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1. Are Epidemiological Estimates Able to Describe the Ability of Health Systems to Cope with COVID-19 Epidemic?

Author

Castaldi S, Luconi E, Rivieccio BA, Boracchi P, Marano G, Pariani E, Romano L, Auxilia F, Nicolussi F, Micheletti A, Manzi G, Salini S, Galli M, and Biganzoli E

Subjects
covid-19, epidemic, epidemiological estimates, health systems, region, italy, Public aspects of medicine, RA1-1270
Abstract

Silvana Castaldi,1,2,* Ester Luconi,3,* Bruno Alessandro Rivieccio,4,* Patrizia Boracchi,3 Giuseppe Marano,3 Elena Pariani,2 Luisa Romano,2 Francesco Auxilia,1 Federica Nicolussi,5 Alessandra Micheletti,6 Giancarlo Manzi,5 Silvia Salini,5 Massimo Galli,7,* Elia Biganzoli3,* 1Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; 2Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano, Milan, Italy; 3Department of Clinical Sciences and Community Health & DSRC, University of Milan, Milan, Italy; 4Niguarda Hospital, AREU, Regional Emergency Service Agency, Milan, Italy; 5Department of Economics, Management and Quantitative Methods & DSRC, University of Milan, Milan, Italy; 6Department of Environmental Science and Policy, University of Milan, Milan, Italy; 7Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy*These authors contributed equally to this workCorrespondence: Silvana CastaldiDepartment Biomedical Sciences for Health, University of Milan, Via Pascal, 36, Milan, 20133, ItalyTel +390255038342Fax +390255033144Email silvana.castaldi@unimi.itIntroduction: The coronavirus disease 2019 (COVID-19) epidemic is an infectious disease which was declared a pandemic and hit countries worldwide from the beginning of the year 2020. Despite the emergency vigilance plans, health systems in all countries experienced a different ratio of lethality, amount of admissions to intensive care units and quarantine management of positive patients. The aim of this study is to investigate whether some epidemiological estimates could have been useful in understanding the capacity of the Italian Regional Health Services to manage the COVID-19 epidemic.Methods: We have compared data between two different Italian regions in the Northern part of Italy (Lombardy and Veneto) and the national data to determine whether different health strategies might be significant in explaining dissimilar patterns of the COVID-19 epidemic in Italy. Data have been extracted from a public database and were available only in an aggregated form.Results: The regions in question displayed two different health policies to face the COVID-19 epidemic: while Veneto’s health service was largely territorially oriented, Lombardy’s strategy was more hospital-centered.Discussion: The key to facing epidemics like this one consists in identifying solutions outside of hospitals. This however requires there be well-trained general practitioners and enough healthcare personnel working outside hospitals.Keywords: COVID-19, epidemic, epidemiological estimates, health systems, region, Italy

Published
2021

3. The early phase of the COVID-19 outbreak in Lombardy, Italy

Author

Cereda, D, Tirani, M, Rovida, F, Demicheli, V, Ajelli, M, Poletti, P, Trentini, F, Guzzetta, G, Marziano, V, Barone, A, Magoni, M, Deandrea, S, Diurno, G, Lombardo, M, Faccini, M, Pan, A, Bruno, R, Pariani, E, Grasselli, G, Piatti, A, Gramegna, M, Baldanti, F, Melegaro, A, and Merler, S

Subjects
Quantitative Biology - Populations and Evolution
Abstract

In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract specimen results, hospitalization, contact tracing. We provide estimates of the reproduction number and serial interval. The epidemic in Italy started much earlier than February 20, 2020. At the time of detection of the first COVID-19 case, the epidemic had already spread in most municipalities of Southern-Lombardy. The median age for of cases is 69 years (range, 1 month to 101 years). 47% of positive subjects were hospitalized. Among these, 18% required intensive care. The mean serial interval is estimated to be 6.6 days (95% CI, 0.7 to 19). We estimate the basic reproduction number at 3.1 (95% CI, 2.9 to 3.2). We estimated a decreasing trend in the net reproduction number starting around February 20, 2020. We did not observe significantly different viral loads in nasal swabs between symptomatic and asymptomatic. The transmission potential of COVID-19 is very high and the number of critical cases may become largely unsustainable for the healthcare system in a very short-time horizon. We observed a slight decrease of the reproduction number, possibly connected with an increased population awareness and early effect of interventions. Aggressive containment strategies are required to control COVID-19 spread and catastrophic outcomes for the healthcare system.

Published
2020

5. Evaluation of Pre‐Analytical and Analytical Methods for Detecting SARS‐CoV‐2 in Municipal Wastewater Samples in Northern Italy

Author

Pellegrinelli, L, Castiglioni, S, Cocuzza, C, Bertasi, B, Primache, V, Schiarea, S, Salmoiraghi, G, Franzetti, A, Musemeci, R, Tilola, M, Galuppini, E, Bertanza, G, Callegari, M, Stefani, F, Turolla, A, Ammoni, E, Cereda, D, Pariani, E, Binda, S, Pellegrinelli L., Castiglioni S., Cocuzza C. E., Bertasi B., Primache V., Schiarea S., Salmoiraghi G., Franzetti A., Musemeci R., Tilola M., Galuppini E., Bertanza G., Callegari M., Stefani F., Turolla A., Ammoni E., Cereda D., Pariani E., Binda S., Pellegrinelli, L, Castiglioni, S, Cocuzza, C, Bertasi, B, Primache, V, Schiarea, S, Salmoiraghi, G, Franzetti, A, Musemeci, R, Tilola, M, Galuppini, E, Bertanza, G, Callegari, M, Stefani, F, Turolla, A, Ammoni, E, Cereda, D, Pariani, E, Binda, S, Pellegrinelli L., Castiglioni S., Cocuzza C. E., Bertasi B., Primache V., Schiarea S., Salmoiraghi G., Franzetti A., Musemeci R., Tilola M., Galuppini E., Bertanza G., Callegari M., Stefani F., Turolla A., Ammoni E., Cereda D., Pariani E., and Binda S.

Abstract

(1) Background: The surveillance of SARS‐CoV‐2 RNA in urban wastewaters allows one to monitor the presence of the virus in a population, including asymptomatic and symptomatic individuals, capturing the real circulation of this pathogen. The aim of this study was to evaluate the performance of different pre‐analytical and analytical methods for identifying the presence of SARS‐CoV‐2 in untreated municipal wastewaters samples by conducting an inter‐laboratory proficiency test. (2) Methods: three methods of concentration, namely, (A) Dextran and PEG‐6000 two‐phase separation, (B) PEG‐8000 precipitation without a chloroform purification step and (C) PEG‐8000 precipitation with a chloroform purification step were combined with three different protocols of RNA extraction by using commercial kits and were tested by using two primers/probe sets in three different master mixes. (3) Results: PEG‐8000 precipitation without chloroform treatment showed the best performance in the SARS‐CoV‐2 recovery; no major differences were observed among the protocol of RNA extraction and the one‐step real‐time RT‐PCR master mix kits. The highest analytic sensitivity was observed by using primers/probe sets targeting the N1/N3 fragments of SARS‐CoV‐2. (4) Conclusions: PEG‐8000 precipitation in combination with real‐time RT‐PCR targeting the N gene (two fragments) was the best performing workflow for the detection of SARS‐CoV‐2 RNA in municipal wastewaters.

Published
2022

9. Alternative pre-analytical strategies for SARS CoV 2 RNA detection

Author

Martinelli, M, Molteni, C, Calcagno, G, Bubba, L, Galli, C, Musumeci, R, Giubbi, C, Perdoni, F, Castriciano, S, Pariani, E, Pellegrinelli, L, Pilla, L, Bonfanti, P, Malandrin, S, Cavallero, A, Cocuzza, C, MARTINELLI, M, MOLTENI, C, CALCAGNO, G, BUBBA, L, GALLI, C, MUSUMECI, R, GIUBBI, C, PERDONI, F, CASTRICIANO, S, PARIANI, E, PELLEGRINELLI, L, PILLA, L, BONFANTI, P, MALANDRIN, S, CAVALLERO, A, COCUZZA, CE, Martinelli, M, Molteni, C, Calcagno, G, Bubba, L, Galli, C, Musumeci, R, Giubbi, C, Perdoni, F, Castriciano, S, Pariani, E, Pellegrinelli, L, Pilla, L, Bonfanti, P, Malandrin, S, Cavallero, A, Cocuzza, C, MARTINELLI, M, MOLTENI, C, CALCAGNO, G, BUBBA, L, GALLI, C, MUSUMECI, R, GIUBBI, C, PERDONI, F, CASTRICIANO, S, PARIANI, E, PELLEGRINELLI, L, PILLA, L, BONFANTI, P, MALANDRIN, S, CAVALLERO, A, and COCUZZA, CE

Published
2021

12. SARS-CoV-2 infection among asymptomatic homebound subjects in Milan, Italy

Author

Milani, G, Montomoli, E, Bollati, V, Albetti, B, Bandi, C, Bellini, T, Bonzini, M, Buscaglia, M, Cantarella, C, Cantone, L, Carugno, M, Casartelli, S, Cavaletti, G, D'Alessandro, S, De Chiara, F, Delbue, S, Dioni, L, Eberini, I, Favero, C, Ferrari, L, Ferraroni, M, Galastri, L, Galli, C, Hoxha, M, Iodice, S, La Vecchia, C, Macchi, C, Manini, I, Marchi, S, Mariani, J, Pariani, E, Pesatori, A, Rota, F, Ruscica, M, Schioppo, T, Tarantini, L, Trombetta, C, Valsecchi, M, Vicenzi, M, Zanchetta, G, Milani G. P., Montomoli E., Bollati V., Albetti B., Bandi C., Bellini T., Bonzini M., Buscaglia M., Cantarella C., Cantone L., Carugno M., Casartelli S., Cavaletti G., D'Alessandro S., De Chiara F., Delbue S., Dioni L., Eberini I., Favero C., Ferrari L., Ferraroni M., Galastri L., Galli C., Hoxha M., Iodice S., La Vecchia C., Macchi C., Manini I., Marchi S., Mariani J., Pariani E., Pesatori A. C., Rota F., Ruscica M., Schioppo T., Tarantini L., Trombetta C. M., Valsecchi M. G., Vicenzi M., Zanchetta G., Milani, G, Montomoli, E, Bollati, V, Albetti, B, Bandi, C, Bellini, T, Bonzini, M, Buscaglia, M, Cantarella, C, Cantone, L, Carugno, M, Casartelli, S, Cavaletti, G, D'Alessandro, S, De Chiara, F, Delbue, S, Dioni, L, Eberini, I, Favero, C, Ferrari, L, Ferraroni, M, Galastri, L, Galli, C, Hoxha, M, Iodice, S, La Vecchia, C, Macchi, C, Manini, I, Marchi, S, Mariani, J, Pariani, E, Pesatori, A, Rota, F, Ruscica, M, Schioppo, T, Tarantini, L, Trombetta, C, Valsecchi, M, Vicenzi, M, Zanchetta, G, Milani G. P., Montomoli E., Bollati V., Albetti B., Bandi C., Bellini T., Bonzini M., Buscaglia M., Cantarella C., Cantone L., Carugno M., Casartelli S., Cavaletti G., D'Alessandro S., De Chiara F., Delbue S., Dioni L., Eberini I., Favero C., Ferrari L., Ferraroni M., Galastri L., Galli C., Hoxha M., Iodice S., La Vecchia C., Macchi C., Manini I., Marchi S., Mariani J., Pariani E., Pesatori A. C., Rota F., Ruscica M., Schioppo T., Tarantini L., Trombetta C. M., Valsecchi M. G., Vicenzi M., and Zanchetta G.

Published
2020

15. A comparison of coronavirus disease 2019 and seasonal influenza surveillance in five European countries: France, Germany, Italy, Spain and the United Kingdom

Author

de Fougerolles T, Puig-Barbera J, Kassianos G, Vanhems P, Schelling J, Crepey P, de Lejarazu R, Ansaldi F, Fruhwein M, Galli C, Mosnier A, Pariani E, Rasuli A, Vitoux O, Watkins J, Weinke T, and Bricout H

Subjects
Europe, surveillance, COVID-19, epidemiology, influenza, burden
Abstract

BACKGROUND: In response to the coronavirus disease (COVID-19) outbreak that unfolded across Europe in 2020, the World Health Organisation (WHO) called for repurposing existing influenza surveillance systems to monitor COVID-19. This analysis aimed to compare descriptively the extent to which influenza surveillance systems were adapted and enhanced and how COVID-19 surveillance could ultimately benefit or disrupt routine influenza surveillance. METHODS: We used a previously developed framework in France, Germany, Italy, Spain and the United Kingdom to describe COVID-19 surveillance and its impact on influenza surveillance. The framework divides surveillance systems into seven subsystems and 20 comparable outcomes of interest and uses five evaluation criteria based on WHO guidance. Information on influenza and COVID-19 surveillance systems were collected from publicly available resources shared by European and national public health agencies. RESULTS: Overall, non-medically attended, virological, primary care and mortality surveillance were adapted in most countries to monitor COVID-19, although community, outbreak and hospital surveillance were reinforced in all countries. Data granularity improved, with more detailed demographic and medical information recorded. A shift to systematic notification for cases and deaths enhanced both geographic and population representativeness, although the sampling strategy benefited from the roll out of widespread molecular testing. Data communication was greatly enhanced, contributing to improved public awareness. CONCLUSIONS: Well-established influenza surveillance systems are a key component of pandemic preparedness, and their upgrade allowed European countries to respond to the COVID-19 pandemic. However, uncertainties remain on how both influenza and COVID-19 surveillance can be jointly and durably implemented.

Published
2022

17. Co-circulation of SARS-CoV-2 Alpha and Gamma variants in Italy, February and March 2021

Author

Stefanelli, P., Trentini, F., Guzzetta, G., Marziano, V., Mammone, A., Schepisi, M. S., Poletti, P., Grane, C. M., Manica, M., del Manso, M., Andrianou, X., Ajelli, M., Rezza, G., Brusaferro, S., Merler, S., Di Martino, A., Ambrosio, L., Lo Presti, A., Fiore, S., Fabiani, C., Benedetti, E., Di Mario, G., Facchini, M., Puzelli, S., Calzoletti, L., Fontana, S., Venturi, G., Fortuna, C., Marsili, G., Amendola, A., Stuppia, L., Savini, G., Picerno, A., Lopizzo, T., Dell'Edera, D., Minchella, P., Greco, F., Viglietto, G., Atripaldi, L., Limone, A., D'Agaro, P., Licastro, D., Pongolini, S., Sambri, V., Dirani, G., Zannoli, S., Affanni, P., Colucci, M. E., Capobianchi, M. R., Icardi, G., Bruzzone, B., Lillo, F., Orsi, A., Pariani, E., Baldanti, F., Molecolare, U. V., Gismondo, M. R., Maggi, F., Caruso, A., Ceriotti, F., Boniotti, M. B., Barbieri, I., Bagnarelli, P., Menzo, S., Garofalo, S., Scutella, M., Pagani, E., Collini, L., Ghisetti, V., Brossa, S., Ru, G., Bozzetta, E., Chironna, M., Parisi, A., Rubino, S., Serra, C., Piras, G., Coghe, F., Vitale, F., Tramuto, F., Scalia, G., Palermo, C. I., Mancuso, G., Pollicino, T., Di Gaudio, F., Vullo, S., Reale, S., Cusi, M. G., Rossolini, G. M., Pistello, M., Mencacci, A., Camilloni, B., Severini, S., Di Benedetto, M., Terregino, C., Monne, I., Biscaro, V., Stefanelli P, Trentini F, Guzzetta G, Marziano V, Mammone A, Sane Schepisi M, Poletti P, Molina Grané C, Manica M, Del Manso M, Andrianou X, Ajelli M, Rezza G, Brusaferro S, Merler S, Vitale F, Tramuto F, Stefanelli P., Trentini F., Guzzetta G., Marziano V., Mammone A., Sane Schepisi M., Poletti P., Molina Grane C., Manica M., Del Manso M., Andrianou X., Ajelli M., Rezza G., Brusaferro S., Merler S., Sambri V, and (membro del COVID-19 National Microbiology Surveillance Study Group)

Subjects
Epidemiology, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, co-circulation, lineage, SARS-CoV-2 variant of concern, transmissibility, Humans, Italy, Models, Theoretical, Settore MED/42 - Igiene Generale E Applicata, SARS-COV-2 VARIANT OF CONCERN, CO-CIRCULATION, LINEAGE, TRANSMISSIBILITY, HUMANS, ITALY, MODELS, THEORETICAL, COVID-19, SARS-COV-2, Theoretical, Models, Virology, Human
Abstract

Background Several SARS-CoV-2 variants of concern (VOC) have emerged through 2020 and 2021. There is need for tools to estimate the relative transmissibility of emerging variants of SARS-CoV-2 with respect to circulating strains. Aim We aimed to assess the prevalence of co-circulating VOC in Italy and estimate their relative transmissibility. Methods We conducted two genomic surveillance surveys on 18 February and 18 March 2021 across the whole Italian territory covering 3,243 clinical samples and developed a mathematical model that describes the dynamics of co-circulating strains. Results The Alpha variant was already dominant on 18 February in a majority of regions/autonomous provinces (national prevalence: 54%) and almost completely replaced historical lineages by 18 March (dominant across Italy, national prevalence: 86%). We found a substantial proportion of the Gamma variant on 18 February, almost exclusively in central Italy (prevalence: 19%), which remained similar on 18 March. Nationally, the mean relative transmissibility of Alpha ranged at 1.55–1.57 times the level of historical lineages (95% CrI: 1.45–1.66). The relative transmissibility of Gamma varied according to the assumed degree of cross-protection from infection with other lineages and ranged from 1.12 (95% CrI: 1.03–1.23) with complete immune evasion to 1.39 (95% CrI: 1.26–1.56) for complete cross-protection. Conclusion We assessed the relative advantage of competing viral strains, using a mathematical model assuming different degrees of cross-protection. We found substantial co-circulation of Alpha and Gamma in Italy. Gamma was not able to outcompete Alpha, probably because of its lower transmissibility.

Published
2022

18. Characteristics of SARS-CoV-2 variants of concern B.1.1.7, B.1.351 or P.1: data from seven EU/EEA countries, weeks 38/2020 to 10/2021

Author

Funk T., Pharris A., Spiteri G., Bundle N., Melidou A., Carr M., Gonzalez G., Garcia-Leon A., Crispie F., O'Connor L., Murphy N., Mossong J., Vergison A., Wienecke-Baldacchino A. K., Abdelrahman T., Riccardo F., Stefanelli P., Di Martino A., Bella A., Lo Presti A., Casaca P., Moreno J., Borges V., Isidro J., Ferreira R., Gomes J. P., Dotsenko L., Suija H., Epstein J., Sadikova O., Sepp H., Ikonen N., Savolainen-Kopra C., Blomqvist S., Mottonen T., Helve O., Gomes-Dias J., Adlhoch C., Macori G., Russell L., Yandle Z., Bennett C., O'Byrne E., Murphy A., Tuite G., Conroy A., Duffy M., Morley U., Keoghan B., Ford I., Kennedy M., McDonnell S., Flynn A., Clarke A., Crowley A., Martin C., Kelly E., Foxton J., Hare D., Dunford L., Connell J., Moran J., Dean J., Fanning S., Rajan L., De Gascun C., Kenny J., Cotter P., Walsh C., Lawton E., Fitzpatrick A., Mullins E., Della Bartola M., McCabe M., Stapleton P., Meaney C., Fanning L., Prentice M., MacSharry J., Dempsey C., Mallon P., Leon A., Chaturvedi A., Coughlan S., McAndrew G., Reddington K., Walsh F., Fitzpatrick D., Smyth C., O'Dwyer T., Chambers T., Clarke L., Jebb D., Klopp J., Kavanagh D., Haslam K., Buckley P., Lemass K., Fitzpatrick F., Burns K., Cafferkey J., Richmond A., Foley M., Sanchez-Morgado J., Chalapati S., Pinnamaneni N., Crosbie C., Limbachiya D., Tinago W., Garcia Leon A. A., Miles S., Alalwan D., Negi R., Macken A., Feeney E., Kenny G., McCann K., Kelly N., Blair M., McCann R., Kenny C., O'Brion C., Waqas S., Savinelli S., Doran P., Bracken T., Varghese P., Lambert J. S., Cotter A., Muldoon E., Sheehan G., McGinty T., Lambert J., Green S., Leamy K., de Barra E., McConkey S., Kelly C., Horgan M., Sadlier C., Yousif O., O'Donnell J., Fitzgerald M., Petty-Saphon N., Cuddihy J., Fiore S., Fabiani C., Benedetti E., Di Mario G., Facchini M., Puzelli S., Calzoletti L., Fontana S., Venturi G., Fortuna C., Marsili G., Amendola A., Stuppia L., Savini G., Picerno A., Lopizzo T., Dell'Edera D., Minchella P., Greco F., Mauro M. V., Viglietto G., Atripaldi L., Limone A., D'Agaro P., Licastro D., Marcello A., Capobianchi M. R., Icardi G., Bruzzone B., Lillo F., Orsi A., Pariani E., Baldanti F., Gismondo M. R., Maggi F., Caruso A., Ceriotti F., Boniotti B., Bagnarelli P., Garofalo S., Scutella M., Pagani E., Collini L., Ghisetti V., Ru G., Chironna M., Parisi A., Rubino S., Serra C., Piras G., Coghe F., Vitale F., Tramuto F., Scalia G., Palermo C. I., Mancuso G., Di Gaudio F., Vullo S., Reale S., Cusi M. G., Rossolini G. M., Pistello M., Mencacci A., Camilloni B., Severini S., Di Benedetto M., Calogero T., Monne I., Biscaro V., COVID Study Groups, Funk T., Pharris A., Spiteri G., Bundle N., Melidou A., Carr M., Gonzalez G., Garcia-Leon A., Crispie F., O'Connor L., Murphy N., Mossong J., Vergison A., Wienecke-Baldacchino A.K., Abdelrahman T., Riccardo F., Stefanelli P., Di Martino A., Bella A., Lo Presti A., Casaca P., Moreno J., Borges V., Isidro J., Ferreira R., Gomes J.P., Dotsenko L., Suija H., Epstein J., Sadikova O., Sepp H., Ikonen N., Savolainen-Kopra C., Blomqvist S., Mottonen T., Helve O., Gomes-Dias J., Adlhoch C., Macori G., Russell L., Yandle Z., Bennett C., O'Byrne E., Murphy A., Tuite G., Conroy A., Duffy M., Morley U., Keoghan B., Ford I., Kennedy M., McDonnell S., Flynn A., Clarke A., Crowley A., Martin C., Kelly E., Foxton J., Hare D., Dunford L., Connell J., Moran J., Dean J., Fanning S., Rajan L., De Gascun C., Kenny J., Cotter P., Walsh C., Lawton E., Fitzpatrick A., Mullins E., Della Bartola M., McCabe M., Stapleton P., Meaney C., Fanning L., Prentice M., MacSharry J., Dempsey C., Mallon P., Leon A., Chaturvedi A., Coughlan S., McAndrew G., Reddington K., Walsh F., Fitzpatrick D., Smyth C., O'Dwyer T., Chambers T., Clarke L., Jebb D., Klopp J., Kavanagh D., Haslam K., Buckley P., Lemass K., Fitzpatrick F., Burns K., Cafferkey J., Richmond A., Foley M., Sanchez-Morgado J., Chalapati S., Pinnamaneni N., Crosbie C., Limbachiya D., Tinago W., Garcia Leon A.A., Miles S., Alalwan D., Negi R., Macken A., Feeney E., Kenny G., McCann K., Kelly N., Blair M., McCann R., Kenny C., O'Brion C., Waqas S., Savinelli S., Doran P., Bracken T., Varghese P., Lambert J.S., Cotter A., Muldoon E., Sheehan G., McGinty T., Lambert J., Green S., Leamy K., de Barra E., McConkey S., Kelly C., Horgan M., Sadlier C., Yousif O., O'Donnell J., Fitzgerald M., Petty-Saphon N., Cuddihy J., Fiore S., Fabiani C., Benedetti E., Di Mario G., Facchini M., Puzelli S., Calzoletti L., Fontana S., Venturi G., Fortuna C., Marsili G., Amendola A., Stuppia L., Savini G., Picerno A., Lopizzo T., Dell'Edera D., Minchella P., Greco F., Mauro M.V., Viglietto G., Atripaldi L., Limone A., D'Agaro P., Licastro D., Marcello A., Capobianchi M.R., Icardi G., Bruzzone B., Lillo F., Orsi A., Pariani E., Baldanti F., Gismondo M.R., Maggi F., Caruso A., Ceriotti F., Boniotti B., Bagnarelli P., Garofalo S., Scutella M., Pagani E., Collini L., Ghisetti V., Ru G., Chironna M., Parisi A., Rubino S., Serra C., Piras G., Coghe F., Vitale F., Tramuto F., Scalia G., Palermo C.I., Mancuso G., Di Gaudio F., Vullo S., Reale S., Cusi M.G., Rossolini G.M., Pistello M., Mencacci A., Camilloni B., Severini S., Di Benedetto M., Calogero T., Monne I., Biscaro V., and COVID Study Groups

Subjects
Infecções Respiratórias, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Care, Epidemiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), variants of concern, Settore MED/42 - Igiene Generale E Applicata, 03 medical and health sciences, 0302 clinical medicine, Virology, Internal medicine, Medicine, Humans, Intensive care admission, 030212 general & internal medicine, COVID-19, Europe, SARS-CoV-2, surveillance, Surveillance, business.industry, 030503 health policy & services, Public Health, Environmental and Occupational Health, Odds ratio, Confidence interval, Variants of Concern, COVID-19, Europe, SARS-CoV-2, surveillance, variants of concern, 0305 other medical science, business, Rapid Communication, Human
Abstract

COVID study groups - PORTUGAL: Portuguese Laboratory Network for the Diagnosis of COVID-19 and Public Health Department of the Health Administrative Regions, Physicians that provided data and samples from suspected cases and SARS-CoV-2 genetic characterization. INSA laboratory team for the diagnosis of SARS-CoV-2. Algarve Biomedical Center and Unilabs. We compared 19,207 cases of SARS-CoV-2 variant B.1.1.7/S gene target failure (SGTF), 436 B.1.351 and 352 P.1 to non-variant cases reported by seven European countries. COVID-19 cases with these variants had significantly higher adjusted odds ratios for hospitalisation (B.1.1.7/SGTF: 1.7, 95% confidence interval (CI): 1.0-2.9; B.1.351: 3.6, 95% CI: 2.1-6.2; P.1: 2.6, 95% CI: 1.4-4.8) and B.1.1.7/SGTF and P.1 cases also for intensive care admission (B.1.1.7/SGTF: 2.3, 95% CI: 1.4-3.5; P.1: 2.2, 95% CI: 1.7-2.8). ECDC internal funds. The ICSC and the AIID Cohort are supported by Science Foundation Ireland under the Science Foundation Ireland, Enterprise Ireland, IDA Ireland COVID-19 Rapid Response Funding Call (Grant number: COVID-RRC 20/COV/0103 and COVID-RRC 20/COV/0305). info:eu-repo/semantics/publishedVersion

Published
2021

20. Journal of Preventive Medicine and Hygiene, Vol. 62 No. 2s1 (2021): Health Technology Assessment (HTA) dell’introduzione della vaccinazione antinfluenzale per la popolazione giovanile italiana con il vaccino Fluenz Tetra®

Author

Sara, B., Pariani, E., GIOVANNA ELISA CALABRÒ, CHIARA DE WAURE, Donatella, P., Daniela, A., PIERO LUIGI LAI, Caterina, R., Emanuele, A., Francesco, V., Alessandra, C., MARIA LUISA DI PIETRO, Galli, C., Bubba, L., Pellegrinelli, L., Leonardo, V., Floriana, D., Marta, C., Elisa, L., Paola, F., ROSANNA TINDARA MICALE, Davide, F., Elisa, C., Flavio, P., Giacomo, T., Sara, S., Andrea, P., MASSIMILIANO ALBERTO BIAMONTE, Duccio, G., Marco, M., Antonio, D., Claudia, A., EMANUELE LA GATTA, Angela, B., and Paolo, B.

Subjects
carbohydrates (lipids), Settore MED/42 - Igiene Generale e Applicata, education, parasitic diseases, polycyclic compounds, heterocyclic compounds
Abstract

"Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra®"

Published
2021
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21. Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017

Author

Puzelli S., Martino A. D., Facchini M., Fabiani C., Calzoletti L., Mario G. D., Palmieri A., Affanni P., Camilloni B., Chironna M., D'Agaro P., Giannecchini S., Pariani E., Serra C., Rizzo C., Bella A., Donatelli I., Castrucci M. R., Ansaldi F., Arvia R., Azzi A., Bagnarelli P., Baldanti F., Capobianchi M. R., Castaldi S., Colucci M. E., Galli C., Ghisetti V., Orsi A., Pagani E., Palu G., Sanguinetti M., Smeraglia R., Tramuto F., Vitale F., Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G, Palmieri A, Affanni P, Camilloni B, Chironna M, D'Agaro P, Giannecchini S, Pariani E, Serra C, Rizzo C, Bella A, Donatelli I, Castrucci MR, Ansaldi F, Arvia R, Azzi A, Bagnarelli P, Baldanti F, Capobianchi MR, Castaldi S, Colucci ME, Galli C, Ghisetti V, Orsi A, Pagani E, Palù G, Sanguinetti M, Smeraglia R, Tramuto F, Vitale F, Puzelli, S., Martino, A. D., Facchini, M., Fabiani, C., Calzoletti, L., Mario, G. D., Palmieri, A., Affanni, P., Camilloni, B., Chironna, M., D'Agaro, P., Giannecchini, S., Pariani, E., Serra, C., Rizzo, C., Bella, A., Donatelli, I., Castrucci, M. R., Ansaldi, F., Arvia, R., Azzi, A., Bagnarelli, P., Baldanti, F., Capobianchi, M. R., Castaldi, S., Colucci, M. E., Galli, C., Ghisetti, V., Orsi, A., Pagani, E., Palu, G., Sanguinetti, M., Smeraglia, R., Tramuto, F., and Vitale, F.

Subjects
0301 basic medicine, Influenza virological surveillance, Influenza B virus, Victoria lineage, Yamagata lineage, Vaccine match, medicine.medical_specialty, Lineage (evolution), Population, Influenza B viru, Hemagglutinin (influenza), Vaccine match, Settore MED/42 - Igiene Generale E Applicata, Virus, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Immunity, Retrospective Studie, Influenza, Human, medicine, Humans, lcsh:RC109-216, 030212 general & internal medicine, education, Phylogeny, Retrospective Studies, education.field_of_study, biology, Strain (biology), Victoria lineage, Influenza B virus, Influenza virological surveillance, Italy, Yamagata lineage, Virology, Influenza, 030104 developmental biology, Infectious Diseases, Parasitology, Influenza Vaccines, Influenza virological surveillance, Influenza B virus, Victoria lineage, Yamagata lineage, Vaccine match, Italy, Epidemiological Monitoring, biology.protein, Seasons, Influenza Vaccine, Research Article, Human
Abstract

BackgroundSince 1985, two antigenically distinct lineages of influenza B viruses (Victoria-like and Yamagata-like) have circulated globally. Trivalent seasonal influenza vaccines contain two circulating influenza A strains but a single B strain and thus provide limited immunity against circulating B strains of the lineage not included in the vaccine. In this study, we describe the characteristics of influenza B viruses that caused respiratory illness in the population in Italy over 13 consecutive seasons of virological surveillance, and the match between the predominant influenza B lineage and the vaccine B lineage, in each season.MethodsFrom 2004 to 2017, 26,886 laboratory-confirmed influenza cases were registered in Italy, of which 18.7% were type B. Among them, the lineage of 2465 strains (49%) was retrieved or characterized in this study by a real-time RT-PCR assay and/or sequencing of the hemagglutinin (HA) gene.ResultsCo-circulation of both B lineages was observed each season, although in different proportions every year. Overall, viruses of B/Victoria and B/Yamagata lineages caused 53.3 and 46.7% of influenza B infections, respectively. A higher proportion of infections with both lineages was detected in children, and there was a declining frequency of B/Victoria detections with age. A mismatch between the vaccine and the predominant influenza B lineage occurred in eight out of thirteen influenza seasons under study. Considering the seasons when B accounted for > 20% of all laboratory-confirmed influenza cases, a mismatch was observed in four out of six seasons. Phylogenetic analysis of the HA1 domain confirmed the co-circulation of both lineages and revealed a mixed circulation of distinct evolutionary viral variants, with different levels of match to the vaccine strains.ConclusionsThis study contributes to the understanding of the circulation of influenza B viruses in Italy. We found a continuous co-circulation of both B lineages in the period 2004–2017, and determined that children were particularly vulnerable to Victoria-lineage influenza B virus infections. An influenza B lineage mismatch with the trivalent vaccine occurred in about two-thirds of cases.

Published
2019

22. Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra®

Author

Boccalini, S., Pariani, E., Calabro', Giovanna Elisa, De Waure, Chiara, Panatto, D., Amicizia, D., Lai, P. L., Rizzo, C., Amodio, E., Vitale, F., Casuccio, A., Di Pietro, Maria Luisa, Galli, C., Bubba, L., Pellegrinelli, L., Villani, Leonardo, D'Ambrosio, Floriana, Caminiti, M., Lorenzini, E., Fioretti, P., Micale, R. T., Frumento, D., Cantova, E., Parente, F., Trento, G., Sottile, S., Pugliese, A., Biamonte, M. A., Giorgetti, D., Menicacci, M., D'Anna, A., Ammoscato, C., La Gatta, Emanuele, Bechini, A., Bonanni, P., Calabro G. E. (ORCID:0000-0003-0259-3797), DE Waure C. (ORCID:0000-0002-4346-1494), DI Pietro M. L. (ORCID:0000-0002-3893-8788), Villani L. (ORCID:0000-0001-9375-8731), D'Ambrosio F., LA Gatta E., Boccalini, S., Pariani, E., Calabro', Giovanna Elisa, De Waure, Chiara, Panatto, D., Amicizia, D., Lai, P. L., Rizzo, C., Amodio, E., Vitale, F., Casuccio, A., Di Pietro, Maria Luisa, Galli, C., Bubba, L., Pellegrinelli, L., Villani, Leonardo, D'Ambrosio, Floriana, Caminiti, M., Lorenzini, E., Fioretti, P., Micale, R. T., Frumento, D., Cantova, E., Parente, F., Trento, G., Sottile, S., Pugliese, A., Biamonte, M. A., Giorgetti, D., Menicacci, M., D'Anna, A., Ammoscato, C., La Gatta, Emanuele, Bechini, A., Bonanni, P., Calabro G. E. (ORCID:0000-0003-0259-3797), DE Waure C. (ORCID:0000-0002-4346-1494), DI Pietro M. L. (ORCID:0000-0002-3893-8788), Villani L. (ORCID:0000-0001-9375-8731), D'Ambrosio F., and LA Gatta E.

Abstract

Il vaccino antinfluenzale Fluenz Tetra® (vaccino vivo attenuato quadrivalente, spray nasale, in sospensione) sarà disponibile in Italia per la prevenzione e il controllo dell’influenza per la stagione influenzale 2021-2022. Tale vaccino è indicato per la profilassi dell’influenza in bambini e adolescenti di età compresa tra i 24 mesi e i 18 anni [1]. I decision makers dovranno, quindi, presto valutarne l’utilizzo. Questa decisione potrebbe essere supportata dalla disponibilità di uno specifico rapporto di Health Technology Assessment (HTA). Infatti, l’HTA rappresenta oggi l’approccio valutativo più utile per i decision makers per prendere le più appropriate decisioni in ambito sanitario in base alle prove scientifiche disponibili. Anche il Piano Nazionale Prevenzione Vaccinale 2017-2019 (PNPV 2017-2019) conferma il ruolo rilevante dell’HTA ai fini della valutazione delle potenzialità e dei limiti di un vaccino e auspica un sempre maggiore utilizzo di questa metodologia per favorire le decisioni basate sulle evidenze, in un’ottica di corretto utilizzo delle limitate risorse disponibili [2]. In ambito vaccinale l’HTA si esplica nella valutazione dell’epidemiologia della specifica infezione e delle malattie correlate nella popolazione target, del disease burden della patologia, delle attuali misure preventive e terapeutiche disponibili contro l'infezione e le malattie esaminate, dell’efficacia e sicurezza del vaccino oggetto di studio e degli eventuali altri vaccini disponibili, delle valutazioni economiche, e infine degli aspetti etici, legali, sociali e organizzativi correlati all’introduzione di tale vaccino [3]. Pertanto, tutte le evidenze scientifiche disponibili su questi aspetti dovrebbero essere raccolte e esaminate criticamente all’interno di un rapporto di HTA al fine di eseguire una valutazione completa. Particolare attenzione va posta sul fatto che questa metodologia di valutazione si applica non solo per la valutazione dell’introduzione di nuovi vac

Published
2021

24. Influenza surveillance system and Covid-19

Author

Castrofino, A, primary, Del Castillo, G, additional, Grosso, F, additional, Barone, A, additional, Gramegna, M, additional, Galli, C, additional, Tirani, M, additional, Castaldi, S, additional, Pariani, E, additional, and Cereda, D, additional

Published
2020
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26. Interim 2017/18 influenza seasonal vaccine effectiveness: combined results from five European studies

Author

Rondy, M, Kissling, E, Emborg, Hd, Gherasim, A, Pebody, R, Trebbien, R, Pozo, F, Larrauri, A, Mcmenamin, J, Valenciano, M, Kaic, B, Kurecic Filipovic, S, Visekruna-Vucina, V, Pem Novosel, I, Lovric, Z, Petrović, G, Krause, Tg, Fischer, Tk, Lina, B, Falchi, Antonella, Vilcu, Am, Souty, C, Blanchon, T, van der Werf, S, Enouf, V, Behillil, S, Valette, M, Bernard-Stoecklin, S, Lévy-Bruhl, D, Launay, O, Loulergue, P, Lenzi, N, Lesieur, Z, L'Honneur, As, Galtier, F, Agostini, C, Serrand, C, Merle, C, Foulongne, V, Vanhems, P, Lainé, F, Lagathu, G, Carrat, F, Buda, S, Preuss, U, Prahm, K, Schweiger, B, Wedde, M, Heider, A, Martin, M, Biere, B, Duerrwald, R, Domegan, L, Coughlan, L, O’Donnell, J, Joyce, M, Collins, C, Dunford, L, Martin Moran, Josè Manuel, Tuite, G, Duffy, M, Connell, J, de Gascun, C, Rizzo, C, Bella, A, Alfonsi, V, Castrucci, Mr, Puzelli, S, Pagani, E, Ghisetti, V, Pariani, E, Baldanti, F, Palù, G, D'Agaro, P, Ansaldi, F, Affanni, P, Rossolini, Gm, Camilloni, B, Bagnarelli, P, Sanguinetti, M, Atripaldi, L, Chironna, M, Serra, C, Vitale, F, Germinario, C, Orsi, A, Manini, I, Montomoli, E, Napoli, C, Orsi, Gb, Casado, I, Castilla, J, Fernandino, L, Martínez-Baz, I, Ezpeleta, G, Navascués, A, Pérez-García, A, Aguinaga, A, Ezpeleta, C, Meijer, A, van den Brink, S, van der Hoek, W, Goderski, G, Wijsman, L, Bagheri, M, Dijkstra, F, de Lange, M, Marzec, T, Overduin, P, Teirlinck, A, Wentink, E, Donker, G, Marbus, S, van Gageldonk- Lafeber, R, Schneeberger, P, van Oosterheert JJ, Schweitzer, V, Groeneveld, G, Nunes, B, RIBEIRO MACHADO, CARLOS AUGUSTO, Rodrigues, Ap, DIAZ GOMEZ, MARIA VANESSA, Kislaya, I, Guiomar, R, Pechirra, P, Cristóvão, P, Costa, I, Panarra, A, Côrte-Real, R, Poças, J, João Peres, M, García Comas, L, Marisquerena, Mei, Galán, Jc, Folgueira, D, Gonzalez Carril, F, Sancho Martínez, R, Cilla, G, García Cenoz, M, Quiñones Rubio, C, Martinez Ochoa, E, Blasco, M, Gimenez Duran, J, Vanrell, Jm, Reina, J, Castrillejo, D, Gherasim, Am, Delgado, C, Oliva, J, Casas, I, García, M, Latorre, M, Milagro Beamonte AM, Martinez Sapiñ, A, Oribe Amores, M, Aizpurúa, A, Montes, Marco, Zakikhany, K, Brytting, M, Wiman, Å, Carnahan, A, Warburton, F, Djennad, A, Ellis, J, Andrews, N, Marques, D, Cottrell, S, Reynolds, Alexander, Gunson, R, Galiano, M, Lackenby, A, Robertson, C, O’Doherty, M, Sinnathamby, M, Yonova, I, Moore, C, Sartaj, M, de Lusignan, S, Zambon, M, Moren, A, Penttinen, P., Unión Europea, EpiConcept [Paris], Statens Serum Institut [Copenhagen], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Rondy M., Kissling E., Emborg H.-D., Gherasim A., Pebody R., Trebbien R., Pozo F., Larrauri A., McMenamin J., Valenciano M., Kaic B., Filipovic S.K., Visekruna-Vucina V., Novosel I.P., Lovric Z., Petrovic G., Krause T.G., Fische T.K., Lina B., Falchi A., Vilcu A.-M., Souty C., Blanchon T., van der Werf S., Enouf V., Behillil S., Valette M., Bernard-Stoecklin S., Levy-Bruhl D., Launay O., Loulergue P., Lenzi N., Lesieur Z., L'Honneur A.-S., Galtier F., Agostini C., Serrand C., Merle C., Foulongne V., Vanhems P., Laine F., Lagathu G., Carrat F., Buda S., Preuss U., Prahm K., Schweiger B., Wedde M., Heider A., Martin M., Biere B., Duerrwald R., Domegan L., Coughlan L., O'Donnell J., Joyce M., Collins C., Dunford L., Moran J., Tuite G., Duffy M., Connell J., de Gascun C., Rizzo C., Bella A., Alfonsi V., Castrucci M.R., Puzelli S., Pagani E., Ghisetti V., Pariani E., Baldanti F., Palu G., D'Agaro P., Ansaldi F., Affanni P., Rossolini G.M., Camilloni B., Bagnarelli P., Sanguinetti M., Atripaldi L., Chironna M., Serra C., Vitale F., Germinario C., Orsi A., Manini I., Montomoli E., Napoli C., Orsi G.B., Casado I., Castilla J., Fernandino L., Martinez-Baz I., Ezpeleta G., Navascues A., Perez-Garcia A., Aguinaga A., Ezpeleta C., Meijer A., van den Brink S., van der Hoek W., Goderski G., Wijsman L., Bagheri M., Dijkstra F., de Lange M., Marzec T., Overduin P., Teirlinck A., Wentink E., Donker G., Marbus S., van Gageldonk-Lafeber R., Schneeberger P., van Oosterheert J.J., Schweitzer V., Groeneveld G., Nunes B., Machado A., Rodrigues A.P., Gomez V., Kislaya I., Guiomar R., Pechirra P., Cristovao P., Costa I., Panarra A., Corte-Real R., Pocas J., Peres M.J., Comas L.G., Marisquerena M.E.I., Galan J.C., Folgueira M.D., Carril F.G., Martinez R.S., Cilla G., Cenoz M.G., Rubio C.Q., Ochoa E.M., Blasco M., Duran J.G., Vanrell J.M., Reina J., Castrillejo D., Gherasim A.M., Delgado C., Oliva J., Casas I., Garcia M., Latorre M., Beamonte A.M.M., Sapina A.M., Amores M.O., Aizpurua A., Montes M., Zakikhany K., Brytting M., Wiman A., Carnahan A., Warburton F., Djennad A., Ellis J., Andrews N., Marques D., Cottrell S., Reynolds A., Gunson R., Galiano M., Lackenby A., Robertson C., O'Doherty M., Sinnathamby M., Yonova I., Moore C., Sartaj M., de Lusignan S., Zambon M., Moren A., Penttinen P., Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Marc, Rondy, Esther, Kissling, Hanne-Dorthe, Emborg, Alin, Gherasim, Richard, Pebody, Ramona, Trebbien, Francisco, Pozo, Amparo, Larrauri, Jim, Mcmenamin, Marta, Valenciano, D'Agaro, Pierlanfranco, De Lusignan, S, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Université de Montpellier (UM)

Subjects
0301 basic medicine, Male, Pediatrics, Epidemiology, viruses, Influenza B viru, influenza, influenza vaccine effectiveness, influenza vaccination, case control study, multicentre study, Europe, Europe, case control study, influenza, influenza vaccination, influenza vaccine effectiveness, multicentre study, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Interim, Pandemic, Influenza A Virus, 030212 general & internal medicine, QA, Influenza vaccine effectiveness, Child, media_common, Vaccine Effectiveness, Vaccination, virus diseases, Middle Aged, 3. Good health, Treatment Outcome, Influenza Vaccines, Child, Preschool, H3N2 Subtype, Female, Seasons, Influenza Vaccine, Rapid Communication, Human, Adult, RM, medicine.medical_specialty, Adolescent, Influenza vaccine, 030106 microbiology, Case control study, Multicentre study, European studies, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, 03 medical and health sciences, Virology, Influenza, Human, medicine, media_common.cataloged_instance, Humans, H1N1 Subtype, Vacina Antigripal, European Union, European union, Preschool, Pandemics, Aged, Influenza A Virus, H3N2 Subtype, Cuidados de Saúde, Public Health, Environmental and Occupational Health, Infant, Newborn, Infant, Influenza a, influenza vaccine effectivene, Newborn, Influenza, respiratory tract diseases, Influenza vaccination, Influenza B virus, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Determinantes da Saúde e da Doença, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology
Abstract

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, -42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates. Funding: The five studies have received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 634446 to conduct the study in individuals aged 65 years or more. ECDC has contributed to fund some study sites of the EU-PC study under the Framework contract No ECDC/2014/026 for the individuals aged less than 65 years. All study teams are very grateful to all patients, general practitioners, paediatricians, hospital teams, laboratory teams, regional epidemiologists who have contributed to the studies. We acknowledge the authors, originating and submitting laboratories of the sequences from GISAID’s EpiFlu Database used for this study. All submitters of data may be contacted directly via the GISAID website www.gisaid.org Sí

Published
2018

27. Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016: A Case Series and Epidemiologic Overview

Author

Knoester, Marjolein, Helfferich, J, Poelman, Randy, Van Leer-Buter, Coretta, Brouwer, OF, Niesters, Hubert G.M., Aberle, SW, Popow-Kraupp, T, Nikolaeva-Glomb, L, Rainetova, P, Midgley, Sofie, Fischer, T.K., Simonlatser, G, Savolainen-Kopra, Carita, Lina, Bruno, Shuffenecker, I, Kossorotoff, M, Antona, D, Eis-Hübinger, Anna M., Buderus, S, Panning, Marcus, Nowotny, Marlene, Kiechle, L, Böttcher, S, Takács, Monika, Farkas, Árpád, Love, A, Baldanti, Fausto, Piralla, Antonio, Capobianchi, Maria R, Valli, Mats, Esposito, S, Pariani, E, Binda, S, Neuteboom, R, Pas, Suzan D., Benschop, Kimberley, Meijer, A, Nordbø, SA, Hafström, Maria, Dudman, Susanne Gjeruldsen, Pfeiffer, H, Guiomar, R, Palminha, P, Costa, I, Dias, Assembayev, Tecu, C, Cherciu, CM, Lazarevic, Ivana, Filipovic-Vignjevic, S, Berginc, Natasa, Marguello, MG, Cabrerizo, Maria, Garcia-Iniguez, JP, Perez-Castro, S, Rodrigo, CP, Antón, Annie, Rabella, N, Dyrdak, Robert, Albert, J, Kramer, R.B.G., Stacpoole, S, Thomas, R, O'Flaherty, N, Drew, RA, Templeton, K, McDougall, Craig, Eunson, Paul, Chinchankar, N, Shetty, J, Moore, Catherine, and Williams, C

Subjects
Male, Baclofen, PARALYSIS, viruses, OUTBREAK, Settore MED/42 - Igiene Generale e Applicata, Respiratory System, ENTEROVIRUS D68 INFECTION, CHILDREN, medicine.disease_cause, Pediatrics, Original Studies, Disease Outbreaks, Feces, 0302 clinical medicine, EV-D68, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, Child, UPPER RESPIRATORY-TRACT, AUGUST, Enterovirus D, Human, enterovirus, Respiratory disease, virus diseases, Neuromuscular Diseases, Middle Aged, Perinatology and Child Health, Settore MED/07 - Microbiologia e Microbiologia Clinica, Europe, medicine.anatomical_structure, Infectious Diseases, Child, Preschool, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Muscle Hypotonia, Respiratory virus, Female, Rhinovirus, NEUROLOGICAL ILLNESS, laboratory surveillance, Adult, Microbiology (medical), Adolescent, Picornaviridae, Enterovirus D, Young Adult, 03 medical and health sciences, myelitis, 030225 pediatrics, Enterovirus Infections, Humans, IDENTIFICATION, business.industry, Infant, enterovirus D68, CLUSTER, medicine.disease, Virology, Acute flaccid myelitis, Pediatrics, Perinatology and Child Health, Central Nervous System Viral Diseases, Deglutition Disorders, business, Enterovirus D68, Respiratory tract
Abstract

Supplemental Digital Content is available in the text., Background: Enterovirus-D68 (EV-D68) is a respiratory virus within the genus Enterovirus and the family of Picornaviridae. Genetically, it is closely related to rhinovirus that replicates in the respiratory tract and causes respiratory disease. Since 2014, EV-D68 has been associated with the neurologic syndrome of acute flaccid myelitis (AFM). Methods: In October 2016, questionnaires were sent out to a European network including 66 virologists and clinicians, to develop an inventory of EV-D68–associated AFM cases in Europe. Clinical and virologic information of case patients was requested. In addition, epidemiologic information on EV testing was collected for the period between March and October 2016. Results: Twenty-nine cases of EV-D68–associated AFM were identified, from 12 different European countries. Five originated from France, 5 from Scotland and 3 each from Sweden, Norway and Spain. Twenty-six were children (median age 3.8 years), 3 were adults. EV-D68 was detected in respiratory materials (n = 27), feces (n = 8) and/or cerebrospinal fluid (n = 2). Common clinical features were asymmetric flaccid limb weakness, cranial nerve deficits and bulbar symptoms. On magnetic resonance imaging, typical findings were hyperintensity of the central cord and/or brainstem; low motor amplitudes with normal conduction velocities were seen on electromyography. Full clinical recovery was rare (n = 3), and 2 patients died. The epidemiologic data from 16 European laboratories showed that of all EV-D68–positive samples, 99% was detected in a respiratory specimen. Conclusions: For 2016, 29 EV-D68–related AFM cases were identified in mostly Western Europe. This is likely an underestimation, because case identification is dependent on awareness among clinicians, adequate viral diagnostics on respiratory samples and the capability of laboratories to type EVs.

Published
2019

29. Moderate influenza vaccine effectiveness against A(H1N1)pdm09 virus, and low effectiveness against A(H3N2) subtype, 2018/19 season in Italy

Author

Bellino, S., Bella, A., Puzelli, S., Di Martino, A., Facchini, M., Punzo, O., Pezzotti, P., Castrucci, M.R., Di Mario, G., Calzoletti, L., Fabiani, C., Chironna, M., Germinario, C., Tramuto, F., Di Carlo, V., Affanni, P., Grazia Pascucci, M., D'Agaro, P., Gallo, T., Pagani, E., Natter, B., Camilloni, B., Tosti, A., Pariani, E., Senatore, S., Serra, C., Rita Tanchis, P., Ghisetti, V., Tiberti, D., Romano, L., Volpe, E., Giannecchini, S., and Bellino S, Bella A, Puzelli S, Di Martino A, Facchini M, Punzo O, Pezzotti P, Castrucci MR, Tramuto F, The InfluNet Study Group.

Subjects
Male, test-negative case-control study, 0301 basic medicine, Prevalence, Influenza vaccine effectiveness, test-negative case-control study, national influenza surveillance network, Italy, Settore MED/42 - Igiene Generale E Applicata, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Drug Discovery, Epidemiology, 030212 general & internal medicine, Child, Influenza vaccine effectiveness, Aged, 80 and over, national influenza surveillance network, Age Factors, virus diseases, Middle Aged, 3. Good health, Vaccination, Treatment Outcome, Italy, Influenza Vaccines, Child, Preschool, Molecular Medicine, Female, Adult, medicine.medical_specialty, Adolescent, Influenza vaccine, Immunology, Context (language use), Virus, Young Adult, 03 medical and health sciences, Internal medicine, Influenza, Human, medicine, Animals, Humans, Aged, Pharmacology, business.industry, Influenza A Virus, H3N2 Subtype, Case-control study, Infant, 030104 developmental biology, Immunization, Case-Control Studies, business
Abstract

Background: Influenza vaccines are updated every year to match the vaccine strains with currently circulating viruses; consequently influenza vaccine effectiveness (IVE) has to be assessed annually.Research design and methods: A test-negative case-control study was conducted within the context of the Italian sentinel influenza surveillance network to estimate IVE by age group, virus subtype, and vaccine brand in medically attended laboratory-confirmed influenza.Results: In Italy, the 2018/19 influenza season was characterized by the co-circulation of influenza A(H1N1)pdm09 and A(H3N2) viruses. The adjusted IVE estimate in preventing influenza was moderate (44.8%, 95% CI: 18.8 to 62.5) against A(H1N1)pdm09, whereas there was no evidence of effectiveness (1.8%, 95% CI: -37.8 to 30.1) in persons affected by A(H3N2). IVE against A(H1N1)pdm09 decreased with age ranging from 65.7% to 13.1% among children/adolescents and elderly, respectively; moreover results suggest that Vaxigrip Tetra® was more effective against A(H1N1)pdm09 compared to Fluarix Tetra® [62.5% (95% CI: 34.3 to 78.6) vs 24.5% (95% CI: -40.6 to 59.6)]. Low effectiveness (35.2%, 95% CI: -50.8 to 72.1) against A(H3N2) was detected only in the elderly immunized with Fluad®.Conclusions: Findings suggest that influenza vaccines were low to moderately effective, probably due to a mismatch between circulating and vaccine strains.

Published
2019
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31. Influenza Vaccination in Italian Healthcare Workers (2018–2019 Season): Strengths and Weaknesses. Results of a Cohort Study in Two Large Italian Hospitals

Author

Panatto, D., Lai, P. L., Mosca, S., Lecini, E., Orsi, A., Signori, A., Castaldi, S., Pariani, E., Pellegrinelli, L., Galli, C., Anselmi, G., Icardi, G., Sticchi, L., Zangrillo, F., Iovine, M., Marchini, F., Grammatico, F., Pennati, B. M., Zacconi, M., Tassinari, F., Arcuri, C., Canepa, P., Caligiuri, P., Rappazzo, E., Guarona, G., Barisione, G., Varesano, S., Cavazzana, L., Carnevali, D., Del Castillo, G., Forni, G., Gandolfi, C., Grimoldi, L., Magnoni, P., Mosillo, M., Pietronigro, A., Principi, N., Tiwana, N., Battistini, A., Di Bella, A. M., Guglielmi, B., Bellina, D., Talamini, A., Daturi, V., and Ziferro, R.

Subjects
0301 basic medicine, Influenza vaccine, Healthcare workers, Influenza, Influenza vaccination, Influenza vaccination coverage, Laboratory-confirmed influenza, 030106 microbiology, Immunology, lcsh:Medicine, laboratory-confirmed influenza, Article, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Drug Discovery, Health care, Medicine, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, influenza vaccination coverage, healthcare workers, business.industry, Proportional hazards model, lcsh:R, Confounding, virus diseases, Influenza a, influenza vaccination, 3. Good health, Vaccination, Infectious Diseases, influenza, business, Strengths and weaknesses, Cohort study
Abstract

Background: Annual vaccination is the most effective way to combat influenza. As influenza viruses evolve, seasonal vaccines are updated annually. Within the European project Development of Robust and Innovative Vaccine Effectiveness (DRIVE), a cohort study involving Italian healthcare workers (HCWs) was carried out during the 2018-2019 season. Two aims were defined: to measure influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza cases and to conduct an awareness-raising campaign to increase vaccination coverage. Methods: Each subject enrolled was followed up from enrollment to the end of the study. Each HCW who developed ILI was swabbed for laboratory confirmation of influenza. Influenza viruses were identified by molecular assays. A Cox regression analysis, crude and adjusted for confounding variables, was performed to estimate the IVE. Results: Among the 4483 HCWs enrolled, vaccination coverage was 32.5%, and 308 ILI cases were collected: 23.4% were positive for influenza (54.2% A(H1N1) pdm09, 45.8% A(H3N2)). No influenza B viruses were detected. No overall IVE was observed. Analyzing the subtypes of influenza A viruses, the IVE was estimated as 45% (95% CI: -59 to 81) for A(H1N1) pdm09. Conclusions: Vaccination coverage among HCWs increased. Study difficulties and the circulation of drifted variants of A(H3N2) could partly explain the observed IVE.

Published
2020

32. Interim 2017/18 influenza seasonal vaccine effectiveness: Combined results from five European studies

Author

Rondy, M., Kissling, E., Emborg, H. -D., Gherasim, A., Pebody, R., Trebbien, R., Pozo, F., Larrauri, A., Mcmenamin, J., Valenciano, M., Kaic, B., Filipovic, S. K., Visekruna-Vucina, V., Novosel, I. P., Lovric, Z., Petrovic, G., Krause, T. G., Fische, T. K., Lina, B., Falchi, A., Vilcu, A. -M., Souty, C., Blanchon, T., van der Werf, S., Enouf, V., Behillil, S., Valette, M., Bernard-Stoecklin, S., Levy-Bruhl, D., Launay, O., Loulergue, P., Lenzi, N., Lesieur, Z., L'Honneur, A. -S., Galtier, F., Agostini, C., Serrand, C., Merle, C., Foulongne, V., Vanhems, P., Laine, F., Lagathu, G., Carrat, F., Buda, S., Preuss, U., Prahm, K., Schweiger, B., Wedde, M., Heider, A., Martin, M., Biere, B., Duerrwald, R., Domegan, L., Coughlan, L., O'Donnell, J., Joyce, M., Collins, C., Dunford, L., Moran, J., Tuite, G., Duffy, M., Connell, J., de Gascun, C., Rizzo, C., Bella, A., Alfonsi, V., Castrucci, M. R., Puzelli, S., Pagani, E., Ghisetti, V., Pariani, E., Baldanti, F., Palu, G., D'Agaro, P., Ansaldi, F., Affanni, P., Rossolini, G. M., Camilloni, B., Bagnarelli, P., Sanguinetti, Maurizio, Atripaldi, L., Chironna, M., Serra, C., Vitale, F., Germinario, C., Orsi, A., Manini, I., Montomoli, E., Napoli, C., Orsi, G. B., Casado, I., Castilla, J., Fernandino, L., Martinez-Baz, I., Ezpeleta, G., Navascues, A., Perez-Garcia, A., Aguinaga, A., Ezpeleta, C., Meijer, A., van den Brink, S., van der Hoek, W., Goderski, G., Wijsman, L., Bagheri, M., Dijkstra, F., de Lange, M., Marzec, T., Overduin, P., Teirlinck, A., Wentink, E., Donker, G., Marbus, S., van Gageldonk-Lafeber, R., Schneeberger, P., van Oosterheert, J. J., Schweitzer, V., Groeneveld, G., Nunes, B., Machado, A., Rodrigues, A. P., Gomez, V., Kislaya, I., Guiomar, R., Pechirra, P., Cristovao, P., Costa, I., Panarra, A., Corte-Real, R., Pocas, J., Peres, M. J., Comas, L. G., Marisquerena, M. E. I., Galan, J. C., Folgueira, M. D., Carril, F. G., Martinez, R. S., Cilla, G., Cenoz, M. G., Rubio, C. Q., Ochoa, E. M., Blasco, M., Duran, J. G., Vanrell, J. M., Reina, J., Castrillejo, D., Gherasim, A. M., Delgado, C., Oliva, J., Casas, I., Garcia, M., Latorre, M., Beamonte, A. M. M., Sapina, A. M., Amores, M. O., Aizpurua, A., Montes, M., Zakikhany, K., Brytting, M., Wiman, A., Carnahan, A., Warburton, F., Djennad, A., Ellis, J., Andrews, N., Marques, D., Cottrell, S., Reynolds, A., Gunson, R., Galiano, M., Lackenby, A., Robertson, C., O'Doherty, M., Sinnathamby, M., Yonova, I., Moore, C., Sartaj, M., de Lusignan, S., Zambon, M., Moren, A., Penttinen, P., Sanguinetti M. (ORCID:0000-0002-9780-7059), Rondy, M., Kissling, E., Emborg, H. -D., Gherasim, A., Pebody, R., Trebbien, R., Pozo, F., Larrauri, A., Mcmenamin, J., Valenciano, M., Kaic, B., Filipovic, S. K., Visekruna-Vucina, V., Novosel, I. P., Lovric, Z., Petrovic, G., Krause, T. G., Fische, T. K., Lina, B., Falchi, A., Vilcu, A. -M., Souty, C., Blanchon, T., van der Werf, S., Enouf, V., Behillil, S., Valette, M., Bernard-Stoecklin, S., Levy-Bruhl, D., Launay, O., Loulergue, P., Lenzi, N., Lesieur, Z., L'Honneur, A. -S., Galtier, F., Agostini, C., Serrand, C., Merle, C., Foulongne, V., Vanhems, P., Laine, F., Lagathu, G., Carrat, F., Buda, S., Preuss, U., Prahm, K., Schweiger, B., Wedde, M., Heider, A., Martin, M., Biere, B., Duerrwald, R., Domegan, L., Coughlan, L., O'Donnell, J., Joyce, M., Collins, C., Dunford, L., Moran, J., Tuite, G., Duffy, M., Connell, J., de Gascun, C., Rizzo, C., Bella, A., Alfonsi, V., Castrucci, M. R., Puzelli, S., Pagani, E., Ghisetti, V., Pariani, E., Baldanti, F., Palu, G., D'Agaro, P., Ansaldi, F., Affanni, P., Rossolini, G. M., Camilloni, B., Bagnarelli, P., Sanguinetti, Maurizio, Atripaldi, L., Chironna, M., Serra, C., Vitale, F., Germinario, C., Orsi, A., Manini, I., Montomoli, E., Napoli, C., Orsi, G. B., Casado, I., Castilla, J., Fernandino, L., Martinez-Baz, I., Ezpeleta, G., Navascues, A., Perez-Garcia, A., Aguinaga, A., Ezpeleta, C., Meijer, A., van den Brink, S., van der Hoek, W., Goderski, G., Wijsman, L., Bagheri, M., Dijkstra, F., de Lange, M., Marzec, T., Overduin, P., Teirlinck, A., Wentink, E., Donker, G., Marbus, S., van Gageldonk-Lafeber, R., Schneeberger, P., van Oosterheert, J. J., Schweitzer, V., Groeneveld, G., Nunes, B., Machado, A., Rodrigues, A. P., Gomez, V., Kislaya, I., Guiomar, R., Pechirra, P., Cristovao, P., Costa, I., Panarra, A., Corte-Real, R., Pocas, J., Peres, M. J., Comas, L. G., Marisquerena, M. E. I., Galan, J. C., Folgueira, M. D., Carril, F. G., Martinez, R. S., Cilla, G., Cenoz, M. G., Rubio, C. Q., Ochoa, E. M., Blasco, M., Duran, J. G., Vanrell, J. M., Reina, J., Castrillejo, D., Gherasim, A. M., Delgado, C., Oliva, J., Casas, I., Garcia, M., Latorre, M., Beamonte, A. M. M., Sapina, A. M., Amores, M. O., Aizpurua, A., Montes, M., Zakikhany, K., Brytting, M., Wiman, A., Carnahan, A., Warburton, F., Djennad, A., Ellis, J., Andrews, N., Marques, D., Cottrell, S., Reynolds, A., Gunson, R., Galiano, M., Lackenby, A., Robertson, C., O'Doherty, M., Sinnathamby, M., Yonova, I., Moore, C., Sartaj, M., de Lusignan, S., Zambon, M., Moren, A., Penttinen, P., and Sanguinetti M. (ORCID:0000-0002-9780-7059)

Abstract

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, -42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates.

Published
2018

33. Tobacco and e-cigarette smoking habits among Italian healthcare students.

Author

Prigitano, A., Binda, S., Pariani, E., Destrebecq, A., Castaldi, S., Cogliati, M., Esposto, M. C., and RomanÃ, L.

Subjects
ELECTRONIC cigarettes, SMOKING cessation, CROSS-sectional method, MEDICAL students, DISEASE prevalence
Abstract

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2020
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34. A 4-year Study on Epidemiologic and Molecular Characteristics of Human Parechoviruses and Enteroviruses Circulating in Children Younger Than 5 Years in Northern Italy

Author

Bubba, L, Martinelli, M, Pellegrinelli, L, Primache, V, Tanzi, E, Pariani, E, Binda, S, MARTINELLI, MARIANNA, Binda, S., Bubba, L, Martinelli, M, Pellegrinelli, L, Primache, V, Tanzi, E, Pariani, E, Binda, S, MARTINELLI, MARIANNA, and Binda, S.

Abstract

Background: Human parechovirus (HPeV) and enterovirus (EV) infections are widespread and can lead to a broad range of symptoms, from the common cold to severe disease (SD). Because of the lack of Italian data, this 4-year retrospective cross-sectional study aimed to investigate the frequency, seasonality and molecular characteristics of EV and HPeV circulating in children younger than 5 years. Methods: A total of 812 samples were collected from children ≤5 years (56.5% males; median age: 20.6 months; interquartile range: 30.1 months) from September 2010 to August 2014. Two real-time RT-PCR assays were used for EV/HPeV and EV-D68 detection. Phylogenetic analysis was performed on the EV-VP1 gene and the HPeV-VP3/VP1 junction. Results: 16.1% and 5.2% of samples were EV- and HPeV-positive, respectively. One sample was EV-D68-positive. The majority (nearly 80%) of EV/HPeV-positive samples was detected in children ≤3 years, during the summer/autumn seasons. The risk of EV infection was higher in children presenting with SD, whereas the risk of infection from HPeV was higher in infants ≤1 year. Most (61.7%) of molecularly characterized EVs belonged to species B, followed by A (29.4%). The majority (66.7%) of characterized HPeVs were type 1, followed by types 3 (20%) and 6 (13.3%). Conclusions: This study shows the significant impact of EV/HPeV circulation in children, particularly among those ≤3 years and during and early autumn, with different pattern of viral strains. The implementation of a national surveillance system could clarify the epidemiologic and clinical characteristics of these viruses in the general population.

Published
2017

35. Genetic analysis of human and swine influenza A viruses isolated in Northern Italy during 2010-2015

Author

Chiapponi, C., primary, Ebranati, E., additional, Pariani, E., additional, Faccini, S., additional, Luppi, A., additional, Baioni, L., additional, Manfredi, R., additional, Carta, V., additional, Merenda, M., additional, Affanni, P., additional, Colucci, M. E., additional, Veronesi, L., additional, Zehender, G., additional, and Foni, E., additional

Published
2017
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39. Genetic analysis of human and swine influenza A viruses isolated in Northern Italy during 2010–2015.

Author

Chiapponi, C., Ebranati, E., Pariani, E., Faccini, S., Luppi, A., Baioni, L., Manfredi, R., Carta, V., Merenda, M., Affanni, P., Colucci, M. E., Veronesi, L., Zehender, G., and Foni, E.

Subjects
SWINE influenza diagnosis, INFLUENZA transmission, PANDEMICS, GENETIC epidemiology
Abstract

Summary: Influenza A virus (IAV) infection in swine plays an important role in the ecology of influenza viruses. The emergence of new IAVs comes through different mechanisms, with the genetic reassortment of genes between influenza viruses, also originating from different species, being common. We performed a genetic analysis on 179 IAV isolates from humans (n. 75) and pigs (n. 104) collected in Northern Italy between 2010 and 2015, to monitor the genetic exchange between human and swine IAVs. No cases of human infection with swine strains were noticed, but direct infections of swine with H1N1pdm09 strains were detected. Moreover, we pointed out a continuous circulation of H1N1pdm09 strains in swine populations evidenced by the introduction of internal genes of this subtype. These events contribute to generating new viral variants—possibly endowed with pandemic potential—and emphasize the importance of continuous surveillance at both animal and human level. [ABSTRACT FROM AUTHOR]

Published
2018
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41. Influenza and other respiratory viruses involved in severe acute respiratory disease in northern Italy during the pandemic and postpandemic period (2009-2011)

Author

Pariani, E, Martinelli, M, Canuti, M, Jazaeri Farsani, S, Oude Munnink, B, Deijs, M, Tanzi, E, Zanetti, A, Van Der Hoek, L, Amendola, A, Amendola, A., MARTINELLI, MARIANNA, Pariani, E, Martinelli, M, Canuti, M, Jazaeri Farsani, S, Oude Munnink, B, Deijs, M, Tanzi, E, Zanetti, A, Van Der Hoek, L, Amendola, A, Amendola, A., and MARTINELLI, MARIANNA

Abstract

Since 2009 pandemic, international health authorities recommended monitoring severe and complicated cases of respiratory disease, that is, severe acute respiratory infection (SARI) and acute respiratory distress syndrome (ARDS). We evaluated the proportion of SARI/ARDS cases and deaths due to influenza A(H1N1)pdm09 infection and the impact of other respiratory viruses during pandemic and postpandemic period (2009-2011) in northern Italy; additionally we searched for unknown viruses in those cases for which diagnosis remained negative. 206 respiratory samples were collected from SARI/ARDS cases and analyzed by real-time RT-PCR/PCR to investigate influenza viruses and other common respiratory pathogens; also, a virus discovery technique (VIDISCA-454) was applied on those samples tested negative to all pathogens. Influenza A(H1N1)pdm09 virus was detected in 58.3% of specimens, with a case fatality rate of 11.3%. The impact of other respiratory viruses was 19.4%, and the most commonly detected viruses were human rhinovirus/enterovirus and influenza A(H3N2). VIDISCA-454 enabled the identification of one previously undiagnosed measles infection. Nearly 22% of SARI/ARDS cases did not obtain a definite diagnosis. In clinical practice, great efforts should be dedicated to improving the diagnosis of severe respiratory disease; the introduction of innovative molecular technologies, as VIDISCA-454, will certainly help in reducing such "diagnostic gap." © 2014 Elena Pariani et al

Published
2014

42. Phylogeny and population dynamics of respiratory syncytial virus (Rsv) A and B

Author

Martinelli, M, Frati, E, Zappa, A, Ebranati, E, Bianchi, S, Pariani, E, Amendola, A, Zehender, G, Tanzi, E, MARTINELLI, MARIANNA, Tanzi, E., Martinelli, M, Frati, E, Zappa, A, Ebranati, E, Bianchi, S, Pariani, E, Amendola, A, Zehender, G, Tanzi, E, MARTINELLI, MARIANNA, and Tanzi, E.

Abstract

Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in infants and young children. RSV is characterised by high variability, especially in the G glycoprotein, which may play a significant role in RSV pathogenicity by allowing immune evasion. To reconstruct the origin and phylodynamic history of RSV, we evaluated the genetic diversity and evolutionary dynamics of RSV A and RSV B isolated from children under 3 years old infected in Italy from 2006 to 2012. Phylogenetic analysis revealed that most of the RSV A sequences clustered with the NA1 genotype, and RSV B sequences were included in the Buenos Aires genotype. The mean evolutionary rates for RSV A and RSV B were estimated to be 2.1×10-3 substitutions (subs)/site/year and 3.03×10-3 subs/site/year, respectively. The time of most recent common ancestor for the tree root went back to the 1940s (95% highest posterior density-HPD: 1927-1951) for RSV A and the 1950s (95%HPD: 1951-1960) for RSV B. The RSV A Bayesian skyline plot (BSP) showed a decrease in transmission events ending in about 2005, when a sharp growth restored the original viral population size. RSV B BSP showed a similar trend. Site-specific selection analysis identified 10 codons under positive selection in RSV A sequences and only one site in RSV B sequences. Although RSV remains difficult to control due to its antigenic diversity, it is important to monitor changes in its coding sequences, to permit the identification of future epidemic strains and to implement vaccine and therapy strategies. © 2014 Elsevier B.V

Published
2014

44. Segregation of virulent influenza A(H1N1) variants in the lower respiratory tract of critically ill patients during the 2010-2011 seasonal epidemic

Author

Piralla, A, Pariani, E, Rovida, F, Campanini, G, Muzzi, A, Emmi, V, Iotti, G, Pesenti, A, Conaldi, P, Zanetti, A, Baldanti, F, Iotti, GA, PESENTI, ANTONIO MARIA, Conaldi, PG, Baldanti, F., Piralla, A, Pariani, E, Rovida, F, Campanini, G, Muzzi, A, Emmi, V, Iotti, G, Pesenti, A, Conaldi, P, Zanetti, A, Baldanti, F, Iotti, GA, PESENTI, ANTONIO MARIA, Conaldi, PG, and Baldanti, F.

Abstract

Background: Since its appearance in 2009, the pandemic influenza A(H1N1) virus circulated worldwide causing several severe infections. Methods: Respiratory samples from patients with 2009 influenza A(H1N1) and acute respiratory distress attending 24 intensive care units (ICUs) as well as from patients with lower respiratory tract infections not requiring ICU admission and community upper respiratory tract infections in the Lombardy region (10 million inhabitants) of Italy during the 2010-2011 winter-spring season, were analyzed. Results: In patients with severe ILI, the viral load was higher in bronchoalveolar lavage (BAL) with respect to nasal swab (NS), (p<0.001) suggesting a higher virus replication in the lower respiratory tract. Four distinct virus clusters (referred to as cluster A to D) circulated simultaneously. Most (72.7%, n = 48) of the 66 patients infected with viruses belonging to cluster A had a severe (n = 26) or moderate ILI (n = 22). Amino acid mutations (V26I, I116M, A186T, D187Y, D222G/N, M257I, S263F, I286L/M, and N473D) were observed only in patients with severe ILI. D222G/N variants were detected exclusively in BAL samples. Conclusions: Multiple virus clusters co-circulated during the 2010-2011 winter-spring season. Severe or moderate ILI were associated with specific 2009 influenza A(H1N1) variants, which replicated preferentially in the lower respiratory tract. © 2011 Piralla et al.

Published
2011

45. Epidemiological and clinical features of respiratory viral infections in hospitalized children during the circulation of influenza virus A(H1N1) 2009

Author

Zuccotti, G, Dilillo, D, Zappa, A, Galli, E, Amendola, A, Martinelli, M, Pariani, E, Salvini, F, Tanzi, E, Riva, E, Giovannini, M, Giovannini, M., MARTINELLI, MARIANNA, Zuccotti, G, Dilillo, D, Zappa, A, Galli, E, Amendola, A, Martinelli, M, Pariani, E, Salvini, F, Tanzi, E, Riva, E, Giovannini, M, Giovannini, M., and MARTINELLI, MARIANNA

Abstract

Please cite this paper as: Zuccotti et al. (2011) Epidemiological and clinical features of respiratory viral infections in hospitalized children during the circulation of influenza virus A(H1N1) 2009. Influenza and Other Respiratory Viruses 5(6), e528-e534. Background Seasonal influenza viruses and respiratory syncytial virus (RSV) are primary causes of acute respiratory tract infections (ARTIs) in children. New respiratory viruses including human metapneumovirus (hMPV), human bocavirus (hBoV), and influenza 2009 A(H1N1) virus have a strong impact on the pediatric population. Objectives To evaluate epidemiological and clinical features of ARTIs in hospitalized children. Methods From December 1, 2008, to December 31, 2009, all children under age fifteen (n=575) hospitalized for ARTIs were investigated for influenza A (subtype H1N1, H3N2, and 2009 H1N1) and B, RSV A and B, hMPV, and hBoV by PCR. Results Fifty-one percent of samples were positive for these respiratory viruses. The frequencies of virus detection were RSV 34·1%, hBoV 6·8%, hMPV 5%, seasonal influenza A 5%, and seasonal influenza B 0%. From April 2009, 11·6% of collected samples were influenza 2009 A(H1N1) positive. Respiratory syncytial virus activity peaked in January, hBoV in February, and hMPV in April. Seasonal influenza A was detected only between January and April 2009, while influenza 2009 A(H1N1) peaked in November. Respiratory syncytial virus and hMPV were mainly associated with lower respiratory tract infections (LRTIs) and with necessity of O 2 administration. The 2009 pandemic influenza was more frequently detected in elder children (P<0·001) and was associated with higher, longer-lasting fevers compared with other viral infections (P<0·05). Conclusions All considered viruses were involved in LRTIs. The primary clinical relevance of RSV and a similar involvement of both seasonal influenza and emerging viruses investigated were observed on the pediatric population. © 2011 Blackwell Publishing

Published
2011

50. Is avian influenza virus A(H5N1) a real threat to human health?

Author

Antonella Amendola, Ranghiero, A., Zanetti, A., and Pariani, E.

Subjects
virus diseases
Abstract

The A(H5N1) influenza remains a disease of birds with a significant species barrier: in the presence of some tens million cases of infection in poultry - with a wide geographical spread -, only a few hundreds cases have occurred in humans. To date, human cases have been reported in 15 countries - mainly in Asia - and all were related to the onset of outbreaks in poultry. A peak of H5N1 human cases was recorded in 2006, then decreasing in subsequent years. Despite this trend, the H5N1 virus still represents a possible threat to human health, considering that more than half of human cases of H5N1 have been fatal. Moreover, despite the drop in the number of cases, the risk of a novel pandemic cannot be excluded, since H5N1 continues to circulate in poultry in countries with elevated human population density and where monitoring systems are not fully appropriate. In addition, there is a major global concern about the potential occurrence of a reassortment between the 2009 pandemic H1N1 and the highly pathogenic H5N1 influenza viruses following a co-infection in a susceptible host. Therefore, the implementation of appropriate surveillance and containment measures is crucial in order to minimize such risk. In conclusion, H5N1 avian influenza is still a rare disease in humans but its clinical severe outcome requires a careful monitoring of the virus?s ability to evolve and to trigger a new pandemic., Journal of Preventive Medicine and Hygiene, Vol 52, No 3 (2011)

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