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d'Andrea V, Trentini F, Marziano V, Zardini A, Manica M, Guzzetta G, Ajelli M, Petrone D, Del Manso M, Sacco C, Andrianou X, Bella A, Riccardo F, Pezzotti P, Poletti P, Merler S. Spatial spread of COVID-19 during the early pandemic phase in Italy. BMC Infect Dis 2024; 24:450. [PMID: 38684947 PMCID: PMC11057115 DOI: 10.1186/s12879-024-09343-8] [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: 07/19/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
Quantifying the potential spatial spread of an infectious pathogen is key to defining effective containment and control strategies. The aim of this study is to estimate the risk of SARS-CoV-2 transmission at different distances in Italy before the first regional lockdown was imposed, identifying important sources of national spreading. To do this, we leverage on a probabilistic model applied to daily symptomatic cases retrospectively ascertained in each Italian municipality with symptom onset between January 28 and March 7, 2020. Results are validated using a multi-patch dynamic transmission model reproducing the spatiotemporal distribution of identified cases. Our results show that the contribution of short-distance ( ≤ 10 k m ) transmission increased from less than 40% in the last week of January to more than 80% in the first week of March 2020. On March 7, 2020, that is the day before the first regional lockdown was imposed, more than 200 local transmission foci were contributing to the spread of SARS-CoV-2 in Italy. At the time, isolation measures imposed only on municipalities with at least ten ascertained cases would have left uncontrolled more than 75% of spillover transmission from the already affected municipalities. In early March, national-wide restrictions were required to curb short-distance transmission of SARS-CoV-2 in Italy.
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Affiliation(s)
- Valeria d'Andrea
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
- Department of Physics and Astronomy "Galileo Galilei", University of Padua, Padua, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
- Dondena Centre for Research On Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Department of Decision Sciences, Bocconi University, Milan, Italy
| | | | - Agnese Zardini
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Mattia Manica
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Giorgio Guzzetta
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- Department of Statistics, Sapienza University of Rome, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Piero Poletti
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Merler
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy.
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Verscheure E, Stierum R, Schlünssen V, Lund Würtz AM, Vanneste D, Kogevinas M, Harding BN, Broberg K, Zienolddiny-Narui S, Erdem JS, Das MK, Makris KC, Konstantinou C, Andrianou X, Dekkers S, Morris L, Pronk A, Godderis L, Ghosh M. Characterization of the internal working-life exposome using minimally and non-invasive sampling methods - a narrative review. Environ Res 2023; 238:117001. [PMID: 37683788 DOI: 10.1016/j.envres.2023.117001] [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] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
During recent years, we are moving away from the 'one exposure, one disease'-approach in occupational settings and towards a more comprehensive approach, taking into account the totality of exposures during a life course by using an exposome approach. Taking an exposome approach however is accompanied by many challenges, one of which, for example, relates to the collection of biological samples. Methods used for sample collection in occupational exposome studies should ideally be minimally invasive, while at the same time sensitive, and enable meaningful repeated sampling in a large population and over a longer time period. This might be hampered in specific situations e.g., people working in remote areas, during pandemics or with flexible work hours. In these situations, using self-sampling techniques might offer a solution. Therefore, our aim was to identify existing self-sampling techniques and to evaluate the applicability of these techniques in an occupational exposome context by conducting a literature review. We here present an overview of current self-sampling methodologies used to characterize the internal exposome. In addition, the use of different biological matrices was evaluated and subdivided based on their level of invasiveness and applicability in an occupational exposome context. In conclusion, this review and the overview of self-sampling techniques presented herein can serve as a guide in the design of future (occupational) exposome studies while circumventing sample collection challenges associated with exposome studies.
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Affiliation(s)
- Eline Verscheure
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Rob Stierum
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Research unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Anne Mette Lund Würtz
- Department of Public Health, Research unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Dorian Vanneste
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Manolis Kogevinas
- Environment and Health over the Lifecourse Program, ISGlobal, Barcelona, Spain
| | - Barbara N Harding
- Environment and Health over the Lifecourse Program, ISGlobal, Barcelona, Spain
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Mrinal K Das
- National Institute of Occupational Health, Oslo, Norway
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Xanthi Andrianou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Susan Dekkers
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | | | - Anjoeka Pronk
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | - Lode Godderis
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium; Idewe, External Service for Prevention and Protection at work, Heverlee, Belgium.
| | - Manosij Ghosh
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium.
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Riccardo F, Guzzetta G, Mateo Urdiales A, Del Manso M, Andrianou X, Bella A, Pezzotti P, Carbone S, De Vito T, Maraglino F, Demicheli V, Dario C, Coscioni E, Rezza G, Urbani A, Merler S, Brusaferro S. COVID-19 response: effectiveness of weekly rapid risk assessments, Italy. Bull World Health Organ 2022. [DOI: 10.2471/blt.20.286317] [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: 11/27/2022] Open
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Stefanelli P, Trentini F, Guzzetta G, Marziano V, Mammone A, Sane Schepisi M, Poletti P, Molina Grané C, Manica M, del Manso M, Andrianou X, Ajelli M, Rezza G, Brusaferro S, Merler S. Co-circulation of SARS-CoV-2 Alpha and Gamma variants in Italy, February and March 2021. Euro Surveill 2022; 27:2100429. [PMID: 35115077 PMCID: PMC8815098 DOI: 10.2807/1560-7917.es.2022.27.5.2100429] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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] [Indexed: 12/29/2022] Open
Abstract
BackgroundSeveral SARS-CoV-2 variants of concern (VOC) have emerged through 2020 and 2021. There is need for tools to estimate the relative transmissibility of emerging variants of SARS-CoV-2 with respect to circulating strains.AimWe aimed to assess the prevalence of co-circulating VOC in Italy and estimate their relative transmissibility.MethodsWe conducted two genomic surveillance surveys on 18 February and 18 March 2021 across the whole Italian territory covering 3,243 clinical samples and developed a mathematical model that describes the dynamics of co-circulating strains.ResultsThe Alpha variant was already dominant on 18 February in a majority of regions/autonomous provinces (national prevalence: 54%) and almost completely replaced historical lineages by 18 March (dominant across Italy, national prevalence: 86%). We found a substantial proportion of the Gamma variant on 18 February, almost exclusively in central Italy (prevalence: 19%), which remained similar on 18 March. Nationally, the mean relative transmissibility of Alpha ranged at 1.55-1.57 times the level of historical lineages (95% CrI: 1.45-1.66). The relative transmissibility of Gamma varied according to the assumed degree of cross-protection from infection with other lineages and ranged from 1.12 (95% CrI: 1.03-1.23) with complete immune evasion to 1.39 (95% CrI: 1.26-1.56) for complete cross-protection.ConclusionWe assessed the relative advantage of competing viral strains, using a mathematical model assuming different degrees of cross-protection. We found substantial co-circulation of Alpha and Gamma in Italy. Gamma was not able to outcompete Alpha, probably because of its lower transmissibility.
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Affiliation(s)
- Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy,Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | - Alessia Mammone
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | | | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Carla Molina Grané
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy,University of Trento, Trento, Italy
| | - Mattia Manica
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Martina del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy,Cyprus University of Technology, Limassol, Cyprus
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, United States
| | - Giovanni Rezza
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | | | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
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Dorrucci M, Minelli G, Boros S, Manno V, Prati S, Battaglini M, Corsetti G, Andrianou X, Riccardo F, Fabiani M, Vescio MF, Spuri M, Mateo-Urdiales A, Del Manso M, Pezzotti P, Bella A. A population-based cohort approach to assess excess mortality due to the spread of COVID-19 in Italy, January-May 2020. Ann Ist Super Sanita 2022; 58:25-33. [PMID: 35324471 DOI: 10.4415/ann_22_01_04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIMS To assess the impact of the COVID-19 pandemic on all-cause mortality in Italy during the first wave of the epidemic, taking into consideration the geographical heterogeneity of the spread of COVID-19. METHODS This study is a retrospective, population-based cohort study using national statistics throughout Italy. Survival analysis was applied to data aggregated by day of death, age groups, sex, and Italian administrative units (107 provinces). We applied Cox models to estimate the relative hazards (RH) of excess mortality, comparing all-cause deaths in 2020 with the expected deaths from all causes in the same time period. The RH of excess deaths was estimated in areas with a high, moderate, and low spread of COVID-19. We reported the estimate also restricting the analysis to the period of March-April 2020 (first peak of the epidemic). RESULTS The study population consisted of 57,204,501 individuals living in Italy as of January 1, 2020. The number of excess deaths was 36,445, which accounts for 13.4% of excess mortalities from all causes during January-May 2020 (i.e., RH = 1.134; 95% confidence interval (CI): 1.129-1.140). In the macro-area with a relatively higher spread of COVID-19 (i.e., incidence rate, IR): 450-1,610 cases per 100,000 residents), the RH of excess deaths was 1.375 (95% CI: 1.364-1.386). In the area with a relatively moderate spread of COVID-19 (i.e., IR: 150-449 cases) it was 1.049 (95% CI: 1.038-1.060). In the area with a relatively lower spread of COVID-19 (i.e., IR: 30-149 cases), it was 0.967 (95% CI: 0.959-0.976). Between March and April (peak months of the first wave of the epidemic in Italy), we estimated an excess mortality from all causes of 43.5%. The RH of all-cause mortality for increments of 500 cases per 100,000 residents was 1.352 (95% CI: 1.346-1.359), corresponding to an increase of about 35%. CONCLUSIONS Our analysis, making use of a population-based cohort model, estimated all-cause excess mortality in Italy taking account of both time period and of COVID-19 geographical spread. The study highlights the importance of a temporal/geographic framework in analyzing the risk of COVID-19-epidemy related mortality.
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Affiliation(s)
- Maria Dorrucci
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Giada Minelli
- Servizio di Statistica, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Boros
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Valerio Manno
- Servizio di Statistica, Istituto Superiore di Sanità, Rome, Italy
| | - Sabrina Prati
- Servizio Registro della Popolazione, Statistiche Demografiche e Condizioni di Vita, Istituto Nazionale di Statistica, Rome, Italy
| | - Marco Battaglini
- Servizio Registro della Popolazione, Statistiche Demografiche e Condizioni di Vita, Istituto Nazionale di Statistica, Rome, Italy
| | - Gianni Corsetti
- Servizio Registro della Popolazione, Statistiche Demografiche e Condizioni di Vita, Istituto Nazionale di Statistica, Rome, Italy
| | - Xanthi Andrianou
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Matteo Spuri
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Mateo-Urdiales
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy - European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden The members of the Italian Integrated Surveillance COVID-19 Group are listed before the References
| | - Martina Del Manso
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy - European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden The members of the Italian Integrated Surveillance COVID-19 Group are listed before the References
| | - Patrizio Pezzotti
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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6
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Mateo-Urdiales A, Fabiani M, Rosano A, Vescio MF, Del Manso M, Bella A, Riccardo F, Pezzotti P, Regidor E, Andrianou X. Socioeconomic patterns and COVID-19 outcomes before, during and after the lockdown in Italy (2020). Health Place 2021; 71:102642. [PMID: 34339938 PMCID: PMC8318679 DOI: 10.1016/j.healthplace.2021.102642] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/08/2023]
Abstract
The objective was to investigate the association between deprivation and COVID-19 outcomes in Italy during pre-lockdown, lockdown and post-lockdown periods using a retrospective cohort study with 38,534,169 citizens and 222,875 COVID-19 cases. Multilevel negative binomial regression models, adjusting for age, sex, population-density and region of residence were conducted to evaluate the association between area-level deprivation and COVID-19 incidence, case-hospitalisation rate and case-fatality. During lockdown and post-lockdown, but not during pre-lockdown, higher incidence of cases was observed in the most deprived municipalities compared with the least deprived ones. No differences in case-hospitalisation and case-fatality according to deprivation were observed in any period under study.
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Affiliation(s)
- Alberto Mateo-Urdiales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Aldo Rosano
- Servizio Statistico, Istituto nazionale per l'analisi delle politiche pubbliche, Rome, Italy
| | | | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Enrique Regidor
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
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Dorrucci M, Minelli G, Boros S, Manno V, Prati S, Battaglini M, Corsetti G, Andrianou X, Riccardo F, Fabiani M, Vescio MF, Spuri M, Urdiales AM, Martina DM, Onder G, Pezzotti P, Bella A. Excess Mortality in Italy During the COVID-19 Pandemic: Assessing the Differences Between the First and the Second Wave, Year 2020. Front Public Health 2021; 9:669209. [PMID: 34336767 PMCID: PMC8322580 DOI: 10.3389/fpubh.2021.669209] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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: 02/18/2021] [Accepted: 06/11/2021] [Indexed: 11/24/2022] Open
Abstract
COVID-19 dramatically influenced mortality worldwide, in Italy as well, the first European country to experience the Sars-Cov2 epidemic. Many countries reported a two-wave pattern of COVID-19 deaths; however, studies comparing the two waves are limited. The objective of the study was to compare all-cause excess mortality between the two waves that occurred during the year 2020 using nationwide data. All-cause excess mortalities were estimated using negative binomial models with time modeled by quadratic splines. The models were also applied to estimate all-cause excess deaths “not directly attributable to COVD-19”, i.e., without a previous COVID-19 diagnosis. During the first wave (25th February−31st May), we estimated 52,437 excess deaths (95% CI: 49,213–55,863) and 50,979 (95% CI: 50,333–51,425) during the second phase (10th October−31st December), corresponding to percentage 34.8% (95% CI: 33.8%–35.8%) in the second wave and 31.0% (95%CI: 27.2%–35.4%) in the first. During both waves, all-cause excess deaths percentages were higher in northern regions (59.1% during the first and 42.2% in the second wave), with a significant increase in the rest of Italy (from 6.7% to 27.1%) during the second wave. Males and those aged 80 or over were the most hit groups with an increase in both during the second wave. Excess deaths not directly attributable to COVID-19 decreased during the second phase with respect to the first phase, from 10.8% (95% CI: 9.5%–12.4%) to 7.7% (95% CI: 7.5%–7.9%), respectively. The percentage increase in excess deaths from all causes suggests in Italy a different impact of the SARS-CoV-2 virus during the second wave in 2020. The decrease in excess deaths not directly attributable to COVID-19 may indicate an improvement in the preparedness of the Italian health care services during this second wave, in the detection of COVID-19 diagnoses and/or clinical practice toward the other severe diseases.
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Affiliation(s)
- Maria Dorrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giada Minelli
- Statistical Service, Istitituto Superiore di Sanità, Rome, Italy
| | - Stefano Boros
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Valerio Manno
- Statistical Service, Istitituto Superiore di Sanità, Rome, Italy
| | - Sabrina Prati
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, Rome, Italy
| | - Marco Battaglini
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, Rome, Italy
| | - Gianni Corsetti
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, Rome, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Matteo Spuri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Del Manso Martina
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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8
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Mateo-Urdiales A, Del Manso M, Andrianou X, Spuri M, D'Ancona F, Filia A, Rota MC, Petrone D, Vescio MF, Riccardo F, Bella A, Pezzotti P, Fabiani M. Initial impact of SARS-Cov-2 vaccination on healthcare workers in Italy- Update on the 28th of March 2021. Vaccine 2021; 39:4788-4792. [PMID: 34253419 PMCID: PMC8260579 DOI: 10.1016/j.vaccine.2021.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 04/08/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
In Italy, the COVID-19 vaccination campaign started in December 2020 with the vaccination of healthcare workers (HCW). To analyse the real-life impact that vaccination is having on this population group, we measured the association between week of diagnosis and HCW status using log-binomial regression. By the week 22-28 March, we observed a 74% reduction (PPR 0.26; 95% CI 0.22-0.29) in the proportion of cases reported as HCW and 81% reduction in the proportion of symptomatic cases reported as HCW, compared with the week with the lowest proportion of cases among HCWs prior to the vaccination campaign (31 August-7 September). The reduction, both in relative and absolute terms, of COVID-19 cases in HCWs that started around 30 days after the start of the vaccination campaign suggest that COVID-19 vaccines are being effective in preventing infection in this group.
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Affiliation(s)
- Alberto Mateo-Urdiales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Matteo Spuri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Department of Statistics, La Sapienza University, Rome, Italy
| | - Fortunato D'Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Department of Statistics, La Sapienza University, Rome, Italy
| | | | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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9
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Rota MC, Caporali MG, Scaturro M, Girolamo A, Andrianou X, Ricci ML. Legionella pneumophila and SARS-COV-2 co-infection: the importance of laboratory diagnosis. Letter. Ann Ist Super Sanita 2021; 57:199-200. [PMID: 34554112 DOI: 10.4415/ann_21_03_01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maria Cristina Rota
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Maria Scaturro
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Girolamo
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Xanthi Andrianou
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Luisa Ricci
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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10
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Grant R, Dub T, Andrianou X, Nohynek H, Wilder-Smith A, Pezzotti P, Fontanet A. SARS-CoV-2 population-based seroprevalence studies in Europe: a scoping review. BMJ Open 2021; 11:e045425. [PMID: 33795310 PMCID: PMC8021754 DOI: 10.1136/bmjopen-2020-045425] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/09/2021] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES We aimed to review SARS-CoV-2 seroprevalence studies conducted in Europe to understand how they may be used to inform ongoing control strategies for COVID-19. DESIGN Scoping review of peer-reviewed publications and manuscripts on preprint servers from January 2020 to 15 September 2020. PRIMARY MEASURE Seroprevalence estimate (and lower and upper CIs). For studies conducted across a country or territory, we used the seroprevalence estimate and the upper and lower CIs and compared them to the total number of reported infections to calculate the ratio of reported to expected infections. RESULTS We identified 23 population-based seroprevalence studies conducted in Europe. Among 12 general population studies, seroprevalence ranged from 0.42% among residual clinical samples in Greece to 13.6% in an area of high transmission in Gangelt, Germany. Of the eight studies in blood donors, seroprevalence ranged from 0.91% in North-Western Germany to 23.3% in a high-transmission area in Lombardy region, Italy. In three studies which recruited individuals through employment, seroprevalence ranged from 0.5% among factory workers in Frankfurt, Germany, to 10.2% among university employees in Milan, Italy. In comparison to nationally reported cases, the extent of infection, as derived from these seroprevalence estimates, is manyfold higher and largely heterogeneous. CONCLUSION Exposure to the virus in Europe has not reached a level of infection that would prevent further circulation of the virus. Effective vaccine candidates are urgently required to deliver the level of immunity in the population.
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Affiliation(s)
- Rebecca Grant
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- Sorbonne Université, Paris, France
| | - Timothée Dub
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Xanthi Andrianou
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Hanna Nohynek
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
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11
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Grippo F, Grande E, Maraschini A, Navarra S, Pappagallo M, Marchetti S, Crialesi R, Frova L, Orsi C, Simeoni S, Carinci A, Loreto G, Donfrancesco C, Lo Noce C, Palmieri L, Andrianou X, Urdiales AM, Onder G, Minelli G. Evolution of Pathology Patterns in Persons Who Died From COVID-19 in Italy: A National Study Based on Death Certificates. Front Med (Lausanne) 2021; 8:645543. [PMID: 33829025 PMCID: PMC8019728 DOI: 10.3389/fmed.2021.645543] [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: 12/23/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Background: In Italy, during the first epidemic wave of 2020, the peak of coronavirus disease 2019 (COVID-19) mortality was reached at the end of March. Afterward, a progressive reduction was observed until much lower figures were reached during the summer, resulting from the contained circulation of SARS-CoV-2. This study aimed to determine if and how the pathological patterns of the individuals deceased from COVID-19 changed during the phases of epidemic waves in terms of: (i) main cause of death, (ii) comorbidities, and (iii) complications related to death. Methods: Death certificates of persons who died and tested positive for SARS-CoV-2, provided by the National Surveillance system, were coded according to ICD rev10. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Results: The percentage of COVID-19 deaths varied over time. It decreased in the downward phase of the epidemic curve (76.6 vs. 88.7%). In February-April 2020, hypertensive heart disease was mentioned as a comorbidity in 18.5% of death certificates, followed by diabetes (15.9% of cases), ischemic heart disease (13.1%), and neoplasms (12.1%). In May-September, the most frequent comorbidity was neoplasms (17.3% of cases), followed by hypertensive heart disease (14.9%), diabetes (14.8%), and dementia/Alzheimer's disease (11.9%). The most mentioned complications in both periods were pneumonia and respiratory failure with a frequency far higher than any other condition (78.4% in February-April 2020 and 63.7% in May-September 2020). Discussion: The age of patients dying from COVID-19 and their disease burden increased in the May-September 2020 period. A more serious disease burden was observed in this period, with a significantly higher frequency of chronic pathologies. Our study suggests better control of the virus' lethality in the second phase of the epidemic, when the health system was less burdened. Moreover, COVID-19 care protocols had been created in hospitals, and knowledge about the diagnosis and treatment of COVID-19 had improved, potentially leading to more accurate diagnosis and better treatment. All these factors may have improved survival in patients with COVID-19 and led to a shift in mortality to older, more vulnerable, and complex patients.
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Affiliation(s)
- Francesco Grippo
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Enrico Grande
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | | | - Simone Navarra
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Marilena Pappagallo
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Stefano Marchetti
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Roberta Crialesi
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Luisa Frova
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Chiara Orsi
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Silvia Simeoni
- Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | | | - Giuseppe Loreto
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Cinzia Lo Noce
- Department of Cardiovascular, Endocrine-metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Graziano Onder
- Department of Cardiovascular, Endocrine-metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
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12
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Fabiani M, Mateo-Urdiales A, Andrianou X, Bella A, Del Manso M, Bellino S, Rota MC, Boros S, Vescio MF, D'Ancona FP, Siddu A, Punzo O, Filia A, Brusaferro S, Rezza G, Dente MG, Declich S, Pezzotti P, Riccardo F. Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system. Eur J Public Health 2021; 31:37-44. [PMID: 33416859 PMCID: PMC7851886 DOI: 10.1093/eurpub/ckaa249] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. METHODS We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. RESULTS We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33-1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07-1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01-1.75). CONCLUSIONS A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.
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Affiliation(s)
- Massimo Fabiani
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Mateo-Urdiales
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Xanthi Andrianou
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Antonino Bella
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Stefania Bellino
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria C Rota
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Boros
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria F Vescio
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Andrea Siddu
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Ornella Punzo
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giovanni Rezza
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria G Dente
- Centro Nazionale per la Salute Globale, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Declich
- Centro Nazionale per la Salute Globale, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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13
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Bellino S, Rota MC, Riccardo F, Andrianou X, Mateo Urdiales A, Del Manso M, Punzo O, Bella A, Villani A, Pezzotti P. Pediatric COVID-19 Cases Prelockdown and Postlockdown in Italy. Pediatrics 2021; 147:peds.2020-035238. [PMID: 33154154 DOI: 10.1542/peds.2020-035238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Stefania Bellino
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy;
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Mateo Urdiales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.,European Centre for Disease Prevention and Control, European Programme for Intervention Epidemiology Training, Stockholm, Sweden
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.,European Centre for Disease Prevention and Control, European Programme for Intervention Epidemiology Training, Stockholm, Sweden
| | - Ornella Punzo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department and General Pediatrics, Children Hospital Bambino Gesù, Rome, Italy; and
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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14
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Sorgentone S, Busani L, Calistri P, Robuffo G, Bellino S, Acciari V, Ferri M, Graziani C, Antoci S, Lodi F, Alfonsi V, Cammà C, Fazii P, Andrianou X, Cito F, Lombardi G, Centorotola G, D'Amario M, D'Alterio N, Savini V, De Massis F, Pelatti A, Di Domenico M, Di Donato G, Di Giannatale E, Di Marcantonio L, Di Marzio V, Di Serafino G, Janowicz A, Marfoglia C, Marotta F, Morelli D, Migliorati G, Neri D, Pomilio F, Scattolini S, Rezza G, Caponetti A, Pezzotti P, Garofolo G. A large food-borne outbreak of campylobacteriosis in kindergartens and primary schools in Pescara, Italy, May-June 2018. J Med Microbiol 2021; 70. [PMID: 33475480 DOI: 10.1099/jmm.0.001262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. In May-June 2018, an outbreak of campylobacteriosis involved students and school staff from kindergartens and primary schools in Pescara, southern Italy.Aim. We present details of the epidemiological and microbiological investigation, and the findings of the analytical study, as well as the implemented control measures.Methodology. To identify possible risk factors associated with the observed outbreak, a case control study was conducted using a questionnaire to collect information on the date of symptoms onset, type and duration of symptoms, type of healthcare contact, school attendance, and food items consumed at school lunches during the presumed days of exposure. Attack rates were calculated for each date and school. Logistic regression models were used to estimate the odds ratios of being a case and the odds of illness by food items consumed, respectively. Moreover, we carried out a comparative genomic analysis using whole genome multilocus sequence typing (wgMLST) of Campylobacter jejuni strains isolated during the outbreak investigation to identify the source of the outbreak.Results. Overall, 222 probable cases from 21 schools were identified, and C. jejuni was successfully isolated from 60 patients. The meals in the schools involved were provided by two cooking centres managed by a joint venture between two food companies. Environmental and food sampling, epidemiological and microbiological analyses, as well as a case control study with 176 cases and 62 controls from the same schools were performed to identify the source of the outbreak. The highest attack rate was recorded among those having lunch at school on 29 May (7.8 %), and the most likely exposure was 'caciotta' cheese (odds ratio 2.40, 95 % confidence interval 1.10-5.26, P=0.028). C. jejuni was isolated from the cheese, and wgMLST showed that the human and cheese isolates belonged to the same genomic cluster, confirming that the cheese was the vehicle of the infection.Conclusion. It is plausible that a failure of the pasteurization process contributed to the contamination of the cheese batches. Timely suspension of the catering service and summer closure of the schools prevented further spread.
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Affiliation(s)
| | - Luca Busani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Calistri
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Stefania Bellino
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Vicdalia Acciari
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Caterina Graziani
- Present address: San Giovanni di Dio Hospital, Crotone, Italy.,Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Salvatore Antoci
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Fabrizio Lodi
- Department of Prevention - AUSL Pescara, Pescara, Italy
| | - Valeria Alfonsi
- Present address: Sant'Andrea Hospital, Rome, Italy.,Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Cesare Cammà
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Paolo Fazii
- Santo Spirito Hospital, AUSL Pescara, Pescara, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Cito
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Gabriella Centorotola
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Nicola D'Alterio
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Fabrizio De Massis
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Anna Pelatti
- Santo Spirito Hospital, AUSL Pescara, Pescara, Italy
| | - Marco Di Domenico
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Guido Di Donato
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | | | - Lisa Di Marcantonio
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Violeta Di Marzio
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Gabriella Di Serafino
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Anna Janowicz
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Cristina Marfoglia
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Francesca Marotta
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Daniela Morelli
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Giacomo Migliorati
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Diana Neri
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Francesco Pomilio
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Silvia Scattolini
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
| | - Giovanni Rezza
- Present address: General Directorate for Prevention, Ministry of Health, Rome, Italy.,Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giuliano Garofolo
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy
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15
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Guzzetta G, Riccardo F, Marziano V, Poletti P, Trentini F, Bella A, Andrianou X, Del Manso M, Fabiani M, Bellino S, Boros S, Urdiales AM, Vescio MF, Piccioli A, Brusaferro S, Rezza G, Pezzotti P, Ajelli M, Merler S. Impact of a Nationwide Lockdown on SARS-CoV-2 Transmissibility, Italy. Emerg Infect Dis 2021; 27:267-270. [PMID: 33080168 PMCID: PMC7774526 DOI: 10.3201/eid2701.202114] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [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] [Indexed: 11/23/2022] Open
Abstract
On March 11, 2020, Italy imposed a national lockdown to curtail the spread of severe acute respiratory syndrome coronavirus 2. We estimate that, 14 days after lockdown, the net reproduction number had dropped below 1 and remained stable at »0.76 (95% CI 0.67-0.85) in all regions for >3 of the following weeks.
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Affiliation(s)
| | | | - Valentina Marziano
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Piero Poletti
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Filippo Trentini
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Antonino Bella
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Xanthi Andrianou
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Martina Del Manso
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Massimo Fabiani
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Stefania Bellino
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Stefano Boros
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Alberto Mateo Urdiales
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Maria Fenicia Vescio
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Andrea Piccioli
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - COVID-19 Working Group,2
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Silvio Brusaferro
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
| | - Giovanni Rezza
- Fondazione Bruno Kessler, Trento, Italy (G. Guzzetta, V. Marziano, P. Poletti, F. Trentini, S. Merler)
- Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, A. Bella, X. Andrianou, M. Del Manso, M. Fabiani, S. Bellino, S. Boros, A. Mateo Urdiales, M.F. Vescio, A. Piccioli, S. Brusaferro, G. Rezza, P. Pezzotti)
- Cyprus University of Technology, Limassol, Cyprus (X. Andrianou)
- European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Del Manso, A. Mateo Urdiales)
- Indiana University School of Public Health, Bloomington, Indiana, USA (M. Ajelli)
- Northeastern University, Boston, Massachusetts, USA (M. Ajelli)
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16
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Bellino S, Punzo O, Rota MC, Del Manso M, Urdiales AM, Andrianou X, Fabiani M, Boros S, Vescio F, Riccardo F, Bella A, Filia A, Rezza G, Villani A, Pezzotti P. COVID-19 Disease Severity Risk Factors for Pediatric Patients in Italy. Pediatrics 2020; 146:peds.2020-009399. [PMID: 32665373 DOI: 10.1542/peds.2020-009399] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To describe the epidemiological and clinical characteristics of coronavirus disease (COVID-19) pediatric patients aged <18 years in Italy. METHODS Data from the national case-based surveillance system of confirmed COVID-19 infections until May 8, 2020, were analyzed. Demographic and clinical characteristics of subjects were summarized by age groups (0-1, 2-6, 7-12, 13-18 years), and risk factors for disease severity were evaluated by using a multilevel (clustered by region) multivariable logistic regression model. Furthermore, a comparison among children, adults, and elderly was performed. RESULTS Pediatric patients (3836) accounted for 1.8% of total infections (216 305); the median age was 11 years, 51.4% were male, 13.3% were hospitalized, and 5.4% presented underlying medical conditions. The disease was mild in 32.4% of cases and severe in 4.3%, particularly in children ≤6 years old (10.8%); among 511 hospitalized patients, 3.5% were admitted in ICU, and 4 deaths occurred. Lower risk of disease severity was associated with increasing age and calendar time, whereas a higher risk was associated with preexisting underlying medical conditions (odds ratio = 2.80, 95% confidence interval = 1.74-4.48). Hospitalization rate, admission in ICU, disease severity, and days from symptoms onset to recovery significantly increased with age among children, adults and elderly. CONCLUSIONS Data suggest that pediatric cases of COVID-19 are less severe than adults; however, age ≤1 year and the presence of underlying conditions represent severity risk factors. A better understanding of the infection in children may give important insights into disease pathogenesis, health care practices, and public health policies.
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Affiliation(s)
- Stefania Bellino
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; .,Contributed equally as co-first authors
| | - Ornella Punzo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.,Contributed equally as co-first authors
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Boros
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Rezza
- General Directorate for Prevention, Ministry of Health, Rome, Italy; and
| | - Alberto Villani
- General Pediatrics and Infectious Diseases Unit, Pediatric Hospital Bambino Gesù, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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17
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Pezzotti P, Punzo O, Bella A, Del Manso M, Urdiales AM, Fabiani M, Ciervo A, Andrianou X, Riccardo F, Stefanelli P. The challenges of the outbreak: the Italian COVID-19 integrated surveillance system. Eur J Public Health 2020. [PMCID: PMC7543512 DOI: 10.1093/eurpub/ckaa165.356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/13/2022] Open
Abstract
Background In Italy, the National surveillance of all SARS-CoV-2 laboratory-confirmed cases was established on 27 February 2020, building on a previously existing laboratory network focused on suspected and confirmed COVID-19 severe respiratory infections. Methods The integrated epidemiological and microbiological surveillance systematically collects and analyzes information on all SARS-CoV-2 confirmed cases. Regional reference laboratories analyze samples, inform Local Health Authorities of the results and coordinate data flow between cases, hospitals and GPs. Regions provide data through a web interface connected to a dedicated IT platform or by sending a dataset. The Infectious Diseases Department at Istituto Superiore di Sanità processes and analyzes data, producing reports on a daily and weekly basis, as well as indicator analyses based on the monitoring of “phase 2” (post-lockdown). Moreover, mathematical models are constructed daily on these data. Results Since the beginning of the epidemic, the surveillance system recorded 238.901 COVID-19 cases and 33.369 deaths on 19-6. Main challenges were the coordination of different actors, hampered by the decentralization of health to the Regions, and data interpretation due to the delay in the detection of cases and deaths. Besides the COVID-19 surveillance, we planned ad hoc studies and periodic surveys: health care workers, long term care facilities, clusters and red zones, health system resilience monitoring. Conclusions COVID-19 surveillance is an essential tool to inform the public about the epidemic trend and provide support to public health response. We urge upon all relevant stakeholders a reflection on important issues such as defining ethical boundaries for data scavenging during emergencies, how existing laws on data protection could affect record linkage among different existing datasets to assess diseases and other variables for correlation, or which ethical approaches on open data would apply to our setting. Key messages A strong and adequately funded public health system in place allows an efficient response in times of epidemics both in terms of data collection and public health response, policy and decisions. COVID-19 epidemic showed us all the limits of a regionalized health system which was not entirely coordinated between periphery and central institutions.
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Affiliation(s)
- P Pezzotti
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - O Punzo
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A Bella
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - M Del Manso
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A M Urdiales
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - M Fabiani
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A Ciervo
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - X Andrianou
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - F Riccardo
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
| | - P Stefanelli
- Department of Infectious diseases, Istituto Superiore di Sanità, Rome, Italy
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18
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Del Manso M, Andrianou X, Urdiales AM, Vescio MF, Rota MC, Fabiani M, Boros S, Bellino S, Stefanelli P, Ciervo A, Punzo O, Filia A, Tallon M, Di Benedetto C, Spuri M, Pezzotti P, Riccardo F, Bella A. [Integrated Surveillance in Italy: outputs and related activities]. Epidemiol Prev 2020; 44:70-80. [PMID: 33412796 DOI: 10.19191/ep20.5-6.s2.105] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES to describe the integrated surveillance system of COVID-19 in Italy, to illustrate the outputs used to return epidemiological information on the spread of the epidemic to the competent public health bodies and to the Italian population, and to describe how the surveillance data contributes to the ongoing weekly regional monitoring and risk assessment system. METHODS the COVID-19 integrated surveillance system is the result of a close and continuous collaboration between the Italian National Institute of Health (ISS), the Italian Ministry of Health, and the regional and local health authorities. Through a web platform, it collects individual data of laboratory confirmed cases of SARS-CoV-2 infection and gathers information on their residence, laboratory diagnosis, hospitalisation, clinical status, risk factors, and outcome. Results, for different levels of aggregation and risk categories, are published daily and weekly on the ISS website, and made available to national and regional public health authorities; these results contribute one of the information sources of the regional monitoring and risk assessment system. RESULTS the COVID-19 integrated surveillance system monitors the space-time distribution of cases and their characteristics. Indicators used in the weekly regional monitoring and risk assessment system include process indicators on completeness and results indicators on weekly trends of newly diagnosed cases per Region. CONCLUSIONS the outputs of the integrated surveillance system for COVID-19 provide timely information to health authorities and to the general population on the evolution of the epidemic in Italy. They also contribute to the continuous re-assessment of risk related to transmission and impact of the epidemic thus contributing to the management of COVID-19 in Italy.
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Affiliation(s)
- Martina Del Manso
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma;
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm (Sweden)
| | - Xanthi Andrianou
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Alberto Mateo Urdiales
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm (Sweden)
| | | | | | - Massimo Fabiani
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Stefano Boros
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Stefania Bellino
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Paola Stefanelli
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | | | - Ornella Punzo
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Antonietta Filia
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Marco Tallon
- Servizio di informatica, Istituto superiore di sanità, Roma
| | | | - Matteo Spuri
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
- Dipartimento di scienze statistiche, Facoltà di ingegneria dell'informazione, informatica e statistica, Università Sapienza, Roma
| | | | - Flavia Riccardo
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Antonino Bella
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
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19
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Michelozzi P, de' Donato F, De Sario M, Scortichini M, Stafoggia M, Noccioli F, Andrianou X, Boros S, Del Manso M, Fabiani M, Urdiales AM, Pezzotti P, Rossi P, Rezza G, Costa G, Davoli M. [Temporal variations in excess mortality during phase 1 and phase 2 of the COVID-19 epidemic in Italy]. Epidemiol Prev 2020; 44:236-243. [PMID: 33412815 DOI: 10.19191/ep20.5-6.s2.123] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES to assess the temporal variation in excess total mortality and the portion of excess explained by COVID-19 deaths by geographical area, gender, and age during the COVID-19 epidemic. DESIGN descriptive analysis of temporal variations of total excess deaths and COVID-19 deaths in the phase 1 and phase 2 of the epidemic in Italy. SETTING AND PARTICIPANTS 12 Northern cities and 20 Central-Southern cities from December 2019 to June 2020: daily mortality from the National Surveillance System of Daily Mortality (SiSMG) and COVID-19 deaths from the integrated COVID-19 surveillance system. MAIN OUTCOME MEASURES total mortality excess and COVID-19 deaths, defined as deaths in microbiologically confirmed cases of SARS-CoV-2, by gender and age groups. RESULTS the largest excess mortality was observed in the North and during the first phase of the epidemic. The portion of excess mortality explained by COVID-19 decreases with age, decreasing to 51% among the very old (>=85 years). In phase 2 (until June 2020), the impact was more contained and totally attributable to COVID-19 deaths and this suggests an effectiveness of social distancing measures. CONCLUSIONS mortality surveillance is a sensible information basis for the monitoring of health impact of the different phases of the epidemic and supporting decision making at the local and national level on containment measures to put in place in coming months.
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Affiliation(s)
- Paola Michelozzi
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
| | - Francesca de' Donato
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
| | - Manuela De Sario
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma;
| | - Matteo Scortichini
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
| | - Massimo Stafoggia
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
| | - Fiammetta Noccioli
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
| | - Xanthi Andrianou
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Stefano Boros
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Martina Del Manso
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm (Sweden)
| | - Massimo Fabiani
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
| | - Alberto Mateo Urdiales
- Dipartimento malattie infettive, Istituto superiore di sanità, Roma
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm (Sweden)
| | | | - Pasqualino Rossi
- Direzione generale della prevenzione sanitaria, Ministero della salute, Roma
| | - Giovanni Rezza
- Direzione generale della prevenzione sanitaria, Ministero della salute, Roma
| | | | - Marina Davoli
- Dipartimento di epidemiologia del Sistema sanitario regionale, Regione Lazio, ASL Roma 1, Roma
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20
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Riccardo F, Venturi G, Di Luca M, Del Manso M, Severini F, Andrianou X, Fortuna C, Remoli ME, Benedetti E, Caporali MG, Fratto F, Mignuoli AD, Rizzo L, De Vito G, De Giorgio V, Surace L, Vairo F, Angelini P, Re MC, Amendola A, Fiorentini C, Marsili G, Toma L, Boccolini D, Romi R, Pezzotti P, Rezza G, Rizzo C. Secondary Autochthonous Outbreak of Chikungunya, Southern Italy, 2017. Emerg Infect Dis 2020; 25:2093-2095. [PMID: 31625839 PMCID: PMC6810187 DOI: 10.3201/eid2511.180949] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In 2017, a chikungunya outbreak in central Italy later evolved into a secondary cluster in southern Italy, providing evidence of disease emergence in new areas. Officials have taken action to raise awareness among clinicians and the general population, increase timely case detection, reduce mosquito breeding sites, and promote mosquito bite prevention.
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