Lead isotopes of prehistoric copper tools define metallurgical phases in Late Neolithic and Eneolithic Italy

The diffuse presence of small copper ore deposits in the Alpine area, mostly exploited since Late Medieval times, led most scholars to assume that these deposits may actually be active much earlier and that many of the circulating prehistoric metal objects found in the area were produced with local copper sources. This assumption was recently validated for the Recent Bronze Age through the use of lead isotope tracers, and well supported by the archaeometallurgical evidences found in the South-Eastern Alps. However, the scarcity of available lead isotope data for pre-Bronze Age metals precluded to date the reconstruction of the metal flow through the Late Neolithic and Eneolithic (or Copper Age). Based on 49 new analyses of important archaeological objects from the Alpine region, the Po River Valley and Central Italy, mostly axes dated from the Late Neolithic to the Late Eneolithic, here we show that the diffusion of copper in Northern Italy (approximately 4500-2200 BC) includes three major periods of metal use and/or production, each related to specific ore sources. The South Alpine copper was massively used only starting from the middle of the 3rd millennium BC, in connection or slightly earlier than the Beaker event.

Assessing the distribution of invasive Asian mosquitoes in Northern Italy and modelling the potential spread of Aedes koreicus in Europe

In the last decade, Aedes koreicus and Aedes japonicus japonicus mosquitoes, which are competent vectors for various arboviruses of public health relevance, colonised Italy and other European countries. Nevertheless, information about their current and potential distribution is partial. Accordingly, in this study four regions of Northern Italy (Lombardy, Liguria, Piedmont and Aosta Valley) were surveyed during 2021 for the presence of eggs, larvae and pupae of these two invasive species. We found evidence for a widespread presence of Ae. koreicus in pre-Alpine territories of Lombardy and Piedmont. Larvae from the invasive subspecies of Ae. j. japonicus were also collected in the same geographic areas, though they were less frequent. Occurrence data from this study and results from previous monitoring campaigns were used to generate a Maxent model for the prediction of habitat suitability for Ae. koreicus mosquitoes in Northern Italy and the rest of Europe. Peri-urban areas located in proximity to forests, pastures and vineyards were revealed as highly suitable environments for colonisation by this invasive species. Maps of the potential distribution also suggest the presence of further suitable areas in currently uncolonized countries. We conclude that this invasive mosquito species has the potential for a broad expansion at the European level in the coming decades.

Monitoring and detection of new endemic foci of canine leishmaniosis in northern continental Italy: An update from a study involving five regions (2018-2019)

Canine leishmaniosis (CanL) is an emerging zoonosis caused by Leishmania infantum and transmitted in southern Europe by phlebotomine sand flies of the subgenus Phlebotomus (Larroussius). Endemic foci of CanL have been recorded in northern continental Italy since early 1990s and attributed to the northward expansion of vector populations due to climatic changes in association with travelling/relocated infected dogs from the southern Mediterranean littoral. In this study, further spread of endemic Leishmania foci was monitored during 2018-2019 in five regions (Aosta Valley, Piedmont, Lombardy, Veneto and Friuli-Venezia Giulia), with focus to territories where investigations were not performed, or they have been inconclusive. Clinical cases of CanL identified by local veterinary practitioners and confirmed by reference diagnosis centers were regarded as autochthonous if their origin from, or travel to, areas endemic for CanL were excluded in the previous ≥2 years. Around these index cases, i) serosurveys for L infantum were carried out where indicated, ii) sampling from potential autochthonous cases in healthy or clinically-suspected resident dogs was intensified by collaborating veterinary practitioners, and iii) suitable sites were investigated for the presence of competent phlebotomine vectors. Fifty-seven municipalities whose enzootic status of CanL was unreported before 2018, were identified as endemic. The stability of 27 foci recorded over the past decade, was also confirmed. Competent phlebotomine vectors, mainly Phlebotomus perniciosus, were collected for the first time in 23 municipalities. The newly recorded endemic municipalities appear to be distributed over a west-to-east decreasing gradient: 30 in Piedmont, 21 in Lombardy, 4 in Veneto and 2 in Friuli-Venezia Giulia. As regards Veneto, it should be noted that a relatively restricted territory was investigated as several municipalities of the region had already been surveyed and detected as endemic for CanL in the past. Cold climate conditions of the easternmost region of Friuli-Venezia Giulia bordering non-endemic territories of Slovenia, are probably less favorable to L infantum transmission.

Investigation of Tick-Borne Pathogens in Ixodes ricinus in a Peri-Urban Park in Lombardy (Italy) Reveals the Presence of Emerging Pathogens

Ticks are important vectors of a great range of pathogens of medical and veterinary importance. Lately, the spread of known tick-borne pathogens has been expanding, and novel ones have been identified as (re)emerging health threats. Updating the current knowledge on tick-borne pathogens in areas where humans and animals can be easily exposed to ticks represents a starting point for epidemiological studies and public awareness. A PCR screening for tick-borne pathogens was carried out in Ixodes ricinus ticks collected in a peri-urban recreational park in Ticino Valley, Italy. The presence of Rickettsia spp., Borrelia burgdorferi senso latu complex, Anaplasma spp. and Babesia spp. was evaluated in a total of 415 I. ricinus specimens. Rickettsia spp. (R monacensis and R. helvetica) were detected in 22.96% of the samples, while B. burgdorferi s.l. complex (B. afzelii and B. lusitaniae) were present in 10.94%. Neoehrlichia mikurensis (1.99%) and Babesia venatorum (0.73%) were reported in the area of study for the first time. This study confirmed the presence of endemic tick-borne pathogens and highlighted the presence of emerging pathogens that should be monitored especially in relation to fragile patients, the difficult diagnosis of tick-borne associated diseases and possible interactions with other tick-borne pathogens.

COVID-19 After Lung Resection in Northern Italy

We reviewed surgical cases from 4 Thoracic Surgery departments in the Lombardia region of Italy, the area mostly affected by Coronavirus pandemic in Europe, with the aim to describe the impact of COVID-19 on the treatment of thoracic surgical patients. Clinical, radiological and laboratory data from patients who underwent lung resection from December 2019 to March 2020 were retrospectively collected until June 2020. Univariable Cox regression models were estimated to evaluate potential prognostic factors for developing COVID-19 and to investigate postoperative mortality among patients who developed symptomatic COVID-19 infection. We examined data from 107 patients. (74 lobectomies, 32 wedge/segmentectomies and 1 pneumonectomy). Twelve patients developed COVID-19 (Group 1), whereas 95 patients were not infected (Group 2). In Group 1, 6 patients (50%) died from complications related to infection; in Group 2, one patient (1%) died because of non-COVID-19-related causes. Median days from surgery to first symptoms, CT confirmation, clinical confirmation and PCR positivity was 48.1, 54.3, 55.1, and 55.2 respectively. At univariable analysis, DLCO/VA% (P = 0.008), duration of the surgery (P = 0.009), smoking history (pack/year) (P < 0.001), BMI (P< 0.001) and number of segments resected (P = 0.010) were associated with COVID-19 onset. Moreover, CCI (P < 0.001), DLCO/VA% (P = 0.002), cigarette pack/year (P < 0.001), BMI (P < 0.001) and COVID-19 (P < 0.001) were associated with death. Patients who undergo lung resection and then develop symptomatic COVID-19 infection are at higher risk of developing severe respiratory complications and postoperative death. Insidious symptoms’ onset may lead to a delay in diagnosis. We suggest two mitigating strategies: (1) Improve symptoms surveillance and isolation during recovery period, (2) Be aware of a potential greater risk of developing symptomatic COVID-19 and death correlated with elevated CCI, BMI, smoking history, DLCO/VA%, number of resected segments and duration of surgery.

Estimating temporal and spatial levels of PAHs in air using rain samples and SPME analysis: Feasibility evaluation in an urban scenario

There is a growing interest in evaluating the role of concentration changes of contaminants in temporal and spatial gradients. This is often relevant for fast moving environmental phases such as air and water. In this paper, small volumes of rainwater were sampled as proxy for air concentrations of Polycyclic Aromatic Hydrocarbons (PAHs): rain was collected in three sampling sites (high traffic, restricted traffic and a low traffic zone) in Como. Solid phase micro extraction (SPME) was used for the extraction to reduce required sample volumes, allowing the acquisition of more samples in time. Rain samples highlighted a spatial and temporal variability along a traffic gradient in the Como city, especially for the most abundant PAH, e.g. phenanthrene. Air concentrations were then estimated from rain concentrations. The results show that this is a cheap and promising method, although requiring rainfall/snowfall conditions, that can be used to perform monitoring campaign of air concentrations at a higher temporal and spatial resolution than the adopted standard methods (e.g. high-volume air samplers). The results could be employed for evaluation of the exposure, emission profiles and calibration of fate models.

Detection of Serum Allergen-Specific IgE in Atopic Dogs Tested in Northern Italy: Preliminary Study

Canine atopic dermatitis (CAD) is a pruritic allergic skin disease associated with IgE-mediated hypersensitivity. IgE is detected using Serum Allergen-Specific IgE test (SAT) in order to identify allergens. The present study aims to identify the environmental allergens in atopic dogs living in Northern Italy using SAT. The screening SAT (sSAT), using a monoclonal antibody cocktail-based ELISA to identify indoor and outdoor allergens, was performed. In all positive samples, an anti-IgE monoclonal antibody ELISA test was performed to extend panel of allergens. Out of 117 selected dogs, 69 were included in the study; 71% were positive and 29% were negative to sSAT. Among the 49 positive sSAT, 53% were positive for both indoor and outdoor, 38.8% only for indoor, and 8.2% only for outdoor allergens. This is the first study on the frequency of allergens involved in CAD in Italy using SAT. IgE hypersensitivity in atopic dogs of Northern Italy is usually associated with indoor allergens, primarily house dust mites. Among the outdoor allergens, an important role was played by Rumex acetosa. Polysensitization also commonly occurs. Therefore, since the numerous factors affect the IgE positivity in CAD, specific panels for geographical areas should be considered and re-evaluated at time intervals.

Back to (new) normality-A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

Background

Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery.

Materials and methods

A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after.

Results

All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients.

Conclusion

The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments.

Electronic supplementary material

The online version of this article (10.1007/s12032-020-01434-1) contains supplementary material, which is available to authorized users.

A case series of novel coronavirus infection in heart transplantation from 2 centers in the pandemic area in the North of Italy

Background

Little is known about the coronavirus SARS-CoV-2 disease (COVID-19) in solid organ transplanted patients. We here report a series of heart transplanted patients with COVID-19 from two centers of Italy.

Methods

All heart transplanted patients of Transplant Centers of Bergamo and Torino with a microbiologically confirmed SARS-CoV-2 infection were enrolled. Data collection included clinical presentation, laboratory and radiological findings, treatment and outcome. Follow-up was performed by visit or phone.

Results

From February to March 2020 twenty-six heart transplanted patients (age 62±12 years; 77% males; time from transplant 10±10 years; 69% with comorbidities) had a microbiologically confirmed COVID-19. The most frequent symptom was fever, followed by cough. Seventeen patients had a pneumonia, 8 of them severe pneumonia. Seven patients died (27%) and 17 (65%) were hospitalized. Discontinuation of immunosuppression was associated with death (71 vs 21%, p=0.02). Conversely, all patients receiving steroids survived (p<0.001). Patients who received heart transplantation during COVID-19 outbreak survived and no acute graft rejection occurred. Patients who died were older than survivors, had a longer time from transplant and a worse clinical presentation at diagnosis.

The current regimen enabled the prolonged survival and function of orthotopic cardiac xenografts in altogether 6 of 8 baboons, of which 4 were now added. These results exceed the threshold set by the Advisory Board of the International Society for Heart and Lung Transplantation.

Conclusions

COVID-19 has a significant impact on long term heart transplanted patients. Conversely, SARS-CoV-2 infection seems to have a limited influence on more recent transplants. Our experience may suggest that heart transplantation programs can be maintained even during the pandemic phase if specific and tailored paths to prevent and to limit virus transmission are provided.

Two waves of canine distemper virus showing different spatio-temporal dynamics in Alpine wildlife (2006-2018)

Canine distemper virus (CDV) represents an important threat for both wild and domestic carnivores. Since 2006, the North-Eastern regions in Italy have been experiencing severe and widespread recurring outbreaks of CDV affecting the wild carnivore population. In this study we performed an extensive phylogeographic analysis of CDV strains belonging to the Wildlife-Europe genetic group identified between 2006 and 2018 in Veneto, Trentino Alto Adige and Friuli Venezia Giulia regions. Our analysis revealed that viruses from the first (2006-2009) and the second (2011-2018) epidemic wave cluster separately, suggesting the introduction of two distinct genetic variants. These two events were characterized by different diffusion rates and spatial distribution, thus suggesting the existence of a connection between infection spread and host population dynamics. We also report the first spillover event of this strain to a non-vaccinated dog in a rural area of Friuli Venezia Giulia. The increasing prevalence of the infection in wildlife population, the broad host range of CDV circulating in the Alpine wildlife and the first reported transmission of a wild-adapted strain to a domestic dog in this region raise concerns over the vulnerability of wildlife species and the exposure of our pets to new threatening strains. Understanding the dynamic of CDV epidemics will also improve preparedness for re-emerging diseases affecting carnivore species.

Feline Leishmania spp. Infection in a Non-Endemic Area of Northern Italy

Simple Summary

Leishmaniosis caused by Leishmania infantum is a parasitic disease of people and animals transmitted by sand fly vectors. Although dogs in south and central Italy are most affected, in recent decades feline leishmaniosis (FeL) has become an emerging disease. This study aimed to update information on the presence of FeL in stray cats in Milan, in northern Italy; to compare these results with previous studies performed in the same area; and to report aspects of Leishmania infection in cats. A total of 117 stray cats were included and 10 (8.6%) had L. infantum infection. The parasite was identified in popliteal lymph nodes in five cats and five had antibodies against L. infantum. Most infected cats were from a specific area of Milan. Increased gammaglobulins were seen in infected cats, which also had antibodies against the pathogens Anaplasma phagocytophilum, Chlamydophila felis, and Toxoplasma gondii. There was a high prevalence of FeL in the surveyed area of northern Italy. Further studies are needed to understand if these infected cats are being imported from other areas, or if there is a real Leishmania focus in Milan. Investigation of the presence of sand fly vectors in Milan would be useful.

Abstract

Feline leishmaniosis (FeL) is an emerging vector-borne feline disease, with increasing numbers of cases reported and studies performed internationally. This study aimed to update the epidemiological status for FeL in stray cats in Milan, northern Italy; compare these results with previous studies in Northern Italy; and report clinicopathologic findings and coinfections in cats infected with Leishmania spp. A total of 117 cats were tested for L. infantum and retrovirus infection, hematological, and biochemical parameters. Demographic and clinical data were collected and FeL affected cats screened for selected coinfections. Overall, 10/117 (8.6%) cats tested positive for L. infantum: in five cats L. infantum DNA was found in popliteal lymph nodes and five were IFAT seropositive at titers from 1:80 to 1:160. Infected cats were concentrated in a specific area of Milan (p = 0.0154). No specific clinicopathologic abnormalities or retroviral infections were significantly linked to the infection, other than hypergammaglobulinemia (p = 0.0127). Seroreactivity to Anaplasma phagocytophilum, Chlamydophila felis, and Toxoplasma gondii was found in some infected cats. A high prevalence of FeL was found in a non-endemic area of northern Italy and future studies should continually monitor this data to understand whether these cases are imported or if Leishmania vectors are present in this area.

Rotavirus molecular epidemiology in hospitalized patients, Northern Italy, 2015-2018

About 15,000 hospitalizations due to group A Rotavirus gastroenteritis (RVA) are recorded each year in Italy. In the present study, we report the seasonal distribution and molecular characterization of RVA in pediatric and adult hospitalized patients in the period September 2015-April 2018 in Pavia province, Lombardy Region. During the study period, stool samples of 1450 patients with acute gastroenteritis were analyzed and 122 were RVA positive, the majority belonging to pediatric patients (94.0%) while only a minority of patients (6.0%) were adults. G3P[8], G1P[8], G9P[8] and G2P[4] were the most detected RVA strains, with a prevalence of 82.4%. However, a variety of RVA strains circulated in Northern Italy in hospitalized patients over a period of three years, emphasizing distinct patterns of distribution in different age groups and between years.

Anthelmintic resistance in gastrointestinal nematodes in sheep raised under mountain farming conditions in Northern Italy

Anthelmintic resistance (AR) in sheep raised under mountain farming conditions in South Tyrol (Northern Italy) was assessed on eight farms (n=99 animals). A faecal egg count reduction (FECR) test was done after routine anthelmintic treatments. Furthermore, on 27 farms (n=306 animals), a FECR test was conducted after oral formulations of a macrocyclic lactone (ML), benzimidazole (BZ) (partly in combination with salicylanilide (SA)) or a combination of imidazothiazole and SA were applied under controlled conditions on the same farm. Following routine treatments, three of five ML-treated flocks showed an adequate efficacy, while the other two reached a FECR of only around 75 per cent. A wide range of gastrointestinal nematode genera were identified in one flock following the treatment. From the three BZ-treated flocks, only one showed an adequate FECR, both other farms reached 68 per cent and 84 per cent, respectively. Under controlled conditions, FECR ranged between 77 per cent and 81 per cent indicating AR for all the applied anthelmintics. Trichostrongylus species, Teladorsagia species and Haemonchus species were identified after ML treatment, Teladorsagia species after BZ treatment and Trichostrongylus species and Haemonchus species after combined BZ and SA application. Taking into consideration that underdosing might have affected results of the routine treatments, a high prevalence of AR was found in sheep under mountain farming conditions.

Anthelmintic efficacy against gastrointestinal nematodes in goats raised under mountain farming conditions in northern Italy

Background

This study aimed to evaluate the efficacy of anthelmintics in goats raised under mountain farming conditions in northern Italy. On 8 goat farms (n = 143 animals), a faecal egg count reduction (FECR) test was done after farmers conducted their routine anthelmintic treatments. Furthermore, on 5 goat farms (n = 135 animals) a FECR test was done under controlled conditions applying oral formulations of a macrocyclic lactone (ML), benzimidazole (BZ) (partly in combination with salicylanilide (SA)) or a combination of imidazothiazole (IT) and SA on the same farm. AR was assumed if FECR and the upper confidence interval (CI) was < 95% and the lower 95% CI was < 90%.

Results

Underdosing was found in 6 of the 8 farms tested after routine treatments. Out of the 6 routinely ML-treated goat flocks, only three were found where ML showed adequate efficacy. FECR in all others ranged between 64 and 93%. In one flock Trichostrongylus spp. and in one Haemonchus spp. larvae were identified after treatment. BZ-treated flocks had an efficacy of 99 and 37%. Larvae identified after treatment were Trichostrongylus spp. in one and Haemonchus spp. in the other flock. Under controlled conditions, ML had an adequate efficacy on 4 farms and a FECR of 88% on another one. BZ was effective on all farms. The combination of BZ and SA had a FECR of 99% on the farm it was tested. IT + SA in combination was effective on 2 farms and had a FECR of 91% on a third farm. Larvae identified after treatment were composed of Haemonchus spp. (ML and BZ), Trichostrongylus spp. (BZ) and Teladorsagia spp. (BZ and SA).

Conclusions

This first report on the prevalence of AR in goats in the mountainous region of South Tyrol reveals a low efficacy of the most commonly used anthelmintics after routine treatments. This might be explained by a high level of underdosing as observed in the farms. However, results from the controlled FECR tests suggest that the observed level of AR was lower but cannot be solely explained by underdosing.

A case of erosive polyarthropathy from Medieval northern Italy (12th-13th centuries)

OBJECTIVE

To evaluate and differentially diagnose erosive skeletal lesions located on multiple joints of an individual archaeologically recovered in 2017.

MATERIALS

Skeletal remains of a well-preserved skeleton dating to the 12th-13th centuries from the medieval church of San Biagio in Cittiglio (Varese, northern Italy).

METHODS

Macroscopic and radiographic imaging.

RESULTS

Erosive marginal symmetrical lesions are present on the metatarsophalangeal, metacarpophalangeal and interphalangeal joints of an adult male, aged 55-75 years. Osteolytic changes, in the form of pocket erosions, surface resorptions and pseudocyst formations, are also macroscopically observed on some carpal and tarsal bones and on several large peripheral joints.

CONCLUSIONS

A careful differential diagnosis of the lesions and their macroscopic and radiological appearance is suggestive of a case of rheumatoid arthritis-like polyarthropathy.

SIGNIFICANCE

This case contributes to the debate regarding the antiquity of erosive polyarthropathies, providing additional evidence for the existence of these diseases in the Old World prior to the European discovery of the Americas.

LIMITATIONS

Small sample size limits discussion of the scope of the disease in antiquity.

SUGGESTIONS FOR FURTHER RESEARCH

This case highlights the need for further macroscopic, radiographic, and biomolecular studies of pre-modern European skeletal samples to investigate the hypothesized pre-existence of these pathological conditions in Europe prior to 1492.

Subclinical Leishmania infection in patients with rheumatic diseases under biological drugs

PURPOSE

Climate changes and immunosuppression are influencing the spread of leishmaniasis and re-emergence in Northern Italy, respectively. We evaluated the prevalence of subclinical leishmaniasis in patients from a Northern Italian region with chronic inflammatory rheumatism (CIRD) receiving biological drugs (BD) and correlated it to the area of residence.

METHODS

DNA from PBMC of patients affected by CIRD treated with either BD for at least 5 years (Group A) or other immunosuppressive drugs (Group B) was investigated by a qPCR for Leishmania infantum kDNA and compared to healthy subjects (Group C). Variables such as sex and age, rural areas, dog ownership, type of BD administered and association between BD and steroids, were evaluated by statistical analysis.

RESULTS

A higher proportion of L. infantum DNA positivity was found in Group A than in Group C (p < 0.05), while no parasite DNA was detected in Group B. In Group A, 18/50 patients (36%) had higher rates of parasite DNA (from 1 to 136 to 1.000.000 copies/ml) than Group C (from 1 to 10 copies/ml). 14/18 (77.7%) of positive patients from Group A lived in rural areas, but no statistical differences occurred in relation to dog ownership or BD type (p < 0.0003).

CONCLUSIONS

We can speculate that exposure to rural areas appears to be a factor closely linked with the risk of developing Leishmania subclinical infection. A screening with molecular methods in patients with CIRD treated with BD living in these areas and monitoring Leishmania DNA during such therapies, would be mandatory to prevent delay in diagnosis should VL symptoms appear.

First detection of Borrelia miyamotoi in Ixodes ricinus ticks from northern Italy

BACKGROUND

Borrelia miyamotoi is a spirochete transmitted by several ixodid tick species. It causes a relapsing fever in humans and is currently considered as an emerging pathogen. In Europe, B. miyamotoi seems to occur at low prevalence in Ixodes ricinus ticks but has a wide distribution. Here we report the first detection of B. miyamotoi in Ixodes ricinus ticks collected in two independent studies conducted in 2016 in the north-eastern and north-western Alps, Italy.

RESULTS

Three out of 405 nymphs (0.74%) tested positive for Borrelia miyamotoi. In particular, B. miyamotoi was found in 2/365 nymphs in the western and in 1/40 nymphs in the eastern alpine area. These are the first findings of B. miyamotoi in Italy.

CONCLUSIONS

Exposure to B. miyamotoi and risk of human infection may occur through tick bites in northern Italy. Relapsing fever caused by Borrelia miyamotoi has not yet been reported in Italy, but misdiagnoses with tick-borne encephalitis, human granulocytic anaplasmosis or other relapsing fever can occur. Our findings suggest that B. miyamotoi should be considered in the differential diagnosis of febrile patients originating from Lyme borreliosis endemic regions. The distribution of this pathogen and its relevance to public health need further investigation.

The Degree of One Health Implementation in the West Nile Virus Integrated Surveillance in Northern Italy, 2016

West Nile virus (WNV) is endemic in the Po valley area, Northern Italy, and within the legal framework of the national plan for the surveillance of human vector-borne diseases, WNV surveillance has over time been implemented. The surveillance plans are based on the transdisciplinary and trans-sectorial collaboration between regional institutions involved in public, animal, and environmental health. This integrated surveillance targets mosquitoes, wild birds, humans, and horses and aims at early detecting the viral circulation and reducing the risk of infection in the human populations. The objective of our study was to assess the degree of One Health (OH) implementation (OH-ness) of the WNV surveillance system in three North Italian regions (Emilia-Romagna, Lombardy, Piedmont) in 2016, following the evaluation protocol developed by the Network for Evaluation of One Health (NEOH). In detail, we (i) described the OH initiative (drivers, outcomes) and its system (boundaries, aim, dimensions, actors, stakeholders) and (ii) scored different aspects of this initiative (i.e., OH-thinking, -planning, -sharing, -learning, transdisciplinarity and leadership), with values from 0 (=no OH approach) to 1 (=perfect OH approach). We obtained a mean score for each aspect evaluated. We reached high scores for OH thinking (0.90) and OH planning (0.89). Lower scores were attributed to OH sharing (0.83), transdisciplinarity and leadership (0.77), and OH learning (0.67), highlighting some critical issues related to communication and learning gaps. The strengths and weaknesses detected by the described quantitative evaluation will be investigated in detail by a qualitative evaluation (process evaluation), aiming to provide a basis for the development of shared recommendations to refine the initiative and conduct it in a more OH-oriented perspective.

Co-circulation of two Usutu virus strains in Northern Italy between 2009 and 2014

Usutu virus is an arbovirus closely related to West Nile virus (genus Flavivirus), which circulates between mosquitoes and wild birds. This virus has been increasingly reported in Europe, raising concerns for its possible pathogenic potential for wild birds and humans. This study reports the whole genome sequences of 15 strains of USUV, isolated between 2010 and 2014 from mosquitoes and wild birds in the course of West Nile virus surveillance in the Emilia-Romagna and Lombardy regions of Northern Italy. Both whole and 656 partial genome sequences, obtained from isolated viruses and field samples (mosquitoes and wild birds), were analyzed to describe the temporal and geographical spread of USUV in the surveyed area. The detected sequences belonged to two groups, with one circulating primarily in the northwestern part of the area and the other in the southeastern part. This pattern is likely the result of different routes of introduction from the North (over the Alps) and from the East, respectively. The phylogenetic analysis of obtained sequences and other European sequences demonstrated that the majority of European strains belonged to one main clade, while less common strains, mainly from Western Europe, fell in other two clades. This analysis strongly suggested an autochthonous evolution process of strains of the main clade from a common ancestor with an estimated time of arrival in Europe at the beginning of the 1990s. In addition to causing mass mortality in wild birds, Usutu virus can infect humans and can sporadically cause disease. These factors and the endemization of the Usutu virus in a large area of Europe, sustained by the obtained data, strongly support the need to adequately survey Usutu virus in areas in which its circulation is detected.

Prevalence and molecular characterization of canine and feline hemotropic mycoplasmas (hemoplasmas) in northern Italy

BACKGROUND

Hemotropic mycoplasmas (hemoplasmas), the agents of infectious anemia, have been reported in dogs and cats. Little data are available on hemoplasma infections in Italy. The aim of this study was to evaluate the species of hemoplasmas and their prevalence in dogs and cats of northern Italy.

METHODS

Blood samples were obtained from 117 candidate blood donor dogs, 278 free-roaming dogs and 227 free-roaming cats in 2014 and 2015. Samples were first screened for hemoplasmas with a SYBR green real time PCR. The positive samples were confirmed by a second SYBR green real time PCR and sequencing. Co-infections were detected using species-specific SYBR green real time PCR.

RESULTS

The overall prevalence in dogs was 4.5% (18/395). Among the donors only one dog was positive for Mycoplasma haemocanis (0.8%). The overall prevalence of infection in free-roaming dogs was 6.1% (17/278), which was significantly higher than in candidate donors (P < 0.05). Both M. haemocanis (13/278; 4.7%) and "Candidatus M. haematoparvum" (4/278; 1.4%) were identified. In dogs, no significant association was found between hemoplasma infection and gender, age or origin. The overall prevalence in cats was 13.2% (30/227). All three feline hemoplasma species were detected, i.e. "Candidatus Mycoplasma haemominutum" (28; 12.3%), "Candidatus Mycoplasma turicensis" (11; 4.8%) and Mycoplasma haemofelis (9; 4.0%). Half of the infected cats were co-infected (15; 6.6%) with different species of hemoplasmas. Risk factor analysis confirmed that older age, male gender and FIV positivity are predisposing factors for hemoplasma infection in cats.

CONCLUSION

This study found that candidate blood donor dogs in northern Italy show a negligible risk for hemoplasma infection, confirming the appropriateness of the candidate selection criteria and the low prevalence in the study area. Accordingly, testing for hemoplasma should be considered optional for canine blood donor screening. Hemoplasma infection was instead common in free-roaming cats, and is expected to be non-negligible in owned cats with outdoor access. Feline candidates for blood donation will therefore need to be carefully selected.

Environmental assessment of different harvesting solutions for Short Rotation Coppice plantations

Although several studies have been carried out on Short Rotation Coppice (SRC) plantations and on their environmental performances, there is a lack of information about the environmental impact of the harvesting operations. In this study, using LCA approach, the environmental performance of two different harvesting solutions for Short Rotation Coppice plantations was evaluated. In more details, for 2-years cutting time poplar plantations, harvesting with a self-propelled forager equipped with a specific header was compared in terms of environmental impact with a tractor-based solution. The LCI was built with experimental data collected during field tests carried out over about 70 ha of SRC plantation in Northern Italy. The following nine impact potentials were evaluated according to the selected method: climate change (CC), ozone depletion (OD), particulate matter (PM), photochemical ozone formation (POF), acidification (TA), freshwater eutrophication (FE), terrestrial eutrophication (TE), marine eutrophication (ME) and mineral, fossil and renewable resource depletion (MFRD). Although harvesting with self-propelled foragers requires higher power and higher diesel consumption, it achieves better environmental performances respect to the harvest with the tractor-based solution. The tractor-based option is characterized by lower operative field capacity (about - 70% for all the evaluated impact categories except for MFRD, which is - 94% compared to the first option). The environmental differences are mainly related to the different machine productivity. From an environmental point of view, respect to the harvesting with self-propelled foragers, the tractor-based solution can achieve a lower environmental impact only in small SRC plantations (<1-2 ha).

Plants, people and traditions: ethnobotanical survey in the Lombard Stelvio National Park and neighbouring areas (Central Alps, Italy)

ETHNOPHARMACOLOGICAL RELEVANCE

The value of ethnobotanical information is now increasingly acknowledged. Our investigation added new data to the traditional knowledge on the plant uses in Italian alpine areas, where only in recent years the awareness of losing such valuable heritage stimulated interest of the scientific community and land managers in its recovery and enhancement. To this end, the present study aimed to collect and analyse information on plant species employed in Northern Italy (Lombardy Region), particularly in Alta Valtellina, an area of high naturalistic interest, where ethnobotanical knowledge is at the risk of passing covering a secondary role compared to other aspects of the local culture.

MATERIALS AND METHODS

A total of 328 people from six municipalities were interviewed using semi-structured questionnaires. Data were evaluated by quantitative parameters such as ethnobotanicity and ethnophytonomic indices, factor informant consensus (Fic), fidelity level (Fl). Abandoned and current uses were compared. Herbarium materials were prepared and conserved.

RESULTS

Inhabitants of Alta Valtellina used 212 plant species, including 19 mushrooms and 1 lichen for medicinal, food and cosmetic purposes. Despite half of medicinal uses has fallen into disuse, the plant species of this category were still collected in largest number. Digestive, respiratory and skin systems were the most frequently treated. Fic and Fl values, in addition to simple percentage data confirmed this finding. Although 40% of the known uses is now abandoned, a considerable number of them was recorded for the first time in an alpine area.

CONCLUSIONS

The study revealed that the popular knowledge of plant species is still alive in the Alta Valtellina. The prerogatives of some species are now outdated, but they leave room for other uses of the plant resources that may provide new opportunities from the scientific, cultural and economic points of view.

Effects of combined hormonal contraception on health and wellbeing: women's knowledge in northern Italy

OBJECTIVES

We investigated levels of knowledge of the effects of combined hormonal contraceptives (CHCs) on general/reproductive health and physical/psychosexual wellbeing.

METHODS

A cross-sectional study was conducted in two university hospitals in northern Italy. Healthy current-, past- and never CHC users (n = 545; age 18-44 years) completed a self-administered questionnaire.

RESULTS

Ninety-three percent of current-, 74% of past-, and 56% of never users believed they were sufficiently informed (χ(2): 67.1; p = 0.001) about the benefits and risks of CHCs. Respondents mentioned: (i) a reduced risk of ovarian (67%) and endometrial (53%) cancer; (ii) an increased risk of thrombosis (82%); (iii) an increased risk of breast cancer (45%); (iv) a decreased fertility (19%) and no influence on risk of sexually transmitted infections (48%); (v) a reduced risk of menstrual abnormalities (77%) and acne (79%); (vi) less dysmenorrhoea (83%) and more headache (56%), weight gain (74%), increased appetite (51%), leg cramps (77%), mood swings (45%), vaginal dryness (47%), and low sex drive (48%). Beliefs about diseases/conditions and symptoms were influenced by CHC use.

CONCLUSIONS

CHC use is linked to good knowledge of risks and benefits. Our data suggest HCPs must be proactive in providing relevant information so that women can choose their contraception with a balanced insight of side effects.