Emerging and Re-emerging Arboviral Diseases as a Global Health Problem

Newly emerging or re-emerging infections continue to pose significant global public health threats. This chapter provides an overview of the combinations of factors that led to the emergence of arthropod-borne viruses as human and veterinary health threats, in order to understand the risk associated and how this can be mitigated. Considering the history of emergence of some arboviruses, these epidemics have occurred globally as a result of climate and socioeconomic changes that have allowed the spread to new geographical areas of viruses previously confined to specific ecological niches such as West Nile and Chikungunya, or viruses considered under control such as Dengue, Japanese encephalitis, and Yellow fever. Moreover, the greatest risk for humans derives from the ability of these viruses to adopt transmission cycles involving highly anthropophilic mosquito species. Finally, many other arboviruses are largely ignored despite their potential to emerge globally. The recent epidemic spread of Zika virus throughout the Americas is the evidence that arboviruses are likely to continually emerge and re-emerge and that improved scientific technologies and knowledge is essential to deal with future vector-borne epidemics. Research priorities should therefore focus on surveillance systems and vector control tools, as well as on the development of antiviral molecules or candidate vaccine

IMPACT OF ERYTHROCYTE SPECIES ON ASSAYS FOR INFLUENZA SEROLOGY

The influenza viruses have the ability to agglutinate erythrocytes by binding to sialic acid receptors on the host cell. Human influenza viruses preferentially bind to sialic acid linked to galactose by α 2,6 linkage, while avian influenza viruses preferentially bind to sialic acid linked to Gal by 2,3 linkage. There is a close correlation between the ability of influenza A viruses to agglutinate erythrocytes from different animal species and their receptor specificity. The haemagglutination and haemagglutination inhibition assays are influenced by the species of erythrocytes. To provide an overview of the expression of sialic acid receptors on different erythrocytes, avian (turkey, chicken, pigeon) and mammalian (sheep, horse, human) species have been analysed. The erythrocytes from the same avian and mammalian species have been evaluated by haemagglutination and haemagglutination inhibition assays with seasonal and avian strains. Chicken, turkey and human erythrocytes display both types of linkages. Horse and sheep erythrocytes show almost exclusively a sialic acid α 2,3 Gal linkage, while pigeon erythrocytes express almost exclusively a sialic acid α 2,6 Gal linkage. Chicken and turkey erythrocytes seem to be the most appropriate for both assays with seasonal influenza strains, in addition to pigeon erythrocytes, particularly for the B strains. In the case of the avian strain, chicken erythrocytes are suitable for haemagglutination assay and horse erythrocytes for haemagglutination inhibition assay. The choice of erythrocytes has a significant impact on the titres measured by both assays

Toxoplasma gondii in women of childbearing age and during pregnancy: seroprevalence study in Central and Southern Italy from 2013 to 2017

Toxoplasmosis is a worldwide health problem. Infection in pregnant women can result in severe fetal morbidity or in subclinical neonatal infection; most subclinical cases develop ocular and neurological sequelae. The purpose of this serological study was to assess the prevalence of Toxoplasma gondii in two populations of women of childbearing age in Siena (Tuscany, Central Italy) and Bari (Apulia, Southern Italy) between 2013 and 2017 and in a group of pregnant women in Bari in 2016-2017. Serum samples were tested for the presence of specific anti-Toxoplasma gondii IgG antibodies by a commercially available ELISA test. The percentage of seropositive subjects in Bari was significantly higher than in Siena (22.4% vs. 12.4%) and an age-related trend was observed. A low prevalence of T. gondii infection (13.8%) was observed among the pregnant women tested. In addition to showing a significant difference between Central and Southern Italy, this study provides updated data on T. gondii seroprevalence in women during childbearing age and pregnancy. The results confirm a trend toward a decrease, especially in younger people and pregnant women

Epidemiology of herpes simplex virus type 1 and 2 in Italy: a seroprevalence study over 15 years

Introduction: Herpes simplex viruses (HSV) are among the most widespread causative agents of human viral infections. HSV-2 is one of the commonest causes of genital disease, while HSV-1 is associated primarily with orolabial ulceration; however, recent changes in HSV epidemiology showed an increase in genital and neonatal herpes particularly caused by HSV-1. The main purpose of this study was to assess the seroprevalence of HSV-1 and HSV-2 in a random population in Siena (central Italy) in 2000, 2005 and 2013-2014 and in Bari (southern Italy) in 2005. Moreover, a preliminary study was conducted to investigate the spread of HSV infection in a population of pregnant women and infants in Bari in 2003, 2004 and 2005. Methods: Human serum samples were tested for the presence of specific anti-HSV-1 and anti-HSV-2 IgG antibodies using a commercially available ELISA test. Results and conclusions: For the primary purpose, seroprevalence rates observed in Siena were compared over the years sampled and with the seroprevalence rate found in Bari. Results of seroprevalence in Siena show a decreased trend for both viruses, especially in adolescents and young adults; moreover, HSV-2 seroprevalence rates found in the two cities suggest geographical differences. For the secondary purpose, prevalence rates among pregnant women were compared with the seroprevalence found in women of the general population. No significant difference in prevalence rates were found among pregnant women, while results indicate both viruses are a source of infection in infants

Uma análise da adaptação cinematográfica e da obra literária “Morte e vida Severina: auto de natal Pernambucano” enquanto enunciados de acordo com os conceitos de Mikhail Bakhtin e Robert Stam

The poem “Morte e Vida Severina: auto de Natal Pernambucano” by João Cabral de Mello was adapted  by movie director Zelito Viana in 1977, 22 years after the literary publication, which, in turn, had other adaptations, from the TV special by Rede Globo to comics and animation. Given the concepts of  Russian linguist Mikhail Bakhtin, as well as those related to Robert Stam's adaptation theories, we intend, specifically, to investigate whether discussions that overestimate literary content at the expense of cinematographic content still have some plausibility. The theme will be approached in line with the dialectical method, we will also make use of the historical, comparative and, possibly, monographic method.O poema “Morte e Vida Severina: auto de Natal Pernambucano” de João Cabral de Mello foi adaptado para o cinema pelo diretor Zelito Viana em 1977, 22 anos após a publicação literária que, por sua vez, teve outras adaptações, desde especial da Rede Globo até quadrinhos e animação. Diante dos conceitos do linguista russo Mikhail Bakhtin, bem como daqueles correlatos as teorias da adaptação, de Robert Stam, pretendemos, especificamente, investigar se as discussões que superestimam o conteúdo literário em detrimento do cinematográfico ainda possuem alguma plausibilidade. O tema será abordado em consonância com o método dialético, valer-nos-emos, também, do método histórico, comparativo e, possivelmente, monográfico

Evaluation of maternal perception of children's weight and Body Mass Index in Tuscany, Italy

Background: The prevention of overweight is a high-priority public health task. The perception that parents have of their children’s nutritional status is a well recognized risk factor for obesity in children, so the aim of our study was to evaluate mothers’ perceptions of their children’s nutritional status. Methods: We conducted, in 2016, a cross-sectional study enrolling1710 children (third grade of all primary schools ) in Tuscany, as well as their mothers. Mothers’ information were collected through a self-administered questionnaire, while children (weighed and measured) filled a questionnaire under the supervision of qualified personnel. Results: 1449 children completed the questionnaire. 74.12% of mothers were able to correctly identify children BMI. The non correct classification tends to significantly decrease in presence of a high educational level compared to low educational level. Mothers’ BMI seems to not be associated with misclassification. The non correct classification was significantly associated with mothers’ opinion about their children’s eating habit. Conclusion: Our data confirmed that, in Tuscany, a limited percentage of mothers tend to misclassify the nutritional state of their children, but in order to maintain these encouraging results, further efforts should be done in order to make all mothers able to correctly evaluate their children. Statements:Authors declare no conflict of interest. The study was conducted according to the criteria set by the declaration of Helsinki and each subject signed an informed consent before participating to the study. Approval of the protocol was obtained from the institutional review board of the National Institute of Health, including the use of opt-out consent; that is, parents could refuse participation but the lack of a returned form was taken to imply consent to their child’s participation

Syphilitic Balanitis of Follmann: Can Dermoscopy Be Useful Tool in the Differential Diagnosis?

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Influenza vaccines: Evaluation of the safety profile

3noopenThe safety of vaccines is a critical factor in maintaining public trust in national vaccination programs. Vaccines are recommended for children, adults and elderly subjects and have to meet higher safety standards, since they are administered to healthy subjects, mainly healthy children. Although vaccines are strictly monitored before authorization, the possibility of adverse events and/or rare adverse events cannot be totally eliminated. Two main types of influenza vaccines are currently available: parenteral inactivated influenza vaccines and intranasal live attenuated vaccines. Both display a good safety profile in adults and children. However, they can cause adverse events and/or rare adverse events, some of which are more prevalent in children, while others with a higher prevalence in adults. The aim of this review is to provide an overview of influenza vaccine safety according to target groups, vaccine types and production methods.openTrombetta, Claudia Maria*; Gianchecchi, Elena; Montomoli, EmanueleTrombetta, Claudia Maria; Gianchecchi, Elena; Montomoli, Emanuel

Emerging influenza strains in the last two decades: A threat of a new pandemic?

In the last 20 years, novel non-seasonal influenza viruses have emerged, most of which have originated from birds. Despite their apparent inability to cause pandemics, with the exception of H1N1 swine influenza virus, these viruses still constitute a constant threat to public health. While general concern has decreased after the peak of the H5N1 virus, in recent years several novel reassorted influenza viruses (e.g., H7N9, H9N2, H10N8) have jumped the host-species barrier and are under surveillance by the scientific community and public health systems. It is still unclear whether these viruses can actually cause pandemics or just isolated episodes. The purpose of this review is to provide an overview of old and novel potential pandemic strains of recent decades

Comparison of hemagglutination inhibition, single radial hemolysis, virus neutralization assays, and ELISA to detect antibody levels against seasonal influenza viruses

Background: The immunological response to influenza vaccine and/or natural infection is evaluated by serological techniques, the most common being hemagglutination inhibition (HI), single radial hemolysis (SRH), and virus neutralization assays, which is commonly used in a micro-neutralization (MN) format. ELISA is not officially required; however, this assay is able to measure different class-specific antibodies. The four assays identify different sets or subsets of antibodies. Objectives: The aim of this study was to establish the correlation among four serological assays using four seasonal influenza strains. Methods: The HI, SRH, MN assays, and ELISA were performed on four seasonal influenza strains. Results: A strong positive correlation was found between HI and MN and between SRH and MN assays for influenza A strains. The B strains also showed good correlations among the three assays. A positive correlation was also found between ELISA and the “classical” assays for all strains. Concerning the correlates of protection, as defined by HI ≥ 40 and SRH ≥ 25 mm2, good agreement was observed for the influenza A strains. By contrast, the agreement for the B strains was very low. Conclusions: There is a positive strong correlation among the four serological assays for both A and B strains, especially for the HI and MN assays. There is good agreement on correlates of protection between HI and SRH assays for the A strains, but very low agreement for the B strains, suggesting higher sensitivity of SRH than HI assay in detecting antibodies against the influenza B viruses