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Given the wide range of latitudes at which the bacterium Xylella fastidiosa (Xf), susceptible host plants and insect vectors may coexist, we have investigated the effect of different range of temperatures on the capability of Philaenus spumarius, the predominant insect vector of Xf in Europe, to acquire and transmit Xf from olive to olive. Plants cv Cellina di Nardò infected with Xf susbsp. pauca ST53 were exposed at the following conditions: 38-32°C; 36-28°C; 32-24°C; 28-20°C; 20-14°C. More specifically, to simulate day/night conditions, in each treatment, plants were daily exposed for 10h at the highest temperature, then for 14h at the lowest one. Infected source plants were pre-conditioned at the same temperatures either for 3 or 8 days before starting the experiments. After an acquisition access period (AAP) of 3 days, insects were moved to receptor plants maintained at the same temperatures of the correspondent AAP. Insect mortality was recorded after both AAP and IAP, whereas the acquisition of Xf was estimated by qPCR on individual insects tested after the IAP. As the experiment is still ongoing, herein we report only the data on the AAP. Briefly, mortality reached average values of 99-100% when insects were caged on the plants maintained at 38°C; it dropped to approx. 60% at 36°C, and to 20-30% at 28°C and 32°C, respectively, while at 20°C it was less than 10%. The acquisition rate could not be estimated for the highest temperature (due to the high mortality). Acquisition was lower at 36°C (about 9%), compared to the other tested temperatures (about 35%). Only at the highest temperatures, pre-conditioning the plants for 8 days reduced the AAP efficiency compared to 3 days pre-conditioning, suggesting an effect of the high temperature on the bacterium in the host plant. Although limited to the AAP, these results demonstrate a significant impact of high temperatures (> 32°C) on insect survival and Xf acquisition efficiency., IT; PDF; enzadongiovanni@crsfa.it

Introduction: Outbreaks of silicosis have bene recently reported in artificial stone workers. Aim: To describe the features of silicosis in quartz conglomerate workers in North-Eastern Italy. Methods: Active search of pneumoconiosis was performed in 11 companies of North-Eastern Italy involved in the fabrication of quartz conglomerate countertops. Occupational history, lung function tests, chest X-ray and high resolution computed tomography (HRCT) were performed. In selected cases, trans-bronchial biopsies were taken for histological evaluation and identification of silica crystals in the tissue. Cumulative exposure to crystalline silica was estimated. Results: We recruited 45 workers and 24 cases of silicosis were diagnosed. Mean age at diagnosis was 43 years and duration of exposure to quartz conglomerate dust was 3.5 to 20 years. The average silica cumulative exposure was 4.3 mg/m 3 /y. Abnormal findings were detected in 42% of chest X-rays, in 33% of spirometry and 50% of carbon monoxide lung diffusion (DLco). HRCTs were abnormal in all cases showing well-defined rounded opacities, irregular/linear intralobular opacities and bilateral enlarged mediastinal lymph-nodes. Histological findings consistent with silicosis were observed in 24 cases. Numerous silica particles (diameter 0.1-5 μm) were identified in lung tissue. Conclusions: We reported an unexpected high incidence of silicosis in Italian workers exposed to quartz conglomerate dust. The results suggest that chest HRCT is indicated for screening of workers with high exposure to silica and DLco should be added to spirometry in health surveillance. More rigorous application of safety regulations and more effective preventive interventions at work are necessary.

Objectives To document patients' and healthcare professionals' (HCP) experiences with hepatitis B virus (HBV) and hepatitis C virus (HCV) diagnosis and care, as well as consequences of these infections on patients' life trajectories in Cameroon, an endemic country in sub-Saharan Africa. Design Qualitative sociological study combining in-depth interviews and observations of medical consultations. Interviews and observations transcripts were thematically analysed according to the following themes: circumstances and perceptions surrounding hepatitis screening, counselling and disclosure, information provided by HCP on hepatitis prevention and treatment, experience of access to care and treatment, social/economic trajectories after diagnosis. Setting HIV and gastroenterology/medical services in two reference public hospitals in Yaounde (Cameroon). Participants 12 patients affected by HBV and/or HCV (co-infected or not with HIV), 14 HCP, 14 state and international stakeholders. Findings Many patients are screened for HBV and HCV at a time of great emotional and economic vulnerability. The information and counselling delivered after diagnosis is limited and patients report feeling alone, distressed and unprepared to cope with their infection. After screening positive, patients struggle with out-of-pocket expenditures related to the large number of tests prescribed by physicians to assess disease stage and to decide whether treatment is needed. These costs are so exorbitant that many decide against clinical and biological follow-up. For those who do pay, the consequences on their social and economic life trajectories are catastrophic. Conclusion Large out-of-pocket expenditures related to biological follow-up and treatment pose a real challenge to receiving appropriate care. Free or reasonably priced access to hepatitis B and C treatments can only be effective and efficient at reducing the hepatitis disease burden if the screening algorithm and the whole pretherapeutic assessment package are simplified, standardised and subsidised by comprehensive national policies orientated towards universal healthcare.

Background In countries where hepatitis B virus (HBV) is endemic, including Senegal, the World Health Organization recommends systematic HBV screening of pregnant women and vaccination at birth to prevent mother-to-child transmission (MTCT). This study investigated healthcare workers' (HCW) knowledge and practices regarding HBV prevention and care in the rural region of Fatick in Senegal, as well as challenges they faced in implementing prevention activities related to HBV MTCT. Methods A mixed-methods survey was conducted between May-July 2017 among 112 HCW working in 15 healthcare facilities in two districts of the Fatick region using face-to-face questionnaires and semi-structured interviews. Descriptive statistics and chi-square/Mann-Whitney tests were used to analyze quantitative data, while qualitative data were analyzed thematically. Results The study population included 87 HCW in the quantitative component (83% women, median age [interquartile range, IQR] = 35 [31-40] years) and 11 in the qualitative component. A knowledge gap was observed in key areas of HBV infection: only 24, 51 and 38%, respectively, correctly reported that early HBV acquisition is associated with a high risk of developing chronic infection, that perinatal transmission is one of the main modes of HBV transmission in Senegal, and that three to four doses of HBV vaccine are required to ensure immunization in children. Despite good acceptability of systematic screening of pregnant women and vaccination at birth, only 48% of HCW mainly involved in prenatal care and 71% of those involved exclusively in vaccination routinely performed these two key interventions. HCW reported several structural barriers that may hinder their implementation: a lack of training in HBV and in counseling, poor availability of rapid diagnostic tests (RDT), high costs of both screening and treatment, a lack of adequate information on treatment options and missed opportunities for vaccination at birth. Conclusions HCW working in the Fatick region may be insufficiently trained and supported to effectively implement HBV prevention strategies. Our findings suggest an urgent need to strengthen MTCT prevention in this region, by improving HCW knowledge in key areas of HBV infection, providing RDT and antiviral treatment at low cost, and enhancing community-based interventions for the timely vaccination of newborns.