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Gori M, Fappani C, Bianchi S, Senatore S, Colzani D, Pasutto P, Baggieri M, Gioacchini S, Marchi A, Bucci P, D'Ugo E, Faccini M, Cereda D, Vezzosi L, Tanzi E, Magurano F, Amendola A. Increased reports of measles in the Metropolitan City of Milan, northern Italy, September 2023 to March 2024. Euro Surveill 2024; 29:2400201. [PMID: 38639092 PMCID: PMC11027472 DOI: 10.2807/1560-7917.es.2024.29.16.2400201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024] Open
Abstract
Since late 2023, the Metropolitan City of Milan and surrounding areas (northern Italy) have been experiencing a resurgence of measles, with most cases detected starting from January 2024. During this brief period, we observed measles in travellers from endemic areas, participants in international events, vaccinees and healthcare workers. Indigenous cases have also been identified. Even though we have not yet identified large and disruptive outbreaks, strengthening surveillance and vaccination activities is pivotal to help limit the impact of measles spread.
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Affiliation(s)
- Maria Gori
- These authors contributed equally to the work and share first authorship
- Coordinated Research Centre "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Centre "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- These authors contributed equally to the work and share first authorship
| | - Silvia Bianchi
- Coordinated Research Centre "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Sabrina Senatore
- Health Protection Agency of the Metropolitan Area of Milan, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Priscilla Pasutto
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Melissa Baggieri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Gioacchini
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Marchi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Bucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Emilio D'Ugo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marino Faccini
- Health Protection Agency of the Metropolitan Area of Milan, Milan, Italy
| | - Danilo Cereda
- General Directorate of Welfare, Regione Lombardia, Milan, Italy
| | - Luigi Vezzosi
- General Directorate of Welfare, Regione Lombardia, Milan, Italy
| | - Elisabetta Tanzi
- Coordinated Research Centre "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Fabio Magurano
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Amendola
- Coordinated Research Centre "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Henin D, Fappani C, Carmagnola D, Gori M, Pellegrini G, Colzani D, Amendola A, Perrotta M, Tanzi E, Dellavia C. COVID-19 monitoring of school personnel through molecular salivary test and dried blood spot analysis. J Glob Health 2024; 14:05004. [PMID: 38330189 PMCID: PMC10852534 DOI: 10.7189/jogh.14.05004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background When the coronavirus disease 2019 (COVID-19) pandemic broke out, most countries enforced school closures as a precautionary measure. Although COVID-19 is still present three years later, schools have been reopened. We aimed to test the association of molecular salivary testing (MST) and dried blood spot (DBS) analysis for community surveillance by investigating the immunological profile of a group of school staff during and following COVID-19 vaccination. Methods We conducted the study in a school in Milan from April 2021, when school staff were administered the first dose of vaccine against SARS-CoV-2, until the school year ended in June 2022. Each participant provided samples for MST and DBS one month (T1, W1) after receiving their first dose of vaccine. Subsequently, they collected weekly MST samples for five weeks (W2-W6), plus a DBS sample in the last week (T2). Both samples were collected one (T3), four (T4), and seven months (T5) after the administration of the second vaccine dose in May 2021. A final DBS sample was collected one year (T6) after T3. Results Sixty participants provided 327 MSTs and 251 DBSs. None of the MST samples tested positive for SARS-CoV-2 RNA during the study period. A total of 201 DBS samples tested positive for the IgG semiquantitative analysis. Negative samples were found only at T1 (20.45%) and T2 (7.32%). We observed borderline results at T1 (4.55%), T2 (7.32%), and T4 (2.70%). The anti-SARS-CoV-2 average antibody ratio increased after the second dose between T2 and T3, and the trend peaked after the third dose between T4 and T6. We performed an immunoenzymatic assay of antibodies against nucleocapsid protein on samples collected at T1 from five participants who reported having been infected before the study and from four subjects with an abnormal increase in the antibody values at T4. Two samples tested positive in the first group and two in the second one. Conclusions Our findings show that MST and DBS could be effective tools in the active surveillance of school personnel and that schools could be considered safe settings in view of SARS-CoV-2 infection. Vaccines might have contributed to case and/or symptom reduction.
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Affiliation(s)
- Dolaji Henin
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
| | - Mariachiara Perrotta
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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Fappani C, Gori M, Bianchi S, Canuti M, Colzani D, Baggieri M, Gioacchini S, D'Ugo E, Tanzi E, Magurano F, Amendola A. Letter to the editor: Further identification of a measles variant displaying mutations impacting molecular diagnostics, Northern Italy, 2024. Euro Surveill 2024; 29:2400079. [PMID: 38362623 PMCID: PMC10986655 DOI: 10.2807/1560-7917.es.2023.29.7.2400079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- These authors contributed equally to this work and share first authorship
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
- These authors contributed equally to this work and share first authorship
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
| | - Marta Canuti
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
| | - Melissa Baggieri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Gioacchini
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Emilio D'Ugo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
| | - Fabio Magurano
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università Degli Studi di Milano, Milan, Italy
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Fappani C, Gori M, Bianchi S, Terraneo M, Bilardi E, Colzani D, Tanzi E, Canuti M, Amendola A. Differential diagnosis of fever and rash cases negative for measles and rubella to complement surveillance activities. J Med Virol 2023; 95:e29141. [PMID: 37796084 DOI: 10.1002/jmv.29141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/09/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
In the quest to eliminate measles virus (MV) and rubella virus (Ruv), every suspected case must be properly identified and diagnosed. Since 2017, in Milan (Italy), a total of 978 measles and rubella suspected cases (fever and rash) were investigated and 310 were not laboratory confirmed (discarded cases). To improve surveillance activities, we investigated the presence in discarded cases of 8 other viral pathogens commonly associated with rash: human herpesvirus 6 (HHV-6) and 7 (HHV-7), parvovirus B19 (B19V), enterovirus (EV), Epstein-Barr virus (EBV), human adenovirus (HAdV), cytomegalovirus (HCMV), and SARS-CoV-2. Differential diagnosis was carried out on 289 discarded cases by multiplex real-time PCR assays. At least one pathogen was detected in 188 cases (65.1%) with HHV-7 being the most frequently detected virus. No difference in the number of detected infections overtime was observed and infections were identified in all age groups. As expected, most HHV-6, EV, HAdV, and HCMV-positive cases were found in children aged 0-4 years and HHV-7 was most frequent in the 15-39 age group. In light of the World Health Organization measles elimination goal, the introduction of laboratory methods for differential diagnosis is required for the final classification of clinically compatible cases. The used screening panel allowed us to increase the percentage of virus-positive cases to 87.5%, allowing us to clarify viral involvement and epidemiology, improve diagnosis, and strengthen surveillance activities. As all investigated pathogens were detected, this diagnostic panel was a suitable tool to complement MV and RuV surveillance activities.
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Affiliation(s)
- Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Mara Terraneo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Erica Bilardi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
| | - Marta Canuti
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
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Amendola A, Borghi E, Bianchi S, Gori M, Fappani C, Barcellini L, Forlanini F, Garancini N, Nava C, Mari A, Sala A, Gasparini C, Ottaviano E, Colzani D, Biganzoli EM, Tanzi E, Zuccotti GV. Preschool-located influenza vaccination and influenza-like illness surveillance: an Italian pilot experience. Ital J Pediatr 2023; 49:91. [PMID: 37480047 PMCID: PMC10362647 DOI: 10.1186/s13052-023-01481-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/01/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND We describe the first school-located influenza vaccination campaign with quadrivalent live-attenuated influenza vaccine (LAIV) among pre-school children in Italy, coupled with an innovative school-centred influenza-like illnesses (ILIs) surveillance using a self-sampling non-invasive saliva collection method. METHODS The pilot study was proposed during the 2021/2022 influenza season to fifteen pre-schools in the Milan municipality. LAIV was offered directly in school to all healthy children without contraindications. ILI differential diagnosis was conducted by real-time RT-PCR for influenza A/B and SARS-CoV-2. RESULTS Five pre-schools were involved in the pilot project and overall, 135 families (31.2%) participated in the study, adhering to both surveillance and vaccination; 59% of families had an immigrant background. No pupil experienced adverse reactions after vaccination. Nineteen saliva samples were collected from sixteen children (11.8%). Six samples (31.6%) tested positive for SARS-CoV-2; none was positive for influenza A/B. CONCLUSIONS The participation in the immunisation campaign was good, considering possible absences due to COVID-19 pandemic, and the intranasal administration was well tolerated and helped to overcome parental hesitancy. Saliva sampling represented a useful tool to reduce children's stress and increase parents' compliance. The high participation of families with an immigrant background suggests that school-based interventions can represent an effective strategy to overcome socioeconomic and cultural barriers.
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Affiliation(s)
- Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy.
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy.
| | - Elisa Borghi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, 20133, Italy
| | - Lucia Barcellini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Federica Forlanini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Nicolò Garancini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Chiara Nava
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Alessandra Mari
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Anna Sala
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Chiara Gasparini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Emerenziana Ottaviano
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
| | - Elia Mario Biganzoli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, 20157, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
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Bianchi S, Fappani C, Gori M, Canuti M, Colzani D, Monti MC, Torriani C, Raviglione MC, Zuccotti G, Tanzi E, Amendola A. Serological investigation of SARS-CoV-2 infection in patients with suspect measles, 2017-2022. Virol J 2023; 20:160. [PMID: 37474969 PMCID: PMC10357797 DOI: 10.1186/s12985-023-02117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Several studies suggested that SARS-CoV-2 was already spreading worldwide during the last months of 2019 before the first outbreak was detected in Wuhan, China. Lombardy (Northern Italy) was the first European region with sustained SARS-CoV-2 transmission and recent investigations detected SARS-CoV-2-RNA-positive patients in Lombardy since late 2019. METHODS We tested for anti-SARS-CoV-2 IgG all serum samples available in our laboratory (N = 235, collected between March 2017 and March 2022) that we received within the framework of measles/rubella surveillance from measles and rubella virus-negative patients. RESULTS Thirteen of 235 samples (5.5%) were IgG-positive. The positivity rate increased starting in 2019 and was significantly different from the expected false positive rate from 2019 onwards. Additionally, in 2019 the percentage of IgG-positive patients was significantly lower among SARS-CoV-2 RNA-negative patients (3/92) compared to SARS-CoV-2 RNA-positive patients (2/7, p = 0.04). The highest percentage of IgG positivity in the pre-pandemic period was recorded during the second half of 2019. This coincided with an increase in negativity for measles and a widening of the peak of the number of measles discarded cases per 100,000 inhabitants, indicating a higher-than-normal number of measles-negative patients experiencing fever and rash. This also coincided with the first patient positive for SARS-CoV-2 RNA (September 12th, 2019); this patient was also positive for anti-SARS-CoV-2 IgG and IgM. CONCLUSIONS Although the number of samples was low and one cannot conclusively establish that the virus started circulating in Lombardy around September 2019, our findings should stimulate similar research investigating the possibility of undetected SARS-CoV-2 pre-pandemic circulation.
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Affiliation(s)
- Silvia Bianchi
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy
| | - Clara Fappani
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy
| | - Marta Canuti
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy.
- Department of Pathophysiology and Transplantation, Universita' degli Studi di Milano, Milan, Italy.
- Centre for Multidisciplinary Research in Health Science (MACH), Universita' degli Studi di Milano, Milan, Italy.
| | - Daniela Colzani
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Maria Cristina Monti
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Camilla Torriani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Mario C Raviglione
- Department of Pathophysiology and Transplantation, Universita' degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Universita' degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Paediatrics, Children Hospital V. Buzzi, Universita' degli Studi di Milano, Milan, Italy
- Romeo and Enrica Invernizzi Pediatric Research Center, Universita' degi Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Universita' degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Universita' degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Universita' degli Studi di Milano, Milan, Italy
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7
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Tanzi E, Bianchi S, Fappani C, Gori M, Colzani D, Passera I, Tincati C, Canuti M, Raviglione M, Amendola A. Detection of human papillomavirus in fresh and dried urine through an automated system for cervical cancer screening in low- and middle-income countries. J Med Virol 2023; 95:e28802. [PMID: 37219045 DOI: 10.1002/jmv.28802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
The majority of cervical cancer cases and associated deaths occur in low- and middle-income countries (LMICs), where sociocultural barriers, poor access to prevention and care, and technical and practical difficulties hinder screening coverage improvement. Using urine specimens for human papillomaviruses (HPV) molecular screening through automated testing platforms can help to overcome these problems. We evaluated the high-risk (HR) HPV detection performance of the Xpert® HPV test on GeneXpert® System (Cepheid), on fresh and dried urine (Dried Urine Spot [DUS]) samples as compared to an in-house polymerase chain reaction (PCR) genotyping assay. Forty-five concentrated urine samples collected from women with known cytological and HPV infection status, determined through in-house PCR and genotyping assays, were tested "as is" and as DUS with the Xpert® HPV test. This system detected HR-HPV in 86.4% of fresh and in 77.3% of dried urine samples collected from HPV+ women, correctly identifying HR-HPV infection in 100% of women with low- and high-grade lesions. High concordance (91.4%, k = 0.82) was found between PCR test and Xpert® HPV Test from urine. Urine-based Xpert® HPV test seems to be a suitable screening test for detection of HR-HPV infections associated with low- and high-grade lesions requiring follow-up monitoring or treatment. This methodology, relying on noninvasively collected samples and on available rapid testing platforms, could facilitate large, at-scale screening programs, particularly in LMICs and rural areas, thus reducing adverse outcomes of HPV infection and facilitating achievement of the WHO cervical cancer elimination goal.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Passera
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Camilla Tincati
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Marta Canuti
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Mario Raviglione
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre MACH (Centre for Multidisciplinary Research in Health Sciences), Università degli Studi di Milano, Milan, Italy
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8
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Amendola A, Canuti M, Bianchi S, Kumar S, Fappani C, Gori M, Colzani D, Kosakovsky Pond SL, Miura S, Baggieri M, Marchi A, Borghi E, Zuccotti G, Raviglione MC, Magurano F, Tanzi E. Molecular evidence for SARS-CoV-2 in samples collected from patients with morbilliform eruptions since late 2019 in Lombardy, northern Italy. Environ Res 2022; 215:113979. [PMID: 36029839 PMCID: PMC9404229 DOI: 10.1016/j.envres.2022.113979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/07/2022] [Accepted: 07/21/2022] [Indexed: 05/12/2023]
Abstract
As a reference laboratory for measles and rubella surveillance in Lombardy, we evaluated the association between SARS-CoV-2 infection and measles-like syndromes, providing preliminary evidence for undetected early circulation of SARS-CoV-2. Overall, 435 samples from 156 cases were investigated. RNA from oropharyngeal swabs (N = 148) and urine (N = 141) was screened with four hemi-nested PCRs and molecular evidence for SARS-CoV-2 infection was found in 13 subjects. Two of the positive patients were from the pandemic period (2/12, 16.7%, March 2020-March 2021) and 11 were from the pre-pandemic period (11/44, 25%, August 2019-February 2020). Sera (N = 146) were tested for anti-SARS-CoV-2 IgG, IgM, and IgA antibodies. Five of the RNA-positive individuals also had detectable anti-SARS-CoV-2 antibodies. No strong evidence of infection was found in samples collected between August 2018 and July 2019 from 100 patients. The earliest sample with evidence of SARS-CoV-2 RNA was from September 12, 2019, and the positive patient was also positive for anti-SARS-CoV-2 antibodies (IgG and IgM). Mutations typical of B.1 strains previously reported to have emerged in January 2020 (C3037T, C14408T, and A23403G), were identified in samples collected as early as October 2019 in Lombardy. One of these mutations (C14408T) was also identified among sequences downloaded from public databases that were obtained by others from samples collected in Brazil in November 2019. We conclude that a SARS-CoV-2 progenitor capable of producing a measles-like syndrome may have emerged in late June-late July 2019 and that viruses with mutations characterizing B.1 strain may have been spreading globally before the first Wuhan outbreak. Our findings should be complemented by high-throughput sequencing to obtain additional sequence information. We highlight the importance of retrospective surveillance studies in understanding the early dynamics of COVID-19 spread and we encourage other groups to perform retrospective investigations to seek confirmatory proofs of early SARS-CoV-2 circulation.
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Affiliation(s)
- Antonella Amendola
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Marta Canuti
- Department of Health Sciences, University of Milan, 20142, Milan, Italy.
| | - Silvia Bianchi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Sudhir Kumar
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA; Center for Excellence in Genome Medicine and Research, King Abdulaziz University, 22252, Jeddah, Saudi Arabia.
| | - Clara Fappani
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Maria Gori
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Daniela Colzani
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Sergei L Kosakovsky Pond
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA.
| | - Sayaka Miura
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA.
| | - Melissa Baggieri
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Antonella Marchi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Elisa Borghi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Gianvincenzo Zuccotti
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, 20154, Milan, Italy; Romeo and Enrica Invernizzi Pediatric Research Center, University of Milan, 20154, Milan, Italy.
| | - Mario C Raviglione
- Centre for Multidisciplinary Research in Health Science, University of Milan, 20122, Milan, Italy.
| | - Fabio Magurano
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Elisabetta Tanzi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
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9
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Fappani C, Gori M, Canuti M, Terraneo M, Colzani D, Tanzi E, Amendola A, Bianchi S. Breakthrough Infections: A Challenge towards Measles Elimination? Microorganisms 2022; 10:microorganisms10081567. [PMID: 36013985 PMCID: PMC9413104 DOI: 10.3390/microorganisms10081567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
Measles is one of the most contagious diseases known to man. Despite the existence of a safe and effective live attenuated vaccine, measles can appear in vaccinated individuals. Paradoxically, breakthrough cases increase as vaccination coverage in the general population rises. In measles endemic areas, breakthrough cases represent less than 10% of total infections, while in areas with high vaccination coverage these are over 10% of the total. Two different vaccination failures have been described: primary vaccination failure, which consists in the complete absence of humoral response and occurs in around 5% of vaccinated individuals; and secondary vaccination failure is due to waning immunity or incomplete immunity and occurs in 2–10% of vaccinees. Vaccination failures are generally associated with lower viral loads and milder disease (modified measles) since vaccination limits the risk of complicated disease. Vaccination failure seems to occur between six and twenty-six years after the last vaccine dose administration. This review summarizes the literature about clinical, serological, epidemiological, and molecular characteristics of measles breakthrough cases and their contribution to virus transmission. In view of the measles elimination goal, the assessment of the potential decline in antibody protection and the targeted implementation of catch-up vaccination are essential.
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Affiliation(s)
- Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Marta Canuti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Mara Terraneo
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Coordinated Research Center “EpiSoMI”, Università degli Studi di Milano, 20133 Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Coordinated Research Center “EpiSoMI”, Università degli Studi di Milano, 20133 Milan, Italy
- Correspondence: (A.A.); (S.B.)
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Correspondence: (A.A.); (S.B.)
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10
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Canuti M, Bianchi S, Kolbl O, Pond SLK, Kumar S, Gori M, Fappani C, Colzani D, Borghi E, Zuccotti G, Raviglione MC, Tanzi E, Amendola A. Waiting for the truth: is reluctance in accepting an early origin hypothesis for SARS-CoV-2 delaying our understanding of viral emergence? BMJ Glob Health 2022; 7:e008386. [PMID: 35296465 PMCID: PMC8927931 DOI: 10.1136/bmjgh-2021-008386] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/19/2022] [Indexed: 01/22/2023] Open
Abstract
Two years after the start of the COVID-19 pandemic, key questions about the emergence of its aetiological agent (SARS-CoV-2) remain a matter of considerable debate. Identifying when SARS-CoV-2 began spreading among people is one of those questions. Although the current canonically accepted timeline hypothesises viral emergence in Wuhan, China, in November or December 2019, a growing body of diverse studies provides evidence that the virus may have been spreading worldwide weeks, or even months, prior to that time. However, the hypothesis of earlier SARS-CoV-2 circulation is often dismissed with prejudicial scepticism and experimental studies pointing to early origins are frequently and speculatively attributed to false-positive tests. In this paper, we critically review current evidence that SARS-CoV-2 had been circulating prior to December of 2019, and emphasise how, despite some scientific limitations, this hypothesis should no longer be ignored and considered sufficient to warrant further larger-scale studies to determine its veracity.
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Affiliation(s)
- Marta Canuti
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Otto Kolbl
- Faculty of Arts, University of Lausanne, Lausanne, Switzerland
| | - Sergei L Kosakovsky Pond
- Department of Biology, Temple University, Philadelphia, Pennsylvania, USA
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Sudhir Kumar
- Department of Biology, Temple University, Philadelphia, Pennsylvania, USA
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, Pennsylvania, USA
- Center for Excellence in Genome Medicine and Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Elisa Borghi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Ospedale dei Bambini, Università degli Studi di Milano, Milan, Italy
- Romeo and Enrica Invernizzi Pediatric Research Center, Università degli Studi di Milano, Milan, Italy
| | - Mario C Raviglione
- Centre for Multidisciplinary Research in Health Science, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinated Research Center "EpiSoMI", Università degli Studi di Milano, Milan, Italy
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11
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Barcellini L, Amendola A, Tanzi E, Folgori L, Bianchi S, Gori M, Colzani D, Longoni E, Zuccotti GV. Agreement between two commercially available SARS-CoV-2 serologic tests among Italian healthcare workers. Epidemiol Prev 2021; 45:5-6. [PMID: 33884831 DOI: 10.19191/ep21.1-2.p005.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lucia Barcellini
- Department of Paediatrics, Children's Hospital V. Buzzi, University of Milan, Milan (Italy).,Joint last authors
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy); .,Coordinated Research Centre "EpiSoMI", University of Milan, Milan (Italy).,Joint last authors
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy).,Coordinated Research Centre "EpiSoMI", University of Milan, Milan (Italy)
| | - Laura Folgori
- Department of Paediatrics, Children's Hospital V. Buzzi, University of Milan, Milan (Italy)
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy)
| | - Maria Gori
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy)
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy)
| | - Emma Longoni
- Department of Paediatrics, Children's Hospital V. Buzzi, University of Milan, Milan (Italy)
| | - Gian Vincenzo Zuccotti
- Department of Paediatrics, Children's Hospital V. Buzzi, University of Milan, Milan (Italy)
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12
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Amendola A, Bianchi S, Gori M, Barcellini L, Colzani D, Canuti M, Giacomet V, Fabiano V, Folgori L, Zuccotti GV, Tanzi E. Dried Blood Spot as an Alternative to Plasma/Serum for SARS-CoV-2 IgG Detection, an Opportunity to Be Sized to Facilitate COVID-19 Surveillance Among Schoolchildren. Pediatr Infect Dis J 2021; 40:e46-e47. [PMID: 33181785 DOI: 10.1097/inf.0000000000002955] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Antonella Amendola
- Department of Biomedical Sciences for Health, Coordinated Research Center "EpiSoMI", University of Milan, Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Maria Gori
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lucia Barcellini
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Marta Canuti
- Department of Biology, Memorial University of Newfoundland, NL, Canada
| | - Vania Giacomet
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Valentina Fabiano
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Laura Folgori
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, Coordinated Research Center "EpiSoMI", University of Milan, Milan, Italy
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13
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Amendola A, Bianchi S, Gori M, Colzani D, Canuti M, Borghi E, Raviglione MC, Zuccotti GV, Tanzi E. Evidence of SARS-CoV-2 RNA in an Oropharyngeal Swab Specimen, Milan, Italy, Early December 2019. Emerg Infect Dis 2020; 27:648-650. [PMID: 33292923 PMCID: PMC7853584 DOI: 10.3201/eid2702.204632] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We identified severe acute respiratory syndrome coronavirus 2 RNA in an oropharyngeal swab specimen collected from a child with suspected measles in early December 2019, ≈3 months before the first identified coronavirus disease case in Italy. This finding expands our knowledge on timing and mapping of novel coronavirus transmission pathways.
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14
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Bianchi S, Canuti M, Ciceri G, Gori M, Colzani D, Dura M, Pennati BM, Baggieri M, Magurano F, Tanzi E, Amendola A. Molecular Epidemiology of B3 and D8 Measles Viruses through Hemagglutinin Phylogenetic History. Int J Mol Sci 2020; 21:ijms21124435. [PMID: 32580384 PMCID: PMC7352894 DOI: 10.3390/ijms21124435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/15/2023] Open
Abstract
Of the 24 known measles genotypes, only D8 and B3 are responsible for outbreaks in the last years in Europe, Asia, and America. In this study the H gene of 92 strains circulating between 2015 and 2019 in Lombardy, Northern Italy, and 1273 H sequences available in GenBank were analyzed in order to evaluate the genetic variability and to assess the conservation of the immunodominant sites. Overall, in Lombardy we observed the presence of four different B3 and three different D8 clusters, each one of them including sequences derived from viruses found in both vaccinated and unvaccinated subjects. Worldwide, the residue 400 within the H protein, a position located within the main immune epitope, is mutated in all circulating strains that belong to the two globally endemic genotypes, B3 and D8. Our data demonstrate the usefulness of measles virus (MV) H gene sequencing. Indeed, the monitoring the H protein epitopes of circulating strains could be included in the measles laboratory surveillance activities in order to improve and optimize strategies for measles control, as countries go towards elimination phase.
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Affiliation(s)
- Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Marta Canuti
- Department of Biology, Memorial University of Newfoundland, 232 Elizabeth Ave., St. John’s, NL A1B 3X9, Canada;
| | - Giulia Ciceri
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Maria Gori
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Marco Dura
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Beatrice Marina Pennati
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Melissa Baggieri
- Department of Infectious Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy; (M.B.); (F.M.)
| | - Fabio Magurano
- Department of Infectious Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy; (M.B.); (F.M.)
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
- Coordinated Research Center “EpiSoMI”, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy
- Correspondence:
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
- Coordinated Research Center “EpiSoMI”, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy
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15
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Frati ER, Bianchi S, Amendola A, Colzani D, Petrelli F, Zehender G, Tanzi E. Genetic characterization of variants of HPV‑16, HPV‑18 and HPV‑52 circulating in Italy among general and high‑risk populations. Mol Med Rep 2019; 21:894-902. [PMID: 31789404 DOI: 10.3892/mmr.2019.10847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/30/2019] [Indexed: 11/06/2022] Open
Abstract
Viral factors, such as high‑risk human papillomavirus variants, can increase the risk of viral persistence and influence the progression to cancer. In the present study, the long control region (LCR) of human papillomavirus (HPV)‑16 and HPV‑52, and the L1 region of HPV‑16 and HPV‑18, identified from subjects belonging to both general and high‑risk populations (migrants, HIV+ subjects and adolescent/young people) residing in Italy, were characterized using molecular and phylogenetic techniques. To the best of our knowledge, this is the first Italian study to analyze a large number of sequences (n=458) and report phylogenetic data on the HPV‑52 variants. The phylogenetic analysis showed that 90% of the LCR variants of HPV‑16 and HPV‑52 clustered within lineage A (European lineage) and only sequences identified from subjects belonging to high‑risk populations fell into the non‑European lineages. Analysis of the LCRs revealed a high genomic diversity with a large number of changes. Several mutations in the binding sites for viral and cellular transcription factors characterized the HPV‑16 LCR variants belonging to the African lineages B and C, were observed in subjects with cytological abnormalities (high squamous intraepithelial lesions). The HPV‑16 and HPV‑18 L1 molecular characterization identified 30% of changes in the immune‑dominant epitope loops. These data give a clear picture of the situation in Italy, and a starting point for understanding the molecular pathogenesis and developing molecular diagnostics for HPV, vaccines and other therapeutic approaches in order to control and/or eliminate virus‑induced diseases.
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Affiliation(s)
- Elena Rosanna Frati
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
| | - Fabio Petrelli
- School of Medicinal and Health Products Sciences, University of Camerino, I‑62032 Camerino, Italy
| | | | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
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16
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Ciceri G, Canuti M, Bianchi S, Gori M, Piralla A, Colzani D, Libretti M, Frati ER, Baggieri M, Lai A, Rovida F, Zehender G, Baldanti F, Magurano F, Tanzi E, Amendola A. Genetic variability of the measles virus hemagglutinin gene in B3 genotype strains circulating in Northern Italy. Infect Genet Evol 2019; 75:103943. [PMID: 31255832 DOI: 10.1016/j.meegid.2019.103943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 11/18/2022]
Abstract
Sequencing the whole measles virus hemagglutinin (H) gene, in conjunction with a 450-nucleotide region of the nucleoprotein gene (N-450), is helpful for the identification of new genotypes and as an auxiliary in outbreak characterization. In addition, it is essential to be able to predict the antigenic changes of the H protein to gain a better monitoring of the response to the vaccine. In this study, we obtained the full-length H gene sequences from 19 measles virus (MV) strains belonging to two B3 genotype variants circulating in Lombardy (Northern Italy) between July 2015 and February 2016 and evaluated the variability of the whole MV-H gene. Furthermore, we compared the obtained H amino acid sequences to all MV sequences available in the GenBank database (n = 1152 in total) and analyzed the amino acid substitutions in the H protein within clades where the Italian strains were included. We identified a higher variability in the H gene compared to the N-450 region and our results support previous studies, highlighting that the H gene is more informative for characterizing the MV B3 genotype than the N-450 sequence. Some of the amino acid substitutions were fixed in the viral population and, remarkably, some of the amino acid substitutions were typically present only in the Italian sequences. Accumulating further molecular information about MV-H gene will be necessary to enable in-depth analyses of the variability of this gene in the vaccinated population.
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Affiliation(s)
- G Ciceri
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
| | - M Canuti
- Department of Biology, Memorial University of Newfoundland, 232 Elizabeth Ave., St. John's, NL A1B 3X9, Canada
| | - S Bianchi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
| | - M Gori
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy
| | - A Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, via Taramelli, 5, 27100 Pavia, Italy.
| | - D Colzani
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
| | - M Libretti
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy
| | - E R Frati
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy
| | - M Baggieri
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy.
| | - A Lai
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Section of Infectious Diseases, University of Milan, Via Gian Battista Grassi, 74, 20157 Milan, Italy.
| | - F Rovida
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, via Taramelli, 5, 27100 Pavia, Italy.
| | - G Zehender
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Section of Infectious Diseases, University of Milan, Via Gian Battista Grassi, 74, 20157 Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
| | - F Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, via Taramelli, 5, 27100 Pavia, Italy.
| | - F Magurano
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy.
| | - E Tanzi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
| | - A Amendola
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, via Carlo Pascal, 36, 20133 Milan, Italy.
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Amendola A, Bianchi S, Frati ER, Ciceri G, Faccini M, Senatore S, Colzani D, Lamberti A, Baggieri M, Cereda D, Gramegna M, Nicoletti L, Magurano F, Tanzi E. Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March-August 2017. ACTA ACUST UNITED AC 2018; 22:30596. [PMID: 28840825 PMCID: PMC5572939 DOI: 10.2807/1560-7917.es.2017.22.33.30596] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2001] [Accepted: 08/10/2017] [Indexed: 11/20/2022]
Abstract
A large measles outbreak has been ongoing in Milan and surrounding areas. From 1 March to 30 June 2017, 203 measles cases were laboratory-confirmed (108 sporadic cases and 95 related to 47 clusters). Phylogenetic analysis revealed the co-circulation of two different genotypes, D8 and B3. Both genotypes caused nosocomial clusters in two hospitals. The rapid analysis of epidemiological and phylogenetic data allowed effective surveillance and tracking of transmission pathways.
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Affiliation(s)
- Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Coordinated Research Center 'EpiSoMI', University of Milan, Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena R Frati
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giulia Ciceri
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Marino Faccini
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy
| | - Sabrina Senatore
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Anna Lamberti
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy
| | - Melissa Baggieri
- National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Rome, Italy
| | - Danilo Cereda
- DG Salute, UO Governo della prevenzione e tutela sanitaria, Lombardy Region, Milan, Italy
| | - Maria Gramegna
- DG Salute, UO Governo della prevenzione e tutela sanitaria, Lombardy Region, Milan, Italy
| | - Loredana Nicoletti
- National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Magurano
- National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Coordinated Research Center 'EpiSoMI', University of Milan, Milan, Italy
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Frati ER, Fasoli E, Martinelli M, Colzani D, Bianchi S, Carnelli L, Amendola A, Olivani P, Tanzi E. Sexually Transmitted Infections: A Novel Screening Strategy for Improving Women's Health in Vulnerable Populations. Int J Mol Sci 2017. [PMID: 28632191 PMCID: PMC5486132 DOI: 10.3390/ijms18061311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65) were enrolled at the NAGA Centre (2012–2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis (Ct), Trichomonas vaginalis (Tv), Neisseria gonorrhoeae (Ng)-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required.
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Affiliation(s)
- Elena R Frati
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Ester Fasoli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Marianna Martinelli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Luciana Carnelli
- Lega Italiana per la Lotta contro i Tumori (LILT), Section of Milan, Viale Molise 5, 20137 Milan, Italy.
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- Coordinated Research Center "EpiSoMI", University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- CIRI-IV, Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16100 Genoa, Italy.
| | - Pierfranco Olivani
- NAGA Centre, Associazione Volontaria di Assistenza Socio-Sanitaria e per i Diritti di Cittadini Stranieri, Rom e Sinti, Via L. L. Zamenhof 7/A, 20136 Milan, Italy.
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- Coordinated Research Center "EpiSoMI", University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- CIRI-IV, Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16100 Genoa, Italy.
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Panatto D, Amicizia D, Bianchi S, Frati ER, Zotti CM, Lai PL, Domnich A, Colzani D, Gasparini R, Tanzi E. Chlamydia trachomatis prevalence and chlamydial/HPV co-infection among HPV-unvaccinated young Italian females with normal cytology. Hum Vaccin Immunother 2014; 11:270-6. [PMID: 25483545 DOI: 10.4161/hv.36163] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infections caused by Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the two main sexually transmitted infections; however, epidemiological data on Ct prevalence and Ct/HPV co-infection in Italy are scant. This study aimed at estimating the prevalence of Ct infection and Ct/HPV co-infection in young HPV-unvaccinated females with normal cytology, and placed particular attention on the possible association between Ct-DNA positivity and different HPV infecting genotypes. Five hundred 66 healthy females aged 16-26 years without cervical lesions, previously assessed for HPV infection (HPV-DNA prevalence: 18.2%), were tested for Ct-DNA. The overall prevalence of Ct was 5.8% (95% CI: 4.2-8.1), while Ct/HPV co-infection was recorded in 2.7% (95% CI: 1.6-4.3) of subjects. Compared with HPV-DNA-negative females, HPV-DNA positive subjects had significantly (P < 0.001) higher odds of being infected with Ct (odds ratio of 4.20, 95% CI: 2.01-8.71). Both Ct and Ct/HPV infections were much more prevalent in under 18-year-olds than in older women. Subjects positive for single high-risk HPV genotypes and various multiple HPV infections had higher odds of being Ct-DNA positive. Our findings confirm that HPV and Ct infections are very common among asymptomatic young Italian females. This underlines the urgent need for nationwide Ct screening programs and reinforcement of sexual health education, which would be the most important public health strategies, since no Ct vaccines are currently available.
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Tanzi E, Bianchi S, Frati ER, Amicizia D, Martinelli M, Bragazzi NL, Brisigotti MP, Colzani D, Fasoli E, Zehender G, Panatto D, Gasparini R. Human papillomavirus detection in paraffin-embedded colorectal cancer tissues. J Gen Virol 2014; 96:206-209. [PMID: 25296558 DOI: 10.1099/vir.0.070672-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Human papillomavirus (HPV) has a well-recognized aetiological role in the development of cervical cancer and other anogenital tumours. Recently, an association between colorectal cancer and HPV infection has been suggested, although this is still controversial. This study aimed at detecting and characterizing HPV infection in 57 paired biopsies from colorectal cancers and adjacent intact tissues using a degenerate PCR approach. All amplified fragments were genotyped by means of sequencing. Overall, HPV prevalence was 12.3 %. In particular, 15.8 % of tumour tissues and 8.8 % of non-cancerous tissue samples were HPV DNA-positive. Of these samples, 85.7 % were genotyped successfully, with 41.7 % of sequences identifying four genotypes of the HR (high oncogenic risk) clade Group 1; the remaining 58.3 % of HPV-genotyped specimens had an unclassified β-HPV. Examining additional cases and analysing whole genomes will help to outline the significance of these findings.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena R Frati
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Marianna Martinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Maria Pia Brisigotti
- Pathological Anatomy and Histology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ester Fasoli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
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Tanzi E, Bianchi S, Fasolo MM, Frati ER, Mazza F, Martinelli M, Colzani D, Beretta R, Zappa A, Orlando G. High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping. J Med Virol 2012; 85:91-8. [PMID: 23097252 DOI: 10.1002/jmv.23434] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 02/05/2023]
Abstract
Human papillomavirus (HPV) testing has been proposed as a means of replacing or supporting conventional cervical screening (Pap test). However, both methods require the collection of cervical samples. Urine sample is easier and more acceptable to collect and could be helpful in facilitating cervical cancer screening. The aim of this study was to evaluate the sensitivity and specificity of urine testing compared to conventional cervical smear testing using a PCR-based method with a new, designed specifically primer set. Paired cervical and first voided urine samples collected from 107 women infected with HIV were subjected to HPV-DNA detection and genotyping using a PCR-based assay and a restriction fragment length polymorphism method. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated using the McNemar's test for differences. Concordance between tests was assessed using the Cohen's unweighted Kappa (k). HPV DNA was detected in 64.5% (95% CI: 55.1-73.1%) of both cytobrush and urine samples. High concordance rates of HPV-DNA detection (k = 0.96; 95% CI: 0.90-1.0) and of high risk-clade and low-risk genotyping in paired samples (k = 0.80; 95% CI: 0.67-0.92 and k = 0.74; 95% CI: 0.60-0.88, respectively) were observed. HPV-DNA detection in urine versus cervix testing revealed a sensitivity of 98.6% (95% CI: 93.1-99.9%) and a specificity of 97.4% (95% CI: 87.7-99.9%), with a very high NPV (97.4%; 95% CI: 87.7-99.9%). The PCR-based assay utilized in this study proved highly sensitive and specific for HPV-DNA detection and genotyping in urine samples. These data suggest that a urine-based assay would be a suitable and effective tool for epidemiological surveillance and, most of all, screening programs.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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22
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Martinelli M, Zappa A, Bianchi S, Frati E, Colzani D, Amendola A, Tanzi E. Human papillomavirus (HPV) infection and genotype frequency in the oral mucosa of newborns in Milan, Italy. Clin Microbiol Infect 2012; 18:E197-9. [DOI: 10.1111/j.1469-0691.2012.03839.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Frati E, Bianchi S, Colzani D, Zappa A, Orlando G, Tanzi E. Genetic variability in the major capsid L1 protein of human papillomavirus type 16 (HPV-16) and 18 (HPV-18). Infection, Genetics and Evolution 2011; 11:2119-24. [DOI: 10.1016/j.meegid.2011.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 06/16/2011] [Accepted: 06/21/2011] [Indexed: 11/27/2022]
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24
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Pariani E, Frati ER, Amendola A, Zappa A, Bianchi S, Colzani D, Canuti M, Brambilla D, Zanetti A, Tanzi E. Molecular characterization and phylogenetic analysis of human influenza A viruses in three consecutive seasons with different epidemiological profiles. J Prev Med Hyg 2009; 50:113-116. [PMID: 20099442] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Influenza activity and influenza virus circulation were observed in Lombardy (northern Italy) during three consecutive seasons and the molecular characteristics of circulating viruses analysed to control for introduction of new variants. METHODS The molecular characterization of 38 isolates, namely 20 A/H3N2 and 18 A/H1N1 influenza strains from the 2005/06, 2006/07 and 2007/08 seasons, was performed by sequence analysis of the globular head region of the HA protein (HA1 subunit), specific for influenza virus A/H3 and A/H1. RESULTS AND DISCUSSION The last three influenza seasons in the study region were characterized by medium-low activity. A typical co-circulation of several variants was shown for A/H3 viruses for approximately two years and were subsequently almost entirely substituted by new emerging variants. Vice versa, A/H1 viruses had a more homogeneous circulation with a single lineage clearly dominating each season. The HA sequences of the A/H3 and the A/H1 viruses isolated in the last three seasons fell into 4 and 3 principal phylogenetic groups, respectively. No evidence of positive or negative selection in the sequence alignments was observed. CONCLUSIONS Molecular characterization of the influenza viruses in three consecutive seasons highlighted considerable heterogeneity in their HA sequences. A careful surveillance of genetic changes in the HA1 domain during seasonal influenza epidemics may reveal immune escape and provide early information on newly emerging strains with epidemiologic inference.
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Affiliation(s)
- E Pariani
- Department of Public Health-Microbiology-Virology, University of Milan, Italy.
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25
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Canuti M, Zappa A, Pariani E, Amendola A, Colzani D, Bianchi S, Brambilla D, Anselmi G, Tanzi E. P.038 Virological-molecular study of aetiological agents associated to Influenza-Like Illness (ILI). J Clin Virol 2009. [PMCID: PMC7128691 DOI: 10.1016/s1386-6532(08)70101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pariani E, Amendola A, Zappa A, Bianchi S, Colzani D, Anselmi G, Zanetti A, Tanzi E. Molecular characterization of influenza viruses circulating in Northern Italy during two seasons (2005/2006 and 2006/2007) of low influenza activity. J Med Virol 2008; 80:1984-91. [DOI: 10.1002/jmv.21323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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De Maddalena C, Giambelli C, Tanzi E, Colzani D, Schiavini M, Milazzo L, Bernini F, Ebranati E, Cargnel A, Bruno R, Galli M, Zehender G. High level of genetic heterogeneity in S and P genes of genotype D hepatitis B virus. Virology 2007; 365:113-24. [PMID: 17451771 DOI: 10.1016/j.virol.2007.03.015] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [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: 12/27/2006] [Revised: 01/30/2007] [Accepted: 03/09/2007] [Indexed: 12/17/2022]
Abstract
The genetic heterogeneity of hepatitis B virus (HBV) genotypes and subgenotypes was investigated by directly sequencing amplified PreS, S and P genes of HBV isolates obtained from the plasma of 99 subjects with chronic HBV infection. Genotype D showed the greatest intragenotypic and intrasubgenotypic divergence: in particular, the a determinant was mutated in 58.2% of the genotype D patients, two of whom showed prototypic vaccine-induced escape mutants at codon 145. Moreover, five sites under significant positive selection were found in the S protein of the D isolates: one in the a determinant and four in the highly hydrophobic C terminal. Our results suggest that careful surveillance of vaccine-induced escape mutants should be considered in populations with highly frequent genotype D infections, and raise questions concerning the possible relationship between the genetic heterogeneity, host immunity and pathogenicity of this HBV genotype.
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Affiliation(s)
- Chiara De Maddalena
- Department of Clinical Sciences Luigi Sacco, Section of Infectious Diseases, University of Milan, Milan, Italy
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Tanzi E, Amendola A, Pariani E, Zappa A, Colzani D, Logias F, Perego A, Zanetti AR. Lack of effect of a booster dose of influenza vaccine in hemodialysis patients. J Med Virol 2007; 79:1176-9. [PMID: 17596830 DOI: 10.1002/jmv.20936] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To assess whether the administration of a booster dose of influenza vaccine may enhance immune response in hemodialysis patients, 58 subjects were given two doses of the 2003/2004 season influenza vaccine, 1 month apart. "European Agency for the Evaluation of Medicinal Products" (EMEA) criteria were fully met in terms of percentage of response and of mean-fold increase of hemagglutination inhibiting (HI) antibody titer, but not in terms of seroprotection rates (HI antibody titers > or =1:40). The second vaccine administration did not result in additional increase in seroprotection rate or in geometric mean titers. Protective immune response against the epidemic A/H3N2 Fujian-like strain, antigenically distant from that included in the vaccine (A/Panama/2007/99) was observed in 94.7% of vaccinees protected against the A/H3N2 vaccine strain 1 month after immunization. No adverse reactions were reported during follow-up. The study findings suggest that immune response to influenza vaccination may be suboptimal in hemodialysis patients and that the administration of an additional second dose of vaccine does not improve the humoral response.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Public Health-Microbiology-Virology, University of Milan, Via Pascal, Milan, Italy.
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Perin S, Tanzi E, Ruzza M, Amendola A, Colzani D, Podestà A, Farina C. SORVEGLIANZA EPIDEMIOLOGICO-MOLECOLARE DEI VIRUS RESPIRATORI IN UNA COORTE DI SOGGETTI PEDIATRICI (2004). Microbiol Med 2006. [DOI: 10.4081/mm.2006.3218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Tanzi E, Amendola A, Zappa A, Pariani E, Monguzzi A, Colzani D. [Risks and benefits of influenza and pneumococcal immunization in HIV-1 infected individuals]. Ann Ig 2003; 15:567-73. [PMID: 14969311] [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] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Influenza and Streptococcus pneumoniae diseases can cause severe complications in HIV-1 infected individuals leading to increases in hospital admission and even death. Both vaccinations are recommended for such individuals, but some studies reported that such immunizations may stimulate an increase of HIV-1 viral load and decrease of CD4+ cells count. A review of published studies, including our studies carried out in HIV-1 infected former drugs addicts, indicates that influenza and pneumococcal vaccinations are well tolerated in individuals with HIV-1, and do not induce deterioration of the course of HIV-1 infection, even though the immune response to vaccination is lower than that one observed in immunocompetent individuals. Therefore the lack of significant changes of virological and immunological parameters indicates that such immunizations can be safely administrated to HIV-1 infected individuals.
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Affiliation(s)
- E Tanzi
- Istituto di Virologia, Università degli Studi di Milano.
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Amendola A, Tanzi E, Zappa A, Colzani D, Boschini A, Musher DM, Zanetti AR. Safety and immunogenicity of 23-valent pneumococcal polysaccharide vaccine in HIV-1 infected former drug users. Vaccine 2002; 20:3720-4. [PMID: 12399200 DOI: 10.1016/s0264-410x(02)00357-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The immunogenicity of 23-valent pneumococcal polysaccharide vaccine was assessed in 57 HIV-1 infected former intravenous drug users and in 20 HIV-1 negative controls. The effect of vaccination on HIV-1 infection was studied in a subgroup of 38 patients, 60% of whom under highly active antiretroviral therapy (HAART). Antibody to capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 6B, 19F, 23 F, and changes in CD4+ count, HIV-1 RNA, proviral DNA and HIV-1 phenotype were measured in pre- and post-vaccination samples. Vaccinations were well-tolerated. The rate of responders was higher (P<0.05) in HIV-1 negative than in HIV-1 infected individuals. No difference in antibody response was found within HIV-1 infected patients stratified according to CD4+ counts. Post-vaccination antibody geometric mean concentrations (GMCs) to the five antigens were higher (P<0.05) than baseline in HIV-1 negative subjects, but not in HIV-1 positive individuals. Those with CD4+ >500 cells/mm(3) showed a significant increase of antibody against type 3 only. Immunisation caused no significant changes in CD4+ counts and in either plasma HIV-1 RNA nor proviral DNA levels. Pneumococcal vaccination does not induce virological or immunological deterioration in HIV infected patients, but the antibody response to a single dose of vaccine is poor.
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Affiliation(s)
- A Amendola
- Institute of Virology, University of Milan, Via Pascal 38, 20133, Milan, Italy
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Amendola A, Boschini A, Colzani D, Anselmi G, Oltolina A, Zucconi R, Begnini M, Besana S, Tanzi E, Zanetti AR. Influenza vaccination of HIV-1-positive and HIV-1-negative former intravenous drug users. J Med Virol 2001; 65:644-8. [PMID: 11745926 DOI: 10.1002/jmv.2085] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The immunogenicity of an anti-influenza vaccine was assessed in 409 former intravenous drug user volunteers and its effect on the levels of HIV-1 RNA, proviral DNA and on CD4+ lymphocyte counts in a subset HIV-1-positive subjects was measured. HIV-1-positive individuals (n = 72) were divided into three groups on the basis of their CD4+ lymphocyte counts, while the 337 HIV-1-negative participants were allocated into group four. Haemagglutination inhibiting (HI) responses varied from 45.8 to 70% in the HIV-1-positive subjects and were significantly higher in group four (80.7% responses to the H1N1 strain, 81.6% to the H3N2 strain, and 83% to the B strain). The percentage of subjects with HI protective antibody titres (> or = 1:40) increased significantly after vaccination, especially in HIV-1 uninfected subjects. Immunization caused no significant changes in CD4+ counts and in neither plasma HIV-1 RNA nor proviral DNA levels. Therefore, vaccination against influenza may benefit persons infected by HIV-1.
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Affiliation(s)
- A Amendola
- Institute of Virology, University of Milan, Milan, Italy
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Ferroni P, Gasparini V, Zaninetti M, Colzani D, Mascolo G. Hepatitis C viraemia and antibody to core epitopes in anti-HCV ELISA negative blood donors. Eur J Epidemiol 1994; 10:649-50. [PMID: 7532137 DOI: 10.1007/bf01719588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Ferroni P, Mascolo G, Zaninetti M, Colzani D, Pregliasco F, Pirisi M, Barbone F, Gasparini V. Identification of four epitopes in hepatitis C virus core protein. J Clin Microbiol 1993; 31:1586-91. [PMID: 7686184 PMCID: PMC265582 DOI: 10.1128/jcm.31.6.1586-1591.1993] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
We identified four epitopes in hepatitis C virus core protein by using the algorithm of Jameson and Wolf. G15V (amino acids [aa] 31 to 45) appears to be the immunodominant epitope, since it was able to detect antibodies to the core protein in all 40 patients and in 44 of 45 recombinant immunoblot assay-confirmed positive blood donors. This epitope is associated with a low frequency of false-positive results, as found with 522 negative blood donors. A strong reactivity was also observed with the Q15V epitope (aa 7 to 21), although this was associated with low specificity. Occasional reactivity to the R15P (aa 49 to 63) and P15R (aa 99 to 113) epitopes was observed. Q15V and G15V detected antibodies to core protein earlier than the other two epitopes.
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Affiliation(s)
- P Ferroni
- Department of Food Science, University of Udine, Italy
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Ferroni P, Mascolo G, Zaninetti M, Colzani D, Pasquali M, Azzario F. HIV-1 infection in Italian blood donors during a 5 year surveillance. Eur J Epidemiol 1992; 8:885-6. [PMID: 1294399 DOI: 10.1007/bf00145339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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