1
|
Pellegrinelli L, Galli C, Giardina F, Ferrari G, Uceda Renteria SC, Ceriotti F, Seiti A, Binda S, Pitrolo AMG, Schiavo R, Malandrin SMI, Cavallero A, Arosio M, Farina C, Oggioni M, Congedo P, Cereda D, Rovida F, Piralla A, Pariani E, Baldanti F. Increased circulation of echovirus 11 in the general population and hospital patients as elicited by the non-polio enterovirus laboratory-based sentinel surveillance in northern Italy, 2023. Int J Infect Dis 2024; 142:106998. [PMID: 38458420 DOI: 10.1016/j.ijid.2024.106998] [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: 12/22/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES Following the alert of echovirus 11 (E-11) infection in neonates in EU/EEA Member States, we conducted an investigation of E-11 circulation by gathering data from community and hospital surveillance of enterovirus (EV) in northern Italy from 01 August 2021 to 30 June 2023. METHODS Virological results of EVs were obtained from the regional sentinel surveillance database for influenza-like illness (ILI) in outpatients, and from the laboratory database of ten hospitals for inpatients with either respiratory or neurological symptoms. Molecular characterization of EVs was performed by sequence analysis of the VP1 gene. RESULTS In our ILI series, the rate of EV-positive specimens showed an upward trend from the end of May 2023, culminating at the end of June, coinciding with an increase in EV-positive hospital cases. The E-11 identified belonged to the D5 genogroup and the majority (83%) were closely associated with the novel E-11 variant, first identified in severe neonatal infections in France since 2022. E-11 was identified sporadically in community cases until February 2023, when it was also found in hospitalized cases with a range of clinical manifestations. All E-11 cases were children, with 14 out of 24 cases identified through hospital surveillance. Of these cases, 60% were neonates, and 71% had severe clinical manifestations. CONCLUSION Baseline epidemiological data collected since 2021 through EV laboratory-based surveillance have rapidly tracked the E-11 variant since November 2022, alongside its transmission during the late spring of 2023.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federica Giardina
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Ferruccio Ceriotti
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Arlinda Seiti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Roberta Schiavo
- Microbiology Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy
| | | | - Annalisa Cavallero
- Microbiology Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Marco Arosio
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Massimo Oggioni
- S.S.D. Microbiologia, Dipartimento dei Servizi Diagnostici, ASST della Brianza, Vimercate, Italy
| | - Pierluigi Congedo
- S.S.D. Microbiologia, Dipartimento dei Servizi Diagnostici, ASST della Brianza, Vimercate, Italy
| | - Danilo Cereda
- Direzione Generale Welfare Regione Lombardia, Milano, Italy
| | - Francesca Rovida
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
2
|
Galli C, Mazzola G, Arosio M, Pellegrinelli L, Boldrini A, Guarneri D, Lombarda E, Farina C, Cereda D, Pariani E. Real-time investigation of an influenza A(H3N2) virus outbreak in a refugee community, November 2022. Public Health 2024; 230:157-162. [PMID: 38554473 DOI: 10.1016/j.puhe.2024.02.027] [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: 09/09/2023] [Revised: 02/02/2024] [Accepted: 02/27/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVES To report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. STUDY DESIGN Outbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. METHODS An epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. RESULTS The outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9-14 years, 84.6% in those aged 15-24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. CONCLUSIONS The fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved.
Collapse
Affiliation(s)
- C Galli
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - G Mazzola
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - M Arosio
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy; Biobank, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - L Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - A Boldrini
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - D Guarneri
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - E Lombarda
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - C Farina
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - D Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - E Pariani
- Department of Biomedical Sciences for Health, University of Milan, Italy.
| |
Collapse
|
3
|
Scarpaci M, Bracaloni S, Esposito E, De Angelis L, Baglivo F, Casini B, Panatto D, Ogliastro M, Loconsole D, Chironna M, Pariani E, Pellegrinelli L, Pandolfi E, Croci I, Rizzo C. RSV Disease Burden in Primary Care in Italy: A Multi-Region Pediatric Study, Winter Season 2022-2023. Influenza Other Respir Viruses 2024; 18:e13282. [PMID: 38622776 PMCID: PMC11018906 DOI: 10.1111/irv.13282] [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: 10/22/2023] [Revised: 02/05/2024] [Accepted: 03/11/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Human respiratory syncytial virus (RSV) is one of the most frequent causes of respiratory infections in children under 5 years of age, but its socioeconomic impact and burden in primary care settings is still little studied. METHODS During the 2022/2023 winter season, 55 pediatricians from five Italian regions participated in our community-based study. They collected a nasal swab for RSV molecular test from 650 patients under the age of 5 with acute respiratory infections (ARIs) and performed a baseline questionnaire. The clinical and socioeconomic burden of RSV disease in primary care was evaluated by two follow-up questionnaires completed by the parents of positive children on Days 14 and 30. RESULTS RSV laboratory-confirmed cases were 37.8% of the total recruited ARI cases, with RSV subtype B accounting for the majority (65.4%) of RSV-positive swabs. RSV-positive children were younger than RSV-negative ones (median 12.5 vs. 16.5 months). The mean duration of symptoms for all children infected by RSV was 11.47 ± 6.27 days. We did not observe substantial differences in clinical severity between the two RSV subtypes, but RSV-A positive patients required more additional pediatric examinations than RSV-B cases. The socioeconomic impact of RSV infection was considerable, causing 53% of children to be absent from school, 46% of parents to lose working days, and 25% of families to incur extra costs. CONCLUSIONS Our findings describe a baseline of the RSV disease burden in primary care in Italy before the introduction of upcoming immunization strategies.
Collapse
Affiliation(s)
- Michela Scarpaci
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Sara Bracaloni
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Enrica Esposito
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Luigi De Angelis
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Francesco Baglivo
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Beatrice Casini
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | | | | | - Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary MedicineUniversity of Bari “A. Moro”BariItaly
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary MedicineUniversity of Bari “A. Moro”BariItaly
| | - Elena Pariani
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | | | - Elisabetta Pandolfi
- Predictive and Preventive Medicine Research UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Ileana Croci
- Predictive and Preventive Medicine Research UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| |
Collapse
|
4
|
Pietrasanta C, Ronchi A, Bassi L, De Carli A, Caschera L, Lo Russo FM, Crippa BL, Pisoni S, Crimi R, Artieri G, Pellegrinelli L, Dilena R, Conte G, Mosca F, Fumagalli M, Pugni L. Enterovirus and parechovirus meningoencephalitis in infants: A ten-year prospective observational study in a neonatal intensive care unit. J Clin Virol 2024; 173:105664. [PMID: 38493709 DOI: 10.1016/j.jcv.2024.105664] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Non-polio enteroviruses (EV) and human parechoviruses (HPeV) are known etiological agents of meningoencephalitis in neonates. However, reports of neuroradiological findings and neurodevelopmental outcomes in this population are scarce. OBJECTIVES to describe clinical characteristics, neuroradiological findings and, in a subset of patients, neurodevelopmental outcomes in a cohort of infants with EV or HPeV meningoencephalitis within 60 days of life. STUDY DESIGN clinical/laboratory data, neuroradiological findings (cranial ultrasound, cUS, brain magnetic resonance imaging, MRI), and neurodevelopmental outcomes assessed by Ages and Stages Questionnaires - third edition were prospectively collected. RESULTS overall, 32 infants with EV (21, 67.8 %) or HPeV (11, 28.2 %) meningoencephalitis were enrolled. Infants with HPeV (73 %: type 3 HPeV) presented more frequently with seizures (18.2 % vs. 0, p value=0.03), lymphopenia (1120 vs. 2170 cells/mm3, p = 0.02), focal anomalies at electroencephalography (EEG) (63.6 vs. 23.8 %, p = 0.03), and pathological findings at MRI (72.7 % vs. 15.8 %, p value=0.004) compared to those affected by EV. cUS was not significantly altered in any of the enrolled infants. All infants with EV meningoencephalitis evaluated at 12-24 months and at 30-48 months were normal. Two out of the 7 infants with HPeV meningoencephalitis showed some concerns in gross motor (1/7, 14.3 %) or in problem solving (1/7, 14.3 %) function at 30-48 months of age. CONCLUSIONS In our cohort, neonates infected by HPeV had more severe clinical manifestations, more alterations at brain MRI, and some signs of long-term neurodevelopmental delay. Our data highlight the heterogeneity of manifestations in infants with EV or HPeV meningoencephalitis, and the need for long-term follow-up of those infected by HPeV in the neonatal period.
Collapse
Affiliation(s)
- Carlo Pietrasanta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy; University of Milan. Department of Clinical Sciences and Community Health, Milan, Italy.
| | - Andrea Ronchi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Laura Bassi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Agnese De Carli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Luca Caschera
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Silvia Pisoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Riccardo Crimi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Giacomo Artieri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Laura Pellegrinelli
- University of Milan. Department of Biomedical Sciences of Health, Milan, Italy
| | - Robertino Dilena
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Clinical Neurophysiology Unit, Milan, Italy
| | - Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; University of Milan. Department of Pathophysiology and Transplantation, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy; University of Milan. Department of Clinical Sciences and Community Health, Milan, Italy
| | - Monica Fumagalli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy; University of Milan. Department of Clinical Sciences and Community Health, Milan, Italy
| | - Lorenza Pugni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| |
Collapse
|
5
|
Pellegrinelli L, Galli C, Seiti A, Primache V, Hirvonen A, Schiarea S, Salmoiraghi G, Castiglioni S, Ammoni E, Cereda D, Binda S, Pariani E. Wastewater-based epidemiology revealed in advance the increase of enterovirus circulation during the Covid-19 pandemic. Sci Total Environ 2023; 902:166539. [PMID: 37625729 DOI: 10.1016/j.scitotenv.2023.166539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/29/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
Wastewater-based epidemiology (WBE) was conducted to track Enteroviruses (EVs) circulation in the Milan metropolitan area (Northern Italy) during Covid-19 pandemic (March 2020-December 2022). 202 composite 24-hour wastewater samples (WWSs) were collected weekly from March 24, 2020, to December 29, 2022 at the inlet of two wastewater treatment plants (WWTP) in Milan (1.5 million inhabitants). EV-RNA was quantified and molecular characterization of non-polio EVs (NPEV) was performed by Sanger sequence analysis. Data from WWS were matched with virological data collected in the framework of Influenza-Like Illness (ILI) surveillance in the same place and time. EV-RNA was identified in 88.2 % of WWSs. The peak in EVs circulation was observed in late August 2020 (upon conclusion of the first national lockdown), in late August 2021, and in mid-April 2022. EV-RNA concentration in WWS (normalized as copies/d/1000 people) at peak of circulation presented a yearly increase (2020: 2.47 × 1010; 2021: 6.81 × 1010; 2022: 2.14 × 1011). This trend overlapped with trend in EV-positivity rate in ILI cases, expanded from 21.7 % in 2021 to 55.6 % in 2022. EV trends in WWS preceded clinical sample detections in 2021 and 2022 by eight and five weeks, respectively, acting as an early warning of outbreak. Although sequencing of EV-positive WWSs revealed the presence of multiple EV strains, typing remained inconclusive. Molecular characterization of EVs in clinical samples revealed the co-circulation of several genotypes: EV-A accounted for 60 % of EVs, EV-B for 16.7 %, EV-D68 for 23.3 %. EVs were circulating in Milan metropolitan area between March 2020 and December 2022. The epidemiological trends unfolded the progressive accumulation of EV transmission in the population after removal of Covid-19 restrictions. The increased circulation of EVs in 2021-2022 was identified at least 35 days in advance compared to the analysis of clinical data. The inconclusive results of Sanger sequencing lookout for improvement and innovative molecular approaches to deepen track EVs.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Arlinda Seiti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Aurora Hirvonen
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvia Schiarea
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Salmoiraghi
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Sara Castiglioni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Emanuela Ammoni
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
6
|
Giardina F, Ferrari G, Zavaglio F, Paolucci S, Rovida F, Campanini G, Pellegrinelli L, Galli C, Pariani E, Bergami F, Nava A, Matarazzo E, Renica S, Fanti D, Cento V, Alteri C, Scaglione F, Vismara C, Perno CF, Piralla A, Baldanti F. An overview of SARS-CoV-2 variants circulating in the 2020-2022 period in Lombardy. Diagn Microbiol Infect Dis 2023; 107:116070. [PMID: 37714081 DOI: 10.1016/j.diagmicrobio.2023.116070] [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: 05/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/17/2023]
Abstract
Since the beginning of the pandemic, SARS-CoV-2 has shown genetic variability. All the variants that have sustained pandemic waves have shown several mutations, especially in the Spike protein that could affect viral pathogenesis. A total of 15,729 respiratory samples, collected between December 2020 and August 2022, have been included in this study. We report the circulation of SARS-CoV-2 variants in the Lombardy region, Italy, in a 2-year study period. Alpha, Delta, and Omicron variants became predominant causing the majority of cases whereas Beta or Gamma variants mostly caused local outbreaks. Next-generation sequencing revealed several mutations and few deletions in all of the main variants. For example, 147 mutations were observed in the Spike protein of Omicron sublineages; 20% of these mutations occurred in the receptor-binding domain region.
Collapse
Affiliation(s)
- Federica Giardina
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Zavaglio
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefania Paolucci
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Rovida
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giulia Campanini
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federica Bergami
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alice Nava
- Microbiological Analysis Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elisa Matarazzo
- Microbiological Analysis Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Silvia Renica
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Diana Fanti
- Microbiological Analysis Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Valeria Cento
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy
| | - Claudia Alteri
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Francesco Scaglione
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Chiara Vismara
- Microbiological Analysis Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carlo Federico Perno
- Multimodal Research Area, Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
7
|
Pierangeli A, Piralla A, Uceda Renteria S, Giacomel G, Lunghi G, Pagani E, Giacobazzi E, Vian E, Biscaro V, Piccirilli G, Lazzarotto T, Menzo S, Ferreri ML, Novazzi F, Petrarca L, Licari A, Ferrari G, Oliveto G, Antonelli G, Binda S, Galli C, Pellegrinelli L, Pariani E, Baldanti F. Multicenter epidemiological investigation and genetic characterization of respiratory syncytial virus and metapneumovirus infections in the pre-pandemic 2018-2019 season in northern and central Italy. Clin Exp Med 2023; 23:2725-2737. [PMID: 36522554 PMCID: PMC9754777 DOI: 10.1007/s10238-022-00973-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
Respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) cause a high burden of disease, particularly in children and the elderly. With the aim to add knowledge on RSV and HMPV infections in Italy, a prospective, multicenter study was conducted by eight centers of the Working Group on Respiratory Virus Infections (GLIViRe), from December 2018-April 2019. Weekly distribution and patients' demographic and clinical data were compared in 1300 RSV and 222 HMPV-positive cases. Phylogenetic analysis of the G-glycoprotein coding region was performed to characterize circulating strains. RSV positivity ranged from 6.4% in outpatients of all ages to 31.7% in hospitalized children; HMPV positivity was 4-1.2% with no age-association. RSV season peaked in February and ended in mid-April: HMPV circulation was higher when RSV decreased in early spring. RSV was more frequent in infants, whereas HMPV infected comparatively more elderly adults; despite, their clinical course was similar. RSV-B cases were two-thirds of the total and had similar clinical severity compared to RSV-A. Phylogenetic analysis showed the circulation of RSV-A ON1 variants and the predominance of RSV-B genotype BA10. HMPV genotype A2c was the prevalent one and presented insertions of different lengths in G. This first multicenter Italian report on seasonality, age-specific distribution, and clinical presentation of RSV and HMPV demonstrated their substantial disease burden in young patients but also in the elderly. These data may provide the basis for a national respiratory virus surveillance network.
Collapse
Affiliation(s)
- Alessandra Pierangeli
- Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, V.Le Porta Tiburtina, 28; 00185, Rome, Italy
| | - Antonio Piralla
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Uceda Renteria
- Virology Unit, Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore, Milan, Italy
| | - Giovanni Giacomel
- Virology Unit, Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore, Milan, Italy
| | - Giovanna Lunghi
- Virology Unit, Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore, Milan, Italy
| | - Elisabetta Pagani
- Laboratorio Aziendale Di Microbiologia E Virologia, Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy
| | - Elisabetta Giacobazzi
- Laboratorio Aziendale Di Microbiologia E Virologia, Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy
| | - Elisa Vian
- Microbiology Unit, Hospital of Treviso (AULSS2), Treviso, Italy
| | - Valeria Biscaro
- Microbiology Unit, Hospital of Treviso (AULSS2), Treviso, Italy
| | - Giulia Piccirilli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria, Bologna, Italy
| | - Tiziana Lazzarotto
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Menzo
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Monica Lucia Ferreri
- Virology Laboratory, Azienda Ospedaliera Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Federica Novazzi
- Ospedale Di Circolo E Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Amelia Licari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Oliveto
- Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, V.Le Porta Tiburtina, 28; 00185, Rome, Italy
| | - Guido Antonelli
- Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, V.Le Porta Tiburtina, 28; 00185, Rome, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fausto Baldanti
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
8
|
Pellegrinelli L, Luconi E, Marano G, Galli C, Delbue S, Bubba L, Binda S, Castaldi S, Biganzoli E, Pariani E, Boracchi P. A Flexible Regression Modeling Approach Applied to Observational Laboratory Virological Data Suggests That SARS-CoV-2 Load in Upper Respiratory Tract Samples Changes with COVID-19 Epidemiology. Viruses 2023; 15:1988. [PMID: 37896765 PMCID: PMC10610845 DOI: 10.3390/v15101988] [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: 07/04/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background. Exploring the evolution of SARS-CoV-2 load and clearance from the upper respiratory tract samples is important to improving COVID-19 control. Data were collected retrospectively from a laboratory dataset on SARS-CoV-2 load quantified in leftover nasal pharyngeal swabs (NPSs) collected from symptomatic/asymptomatic individuals who tested positive to SARS-CoV-2 RNA detection in the framework of testing activities for diagnostic/screening purpose during the 2020 and 2021 winter epidemic waves. (2) Methods. A Statistical approach (quantile regression and survival models for interval-censored data), novel for this kind of data, was applied. We included in the analysis SARS-CoV-2-positive adults >18 years old for whom at least two serial NPSs were collected. A total of 262 SARS-CoV-2-positive individuals and 784 NPSs were included: 193 (593 NPSs) during the 2020 winter wave (before COVID-19 vaccine introduction) and 69 (191 NPSs) during the 2021 winter wave (all COVID-19 vaccinated). We estimated the trend of the median value, as well as the 25th and 75th centiles of the viral load, from the index episode (i.e., first SARS-CoV-2-positive test) until the sixth week (2020 wave) and the third week (2021 wave). Interval censoring methods were used to evaluate the time to SARS-CoV-2 clearance (defined as Ct < 35). (3) Results. At the index episode, the median value of viral load in the 2021 winter wave was 6.25 log copies/mL (95% CI: 5.50-6.70), and the median value in the 2020 winter wave was 5.42 log copies/mL (95% CI: 4.95-5.90). In contrast, 14 days after the index episode, the median value of viral load was 3.40 log copies/mL (95% CI: 3.26-3.54) for individuals during the 2020 winter wave and 2.93 Log copies/mL (95% CI: 2.80-3.19) for those of the 2021 winter wave. A significant difference in viral load shapes was observed among age classes (p = 0.0302) and between symptomatic and asymptomatic participants (p = 0.0187) for the first wave only; the median viral load value is higher at the day of episode index for the youngest (18-39 years) as compared to the older (40-64 years and >64 years) individuals. In the 2021 epidemic, the estimated proportion of individuals who can be considered infectious (Ct < 35) was approximately half that of the 2020 wave. (4) Conclusions. In case of the emergence of new SARS-CoV-2 variants, the application of these statistical methods to the analysis of virological laboratory data may provide evidence with which to inform and promptly support public health decision-makers in the modification of COVID-19 control measures.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
| | - Ester Luconi
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, 20133 Milan, Italy
| | - Giuseppe Marano
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, 20133 Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Elia Biganzoli
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, 20133 Milan, Italy
- Data Science and Research Center (DSRC), L. Sacco, “Luigi Sacco” University Hospital, University of Milan, 20133 Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (L.P.)
| | - Patrizia Boracchi
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, 20133 Milan, Italy
- Data Science and Research Center (DSRC), L. Sacco, “Luigi Sacco” University Hospital, University of Milan, 20133 Milan, Italy
| |
Collapse
|
9
|
Ang HJ, Menegale F, Preziosi G, Pariani E, Migliari M, Pellegrinelli L, Sechi GM, Buoro S, Merler S, Cereda D, Tirani M, Poletti P, Dorigatti I. Reconstructing the impact of COVID-19 on the immunity gap and transmission of respiratory syncytial virus in Lombardy, Italy. EBioMedicine 2023; 95:104745. [PMID: 37566927 PMCID: PMC10432612 DOI: 10.1016/j.ebiom.2023.104745] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 04/18/2023] [Revised: 06/18/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of hospitalisation and mortality in young children globally. The social distancing measures implemented against COVID-19 in Lombardy (Italy) disrupted the typically seasonal RSV circulation during 2019-2021 and caused substantially more hospitalisations during 2021-2022. The primary aim of this study is to quantify the immunity gap-defined as the increased proportion of the population naïve to RSV infection following the relaxation of COVID-19 restrictions in Lombardy, which has been hypothesised to be a potential cause of the increased RSV burden in 2021-2022. METHODS We developed a catalytic model to reconstruct changes in the age-dependent susceptibility profile of the Lombardy population throughout the COVID-19 pandemic. The model is calibrated to routinely collected hospitalisation, syndromic, and virological surveillance data and tested for alternative assumptions on age-dependencies in the risk of RSV infection throughout the pandemic. FINDINGS We estimate that the proportion of the Lombardy population naïve to RSV infection increased by 60.8% (95% CrI: 55.2-65.4%) during the COVID-19 pandemic: from 1.4% (95% CrI: 1.3-1.6%) in 2018-2019 to 2.3% (95% CrI: 2.2-2.5%) before the 2021-2022 season, corresponding to an immunity gap of 0.87% (95% CrI: 0.87-0.88%). We found evidence of heterogeneity in RSV transmission by age, suggesting that the COVID-19 restrictions had variable impact on the contact patterns and risk of RSV infection across ages. INTERPRETATION We estimate a substantial increase in the population-level susceptibility to RSV in Lombardy during 2019-2021, which contributed to an increase in primary RSV infections in 2021-2022. FUNDING UK Medical Research Council (MRC), UK Foreign, Commonwealth & Development Office (FCDO), EDCTP2 programme, European Union, Wellcome Trust, Royal Society, EU-MUR PNRR INF-ACT.
Collapse
Affiliation(s)
- Hadrian Jules Ang
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Francesco Menegale
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy; Department of Mathematics, University of Trento, Trento, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Sabrina Buoro
- Lombardy Region Welfare General Directorate, Milano, Italy
| | - Stefano Merler
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Danilo Cereda
- Lombardy Region Welfare General Directorate, Milano, Italy
| | - Marcello Tirani
- Lombardy Region Welfare General Directorate, Milano, Italy; Health Protection Agency of the Metropolitan Area of Milan, Milano, Italy
| | - Piero Poletti
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy.
| | - Ilaria Dorigatti
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.
| |
Collapse
|
10
|
Aldè M, Binda S, Primache V, Pellegrinelli L, Pariani E, Pregliasco F, Di Berardino F, Cantarella G, Ambrosetti U. Congenital Cytomegalovirus and Hearing Loss: The State of the Art. J Clin Med 2023; 12:4465. [PMID: 37445500 DOI: 10.3390/jcm12134465] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023] Open
Abstract
In developed countries, congenital cytomegalovirus (cCMV) infection is the most common congenital viral infection, representing the leading non-genetic cause of sensorineural hearing loss (HL). Diagnosis of cCMV infection can be performed by detection of CMV DNA in urine or saliva within 2-3 weeks after birth, or later in dried blood samples on the Guthrie card. Currently, there are many controversies regarding the preventive, diagnostic, and therapeutic approaches to cCMV infection. HL secondary to cCMV is highly variable in onset, side, degree, audiometric configuration, and threshold changes over time. Therefore, it is of paramount importance to perform a long and thorough audiological follow-up in children with cCMV infection to ensure early identification and prompt treatment of progressive and/or late-onset HL. Early cochlear implantation appears to be a valid solution not only for children with bilateral profound HL, but also for those with single-sided deafness, improving localization ability and understanding speech in noisy environments. Moreover, the decision to apply a unilateral cochlear implant in children with cCMV is strengthened by the non-negligible possibility of hearing deterioration of the contralateral ear over time.
Collapse
Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Fabrizio Pregliasco
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| |
Collapse
|
11
|
Piralla A, Mojoli F, Pellegrinelli L, Ceriotti F, Valzano A, Grasselli G, Gismondo MR, Micheli V, Castelli A, Farina C, Arosio M, Lorini FL, Fanti D, Busni A, Laratta M, Maggi F, Novazzi F, Cabrini L, Callegaro AP, Keim R, Remuzzi G, Cavallero A, Malandrin SMI, Rona R, Giardina F, Ferrari G, Zavaglio F, D'angelo P, Galli C, Bubba L, Binda S, Oggioni M, Uceda Renteria SC, Bono P, Baj A, Ferrante FD, Guarneri D, Tonelli M, Napolitano G, Nava A, Romeo L, Nicolini E, Valaperta R, Varisano L, Mele C, Liguori L, Raggi M, Mongodi S, Pagani M, Severgnini P, Gasberti D, Bonanomi E, Gritti P, Marrazzo F, Giovannini I, Sacchi N, Sagliocco O, Cereda D, Buoro S, Baldanti F, Pariani E. Impact of SARS-CoV-2 Omicron and Delta variants in patients requiring intensive care unit (ICU) admission for COVID-19, Northern Italy, December 2021 to January 2022. Respir Med Res 2023; 83:100990. [PMID: 36871459 PMCID: PMC9984278 DOI: 10.1016/j.resmer.2023.100990] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 03/06/2023]
Abstract
This multicenter observational study included 171 COVID-19 adult patients hospitalized in the ICUs of nine hospitals in Lombardy (Northern Italy) from December, 1st 2021, to February, 9th 2022. During the study period, the Delta/Omicron variant ratio of cases decreased with a delay of two weeks in ICU patients compared to that in the community; a higher proportion of COVID-19 unvaccinated patients was infected by Delta than by Omicron whereas a higher rate of COVID-19 boosted patients was Omicron-infected. A higher number of comorbidities and a higher comorbidity score in ICU critically COVID-19 inpatients was positively associated with the Omicron infection as well in vaccinated individuals. Although people infected by Omicron have a lower risk of severe disease than those infected by Delta variant, the outcome, including the risk of ICU admission and the need for mechanical ventilation due to infection by Omicron versus Delta, remains uncertain. The continuous monitoring of the circulating SARS-CoV-2 variants remains a milestone to counteract this pandemic.
Collapse
Affiliation(s)
- Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Francesco Mojoli
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonia Valzano
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Grasselli
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonio Castelli
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marco Arosio
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | | | - Diana Fanti
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Busni
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Laratta
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | - Fabrizio Maggi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Federica Novazzi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Luca Cabrini
- Intensive Care and Anesthesia Unit, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | | | | | | | | | - Roberto Rona
- Department of Anesthesia and Intensive Care Medicine, San Gerardo Hospital ASST Monza, Monza, Italy
| | - Federica Giardina
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Zavaglio
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piera D'angelo
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreina Baj
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Davide Guarneri
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marco Tonelli
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Gavino Napolitano
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Alice Nava
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Romeo
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan
| | - Elena Nicolini
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan
| | | | | | - Caterina Mele
- Laboratory of Immunology and Genetics of Rare Diseases, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
| | - Lucia Liguori
- Laboratory of Immunology and Genetics of Rare Diseases, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
| | - Monica Raggi
- Microbiology Laboratory San Gerardo Hospital, Monza, Italy
| | - Silvia Mongodi
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Pagani
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Severgnini
- Department of Biotechnology and Life, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Dario Gasberti
- Intensive Care and Anesthesia Unit, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Ezio Bonanomi
- Department of Emergency and ICU, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Paolo Gritti
- Department of Emergency and ICU, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Francesco Marrazzo
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | - Ilaria Giovannini
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | | | | | - Danilo Cereda
- Direzione Generale Welfare, Regione Lombardia, Milan, Italy
| | - Sabrina Buoro
- Direzione Generale Welfare, Regione Lombardia, Milan, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
12
|
Galli C, Pellegrinelli L, Giardina F, Ferrari G, Uceda Renteria SC, Novazzi F, Masi E, Pagani E, Piccirilli G, Mauro MV, Binda S, Corvaro B, Tiberio C, Lalle E, Maggi F, Russo C, Ranno S, Vian E, Pariani E, Baldanti F, Piralla A. On the lookout for influenza viruses in Italy during the 2021-2022 season: Along came A(H3N2) viruses with a new phylogenetic makeup of their hemagglutinin. Virus Res 2023; 324:199033. [PMID: 36581046 DOI: 10.1016/j.virusres.2022.199033] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/27/2022]
Abstract
AIMS To assess influenza viruses (IVs) circulation and to evaluate A(H3N2) molecular evolution during the 2021-2022 season in Italy. MATERIALS AND METHODS 12,393 respiratory specimens (nasopharyngeal swabs or broncho-alveolar lavages) collected from in/outpatients with influenza illness in the period spanning from January 1, 2022 (week 2022-01) to May 31, 2022 (week 2022-22) were analysed to identify IV genome and were molecularly characterized by 12 laboratories throughout Italy. A(H3N2) evolution was studied by conducting an in-depth phylogenetic analysis of the hemagglutinin (HA) gene sequences. The predicted vaccine efficacy (pVE) of vaccine strain against circulating A(H3N2) viruses was estimated using the sequence-based Pepitope model. RESULTS The overall IV-positive rate was 7.2% (894/12,393), all were type A IVs. Almost all influenza A viruses (846/894; 94.6%) were H3N2 that circulated in Italy with a clear epidemic trend, with 10% positivity rate threshold crossed for six consecutive weeks from week 2022-11 to week 2022-16. According to the phylogenetic analysis of a subset of A(H3N2) strains (n=161), the study HA sequences were distributed into five different genetic clusters, all of them belonging to the clade 3C.2a, sub-clade 3C.2a1 and the genetic subgroup 3C.2a1b.2a.2. The selective pressure analysis of A(H3N2) sequences showed evidence of diversifying selection particularly in the amino acid position 156. The comparison between the predicted amino acid sequence of the 2021-2022 vaccine strain (A/Cambodia/e0826360/2020) and the study strains revealed 65 mutations in 59 HA amino acid positions, including the substitution H156S and Y159N in antigenic site B, within major antigenic sites adjacent to the receptor-binding site, suggesting the presence of drifted strains. According to the sequence-based Pepitope model, antigenic site B was the dominant antigenic site and the p(VE) against circulating A(H3N2) viruses was estimated to be -28.9%. DISCUSSION AND CONCLUSION After a long period of very low IV activity since public health control measures have been introduced to face COVID-19 pandemic, along came A(H3N2) with a new phylogenetic makeup. Although the delayed 2021-2022 influenza season in Italy was characterized by a significant reduction of the width of the epidemic curve and in the intensity of the influenza activity compared to historical data, a marked genetic diversity of the HA of circulating A(H3N2) strains was observed. The identification of the H156S and Y159N substitutions within the main antigenic sites of most HA sequences also suggested the circulation of drifted variants with respect to the 2021-2022 vaccine strain. Molecular surveillance plays a critical role in the influenza surveillance architecture and it has to be strengthened also at local level to timely assess vaccine effectiveness and detect novel strains with potential impact on public health.
Collapse
Affiliation(s)
- Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federica Giardina
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Federica Novazzi
- Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy; University of Insubria, Varese, Italy
| | - Elisa Masi
- Laboratorio Aziendale di Microbiologia e Virologia, Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Elisabetta Pagani
- Laboratorio Aziendale di Microbiologia e Virologia, Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Giulia Piccirilli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Vittoria Mauro
- Microbiology & Virology Unit, Annunziata Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Benedetta Corvaro
- Virology Laboratory, Azienda Ospedaliera Ospedali Riuniti di Ancona, Ancona, Italy
| | - Claudia Tiberio
- Microbiology and Virology, Cotugno Hospital AORN dei Colli, Naples, Italy
| | - Eleonora Lalle
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Fabrizio Maggi
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Cristina Russo
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Stefania Ranno
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Elisa Vian
- Microbiology Unit, Azienda ULSS2 Marca Trevigiana, Treviso, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | |
Collapse
|
13
|
Pasotti F, Pellegrinelli L, Liga G, Rizzetto M, Azzarà G, Da Molin S, Lungu OL, Greco S, Galli C, Bubba L, Pariani E, Corradin M, Cereda D, Buoro S. First Results of an External Quality Assessment (EQA) Scheme for Molecular, Serological and Antigenic Diagnostic Test for SARS-CoV-2 Detection in Lombardy Region (Northern Italy), 2020–2022. Diagnostics (Basel) 2022; 12:diagnostics12061483. [PMID: 35741293 PMCID: PMC9222140 DOI: 10.3390/diagnostics12061483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
For diagnosing SARS-CoV-2 infection and for monitoring its spread, the implementation of external quality assessment (EQA) schemes is mandatory to assess and ensure a standard quality according to national and international guidelines. Here, we present the results of the 2020, 2021, 2022 EQA schemes in Lombardy region for assessing the quality of the diagnostic laboratories involved in SARS-CoV-2 diagnosis. In the framework of the Quality Assurance Programs (QAPs), the routinely EQA schemes are managed by the regional reference centre for diagnostic laboratories quality (RRC-EQA) of the Lombardy region and are carried out by all the diagnostic laboratories. Three EQA programs were organized: (1) EQA of SARS-CoV-2 nucleic acid detection; (2) EQA of anti-SARS-CoV-2-antibody testing; (3) EQA of SARS-CoV-2 direct antigens detection. The percentage of concordance of 1938 molecular tests carried out within the SARS-CoV-2 nucleic acid detection EQA was 97.7%. The overall concordance of 1875 tests carried out within the anti-SARS-CoV-2 antibody EQA was 93.9% (79.6% for IgM). The overall concordance of 1495 tests carried out within the SARS-CoV-2 direct antigens detection EQA was 85% and it was negatively impacted by the results obtained by the analysis of weak positive samples. In conclusion, the EQA schemes for assessing the accuracy of SARS-CoV-2 diagnosis in the Lombardy region highlighted a suitable reproducibility and reliability of diagnostic assays, despite the heterogeneous landscape of SARS-CoV-2 tests and methods. Laboratory testing based on the detection of viral RNA in respiratory samples can be considered the gold standard for SARS-CoV-2 diagnosis.
Collapse
Affiliation(s)
- Fabio Pasotti
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Laura Pellegrinelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy; (C.G.); (L.B.); (E.P.)
- Correspondence: ; Tel.: +39-0250315125; Fax: +39-0250315120
| | - Giuseppa Liga
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Manuela Rizzetto
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Giovanna Azzarà
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Simona Da Molin
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Oana Livia Lungu
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Silvia Greco
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
| | - Cristina Galli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy; (C.G.); (L.B.); (E.P.)
| | - Laura Bubba
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy; (C.G.); (L.B.); (E.P.)
| | - Elena Pariani
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy; (C.G.); (L.B.); (E.P.)
| | - Matteo Corradin
- Direzione Generale Welfare Regione Lombardia, 20124 Milano, Italy; (M.C.); (D.C.)
| | - Danilo Cereda
- Direzione Generale Welfare Regione Lombardia, 20124 Milano, Italy; (M.C.); (D.C.)
| | - Sabrina Buoro
- Centro di Riferimento per la Qualità dei Servizi di Medicina di Laboratorio di Regione Lombardia, 20162 Milano, Italy; (F.P.); (G.L.); (M.R.); (G.A.); (S.D.M.); (O.L.L.); (S.G.); (S.B.)
- Direzione Generale Welfare Regione Lombardia, 20124 Milano, Italy; (M.C.); (D.C.)
| |
Collapse
|
14
|
Nattino G, Castiglioni S, Cereda D, Della Valle PG, Pellegrinelli L, Bertolini G, Pariani E. Association Between SARS-CoV-2 Viral Load in Wastewater and Reported Cases, Hospitalizations, and Vaccinations in Milan, March 2020 to November 2021. JAMA 2022; 327:1922-1924. [PMID: 35363259 PMCID: PMC9115613 DOI: 10.1001/jama.2022.4908] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study evaluates the association between SARS-CoV-2 load in urban wastewater and surveillance indicators of infection prevalence and severity in Milan, Italy.
Collapse
Affiliation(s)
- Giovanni Nattino
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Sara Castiglioni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Petra Giulia Della Valle
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Guido Bertolini
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| |
Collapse
|
15
|
Castiglioni S, Schiarea S, Pellegrinelli L, Primache V, Galli C, Bubba L, Mancinelli F, Marinelli M, Cereda D, Ammoni E, Pariani E, Zuccato E, Binda S. SARS-CoV-2 RNA in urban wastewater samples to monitor the COVID-19 pandemic in Lombardy, Italy (March-June 2020). Sci Total Environ 2022; 806:150816. [PMID: 34627901 PMCID: PMC8497959 DOI: 10.1016/j.scitotenv.2021.150816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/05/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 04/15/2023]
Abstract
Wastewater-based viral surveillance was proposed as a promising approach to monitor the circulation of SARS-CoV-2 in the general population. The aim of this study was to develop an analytical method to detect SARS-CoV-2 RNA in urban wastewater, and apply it to follow the trends of epidemic in the framework of a surveillance network in the Lombardy region (Northern Italy). This area was the first hotspot of COVID-19 in Europe and was severely affected. Composite 24 h samples were collected weekly in eight cities from end-March to mid-June 2020 (first peak of the pandemic). The method developed and optimized, involved virus concentration using PEG centrifugation, and one-step real-time RT-PCR for analysis. SARS-CoV-2 RNA was identified in 65 (61%) out of 107 samples, and the viral concentrations (up to 2.1 E + 05 copies/L) were highest in March-April. By mid-June, wastewater samples tested negative in all the cities corresponding to the very low number of cases recorded in the same period. Viral loads were calculated considering the wastewater daily flow rate and the population served by each wastewater treatment plant, and were used for inter- city comparison. The highest viral loads were found in Brembate, Ranica and Lodi corresponding to the hotspots of the first peak of pandemic. The pattern of decrease of SARS-CoV-2 in wastewater was closely comparable to the decline of active COVID-19 cases in the population, reflecting the effect of lock-down. This study tested wastewater surveillance of SARS-CoV-2 to follow the pandemic trends in one of most affected areas worldwide, demonstrating that it can integrate ongoing virological surveillance of COVID-19, providing information from both symptomatic and asymptomatic individuals, and monitoring the effect of health interventions.
Collapse
Affiliation(s)
- Sara Castiglioni
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156 Milan, Italy.
| | - Silvia Schiarea
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| | - Federica Mancinelli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | | | | | | | - Elena Pariani
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| | - Ettore Zuccato
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences of Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
| |
Collapse
|
16
|
Pellegrinelli L, Galli C, Bubba L, Seiti A, Anselmi G, Primache V, Signorini L, Delbue S, Binda S, Pariani E. Respiratory syncytial virus in pediatric influenza-like illness cases in Lombardy, Northern Italy, during seven consecutive winter seasons (from 2014-2015 to 2020-2021). Influenza Other Respir Viruses 2021; 16:481-491. [PMID: 34921508 PMCID: PMC8983902 DOI: 10.1111/irv.12940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/15/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza‐like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10 million inhabitants) from 2014–2015 to 2020–2021 winter seasons. Material and Methods Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet). Results RSV accounted for nearly 19% of pediatric ILI with a risk of infection nearly two‐fold greater than that of individuals ≥15 years. RSV positivity rate increased to 28% considering 0–5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly two‐fold higher than the risk of RSV infection, the age group 4–6 months and 7–12 months showed a five‐fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with pre‐existing underlying health conditions had a nearly five‐fold greater risk of getting RSV infection than otherwise healthy 0–5 years old children. RSV was identified in ILI cases <15 years of age in all considered winter seasons except in the 2020–2021 season. Discussion Sentinel surveillance of ILI allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing, and intensity of the RSV and influenza community circulation. This surveillance approach can be implemented to assess the RSV circulation and impact in a real‐time manner.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Arlinda Seiti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lucia Signorini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), University of Genoa, Genoa, Italy
| |
Collapse
|
17
|
Pariani E, Pasciuta R, Novazzi F, Baj A, Galli C, Pellegrinelli L, Bubba L, Cereda D, Puzelli S, Focosi D, Agosti M, Stefanelli P, Maggi F. How multiplex testing approach to respiratory viruses detection can enhance influenza surveillance. Journal of Clinical Virology Plus 2021. [DOI: 10.1016/j.jcvp.2021.100050] [Citation(s) in RCA: 1] [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: 11/26/2022] Open
|
18
|
Benschop KS, Albert J, Anton A, Andrés C, Aranzamendi M, Armannsdóttir B, Bailly JL, Baldanti F, Baldvinsdóttir GE, Beard S, Berginc N, Böttcher S, Blomqvist S, Bubba L, Calvo C, Cabrerizo M, Cavallero A, Celma C, Ceriotti F, Costa I, Cottrell S, Del Cuerpo M, Dean J, Dembinski JL, Diedrich S, Diez-Domingo J, Dorenberg D, Duizer E, Dyrdak R, Fanti D, Farkas A, Feeney S, Flipse J, De Gascun C, Galli C, Georgieva I, Gifford L, Guiomar R, Hönemann M, Ikonen N, Jeannoël M, Josset L, Keeren K, López-Labrador FX, Maier M, McKenna J, Meijer A, Mengual-Chuliá B, Midgley SE, Mirand A, Montes M, Moore C, Morley U, Murk JL, Nikolaeva-Glomb L, Numanovic S, Oggioni M, Palminha P, Pariani E, Pellegrinelli L, Piralla A, Pietsch C, Piñeiro L, Rabella N, Rainetova P, Uceda Renteria SC, Romero MP, Reynders M, Roorda L, Savolainen-Kopra C, Schuffenecker I, Soynova A, Swanink CM, Ursic T, Verweij JJ, Vila J, Vuorinen T, Simmonds P, Fischer TK, Harvala H. Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34763750 PMCID: PMC8646978 DOI: 10.2807/1560-7917.es.2021.26.45.2100998] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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] [Indexed: 01/01/2023]
Abstract
We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.
Collapse
Affiliation(s)
- Kimberley Sm Benschop
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Andres Anton
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maitane Aranzamendi
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Jean-Luc Bailly
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Fausto Baldanti
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy.,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | | | - Stuart Beard
- UK Health Security Agency, Colindale, United Kingdom
| | - Natasa Berginc
- National laboratory of health, environment and food, Laboratory for public health virology, Ljubljana, Slovenia
| | - Sindy Böttcher
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Soile Blomqvist
- National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Bubba
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | - Maria Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, Enterovirus and Viral Gastroenteritis Unit/Polio National Lab, Madrid, Spain
| | - Annalisa Cavallero
- Laboratory of Microbiology, ASST Monza, San Gerardo Hospital, Monza (MB), Italy
| | | | - Ferruccio Ceriotti
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Inês Costa
- National Institute of Health (INSA), Lisbon, Portugal
| | | | - Margarita Del Cuerpo
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jonathan Dean
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | - Sabine Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Javier Diez-Domingo
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | | | - Erwin Duizer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Robert Dyrdak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Diana Fanti
- Chemical-clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Agnes Farkas
- National Public Health Center, Budapest, Hungary
| | - Susan Feeney
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Jacky Flipse
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Cristina Galli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Irina Georgieva
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | | | - Mario Hönemann
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Niina Ikonen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Marion Jeannoël
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Laurence Josset
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Kathrin Keeren
- Secretary of the commission for Polio Eradication in Germany, Robert-Koch Institute, Berlin, Germany
| | - F Xavier López-Labrador
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.,Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Melanie Maier
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - James McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Adam Meijer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Beatriz Mengual-Chuliá
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Sofie E Midgley
- The Danish WHO National Reference Laboratory for Poliovirus, Statens Serum Institut, Copenhagen, Denmark
| | - Audrey Mirand
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Milagrosa Montes
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Ursula Morley
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Jean-Luc Murk
- Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Lubomira Nikolaeva-Glomb
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Sanela Numanovic
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Massimo Oggioni
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Corinna Pietsch
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Luis Piñeiro
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | - Núria Rabella
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Sara Colonia Uceda Renteria
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - María P Romero
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | | | | | - Isabelle Schuffenecker
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Aysa Soynova
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Caroline Ma Swanink
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Tina Ursic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Jorgina Vila
- Pediatric Hospitalization Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Tytti Vuorinen
- Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
| | | | - Thea K Fischer
- Nordsjaellands Hospital, Hillerod, Denmark.,University of Sothern Denmark, Odense, Denmark
| | - Heli Harvala
- University College London (UCL), Department of infection and Immunity, London, United Kingdom.,NHS Blood and Transplant, Microbiology Services, Colindale, United Kingdom
| |
Collapse
|
19
|
Benschop KSM, Broberg EK, Hodcroft E, Schmitz D, Albert J, Baicus A, Bailly JL, Baldvinsdottir G, Berginc N, Blomqvist S, Böttcher S, Brytting M, Bujaki E, Cabrerizo M, Celma C, Cinek O, Claas ECJ, Cremer J, Dean J, Dembinski JL, Demchyshyna I, Diedrich S, Dudman S, Dunning J, Dyrdak R, Emmanouil M, Farkas A, De Gascun C, Fournier G, Georgieva I, Gonzalez-Sanz R, van Hooydonk-Elving J, Jääskeläinen AJ, Jancauskaite R, Keeren K, Fischer TK, Krokstad S, Nikolaeva-Glomb L, Novakova L, Midgley SE, Mirand A, Molenkamp R, Morley U, Mossong J, Muralyte S, Murk JL, Nguyen T, Nordbø SA, Österback R, Pas S, Pellegrinelli L, Pogka V, Prochazka B, Rainetova P, Van Ranst M, Roorda L, Schuffenecker I, Schuurman R, Stoyanova A, Templeton K, Verweij JJ, Voulgari-Kokota A, Vuorinen T, Wollants E, Wolthers KC, Zakikhany K, Neher R, Harvala H, Simmonds P. Molecular Epidemiology and Evolutionary Trajectory of Emerging Echovirus 30, Europe. Emerg Infect Dis 2021; 27:1616-1626. [PMID: 34013874 PMCID: PMC8153861 DOI: 10.3201/eid2706.203096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In 2018, an upsurge in echovirus 30 (E30) infections was reported in Europe. We conducted a large-scale epidemiologic and evolutionary study of 1,329 E30 strains collected in 22 countries in Europe during 2016-2018. Most E30 cases affected persons 0-4 years of age (29%) and 25-34 years of age (27%). Sequences were divided into 6 genetic clades (G1-G6). Most (53%) sequences belonged to G1, followed by G6 (23%), G2 (17%), G4 (4%), G3 (0.3%), and G5 (0.2%). Each clade encompassed unique individual recombinant forms; G1 and G4 displayed >2 unique recombinant forms. Rapid turnover of new clades and recombinant forms occurred over time. Clades G1 and G6 dominated in 2018, suggesting the E30 upsurge was caused by emergence of 2 distinct clades circulating in Europe. Investigation into the mechanisms behind the rapid turnover of E30 is crucial for clarifying the epidemiology and evolution of these enterovirus infections.
Collapse
|
20
|
Grosso F, Castrofino A, Del Castillo G, Galli C, Binda S, Pellegrinelli L, Bubba L, Cereda D, Tirani M, Gramegna M, Bella A, Castaldi S, Pariani E. A comparative study between the incidence and epidemiological features of Influenza-Like Illness and laboratory-confirmed COVID-19 cases in the Italian epicenter (Lombardy). J Infect Public Health 2021; 14:674-680. [PMID: 33865059 PMCID: PMC7901382 DOI: 10.1016/j.jiph.2021.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/10/2020] [Revised: 01/18/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In Lombardy, the influenza surveillance system relies on sentinel physicians that weekly report data on the number of Influenza-Like Illness (ILI) and a part of them also collect nasopharyngeal samples for virologic analyses. This study aims at comparing the ILI incidence of 2019-2020 influenza season with the incidence of COVID-19 cases in order to better understand the current epidemic and to evaluate whether the implementation of ILI surveillance system could succeed in early detection and monitoring of COVID-19 diffusion. METHODS The distribution of ILI cases in the seasons 2017-2018, 2018-2019 and 2019-2020 was taken in consideration and the curve trends were compared and analyzed according to geographical areas, age groups and time differences. RESULTS The curve trends presented a similar pattern up to the 9th week; in fact, a reduction in the ILI incidence rate was observed in the 2017-2018 and 2018-2019 season but in the 2019-2020 an increase in the reported ILI emerged. The relation between the numbers reported by 2019-2020 ILI surveillance and those reported for COVID-19 is supported by the curve trends, the correspondence between age groups, the correspondence by geographical location, and also by the results of the nasopharyngeal swab tests performed. DISCUSSION The influenza surveillance system is an effective tool for early detection of COVID-19. It may provide timely and high-quality data evaluating the SARS-CoV-2 burden among population with ILI. Implementation of the system has to be prioritized in order to identify any future novel respiratory pathogen with pandemic potential.
Collapse
Affiliation(s)
- Francesca Grosso
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ambra Castrofino
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Health Management Department, Fondazione IRCCS Ca' Granda OMP, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
| |
Collapse
|
21
|
Galli C, Pellegrinelli L, Bubba L, Primache V, Anselmi G, Delbue S, Signorini L, Binda S, Cereda D, Gramegna M, Pariani E. When the COVID-19 Pandemic Surges during Influenza Season: Lessons Learnt from the Sentinel Laboratory-Based Surveillance of Influenza-Like Illness in Lombardy during the 2019-2020 Season. Viruses 2021; 13:v13040695. [PMID: 33923819 PMCID: PMC8073979 DOI: 10.3390/v13040695] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 03/23/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022] Open
Abstract
This paper outlines the role of Lombardy’s regional influenza reference laboratory (Northern Italy) in the surveillance of influenza-like illnesses (ILIs) in monitoring SARS-CoV-2 circulation by analyzing 631 consecutive nasopharyngeal swabs (NPSs) collected from ILI outpatients by sentinel physicians during the 2019–2020 season. The samples were tested by specific real-time RT-PCRs targeting SARS-CoV-2, influenza viruses, and RSVs. Results: Of these NPSs, 31% tested positive for influenza viruses, 10% for SARS-CoV-2, and 7% for RSV. No coinfections were detected. Influenza viruses and RSVs circulated throughout the surveillance period until the end of February (week 9-2020), when they suddenly ceased to circulate seven weeks earlier than during the previous five influenza seasons. After the first detection of SARS-CoV-2 in our ILI outpatients at the beginning of March (week 10-2020), SARS-CoV-2 remained the only virus identified throughout the surveillance period. Patients ≥ 65 years had a 3.2-fold greater risk of being infected with SARS-CoV-2, while school-age children (5–14 years) and children < 5 years proved to be the age groups most at risk of contracting influenza viruses and RSV, respectively. Our experience demonstrates that laboratory-based ILI surveillance networks are essential for identifying SARS-CoV-2 cases that would otherwise remain undetected, in order to stop their spread within our communities.
Collapse
Affiliation(s)
- Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (S.D.); (L.S.)
| | - Lucia Signorini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (S.D.); (L.S.)
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
| | - Danilo Cereda
- DG Welfare, UO Prevenzione, Lombardy Region, 20124 Milan, Italy; (D.C.); (M.G.)
| | - Maria Gramegna
- DG Welfare, UO Prevenzione, Lombardy Region, 20124 Milan, Italy; (D.C.); (M.G.)
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (C.G.); (L.P.); (L.B.); (V.P.); (G.A.); (S.B.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-02-5031-5132
| | | |
Collapse
|
22
|
Giardina F, Galli C, Pellegrinelli L, Paolucci S, Tallarita M, Pariani E, Piralla A, Baldanti F. No evidence of SARS-CoV-2 circulation in the framework of influenza surveillance between October 2019 and February 2020 in Lombardy, Italy. Travel Med Infect Dis 2021; 40:102002. [PMID: 33647467 PMCID: PMC7988398 DOI: 10.1016/j.tmaid.2021.102002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Federica Giardina
- Molecular Virology Unit,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefania Paolucci
- Molecular Virology Unit,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Monica Tallarita
- Molecular Virology Unit,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonio Piralla
- Molecular Virology Unit,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy.
| | - Fausto Baldanti
- Molecular Virology Unit,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
23
|
Marano G, Boracchi P, Luconi E, Pariani E, Pellegrinelli L, Galli C, Gandolfi CE, Magoni M, Piro A, Scarcella C, Castaldi S, Biganzoli EM. Evaluation of influenza vaccination efficacy in reducing influenza-related complications and excess mortality in Northern Italy (2014-2017). Expert Rev Vaccines 2021; 20:73-81. [PMID: 33480821 DOI: 10.1080/14760584.2021.1874927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/30/2023]
Abstract
OBJECTIVE The main objective of this study was to estimate the efficacy of influenza vaccination in reducing influenza-attributable hospitalization and emergency room (ER) admission for severe complications and influenza-attributable excess mortality in individuals ≥65 years of age. METHODS We analyzed the ≥65 years-old community (n = 952,822) afferent to the Brescia (Northern Italy) Health Protection Agency, considered an Italian population reference, to evaluate the efficacy of influenza vaccination (seasons 2014-17) in reducing deaths, ER-admissions, and hospitalizations for influenza-related complications in the elderly. RESULTS A protective effect of influenza vaccination emerged in reducing hospitalization and ER admission for diseases of the respiratory system and for death from all causes in people ≥65 years. The major effect of influenza vaccination was the reduction in risk of death from all causes, increasing with age and comorbidity. CONCLUSION Influenza vaccination has reduced the number of ER admissions and hospitalizations caused by influenza-related complications and has prevented death among high-risk groups in elderly ≥65 years, resulting in social and public health cost savings. Stronger or new vaccination strategies are needed to improve vaccination rates among the elderly.
Collapse
Affiliation(s)
- Giuseppe Marano
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy
| | - Patrizia Boracchi
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy
| | - Ester Luconi
- Health Management Department, Fondazione IRCCS Ca' Granda OMP, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cecilia E Gandolfi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Michele Magoni
- Prevention Department, ATS Di Brescia (Brescia Health Protection Agency), Brescia, Italy
| | - Antonio Piro
- Prevention Department, ATS Di Brescia (Brescia Health Protection Agency), Brescia, Italy
| | - Carmelo Scarcella
- Prevention Department, ATS Di Brescia (Brescia Health Protection Agency), Brescia, Italy
| | - Silvana Castaldi
- Health Management Department, Fondazione IRCCS Ca' Granda OMP, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elia M Biganzoli
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy
| |
Collapse
|
24
|
Pugni L, Pietrasanta C, Ronchi A, Lunghi G, Pellegrinelli L, Mosca F, Campanini G, Baldanti F. Inherited Chromosomally Integrated Human Herpesvirus 6: An Unexpected Finding in a Septic Neonate. Pediatr Infect Dis J 2021; 40:74-75. [PMID: 33284253 DOI: 10.1097/inf.0000000000002905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human herpesvirus 6 (HHV-6) can integrate its genome in human chromosomes and be germline transmitted (inherited chromosomally integrated HHV-6). We report a case of chromosomally integrated HHV-6 inherited from the mother unexpectedly diagnosed in a septic neonate. Since HHV-6 has recently been included in multiplex polymerase chain reaction assays for meningitis/encephalitis, diagnosing inherited chromosomally integrated HHV-6 status is essential to avoid misdiagnosis of active HHV-6 infection and unnecessary antiviral treatment.
Collapse
Affiliation(s)
- Lorenza Pugni
- From the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Carlo Pietrasanta
- From the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Andrea Ronchi
- From the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Giovanna Lunghi
- Microbiology and Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Mosca
- From the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulia Campanini
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
25
|
Galli C, Pellegrinelli L, Del Castillo G, Forni G, Gandolfi CE, Mosillo M, Pietronigro A, Tiwana N, Castaldi S, Pariani E. Self-Sampling of Oropharyngeal Swabs Among Healthcare Workers for Molecular Detection of Respiratory Viruses: A Valuable Approach for Epidemiological Studies and Surveillance Programs. Front Public Health 2020; 8:511669. [PMID: 33330298 PMCID: PMC7719692 DOI: 10.3389/fpubh.2020.511669] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 10/26/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed at assessing the validity of self-collected (self-sampled) oropharyngeal (OP) swabs among healthcare workers compared to those collected by trained sentinel general practitioners (GP-sampled) from individuals with influenza-like illness (ILI), to be implemented in epidemiological studies and/or surveillance programs of viral pathogens involved in community respiratory infections. In our study, OP swabs were collected from adults (>18 years) with ILI during the 2018–2019 influenza season. Two groups of samples were considered: group 1−131 self-sampled OP swabs collected by healthcare workers after being trained on the sampling procedure; group 2−131 GP-sampled OP swabs collected from outpatients by sentinel GPs operating within the Italian Influenza Surveillance Network. To assess swabbing quality, following RNA extraction, each sample was tested for the presence of the human ribonuclease P gene (RNP) by in-house real-time reverse transcriptase–polymerase chain reaction (RT-PCR). Samples with a cycle threshold (Ct) <35 were considered adequate for further virological analysis. Influenza viruses (IVs), respiratory syncytial virus (RSV), and rhinovirus (RV) genomes were detected by in-house real-time RT-PCR. All samples were positive to RNP detection with Ct <35. The mean Ct value was similar in the two groups (group 1 vs. group 2: 25.93 ± 2.22 vs. 25.46 ± 2.40; p = 0.10). IVs, RSV, and RV positivity rates were 26.7 vs. 52.7% (p < 0.01), 7.6 vs. 9.9% (p = 0.52), and 21.4 vs. 19.9% (p = 0.76), respectively. Self-sampled OP swabs resulted as valid as GP-sampled OP swabs for molecular detection of respiratory viruses. Self-swabbing can thus be a worthwhile strategy for sample collection to implement molecular surveillance of respiratory pathogens and carry out epidemiological studies, easily reaching a larger population size.
Collapse
Affiliation(s)
- Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Giovanni Forni
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Marco Mosillo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Anna Pietronigro
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Navpreet Tiwana
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), University of Genoa, Genoa, Italy
| |
Collapse
|
26
|
Pellegrinelli L, Galli C, Bubba L, Cereda D, Anselmi G, Binda S, Gramegna M, Pariani E. Respiratory syncytial virus in influenza-like illness cases: Epidemiology and molecular analyses of four consecutive winter seasons (2014-2015/2017-2018) in Lombardy (Northern Italy). J Med Virol 2020; 92:2999-3006. [PMID: 32314816 DOI: 10.1002/jmv.25917] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 02/12/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Besides seasonal influenza viruses (IV), several other pathogens-including respiratory syncytial virus (RSV)-are involved in clinically undistinguished influenza-like illnesses (ILIs). This study aimed at investigating the contribution of RSV in ILI cases in Lombardy (Northern Italy) during four consecutive winter seasons. MATERIALS AND METHODS In the framework of influenza surveillance, respiratory samples from ILI outpatients were collected from 2014-2015 to 2017-2018 season. IV-negative swabs were included in the study and analyzed to detect and molecularly characterize RSV-A and RSV-B. RESULTS A total of 12.9% (135/1047) of samples were positive to RSV that was mostly detected among children ≤5 years (51/183, 27.8%) and those aged 6 to 15 years (30/158, 18.9%), whereas elderly >65 years accounted for 12% of RSV cases (15/125). The median start of RSV epidemic was in the end of November, with a peak in mid-February and a width of nearly 4 months, almost overlapping seasonal influenza epidemic. RSV-A and RSV-B co-circulated in all considered seasons, with RSV-B predominating on RSV-A (63.6% vs 36.4%; P < .001). Most (85.2%) RSV-A belonged to genotype ON1 and the remaining to NA1. All RSV-B clustered within the BA genotype. CONCLUSIONS In this study, RSV significantly contributed to ILI cases, especially among pediatric population (<15 years), although it was detected in all age groups. RSV-B predominated on RSV-A, and the most recent evolved genotypes (BA and ON1, respectively) circulated. Investigating the epidemiological and molecular characteristics of RSV in ILI cases can increase baseline epidemiological information before the introduction of RSV vaccination.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| |
Collapse
|
27
|
Del Castillo G, Castrofino A, Grosso F, Barone A, Crottogini L, Toso C, Pellegrinelli L, Pariani E, Castaldi S, Cereda D. COVID-19 serological testing for Healthcare Workers in Lombardy, Italy. Eur J Public Health 2020. [PMCID: PMC7543569 DOI: 10.1093/eurpub/ckaa165.351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Issue COVID-19 pandemic began in Italy on February 20th, 2020. Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients. Therefore, we implemented a prevention policy for HCW screening through serological and RT-PCR testing. Description of the problem HCW screening for SARS-CoV-2 infection is essential for prevention and control of the pandemic. Lombardy's Healthcare authorities settled a screening process for HCWs divided into three steps: 1) body temperature assessment at the beginning and the end of work shift, if fever > 37.5 °C was present the HCW was sent back home and a nasopharyngeal swab was performed; 2) progressive recruitment for serological testing; 3) on those positive to IgG a nasopharyngeal swab was performed and tested for viral RNA by RT-PCR. Results Among 79185 HCW tested, 9589 (12%) were positive on serological IgG testing. Of the 9589 positive a nasopharyngeal swab was performed on 6884. Of these 358 (5%) tested positive and the remaining 6526 (95%) negative to RT-PCR. We calculated a Positive Predictive Value of 5.2%. The rate of positive serological tests for each Healthcare facility varied between 0% and 78%. Five percent of all facilities, belonging to Brescia, Bergamo and Cremona area, reported a positivity rate higher than 40% in HCWs. A second cluster (18% of all facilities), involving the same geographical area, reported a rate between 20% and 40%, whereas the remaining facilities (76%) of the region a rate <20%. Lessons Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs especially in a high infection prevalence setting. Key messages Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs. Infection prevention in HCW may benefit from a screening campaign especially in high prevalence settings.
Collapse
Affiliation(s)
- G Del Castillo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - A Castrofino
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - F Grosso
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - A Barone
- Welfare Division, ARIA spa, Milan, Italy
| | | | - C Toso
- DG Welfare, Regione Lombardia, Milan, Italy
| | - L Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - E Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - S Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - D Cereda
- DG Welfare, Regione Lombardia, Milan, Italy
| |
Collapse
|
28
|
Hayes A, Nguyen D, Andersson M, Antón A, Bailly J, Beard S, Benschop KSM, Berginc N, Blomqvist S, Cunningham E, Davis D, Dembinski JL, Diedrich S, Dudman SG, Dyrdak R, Eltringham GJA, Gonzales‐Goggia S, Gunson R, Howson‐Wells HC, Jääskeläinen AJ, López‐Labrador FX, Maier M, Majumdar M, Midgley S, Mirand A, Morley U, Nordbø SA, Oikarinen S, Osman H, Papa A, Pellegrinelli L, Piralla A, Rabella N, Richter J, Smith M, Söderlund Strand A, Templeton K, Vipond B, Vuorinen T, Williams C, Wollants E, Zakikhany K, Fischer TK, Harvala H, Simmonds P. A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. J Med Virol 2020; 92:1065-1074. [PMID: 31883139 PMCID: PMC7496258 DOI: 10.1002/jmv.25659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/24/2019] [Indexed: 12/28/2022]
Abstract
Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10-5 ). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.
Collapse
Affiliation(s)
- A. Hayes
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - D. Nguyen
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - M. Andersson
- Microbiology Laboratory, John Radcliffe Hospital, Headley Way, HeadingtonOxfordUK
| | - A. Antón
- Respiratory Viruses Unit, Virology Section, Microbiology DepartmentHospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig Vall d'HebronBarcelonaSpain
| | - J.‐L. Bailly
- Université Clermont Auvergne, LMGE UMR CNRS, UFR MédecineClermont‐FerrandFrance
- CHU Clermont‐Ferrand, National Reference Center for EV and Parechovirus‐Associated LaboratoryClermont‐FerrandFrance
| | - S. Beard
- Enteric Virus Unit, Virus Reference DepartmentNational Infection Service, Public Health EnglandLondonUK
| | - K. S. M. Benschop
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - N. Berginc
- Department for Public Health VirologyNational Laboratory of Health, Environment and FoodLjubljanaSlovenia
| | - S. Blomqvist
- National Institute for Health and Welfare, MannerheimintieHelsinkiFinland
| | - E. Cunningham
- Viapath Infection Sciences, St. Thomas' HospitalLondonUK
| | - D. Davis
- Microbiology, Virology and infection Prevention & ControlGreat Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - J. L. Dembinski
- Department of VirologyNorwegian Institute of Public HealthOsloNorway
| | - S. Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch InstituteBerlinGermany
| | - S. G. Dudman
- Department of MicrobiologyOslo University Hospital Rikshospitalet, Inst. Clinical Medicine, University of OsloOsloNorway
| | - R. Dyrdak
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstituteStockholmSweden
| | - G. J. A. Eltringham
- Molecular Diagnostics Laboratory, Microbiology, Freeman HospitalNewcastle Upon TyneUK
| | - S. Gonzales‐Goggia
- Public Health England Poliovirus Reference Laboratory, National Infection Service, Public Health EnglandLondonUK
| | - R. Gunson
- West of Scotland Specialist Virology CentreGlasgow Royal InfirmaryGlasgowUK
| | - H. C. Howson‐Wells
- Nottingham University Hospitals NHS Trust, Clinical Microbiology, Queens Medical CentreNottinghamUK
| | - A. J. Jääskeläinen
- University of Helsinki and Helsinki University Hospital, HUSLAB, Virology and ImmunologyHelsinkiFinland
| | - F. X. López‐Labrador
- Virology Laboratory, Joint Units in Genomics and Health and Infection and Health, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO‐Public Health)/Universitat de València, Av. CatalunyaValènciaSpain
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
| | - M. Maier
- Institute of VirologyLeipzig University HospitalLeipzigGermany
| | - M. Majumdar
- The National Institute for Biological Standards and ControlHertfordshireUK
| | - S. Midgley
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - A. Mirand
- CHU Clermont‐Ferrand, Laboratoire de Virologie—Centre National de Référence des Entérovirus et Parechovirus, Laboratoire Associé—Clermont‐FerrandFrance
| | - U. Morley
- UCD National Virus Reference LaboratoryUniversity College Dublin, BelfieldDublinIreland
| | - S. A. Nordbø
- Department of Medical MicrobiologySt. Olavs University HospitalTrondheimNorway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - S. Oikarinen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - H. Osman
- Public Health England Birmingham Public Health Laboratory, Heartlands HospitalBirminghamUK
| | - A. Papa
- Department of MicrobiologyMedical School, Aristotle University of ThessalonikiThessalonikiGreece
| | - L. Pellegrinelli
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - A. Piralla
- Molecular Virology Unit, Microbiology and Virology DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - N. Rabella
- Virology Section, Santa Creu i Sant Pau University HospitalBarcelonaSpain
| | - J. Richter
- Department of Molecular VirologyCyprus Institute of Neurology and GeneticsNicosiaCyprus
| | - M. Smith
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- King's College Hospital, Bessemer Wing, Denmark HillLondonUK
| | - A. Söderlund Strand
- Laboratory Medicine, Department of Clinical MicrobiologyLund University Hospital, SölvegatanLundSweden
| | - K. Templeton
- Edinburgh Specialist Virology, Royal Infirmary of EdinburghEdinburghUK
| | - B. Vipond
- Public Health England, South West Regional Laboratory, Pathology Sciences Building, Science QuarterSouthmead HospitalBristolUK
| | - T. Vuorinen
- Clinical MicrobiologyTurku University Hospital and Institute of Biomedicine University of TurkuTurkuFinland
| | | | - E. Wollants
- Clinical and Epidemiological Virology, KU Leuven, REGA Institute, Clinical and Epidemiological VirologyLeuvenBelgium
| | - K. Zakikhany
- Katherina Zakikhany‐Gilg, Public Health Agency of Sweden, Department of MicrobiologyUnit of Laboratory Surveillance of Viral Pathogens and Vaccine Preventable DiseasesStockholmSweden
| | - T. K. Fischer
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - H. Harvala
- NHS Blood and Transplant, ColindaleLondonUK
| | - P. Simmonds
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| |
Collapse
|
29
|
Pellegrinelli L, Giardina F, Lunghi G, Uceda Renteria SC, Greco L, Fratini A, Galli C, Piralla A, Binda S, Pariani E, Baldanti F. Emergence of divergent enterovirus (EV) D68 sub-clade D1 strains, northern Italy, September to October 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 30782269 PMCID: PMC6381661 DOI: 10.2807/1560-7917.es.2018.24.7.1900090] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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] [Indexed: 11/20/2022]
Abstract
Between September and October 2018, an enterovirus D68 (EV-D68) outbreak occurred in patients hospitalised with severe acute respiratory infection in northern Italy; 21 laboratory-confirmed cases were reported. Phylogenetic analysis revealed that 16/20 of the EV-D68 sequences belonged to a divergent group within the sub-clade D1. Since its upsurge, EV-D68 has undergone rapid evolution with the emergence of new viral variants, emphasising the need for molecular surveillance that include outpatients with respiratory illness.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federica Giardina
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanna Lunghi
- Microbiology and Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Letizia Greco
- Microbiology and Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Fratini
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonio Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
30
|
Pellegrinelli L, Alberti L, Pariani E, Barbi M, Binda S. Diagnosing congenital Cytomegalovirus infection: don't get rid of dried blood spots. BMC Infect Dis 2020; 20:217. [PMID: 32164599 PMCID: PMC7069171 DOI: 10.1186/s12879-020-4941-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 03/01/2020] [Indexed: 11/22/2022] Open
Abstract
Background Congenital Cytomegalovirus (cCMV) is a serious global public health issue that can cause irreversible fetal and neonatal congenital defects in symptomatic or asymptomatic newborns at birth. In absence of universal cCMV screening, the retrospective diagnosis of cCMV infection in children is only possible by examining Dried Blood Spot (DBS) samples routinely collected at birth and stored for different time spans depending on the newborn screening regulations in force in different countries. In this article, we summarize the arguments in favor of long-term DBS sample storage for detecting cCMV infection. Main text CMV infection is the most common cause of congenital infection resulting in severe defects and anomalies that can be apparent at birth or develop in early childhood. Sensorineural hearing loss is the most frequent consequence of cCMV infection and may have a late onset and progress in the first years of life. The virological diagnosis of cCMV is essential for clinical research and public health practices. In fact, in order to assess the natural history of CMV infection and distinguish between congenital or acquired infection, children should be diagnosed early by analyzing biological samples collected in the first weeks of life (3 weeks by using viral culture and 2 weeks by molecular assays), which, unfortunately, are not always available for asymptomatic or mildly symptomatic children. It now seems possible to overcome this problem since the CMV-DNA present in the blood of congenitally infected newborns can be easily retrieved from the DBS samples on the Guthrie cards routinely collected and stored within 3 days from birth in the neonatal screening program for genetic and congenital diseases. Early collection and long-term storage are inexpensive methods for long-term bio-banking and are the key points of DBS testing for the detection of cCMV. Conclusion DBS sampling is a reliable and inexpensive method for long-term bio-banking, which enables to diagnose known infectious diseases - including cCMV - as well as diseases not jet recognized, therefore their storage sites and long-term storage conditions and durations should be the subject of political decision-making.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Luisella Alberti
- Newborn Screening Laboratory, ASST Fatebenefratelli Sacco-PO Ospedale dei Bambini "V. Buzzi", Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Maria Barbi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
31
|
Panatto D, Lai PL, Mosca S, Lecini E, Orsi A, Signori A, Castaldi S, Pariani E, Pellegrinelli L, Galli C, Anselmi G, Icardi G. Influenza Vaccination in Italian Healthcare Workers (2018-2019 Season): Strengths and Weaknesses. Results of a Cohort Study in Two Large Italian Hospitals. Vaccines (Basel) 2020; 8:vaccines8010119. [PMID: 32150801 PMCID: PMC7157508 DOI: 10.3390/vaccines8010119] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/31/2020] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Annual vaccination is the most effective way to combat influenza. As influenza viruses evolve, seasonal vaccines are updated annually. Within the European project Development of Robust and Innovative Vaccine Effectiveness (DRIVE), a cohort study involving Italian healthcare workers (HCWs) was carried out during the 2018-2019 season. Two aims were defined: to measure influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza cases and to conduct an awareness-raising campaign to increase vaccination coverage. METHODS Each subject enrolled was followed up from enrollment to the end of the study. Each HCW who developed ILI was swabbed for laboratory confirmation of influenza. Influenza viruses were identified by molecular assays. A Cox regression analysis, crude and adjusted for confounding variables, was performed to estimate the IVE. RESULTS Among the 4483 HCWs enrolled, vaccination coverage was 32.5%, and 308 ILI cases were collected: 23.4% were positive for influenza (54.2% A(H1N1) pdm09; 45.8% A(H3N2)). No influenza B viruses were detected. No overall IVE was observed. Analyzing the subtypes of influenza A viruses, the IVE was estimated as 45% (95% CI: -59 to 81) for A(H1N1) pdm09. CONCLUSIONS Vaccination coverage among HCWs increased. Study difficulties and the circulation of drifted variants of A(H3N2) could partly explain the observed IVE.
Collapse
Affiliation(s)
- Donatella Panatto
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
- Correspondence: ; Tel.: +390103538109
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
| | - Stefano Mosca
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
| | - Elvina Lecini
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 28, 20122 Milano, Italy
| | - Elena Pariani
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy; (S.M.); (E.P.)
| | - CIRI-IT Team
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (P.L.L.); (E.L.); (A.O.); (A.S.); (G.I.)
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milano, Italy; (S.C.); (L.P.); (C.G.); (G.A.)
- Ospedale Policlinico San Martino IRCCS, Largo R. Benzi 10, 16132 Genoa, Italy
| |
Collapse
|
32
|
Marano G, Pariani E, Luconi E, Pellegrinelli L, Galli C, Magoni M, Piro A, Scarcella C, Biganzoli EM, Boracchi P, Castaldi S. Elderly people: propensity to be vaccinated for seasonal influenza in Italy. Hum Vaccin Immunother 2020; 16:1772-1781. [PMID: 32040352 DOI: 10.1080/21645515.2019.1706931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/12/2022] Open
Abstract
Seasonal influenza continues to be a major cause of illness and death. Vaccination is the most cost-effective prophylaxis to prevent the disease and it is particularly important for people who are at high risk of serious complications derived from influenza, especially for people ≥65 years. In Italy, the influenza vaccination program has been unsuccessful with low rates of uptake in people ≥65 years. We analyzed all the community ≥65 years of the Health Promoting Agency (HPA) of Brescia (northern Italy) to evaluate the propensity attitudes toward influenza vaccination among people ≥65 years in four consecutive seasonal influenza campaigns (from 2014/2015 to 2017/2018). Information about subjects were retrieved from administrative databases. Data from 952,822 records were analyzed. The prevalence of vaccinated subjects in the four campaigns was 38.6%, 33.7%, 37.7%, and 40.1%, respectively. Among vaccinated people, the frequencies of individuals aged 65-69.9 years were lower than the frequencies of those in the other age classes, with highest frequencies of vaccinated people in the 75-79.9 years age-class. Overall, males showed a slightly higher propensity to be vaccinated and the propensity toward vaccination increased with age in both genders. Suffering from a chronic disease increased the propensity to vaccination; hypertension had the highest impact on the propensity whereas suffering from vasculopathy has the opposite effect. The value of this study is the possibility to know the factors that might indicate a propensity to get an influenza vaccination and to consider a different approach to people ≥65 years with the characteristics indicating a lower propensity to vaccination.
Collapse
Affiliation(s)
- Giuseppe Marano
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan , Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan , Milan, Italy
| | - Ester Luconi
- Health Management Department, Fondazione IRCCS Ca' Granda OMP , Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan , Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan , Milan, Italy
| | - Michele Magoni
- Prevention Department, ATS di Brescia (Brescia Health Protection Agency) , Brescia, Italy
| | - Antonio Piro
- Prevention Department, ATS di Brescia (Brescia Health Protection Agency) , Brescia, Italy
| | - Carmelo Scarcella
- Prevention Department, ATS di Brescia (Brescia Health Protection Agency) , Brescia, Italy
| | - Elia M Biganzoli
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Data Science Research Center, University of Milan , Milan, Italy.,Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro", Campus Cascina Rosa, Fondazione IRCCS Istituto Nazionale Tumori , Milan, Italy
| | - Patrizia Boracchi
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Data Science Research Center, University of Milan , Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan , Milan, Italy.,Health Management Department, Fondazione IRCCS Ca' Granda OMP , Milan, Italy
| |
Collapse
|
33
|
Galli C, Orsi A, Pariani E, Lai PL, Guarona G, Pellegrinelli L, Ebranati E, Icardi G, Panatto D. In-depth phylogenetic analysis of the hemagglutinin gene of influenza A(H3N2) viruses circulating during the 2016-2017 season revealed egg-adaptive mutations of vaccine strains. Expert Rev Vaccines 2020; 19:115-122. [PMID: 31875483 DOI: 10.1080/14760584.2020.1709827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/10/2023]
Abstract
Objectives: The authors conducted an in-depth phylogenetic analysis of the hemagglutinin (HA) gene of A(H3N2) identified during the 2016-2017 season to compare the circulating strains with both the egg-derived and cell-derived 2016-2017 candidate vaccine virus (CVV).Methods: 162 HA1 sequences of H3N2 viruses identified during the 2016-2017 season were phylogenetically analyzed and compared with egg-/cell-derived CVV. The predicted vaccine efficacy (pVE) of egg-/cell-derived CVV against field strains was quantified by Pepitope model.Results: All H3N2 belonged to 3C.2a genetic clade, most (80.2%) to 3C.2a1 sub-clade. Several H3N2 variants circulated in the 2016-2017 season. HA sequences of field H3N2 strains displayed greater identity with cell-derived CVV than with egg-derived CVV. The amino acid substitutions in positions 160 and 194 identified in egg-derived CVV affected the pVE, which was lower for egg-derived CVV than for cell-derived CVV.Conclusions: The results suggested that reduced vaccine effectiveness observed in 2016-2017 season was probably due to changes in the HA of vaccine strains acquired upon adaptation in eggs, which are the basis of most manufacturing systems currently used globally. Egg-free vaccine manufacturing systems would be advisable to improve the effectiveness of influenza vaccines.
Collapse
Affiliation(s)
- Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giulia Guarona
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Erika Ebranati
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| |
Collapse
|
34
|
Pellegrinelli L, Galli C, Binda S, Primache V, Tagliacarne C, Pizza F, Mazzini R, Pariani E, Romanò L. Molecular Characterization and Phylogenetic Analysis of Enteroviruses and Hepatitis A Viruses in Sewage Samples, Northern Italy, 2016. Food Environ Virol 2019; 11:393-399. [PMID: 31420848 DOI: 10.1007/s12560-019-09401-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/08/2019] [Accepted: 08/09/2019] [Indexed: 05/21/2023]
Abstract
Enteroviruses (EVs) and Hepatitis A Viruses (HAVs) are human pathogens with a wide spectrum of clinical manifestations. The monitoring of sewage samples enables to monitor the EVs and HAVs in circulation among the general population and recognize possible outbreaks. This study focused on the molecular characterization and phylogenetic analysis of the EVs and HAVs identified in 33 sewage samples collected every 15 days at the influent of a wastewater treatment plant located in Northern Italy from March to October 2016. According to the results of the molecular characterization, the most frequently identified viruses were Echovirus 6 (E-6), E-11 and HAV-IA. The phylogenetic analyses indicated the rapid genetic evolution of E-6 and E-1; noteworthy, most E-11 strains clustered with a strain isolated from a clinical sample collected in the same geographical area over the same period by our laboratory. Most of the HAV strains detected clustered with epidemic HAV-IA strains identified during the European hepatitis A outbreak that occurred in 2016-2017 affecting men who have sex with men (MSM). The detection of environmental HAV strains before and at the beginning of its spread amongst humans demonstrated that this outbreak could have been predicted by monitoring sewage samples. Moreover, conducting a genetic comparison between the HAV and EV strains identified in sewage and clinical samples may improve knowledge of viral epidemiology. EV and HAV molecular environmental surveillance may prove useful for identifying viral circulation and for issuing early warning alerts on possible outbreaks among the human population.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy.
| | - Cristina Galli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Sandro Binda
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Valeria Primache
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Catia Tagliacarne
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Francesca Pizza
- MilanoDepur S.p.A, Depuratore di Milano Nosedo, Milan, Italy
| | - Roberto Mazzini
- MilanoDepur S.p.A, Depuratore di Milano Nosedo, Milan, Italy
| | - Elena Pariani
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Luisa Romanò
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| |
Collapse
|
35
|
Mauri E, Mastrangelo A, Testa S, Pellegrinelli L, Pariani E, Binda S, Triulzi F, Barbieri S, Bana C, Montini G, Dilena R. Acute flaccid paralysis due to Echovirus 30 in an immunosuppressed transplant recipient. J Neurovirol 2019; 26:284-288. [PMID: 31642013 DOI: 10.1007/s13365-019-00812-4] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/18/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023]
Abstract
An Italian 13-year-old boy immunosuppressed due to kidney transplant presented in November 2018 with acute flaccid paralysis with anterior horn cell involvement resembling the clinical, radiological, and laboratory features of poliomyelitis. Enterovirus was molecularly identified in cerebral spinal fluid and stool samples and the sequence analysis of the VP1 gene of enterovirus genome revealed the presence of Echovirus 30 both in CSF and in stool samples. Echovirus 30 is an emerging neurotropic virus able to cause outbreaks of aseptic meningitis and meningoencephalitis all over the world, but acute flaccid paralysis is not a classical manifestation. A 6-month follow-up revealed a poor outcome with severe motor deficits and only slight improvement in disability. Clinicians must be aware of the possible role of Echovirus 30 in acute flaccid paralysis and active surveillance should consider the possible influence of immunosuppression on the symptoms caused by the widening spectrum of enterovirus infections.
Collapse
Affiliation(s)
- Eleonora Mauri
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Antonio Mastrangelo
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Testa
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Sergio Barbieri
- Clinical Neurophysiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Bana
- Clinical Neurophysiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Robertino Dilena
- Clinical Neurophysiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. .,Clinical Neurophysiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, via Francesco Sforza 35, Milan, Italy.
| |
Collapse
|
36
|
Pellegrinelli L, Galli C, Primache V, Alde' M, Fagnani E, Di Berardino F, Zanetti D, Pariani E, Ambrosetti U, Binda S. Diagnosis of congenital CMV infection via DBS samples testing and neonatal hearing screening: an observational study in Italy. BMC Infect Dis 2019; 19:652. [PMID: 31331274 PMCID: PMC6647195 DOI: 10.1186/s12879-019-4296-5] [Citation(s) in RCA: 8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background Congenital Cytomegalovirus (cCMV) is the most common cause of non-genetic hearing loss in childhood. A newborn hearing screening program (NHSP) is currently running in Italy, but no universal cCMV nor statewide hearing-targeted CMV screening programs have been implemented yet. This observational monocentric study was aimed at estimating the rate of cCMV infections identified by CMV-DNA analysis on Dried Blood Spots (DBS) samples in deaf children identified via NHSP in Northern Italy in the period spanning from 2014 to 2018. Methods Children with a confirmed diagnosis of deafness and investigated for CMV-DNA by nucleic acid extraction and in-house polymerase-chain reaction (PCR) on stored newborns screening cards (DBS-test) were included in this study. Deafness was defined by a hearing threshold ≥20 decibel (dB HL) by Auditory Brainstem Responses (ABR); all investigated DBS samples were collected within 3 days of life. Results Overall, 82 children were included (median age: 3.4 months; lower-upper quartiles: 2–5.3 months; males: 60.9%). Most of them (70.7%) presented bilateral hearing loss with a symmetrical pattern in 79.3% of the cases. ABR thresholds were ≥ 70 dB HL (severe/profound deafness) in 46.5% of children. Among all tested children, 6.1% resulted positive for cCMV. The rate of severe/profound deafness was statistically higher in children with cCMV infection. Conclusions The addition of DBS-test to the NHSP allowed the identification, in their first months of life, of a cCMV infection in 6.1% of children who had failed NHS. The introduction of a targeted CMV screening strategy could help clinicians in the differential diagnosis and in the babies’ management. DBS samples can be considered a “universal newborns biobank”: their storage site and duration should be the subject of political decision-making.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy.
| | - Cristina Galli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Valeria Primache
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Mirko Alde'
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.,U.O.S.D di Audiologia, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Enrico Fagnani
- U.O.S.D di Audiologia, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Federica Di Berardino
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.,U.O.S.D di Audiologia, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Diego Zanetti
- U.O.S.D di Audiologia, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Elena Pariani
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| | - Umberto Ambrosetti
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.,U.O.S.D di Audiologia, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Sandro Binda
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Carlo Pascal, 36, 20133, Milan, Italy
| |
Collapse
|
37
|
Piralla A, Pariani E, Giardina F, Galli C, Sapia D, Pellegrinelli L, Novazzi F, Anselmi G, Rovida F, Mojoli F, Cereda D, Senatore S, Baldanti F. Molecular Characterization of Influenza Strains in Patients Admitted to Intensive Care Units during the 2017-2018 Season. Int J Mol Sci 2019; 20:ijms20112664. [PMID: 31151205 PMCID: PMC6600310 DOI: 10.3390/ijms20112664] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/27/2019] [Accepted: 05/29/2019] [Indexed: 01/05/2023] Open
Abstract
This study aimed at assessing the frequency and the distribution of influenza virus types/subtypes in 172 laboratory-confirmed influenza-positive patients admitted to intensive care units (ICUs) during the 2017–2018 season in the Lombardy region (Northern Italy), and to investigate the presence of molecular pathogenicity markers. A total of 102/172 (59.3%) patients had influenza A infections (83 A/H1N1pdm09, 2 H3N2 and 17 were untyped), while the remaining 70/172 (40.7%) patients had influenza B infections. The 222G/N mutation in the hemagglutinin gene was identified in 33.3% (3/9) of A/H1N1pdm09 strains detected in the lower respiratory tract (LRT) samples and was also associated with more severe infections, whereas no peculiar mutations were observed for influenza B strains. A single-point evolution was observed in site 222 of A/H1N1pdm09 viruses, which might advantage viral evolution by favouring virus binding and replication in the lungs. Data from 17 paired upper respiratory tract (URT) and LRT samples showed that viral load in LRT samples was mostly higher than that detected in URT samples. Of note, influenza viruses were undetectable in 35% of paired URT samples. In conclusion, LRT samples appear to provide more accurate clinical information than URT samples, thus ensuring correct diagnosis and appropriate treatment of patients with severe respiratory infections requiring ICU admission.
Collapse
Affiliation(s)
- Antonio Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
| | - Federica Giardina
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
| | - Davide Sapia
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
| | - Federica Novazzi
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
| | - Francesca Rovida
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | - Francesco Mojoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
- Anesthesia and Intensive Care, Emergency Department, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy.
| | - Danilo Cereda
- DG Welfare, UO Prevenzione, Lombardy Region, 20124 Milan, Italy.
| | - Sabrina Senatore
- DG Welfare, UO Prevenzione, Lombardy Region, 20124 Milan, Italy.
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| |
Collapse
|
38
|
Zappulo E, Riccio MP, Binda S, Pellegrinelli L, Pregliasco F, Buonomo AR, Pinchera B, D'Urso G, Bravaccio C, Borgia G, Gentile I. Prevalence of HSV1/2 Congenital Infection Assessed Through Genome Detection on Dried Blood Spot in Individuals with Autism Spectrum Disorders. In Vivo 2018; 32:1255-1258. [PMID: 30150453 DOI: 10.21873/invivo.11373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIM Etiopathogenesis of autism spectrum disorders (ASD) remains to be elucidated. Congenital infections, particularly viral infections, have repeatedly been associated with the onset of such disorders. Our study aimed at assessing the prevalence of herpes simplex type 1 and 2 (HSV1/2) congenital infections in patients with ASD. MATERIALS AND METHODS In our case-control study, a total of 38 children with ASD were compared to 44 age- and sex-matched controls regarding the presence of HSV1/2 infection though viral DNA polymerase chain reaction performed on dried blood spots collected at birth. RESULTS No HSV congenital infection was detected in either group. CONCLUSION Our negative finding is in agreement with other studies that failed to demonstrate a definitive role of HSV on the onset of ASD. Further investigation of congenital HSV prevalence in larger and more powerful studies is needed to undeniably discard a role of such virus in the etiopathogenesis of ASD.
Collapse
Affiliation(s)
- Emanuela Zappulo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Maria Pia Riccio
- Department of Medical Translational Science, Federico II University of Naples, Naples, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabrizio Pregliasco
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonio Riccardo Buonomo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Biagio Pinchera
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Giordano D'Urso
- Section of Psychiatry, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Carmela Bravaccio
- Department of Medical Translational Science, Federico II University of Naples, Naples, Italy
| | - Guglielmo Borgia
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| |
Collapse
|
39
|
Delogu R, Battistone A, Buttinelli G, Fiore S, Fontana S, Amato C, Cristiano K, Gamper S, Simeoni J, Frate R, Pellegrinelli L, Binda S, Veronesi L, Zoni R, Castiglia P, Cossu A, Triassi M, Pennino F, Germinario C, Balena V, Cicala A, Mercurio P, Fiore L, Pini C, Stefanelli P. Poliovirus and Other Enteroviruses from Environmental Surveillance in Italy, 2009-2015. Food Environ Virol 2018; 10:333-342. [PMID: 29948963 DOI: 10.1007/s12560-018-9350-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 02/05/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Within the initiatives for poliomyelitis eradication by WHO, Italy activated an environmental surveillance (ES) in 2005. ES complements clinical Acute Flaccid Paralysis (AFP) surveillance for possible polio cases, detects poliovirus circulation in environmental sewage, and is used to monitor transmission in communities. In addition to polioviruses, the analyses comprised: (i) the monitoring of the presence of non-polio enteroviruses in sewage samples and (ii) the temporal and geographical distribution of the detected viruses. From 2009 to 2015, 2880 sewage samples were collected from eight cities participating in the surveillance. Overall, 1479 samples resulted positive for enteroviruses. No wild-type polioviruses were found, although four Sabin-like polioviruses were detected. The low degree of mutation found in the genomes of these four isolates suggests that these viruses have had a limited circulation in the population. All non-polio enteroviruses belonged to species B and the most frequent serotype was CV-B5, followed by CV-B4, E-11, E-6, E-7, CV-B3, and CV-B2. Variations in the frequency of different serotypes were also observed in different seasons and/or Italian areas. Environmental surveillance in Italy, as part of the 'WHO global polio eradication program', is a powerful tool to augment the polio surveillance and to investigate the silent circulation or the re-emergence of enteroviruses in the population.
Collapse
Affiliation(s)
- Roberto Delogu
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy.
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
| | - Andrea Battistone
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Gabriele Buttinelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fontana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Concetta Amato
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Karen Cristiano
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Sabine Gamper
- Comprensorio Sanitario di Bolzano, Servizio Igiene e Sanità Pubblica, Bolzano, Italy
| | - Josef Simeoni
- Comprensorio Sanitario di Bolzano, Servizio Igiene e Sanità Pubblica, Bolzano, Italy
| | | | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Paolo Castiglia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Cossu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Viviana Balena
- Hygiene Unit, Department DIMO, University of Bari, Bari, Italy
| | | | | | - Lucia Fiore
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Pini
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| |
Collapse
|
40
|
Pellegrinelli L, Gambara S, Micheli R, Binda S, Fazzi E, Pariani E. Human parechovirus type 6 and Guillain-Barré syndrome: a case report. J Neurovirol 2018; 24:656-659. [PMID: 29995288 DOI: 10.1007/s13365-018-0656-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/09/2018] [Revised: 05/21/2018] [Accepted: 05/31/2018] [Indexed: 01/08/2023]
Abstract
A previously healthy 6-year-old boy was admitted to hospital with hypotonia and hyposthenia of lower limbs. Electromyography and slow motor nerve conduction velocity test identified a lower limb acute motor axonal neuropathy. Brain and spinal cord magnetic resonance imaging demonstrated multifocal cortical gray matter lesions in both cerebral hemispheres consistent with gray matter acute disseminated encephalitis otherwise with viral/Mycoplasma pneumoniae encephalitis, and signs of involvement of anterior nerve roots of the cauda equina consistent with Guillain-Barré syndrome. The patient resulted negative to routinely bacterial and viral investigations but positive to human parechovirus that sequence analyses confirmed as type 6. Intravenous immunoglobulins and methylprednisolone treatment were administered but did not relieve the symptoms of Guillain-Barré syndrome. The disease improved gradually over the next 3-month follow-up with a complete remission of both central and peripheral nervous system symptoms.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133, Milan, Italy.
| | - S Gambara
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy
| | - R Micheli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy
| | - S Binda
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133, Milan, Italy
| | - E Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - E Pariani
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133, Milan, Italy
- Department of Health Sciences, CIRI-IT, University of Genoa, Genoa, Italy
| |
Collapse
|
41
|
Harvala H, Broberg E, Benschop K, Berginc N, Ladhani S, Susi P, Christiansen C, McKenna J, Allen D, Makiello P, McAllister G, Carmen M, Zakikhany K, Dyrdak R, Nielsen X, Madsen T, Paul J, Moore C, von Eije K, Piralla A, Carlier M, Vanoverschelde L, Poelman R, Anton A, López-Labrador FX, Pellegrinelli L, Keeren K, Maier M, Cassidy H, Derdas S, Savolainen-Kopra C, Diedrich S, Nordbø S, Buesa J, Bailly JL, Baldanti F, MacAdam A, Mirand A, Dudman S, Schuffenecker I, Kadambari S, Neyts J, Griffiths MJ, Richter J, Margaretto C, Govind S, Morley U, Adams O, Krokstad S, Dean J, Pons-Salort M, Prochazka B, Cabrerizo M, Majumdar M, Nebbia G, Wiewel M, Cottrell S, Coyle P, Martin J, Moore C, Midgley S, Horby P, Wolthers K, Simmonds P, Niesters H, Fischer TK. Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. J Clin Virol 2018; 101:11-17. [DOI: 10.1016/j.jcv.2018.01.008] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 12/18/2022]
|
42
|
Pellegrinelli L, Binda S, Galli C, Primache V, Tagliacarne C, Pizza F, Mazzini R, Tortorano A, Romanò L. [Investigation of enteric viruses in wastewater of Milan area (Lombardy Region, Northern Italy)]. Epidemiol Prev 2018; 42:5. [PMID: 29506350 DOI: 10.19191/ep18.1.p005.004] [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)
- Laura Pellegrinelli
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | - Sandro Binda
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | - Cristina Galli
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | - Valeria Primache
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | - Catia Tagliacarne
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | | | | | - Annamaria Tortorano
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano
| | - Luisa Romanò
- Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano.
| |
Collapse
|
43
|
Gentile I, Zappulo E, Riccio MP, Binda S, Bubba L, Pellegrinelli L, Scognamiglio D, Operto F, Margari L, Borgia G, Bravaccio C. Prevalence of Congenital Cytomegalovirus Infection Assessed Through Viral Genome Detection in Dried Blood Spots in Children with Autism Spectrum Disorders. ACTA ACUST UNITED AC 2018; 31:467-473. [PMID: 28438881 DOI: 10.21873/invivo.11085] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIM Autism spectrum disorders (ASD) are neurodevelopmental disorders without a definitive etiology in most cases. Environmental factors, such as viral infections, have been linked with anomalies in brain growth, neuronal development, and functional connectivity. Congenital cytomegalovirus (CMV) infection has been associated with the onset of ASD in several case reports. The aim of this study was to evaluate the prevalence of congenital CMV infection in children with ASD and in healthy controls. PATIENTS AND METHODS The CMV genome was tested by polymerase chain reaction (PCR) on dried blood spots collected at birth from 82 children (38 with ASD and 44 controls). RESULTS The prevalence of congenital CMV infection was 5.3% (2/38) in cases and 0% (0/44) in controls (p=0.212). CONCLUSION The infection rate was about 10-fold higher in patients with ASD than in the general Italian population at birth. For this reason, detection of CMV-DNA on dried blood spots could be considered in the work-up that is usually performed at ASD diagnosis to rule-out a secondary form. Given the potential prevention and treatment of CMV infection, this study could have intriguing consequences, at least for a group of patients with ASD.
Collapse
Affiliation(s)
- Ivan Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - Emanuela Zappulo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - Maria Pia Riccio
- Department of Physical and Mental Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Domenico Scognamiglio
- Screening Center for Metabolic Diseases, AORN Santobono - Pausilipon - Hospital Annunziata, Naples, Italy
| | - Francesca Operto
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Margari
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Guglielmo Borgia
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - Carmela Bravaccio
- Department of Medical Translational Science, University of Naples "Federico II", Naples, Italy
| |
Collapse
|
44
|
Pellegrinelli L, Ianiro G, Pariani E, Monini M, Ruggeri FM, Binda S. Molecular characterization of rotavirus disclosed the first introduction of G12P[8] strain in northern Italy. Future Virol 2018. [DOI: 10.2217/fvl-2017-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This paper discusses the unexpected findings from the RotaNet-Italy hospital-based surveillance study carried out in northern Italy. Materials & methods: From September 2015 to August 2016, 51 rotavirus-A (RVA) positive fecal samples were collected from children aged less than 15 years, who were hospitalized for acute gastroenteritis in Lombardy, northern Italy. Results: Molecular characterization revealed the predominance of the uncommon G12P[8] RVA strain, which was detected in 49% of cases. Phylogenetic analysis showed that these G12 strains clustered into lineage 3. Conclusion: To our knowledge, this is the first study on the G12P[8] genotype’s introduction in northern Italy. Our findings emphasize the importance of the surveillance of RVA gastroenteritis with the aim of obtaining new insight into the unusual newly emerging RVA strains.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Ianiro
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Marina Monini
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Franco Maria Ruggeri
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
45
|
Pellegrinelli L, Bubba L, Galli C, Anselmi G, Primache V, Binda S, Pariani E. Epidemiology and molecular characterization of influenza viruses, human parechoviruses and enteroviruses in children up to 5 years with influenza-like illness in Northern Italy during seven consecutive winter seasons (2010–2017). J Gen Virol 2017; 98:2699-2711. [DOI: 10.1099/jgv.0.000937] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal, 36 - 20133 Milan, Italy
- Department of Health Sciences, CIRI-IT, University of Genoa, Via Antonio Pastore, 1 - 16132 Genoa, Italy
| |
Collapse
|
46
|
Pariani E, Pellegrinelli L, Merlone ADC, Piralla A, Baldanti F, Binda S. Letter to the editor: Need for a European network for enterovirus D68 surveillance after detections of EV-D68 of the new B3 lineage in Sweden and Italy, 2016. ACTA ACUST UNITED AC 2017; 22:30440. [PMID: 28106530 PMCID: PMC5404488 DOI: 10.2807/1560-7917.es.2017.22.2.30440] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/12/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Antonio Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
47
|
Pellegrinelli L, Bubba L, Primache V, Chiaramonte I, Ruggeri FM, Fiore L, Binda S. Burden of pediatrics hospitalizations associated with Rotavirus gastroenteritis in Lombardy (Northern Italy) before immunization program. Ann Ist Super Sanita 2017; 51:346-51. [PMID: 26783223 DOI: 10.4415/ann_15_04_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AIM Rotavirus is recognized as the main cause of acute gastroenteritis in children under 5 years old, representing a considerable public health problem with a great impact on social and public health costs in developed countries. This study aims to assess the frequency and the epidemiological aspect of the hospitalization associated with Rotavirus-gastroenteritis in Lombardy, Northern Italy, from 2005 to 2011. METHODS The Lombardy Hospital Discharge Database was inquired from the official data of the Italian Ministry of Health and investigated for acute gastroenteritis (ICD9-CM code for bacteria, parasitic, viral and undetermined etiologic diarrhea) in primary and secondary diagnosis in children ≤ 5 years, between 2005 and 2011. RESULTS Out of the 32 944 acute-gastroenteritis hospitalizations reported in Lombardy, the 50.8% was caused by Rotavirus infection; of these, the 65.5% were reported in primary diagnosis. The peak of Rotavirus-gastroenteritis hospitalization was observed in February-March in children < 2 years old, with a cumulative prevalence of 64.5%. Patients admitted to hospital with diarrhea of undetermined etiology (about 14% of overall acute-gastroenteritis) showed epidemiological characteristics similar to the Rotavirus-gastroenteritis, suggesting that the virus infection could also be involved in at least some of these. CONCLUSION Our data confirm that Rotavirus are the most important agents involving in acute gastroenteritis hospitalizations. The use of Hospital Discharge Database had proved to be a simple tool to estimate the burden and to describe the epidemiological characteristics of Rotavirus gastroenteritis and could be used as a surveillance activity before and after the introduction of mass vaccination at national and regional level in Italy.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Laura Bubba
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Valeria Primache
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Iacopo Chiaramonte
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Franco Maria Ruggeri
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Fiore
- Centro Nazionale per la Ricerca e la Valutazione dei Prodotti Immunobiologici, Istituto Superiore di Sanità, Rome, Italy
| | - Sandro Binda
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
48
|
Pellegrinelli L, Bubba L, Primache V, Pariani E, Battistone A, Delogu R, Fiore S, Binda S. Surveillance of poliomyelitis in Northern Italy: Results of acute flaccid paralysis surveillance and environmental surveillance, 2012-2015. Hum Vaccin Immunother 2017; 13:332-338. [PMID: 27929744 PMCID: PMC5328214 DOI: 10.1080/21645515.2017.1264726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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] [Indexed: 01/02/2023] Open
Abstract
Although in the last years poliovirus (PV) transmission has been reported at the lowest levels ever recorded, the spread of virus from endemic countries endures; the high levels of immigration flows across the Mediterranean Sea jeopardize Italy for PV reintroduction. The World Health Organization (WHO) strategic plan for global poliomyelitis (polio) eradication indicates the nationwide surveillance of Acute Flaccid Paralysis (AFP) as the gold standard for detecting cases of polio. In addition, the Environmental Surveillance (ES), seeking the presence of PV and Non-Polio Enterovirus (NPEV) in sewage, is recognized as a powerful tool to confirm PV circulation in absence of AFP cases, especially in polio-free countries. Here we report the results of AFP surveillance (AFPS) and ES in Lombardy (Northern Italy) from 2012 to 2015. Forty-eight AFP cases were identified during the study period. No AFP case was caused by PV infection. NPEVs were identified in 6.3% (3/48) of AFP cases. The annual AFP incidence rate was 0.87/100'000 children <15 y in 2012, 1.42/100'000 in 2013, 1.02/100'000 in 2014, and 0.47/100'000 in 2015; according to WHO indicators, the sensitivity of AFPS was adequate in 2013 and 2014. Completeness of case investigation raised progressively during the study period to achieve the WHO standards in 2014 (92.3%) and 2015 (100%). Completeness of follow-up increased from 72.7% in 2012 to 100% in 2014. In the framework of the ES conducted in Milan, 268 wastewater samples were collected from 2012 to 2015 and no PVs were isolated. In contrast, NPEVs were detected in 65.3% (175/268) of samples. All NPEVs characterized belonged to enterovirus species B: echovirus type 11, 6 and 3 were the most frequently detected viruses, representing 29.1% (41/141), 20.6% (29/141) and 9.2% (13/141) of genotyped NPEVs, respectively. Keeping strong and encouraging both AFPS and ES is crucial to ensure that PV will not return unnoticed in Italy - as well as in other polio-free countries - and, as a final point, to achieve the global polio eradication goal.
Collapse
Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Andrea Battistone
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Delogu
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
49
|
Binda S, Pellegrinelli L, Terraneo M, Caserini A, Primache V, Bubba L, Barbi M. What people know about congenital CMV: an analysis of a large heterogeneous population through a web-based survey. BMC Infect Dis 2016; 16:513. [PMID: 27671033 PMCID: PMC5037595 DOI: 10.1186/s12879-016-1861-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Congenital CMV (cCMV) infection is a serious public health issue due to both its worldwide prevalence and the severe and permanent impairments it causes. However, awareness of this infection is low in the general population and among pregnant women, and it also seems to be generally disregarded by healthcare providers. The identification of factors behind this inadequate level of knowledge could provide a basis for future preventive measures. This study aimed at evaluating awareness of CMV and cCMV infection and its correlation with socio-demographic variables in a general population. Methods The survey was carried out by computer-assisted web interviewing (CAWI). A questionnaire was sent via e-mail to the 70,975 individuals who comprised the whole population (students, administrative staff, teaching staff) of Milan University, Italy in 2015. Results Out of the 10,190 respondents, 5,351 (52.5 %) had already heard of CMV but only 3,216 (31.8 %) knew that this virus could be implicated in congenital infection. Urine and breastfeeding were the least recognized transmission routes for CMV infection; less than half of respondents accurately identified the right symptoms and sequelae caused by cCMV infection. The correct hygienic measures against cCMV infection were identified in percentages ranging from 55.6 to 75 % depending on the measures proposed but about one in three of interviewees deemed those measures unnecessary in the event of a pregnant woman already being CMV seropositive. From the mean knowledge scores the most complete quality of awareness of CMV turned out to be linked to childbearing-age (25–40 year) and with not having children, even if results for non-parents showed less of them having heard of cCMV than parents. Conclusion Our results indicate a limited and confused awareness of cCMV infection in a large, fairly young and well-educated Italian population.
Collapse
Affiliation(s)
- Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy.
| | - Marco Terraneo
- Department of Sociology and Social Research, University of Milano-Bicocca, Milan, Italy
| | | | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Maria Barbi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| |
Collapse
|
50
|
Binda S, Bubba L, Pellegrinelli L, Primache V, Gentile I, Zappulo E, Bravaccio C, Barbi M. DNA detection of herpetic viruses in dried blood spots in children with autism spectrum disorders. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.277] [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: 11/16/2022]
|