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Moro ML, Grilli E, Corvetta A, Silvi G, Angelini R, Mascella F, Miserocchi F, Sambo P, Finarelli AC, Sambri V, Gagliotti C, Massimiliani E, Mattivi A, Pierro AM, Macini P. Long-term chikungunya infection clinical manifestations after an outbreak in Italy: a prognostic cohort study. J Infect 2012; 65:165-72. [PMID: 22522292 DOI: 10.1016/j.jinf.2012.04.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/12/2012] [Accepted: 04/08/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Following a Chikungunya (CHIKV) outbreak in Italy, a cohort study was conducted to describe the infection long-term clinical course and outcome. METHODS Persons identified through active and passive surveillance as confirmed or possible CHIKV cases during the outbreak were enrolled and interviewed by trained public health nurses, between 4-5 and 12-13 months following the acute stage. Patients reporting persistent clinical symptoms were evaluated by rheumatologists. Serum samples were obtained and anti-CHIKV specific IgG and IgM immune responses detected. Only confirmed cases who completed the follow-up were analysed. RESULTS Out of 250 patients, 66.5% still reported myalgia, asthenia or arthralgia (most frequent sign) after 12 months. Functional ability, measured by the ROAD index, was more impaired for lower extremities (3.75; Inter Quartile Range - IQR 4.4), and the activities of daily living (average 4.2; IQR 5). Variables independently associated with the presence of joint pain at 12-13 months were increasing age, and history of rheumatologic diseases). Elderly, females, and persons with history of rheumatologic diseases had higher anti-CHIKV IgG titres at 12-13 months. CONCLUSIONS This study confirms, in an unselected population, that the long-lasting burden of CHIKV infection is significant.
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Affiliation(s)
- M L Moro
- Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regione Emilia-Romagna, Viale Aldo Moro 21, Bologna, Italy.
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Capobianchi MR, Sambri V, Castilletti C, Pierro AM, Rossini G, Gaibani P, Cavrini F, Selleri M, Meschi S, Lapa D, Di Caro A, Grossi P, De Cillia C, Venettoni S, Landini MP, Ippolito G, Nanni Costa A. Retrospective screening of solid organ donors in Italy, 2009, reveals unpredicted circulation of West Nile virus. ACTA ACUST UNITED AC 2010; 15. [PMID: 20807488 DOI: 10.2807/ese.15.34.19648-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the occurrence of West Nile virus (WNV) infection in humans in 2008 in Italy, concerns have been raised about the potential risks associated with solid organ transplantation (SOT). A nationwide retrospective survey showed that 1.2% of SOT donors in 2009 were WNV-seropositive and demonstrated that human WNV infection is distributed throughout several Italian regions. Transmission of WNV or other arboviruses through SOT is a possibility and risk assessment should be carried out before SOT to avoid infection through transplantation.
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Affiliation(s)
- M R Capobianchi
- National Institute for Infectious Diseases (INMI) L. Spallanzani , Rome, Italy.
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3
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Angelini P, Tamba M, Finarelli AC, Bellini R, Albieri A, Bonilauri P, Cavrini F, Dottori M, Gaibani P, Martini E, Mattivi A, Pierro AM, Rugna G, Sambri V, Squintani G, Macini P. West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009. Euro Surveill 2010; 15:19547. [PMID: 20430000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.
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Affiliation(s)
- P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy.
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Angelini P, Tamba M, Finarelli AC, Bellini R, Albieri A, Bonilauri P, Cavrini F, Dottori M, Gaibani P, Martini E, Mattivi A, Pierro AM, Rugna G, Sambri V, Squintani G, Macini P. West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009. Euro Surveill 2010. [DOI: 10.2807/ese.15.16.19547-en] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.
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Affiliation(s)
- P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Bellini
- Centro Agricoltura Ambiente “G Nicoli”, Crevalcore, Italy
| | - A Albieri
- Centro Agricoltura Ambiente “G Nicoli”, Crevalcore, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - F Cavrini
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Gaibani
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - E Martini
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A M Pierro
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - G Rugna
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - V Sambri
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola–Malpighi, Bologna, Italy
| | - G Squintani
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - P Macini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
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Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.50.19448-en] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
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Affiliation(s)
- F Cavrini
- These Authors contributed equally to this paper and are listed in alphabetical order
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Gaibani
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
- These Authors contributed equally to this paper and are listed in alphabetical order
| | - G Longo
- Oncology and Haematology Unit, Modena University Hospital, Modena, Italy
| | - A M Pierro
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - G Rossini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Bonilauri
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - G E Gerunda
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - F Di Benedetto
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - A Pasetto
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Girardis
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Dottori
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - M P Landini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - V Sambri
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
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Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009; 14:19448. [PMID: 20070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
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Affiliation(s)
- F Cavrini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies-CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
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