samples with higher rates of pp65 positive PBL and higher numbers of DNA copies/ml. The prognostic significance of the results of these tests will be evaluated on completion of the ongoing collection of follow-up data of these children.</p

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5-11 December, to 17.5% (25/143 samples) in the week 12-18, to 65.9% (89/135 samples) in the week 19-25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased from one in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons. In conclusion, we designed an RT-qPCR assay capable to detect the Omicron variant, which can be successfully used for the purpose of wastewater-based epidemiology. We also described the history of the introduction and diffusion of the Omicron variant in the Italian population and territory, confirming the effectiveness of sewage monitoring as a powerful surveillance tool

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5–11 December, to 17.5% (25/143 samples) in the week 12–18, to 65.9% (89/135 samples) in the week 19–25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased fromone in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons

La sorveglianza della poliomielite in Italia : Lombardia

One of the main objectives of the National Plan of Prevention is prevention of overweight and obesity. The realization of such plan has been submitted at ASL level mostly to the Food and Nutrition Hygiene Services (SIAN) according to their competences, as well specified by the decree of October 16th 1998, which deals with the collective nutritional prevention and overseeing. In the following sections we present the experiences of some SIANs considered meaningful in order to offer a survey, along the whole country, of what already realised about prevention of the obesity and promotion of correct life styles

Diagnosi dell&#8217;infezione congenita di citomegalovirus (cCMV) tramite CMV DBS test in bambini sordi

Il citomegalovirus (CMV) \ue8 il pi\uf9 importante agente di infezione congenita dell\u2019uomo; la sordit\ue0 neurosensoriale in caso di infezione congenita \ue8 la pi\uf9 frequente conseguenza della stessa. Lo screening uditivo neonatale permette di identificare la maggioranza dei bambini con sordit\ue0 bilaterale o monolaterale permanente molto precocemente. Il CMV DBS test, basato sulla evidenziazione, mediante PCR, del DNA virale nei campioni di sangue neonatale essiccato su Guthrie card presenta una sensibilit\ue0 del 99% permettendo di porre la diagnosi di infezione congenita da CMV a posteriori. Nel periodo 2014-2017 i neonati che hanno fallito lo screening audiologico tramite TEOAE e con sordit\ue0 confermata dei potenziali ABR sono stati arruolati nello studio: 85 bambini sono risultati affetti da ipoacusia neurosensoriale; per 71 (83,6%) di questi (et\ue0 mediana 3,4 anni; interquartile; 3,3 anni) \ue8 stato possibile valutare l\u2019eventuale presenza di CMV-DNA nei rispettivi campioni di DBS. Dei 71 bambini esaminati, 51 (71,8 %) presentavano sordit\ue0 bilaterale, di questi 40 (78,4 %) avevano una asimmetria di soglia. Circa la met\ue0 36 (50,7%) dei 71 bambini mostrava una sordit\ue0 di grado grave/profondo (ABR soglia 6570 dB). La presenza di cCMV \ue8 stata accertata nel 7% (5/71) dei bambini; la quota di bambini con sordit\ue0 grave/profonda \ue8 statisticamente maggiore tra quelli risultati cCMV-positivi rispetto ai cCMV-negativi (100% vs 47%; p= 0,028).Cytomegalovirus (CMV) is the most important congenital infection in human beings. Sensorineural hearing loss is the most usual consequence in congenital infection. Newborn auditory screening let us know to identify the majority of children suffering from bilateral or monolateral deafness very early. The CMV DBS test, based on the evidence by PCR test of viral DNA in newborn dried blood samples on Guthrie card, shows a sensibility of 99% and allows to diagnose congenital CMV infection in retrospectively. Within 2014-2017 the newborns that failed the auditory screening by TEOAE suffering from deafness evidenced by ABR test, were selected in this study: 85 newborns were affected by sensorineural hearing loss. 71 newborns were submitted to the DBS test: 71,8% were affected by bilateral deafness; 78,4% were affected by asymmetric deafness; 50,7% had a profound deafness; 7% (5/70) were affected by a congenital CMV infection

When the COVID-19 Pandemic Surges during Influenza Season: Lessons Learnt from the Sentinel Laboratory-Based Surveillance of Influenza-Like Illness in Lombardy during the 2019–2020 Season

This paper outlines the role of Lombardy’s regional influenza reference laboratory (Northern Italy) in the surveillance of influenza-like illnesses (ILIs) in monitoring SARS-CoV-2 circulation by analyzing 631 consecutive nasopharyngeal swabs (NPSs) collected from ILI outpatients by sentinel physicians during the 2019–2020 season. The samples were tested by specific real-time RT-PCRs targeting SARS-CoV-2, influenza viruses, and RSVs. Results: Of these NPSs, 31% tested positive for influenza viruses, 10% for SARS-CoV-2, and 7% for RSV. No coinfections were detected. Influenza viruses and RSVs circulated throughout the surveillance period until the end of February (week 9-2020), when they suddenly ceased to circulate seven weeks earlier than during the previous five influenza seasons. After the first detection of SARS-CoV-2 in our ILI outpatients at the beginning of March (week 10-2020), SARS-CoV-2 remained the only virus identified throughout the surveillance period. Patients ≥ 65 years had a 3.2-fold greater risk of being infected with SARS-CoV-2, while school-age children (5–14 years) and children &lt; 5 years proved to be the age groups most at risk of contracting influenza viruses and RSV, respectively. Our experience demonstrates that laboratory-based ILI surveillance networks are essential for identifying SARS-CoV-2 cases that would otherwise remain undetected, in order to stop their spread within our communities