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OBJECTIVES: to analyse the trade flow of pigs to Lombardy (Northern Italy) to single out the farms more involved in animal movements to identify the holdings and areas most exposed to the risk of introducing pathogens into the region and to plan proper mitigation measures. Indeed, the movement of live animals and of the means of transport is one of the main risk factors in the spread of diseases and this is particularly relevant in areas with high stocking density. DESIGN: statistical analysis on movements of pigs entering Lombardy was carried out. Data on pigs' movements and farm characteristics were collected from the National and Regional databases. Social Network Analysis (SNA) was used to analyse the flows of pigs to Lombardy, to identify the holdings and geographical areas that are central in the trading network and that could have a role in the introduction of swine pathogens into the region. SETTING AND PARTICIPANTS: data on pigs' movements introduced into Lombardy in 2016 were analysed. Lombardy is a region of Northern Italy with intensive livestock husbandry. The pig sector is of particular economic relevance also in view of the processing industry, suited to the production of high quality pork products. Annually about 1.8 million pigs are introduced into the region also to satisfy the request of the processing industry for the production of pork products. MAIN OUTCOME MEASURES: in this study, the farms that buy pigs from outside the region were identified as well as the territories where the largest number of pigs are introduced. The analysis was carried out also considering certain factors related to the movement of animals, which can be relevant for the transmission of pathogens, such as number of commercial partners, number of exchanged animals, and number of shipments. RESULTS: in 2016, 1,782,568 pigs were introduced into Lombardy; by using SNA, it was possible to highlight a complex trade network of pigs, mainly involving the Northern regions. Indeed, the pigs were mostly purchased from Emilia Romagna (33.4%), followed by Veneto and Piedmont. These regions have been the most closely analysed in this study. SNA was also used to identify Lombardy territories (provinces and municipalities) which, based on the number of introduced pigs, are potentially most exposed to the introduction of pathogens from outside the region. Mantua and Brescia provinces resulted the most exposed area. CONCLUSIONS: Italy is one of most important European producers of pigs and about 50% of national pig assets is present in Lombardy; furthermore, about 1.8 million pigs are introduced yearly into the region. Currently, the region is free from the main diseases of pigs and the introduction of an epidemic disease into the pig population could adversely affect the entire productive sector. For this reason, an analysis of the movements of pigs entering the region was carried out to identify the areas (provinces, municipalities) and holdings most exposed to the risk of introduction of pathogens. This information is relevant for the veterinary authorities to plan appropriate control activities (official controls, surveillance, biosecurity, and vaccination, where possible) in order to enhance disease prevention and promote early detection.
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Doenças dos Suínos , Criação de Animais Domésticos , Animais , Fazendas , Itália/epidemiologia , Fatores de Risco , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/prevenção & controleRESUMO
The complex biology underlying chronic lymphocytic leukemia cell migration and tissue invasiveness is not yet completely understood and might provide novel predictive markers and therapeutic targets. A total of 36 patients out of treatment from at least 3 months were enrolled and followed up for a median period of 44.2 months (range: 4.4-99.2). Matrix metalloprotease 9 and tissue inhibitor of metalloproteases 1 plasma levels and production/release from lymphoid cells were measured by zymography and enzyme-linked immunosorbent assay (ELISA) analysis. Malignant and normal lymphocyte mobility and matrix-degradation capability were studied using a Boyden chamber system, with and without autologous plasma. Free matrix metalloprotease 9 plasma levels were related with blood lymphocytosis, especially in more advanced stages (p = 0.003), and higher concentrations were associated with an increased disease progression risk (hazard ratio = 9.0, 95% confidence interval = 1.5-13.8). Leukemic cells expressed and secreted very little matrix metalloprotease 9. On the contrary, normal lymphocytes derived from the same leukemic patients showed matrix metalloprotease 9 intracellular levels that were lower in subjects with higher blood lymphocytosis (p = 0.024) and more advanced stages (p = 0.03); the released quantities were inversely associated with matrix metalloprotease 9 plasma concentrations (p = 0.035). Leukemic cells had a reduced spontaneous mobility and matrix-degradation capability that were stimulated by autologous plasma (p = 0.001) and normal lymphocytes (p = 0.005), respectively. Matrix metalloprotease 9 affected cell invasiveness depending on concentration and disease stage. In conclusion, chronic lymphocytic leukemia cells have a reduced mobility, matrix-degradation capability, and matrix metalloprotease 9 production compared to their own autologous normal lymphocytes. They are exposed to matrix metalloprotease 9 of prevalently systemic origin whose higher levels are associated with both leukemic and normal lymphocyte accumulation in the peripheral blood and have a negative prognostic value.
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Leucemia Linfocítica Crônica de Células B/enzimologia , Linfocitose/enzimologia , Metaloproteinase 9 da Matriz/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Movimento Celular/fisiologia , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/sangue , Leucemia Linfocítica Crônica de Células B/patologia , Linfocitose/sangue , Linfocitose/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Inibidor Tecidual de Metaloproteinase-1/sangueRESUMO
African Swine Fever (ASF) is a contagious viral disease that infects wild and domesticated swine. In early 2022, the virus was found in wild boar in the Apennine mountains of mainland Italy.2 Since then, it has spread from wild boar to domesticated swine. To control the spread of ASF, an effective surveillance system and the implementation of strict biosecurity measures on farms are required yet are unevenly implemented across husbandry systems. Smallholder farms in particular are known to have low levels of biosecurity. In the Apennine mountains of Italy, small commercial farms have been found to have low levels of biosecurity despite being located in areas with high densities of wild boar, and, hence, being high-risk sites for potential ASF incursion and subsequent diffusion. To address the question as to why the level of biosecurity is low, interviews and participant observation were conducted with smallholder commercial farmers. The interviews identified the social, cultural, and ecological factors that affect the implementation of biosecurity measures in small commercial swine farms in the Apennines. Farmers expressed knowledge of priority biosecurity measures and an overall willingness to follow rules and regulations; however, the application of the measures in practice was uneven across farms. Economic, political, and ecological factors as well as farmer beliefs about biosecurity emerged as important factors affecting the implementation of biosecurity measures. These include economic constraints, challenges posed by the mountain environment, a shifting regulatory environment, and ideas about animal welfare. Other important factors include cultural factors such as the use of traditional agricultural methods and norms about customer access to animals, time constraints and the perceived hassle of implementing the measures, farmer age, farmer relationships with government officials and veterinarians, and the role of pigs in reducing farm waste. The study confirmed that wild boar are present in high numbers and in close proximity to smallholder commercial farms in the Apennines.
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Febre Suína Africana , Criação de Animais Domésticos , Surtos de Doenças , Animais , Febre Suína Africana/prevenção & controle , Febre Suína Africana/epidemiologia , Itália/epidemiologia , Suínos , Criação de Animais Domésticos/métodos , Surtos de Doenças/veterinária , Surtos de Doenças/prevenção & controle , Sus scrofa , Biosseguridade , Fazendeiros/psicologiaRESUMO
African swine fever (ASF) is one of the most severe suid diseases, impacting the pig industry and wild suid populations. Once an ASF vaccine is available, identifying a sufficient density of vaccination fields will be crucial to achieve eradication success. In 2020-2023, we live-trapped and monitored 27 wild boars in different areas of Lithuania, in which the wild boars were fed at artificial stations. We built a simulation study to estimate the probability of a successful ASF vaccination as a function of different eco-epidemiological factors. The average 32-day home range size across all individuals was 16.2 km2 (SD = 16.9). The wild boars made frequent visits of short durations to the feeding sites rather than long visits interposed by long periods of absence. A feeding site density of 0.5/km2 corresponded to an expected vaccination rate of only 20%. The vaccination probability increased to about 75% when the feeding site density was 1.0/km2. Our results suggest that at least one vaccination field/km2 should be used when planning an ASF vaccination campaign to ensure that everyone in the population has at least 5-10 vaccination sites available inside the home range. Similar studies should be conducted in the other ecological contexts in which ASF is present today or will be present in the future, with the objective being to estimate a context-specific relationship between wild boar movement patterns and an optimal vaccination strategy.
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Vírus da Febre Suína Africana , Febre Suína Africana , Doenças dos Suínos , Humanos , Suínos , Animais , Febre Suína Africana/epidemiologia , Febre Suína Africana/prevenção & controle , Sus scrofa , Lituânia/epidemiologia , Vacinação/veterináriaRESUMO
African swine fever (ASF) is a severe viral disease characterized by high lethality in suids and caused by the African Swine Fever Virus (ASFV). The ASF genotype I virus was introduced to Europe in 1957, marking the onset of the first European epidemic wave. In 2007, ASFV genotype II was detected in Georgia, affecting domestic pigs and wild boars before spreading to various European and extra-European countries, including Italy. The first case of ASFV in Italy was documented on 7 January 2022, in a wild boar in the Piedmont region. Since then, several ASFV-positive wild boar carcasses have been identified in the Piedmont and Liguria regions. By June 2023, ASFV had spread to Lombardy, one of the major pig-producing regions in northern Italy; the virus was first detected in early summer in wild boar carcasses. Two months later, it was diagnosed in a commercial pig farm as a consequence of the disease's spread amongst wild boars and an increase in the viral environmental load. This report aims to describe the features of ASFV domestic pig outbreaks that occurred in the Zinasco municipality (Lombardy) and the joint efforts to mitigate potential direct and indirect economic impacts on the Italian and global pig industry. The epidemiological investigation and the measures implemented, which were all performed according to national and European regulations, as well as exceptional ad hoc measures aimed at protecting the pig industry, are described in order to provide a practical and effective approach to combating ASF.
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A semi-quantitative risk assessment was developed to classify pig farms in terms of the probability of introduction of African swine fever virus (ASFV). Following on-farm data collection via a specific checklist, we applied a modified failure mode and effect analysis (FMEA) to calculate the risk priority codes (RPC's), indicating increasing risk levels ranging from 1 to 5. The importance of biosecurity measures was attributed by experts. To consider geographic risk factors, we classified pig farms based on local density of farmed pigs, and on the estimated wild boar population density. The combination of RPC's with geographical risk factors resulted into a final ranking of pig farms in terms of the risk of ASFV introduction. Furthermore, the estimation of frequency and levels of non-compliance with biosecurity measures was used to identify weak points in risk prevention at farm level. The outcome of the risk assessment was affected by choices in assigning non-compliance scores and importance to specific components of biosecurity. The method was applied in 60 commercial farms in major pig production areas in Italy. Furthermore, we applied a reduced version of our checklist in 12 non-commercial/small commercial (≤20 pigs) farms in the northern Apennines. In commercial farms, highest RPC's were obtained for biosecurity measures associated with personnel practices and farm buildings/planimetry. Intervention should be addressed to training of personnel on biosecurity and ASF, to avoid contacts with other pig herds, and to improve practices in the entrance into the farm. Sharing trucks with other farms, and loading/unloading of pigs were other weak points. Fencing was classified as insufficient in 70% of the commercial farms. Among these farms, breeding units were characterised by the lowest risk of ASFV introduction (although differences among median ranks were not statistically significant: P-value = 0.07; Kruskal-Wallis test), and increasing herd size was not significantly correlated with a higher risk (Kendall's τ = -0.13; P-value = 0.14). Density of farmed pig was greatest in the main pig production area in northern Italy. Conversely, exposure to wild boars was greatest for non-commercial/small commercial farms on the Apennines, which were also characterised by non-compliance with critical biosecurity measures.
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In a previous study, a semi-quantitative risk assessment was developed to rank pig holdings in terms of likelihood of introducing African swine fever virus (ASFV) by assessing their compliance with biosecurity and exposure to geographical risk factors. The method was initially developed for confined pig holdings, but given that ASF is endemic in wild boar of several countries, we modified the approach to make it suitable for free-range farms as well. In the current study, a total of 41 outdoor pig farms were assessed in an area where exposure to wild boar was generally high (density from 2.3 to 10.3 wild boar per Km2). As expected, non-compliance with biosecurity measures was frequent in outdoor farms, and the frequency of non-compliance indicated that the absence of adequate separation of pigs from the external environment was the major weakness in the farms assessed. In 46.3% of them, there was no fence or, if present, it was not adequate to avoid contact with wild boar. However, the approach adopted proved to be suitable for identifying intervention priorities to mitigate the risk of ASFV spread in free-range pig herds and for identifying the weaknesses of individual farms, as recommended by EFSA in 2021, which suggests implementing tools to improve biosecurity by favoring higher-risk farms.
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African swine fever (ASF) continues to spread worldwide, and has reached multiple countries across Asia, the Caribbean, Europe, and the Pacific, representing a serious economic burden threatening pig health and welfare, as well as food security. The disease affects domestic pigs and wild boar, and in several European countries the disease is endemic in wild boars. The lack of vaccines or effective treatments highlights the importance of effective control measures used to keep domestic and feral pigs separated to prevent the spread of the virus. However, the study of the livestock-wildlife interface is quite complex and has many aspects to consider, including the uncertainty of wild-boar population data. In this study, we determined the risk of spread of the ASF virus at the interface between domestic pigs and wild boars using indicators that can indirectly indicate the presence of wild boars in order to target specific control measures in the highest risk areas. The results of the study were compared with those obtained by Pittiglio, in which the population data for wild boars was estimated using a geostatistical method and similar results were obtained. However, the present study used specific information relating to the wild-boar population and this allowed us to use fewer variables.
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In the last two years, there have been three major epidemic seasons in the territory of the European Union and the HPAI epizootic in 2021-2022 is the most severe in recent history. In Italy, the disease was introduced to dense poultry areas with serious economic consequences for the entire sector. In Lombardy, the analysis of the risk factors was carried out, also taking into account the density of domestic birds. In the most affected areas, 66.7% of the outbreaks occurred in the areas with the highest poultry density and the likelihood of an outbreak occurring increased with an increase in the density of birds per km2. In cells 10 × 10 km with a density greater than 10,000 birds/km2, the probability of outbreak occurrence was over 66.7%. The provinces involved in the last epidemic were the same involved in previous epidemics and, given the risk factors present in the area, it is plausible that the risk remains high also for future epidemic seasons. Therefore, to avoid the repetition of similar events, certain control measures shall be strengthened and vaccination considered as a complementary tool for the control of HPAI virus in risk areas.
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Epidemias , Virus da Influenza A Subtipo H5N1 , Vírus da Influenza A , Influenza Aviária , Animais , Aves , Surtos de Doenças/veterinária , Influenza Aviária/epidemiologia , Itália/epidemiologia , Aves Domésticas , Estações do AnoRESUMO
Torque teno sus virus (TTSuV) is a non-enveloped circular ssDNA virus which frequently infects swine and has been associated with hepatic, respiratory, and autoimmune disorders. TTSuV's pathogenic role is still uncertain, and clear data in the literature on virus reservoirs are lacking. The aims of this study were to investigate the presence of potentially zoonotic TTSuV in wild animals in Northern Italy and to evaluate their role as reservoirs. Liver samples were collected between 2016 and 2020 during four hunting seasons from wild boars (Sus scrofa), red deer (Cervus elaphus), roe deer (Capreolus capreolus), and chamois (Rupicapra rupicapra). Samples originated from areas in Northern Italy characterized by different traits, i.e., mountains and flatland with, respectively low and high farm density and anthropization. Viral identification was carried out by end-point PCR with specific primers for TTSuV1a and TTSuVk2a species. TTSuV prevalence in wild boars was higher in the mountains than in the flatland (prevalence of 6.2% and 2.3%, respectively). In wild ruminants only TTSuVk2a was detected (with a prevalence of 9.4%). Our findings shed light on the occurrence and distribution of TTSuV in some wild animal species, investigating their possible role as reservoirs.
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This study described a SARS-CoV-2 infection in minks on an Italian farm. Surveillance was performed based on clinical examination and a collection of 1879 swabs and 74 sera from dead and live animals. The farm was placed under surveillance for 4.5 months, from the end of July 2020, when a man working on the farm tested positive by RT-PCR, till mid-December 2020 when all the animals were sacrificed. Clinical examination revealed no clinical signs or increased mortality rates attributable to SARS-CoV-2, while diagnostic tests detected only four weak PCR-positive samples, but 100% of sera were positive for SARS-CoV-2 anti-S antibodies. The phylogenetic analysis of two SARS-CoV-2 sequences from two minks and the sequence of the worker showed that they belonged to different clades. It could be therefore assumed that two distinct introductions of the virus occurred on the farm, and that the first introduction probably occurred before the start of the surveillance period. From the data collected, and especially from the detection of specific antibodies through the combination of different tests, it can be postulated that syndromic surveillance combined with genome detection by PCR may not be sufficient to achieve a diagnosis in asymptomatic animals. In particular, the serological approach, especially when using tests directed towards the S protein, may be useful for improving the traceability of virus circulation in similar environments.
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COVID-19 , SARS-CoV-2 , Animais , Anticorpos Antivirais , COVID-19/diagnóstico , COVID-19/veterinária , Teste para COVID-19 , Fazendas , Humanos , Vison , Filogenia , SARS-CoV-2/genéticaRESUMO
Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution.
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Atenção à Saúde/organização & administração , Reforma dos Serviços de Saúde , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Comparação Transcultural , Europa (Continente) , Europa Oriental , Política de Saúde , HumanosRESUMO
African swine fever (ASF) is a notifiable viral disease of pigs and wild boars that could lead to serious economic losses for the entire European pork industry. As no effective treatment or vaccination is available, disease prevention and control rely on strictly enforced biosecurity measures tailored to the specific risk factors of ASF introduction within domestic pig populations. Here, we present a review addressing the risk factors associated with different European pig farming systems in the context of the actual epidemiological scenario. A list of keywords was combined into a Boolean query, "African swine fever" AND ("Risk factors" OR "Transmission" OR "Spread" OR "Pig farming" OR "Pigs" OR "Wild boars"); was run on 4 databases; and resulted in 52 documents of interest being reviewed. Based on our review, each farming system has its own peculiar risk factors: commercial farms, where best practices are already in place, may suffer from unintentional breaches in biosecurity, while backyard and outdoor farms may suffer from poor ASF awareness, sociocultural factors, and contact with wild boars. In the literature selected for our review, human-related activities and behaviours are presented as the main risks, but we also stress the need to implement biosecurity measures also tailored to risks factors that are specific for the different pig farming practices in the European Union (EU).
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The first events of bee decline in Italy were reported during 1999. Since then, population decline has frequently been reported in Lombardy. In this study, the association between bee decline and the type of land surrounding the apiary was evaluated. A risk map was developed to identify areas with the highest risk of decline. Apiaries in Lombardy were selected from the national beekeeping database (BDA). The study period was from 2014 to 2016. Apiaries were deemed "declined" if they reported at least one event of decline or tested positive for plant protection products; apiaries were "not declined" if they did not report any events of bee decline during the study period. Out of 14,188 apiaries extracted from the BDA, 80 were considered declined. The probability of an apiary being declined increases by 10% in orchards and by 2% in arable land for each additional km2 of land occupied by these crops. The study showed an association between bee decline and the type of territory surrounding the apiaries, and the areas at the greatest risk of decline in Lombardy were identified. This information can be used by Veterinary Services as a predictive parameter for planning prevention and control activities.
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The complex health problem of antimicrobial resistance (AMR) involves many host species, numerous bacteria and several routes of transmission. Extended-spectrum ß-lactamase and AmpC (ESBL/AmpC)-producing Escherichia coli are among the most important strains. Moreover, wildlife hosts are of interest as they are likely antibiotics free and are assumed as environmental indicators of AMR contamination. Particularly, wild boar (Sus scrofa) deserves attention because of its increased population densities, with consequent health risks at the wildlife-domestic-human interface, and the limited data available on AMR. Here, 1504 wild boar fecal samples were microbiologically and molecularly analyzed to investigate ESBL/AmpC-producing E. coli and, through generalized linear models, the effects of host-related factors and of human population density on their spread. A prevalence of 15.96% of ESBL/AmpC-producing E. coli, supported by blaCTX-M (12.3%), blaTEM (6.98%), blaCMY (0.86%) and blaSHV (0.47%) gene detection, emerged. Young animals were more colonized by ESBL/AmpC strains than older subjects, as observed in domestic animals. Increased human population density leads to increased blaTEM prevalence in wild boar, suggesting that spatial overlap may favor this transmission. Our results show a high level of AMR contamination in the study area that should be further investigated. However, a role of wild boar as a maintenance host of AMR strains emerged.
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OBJECTIVE: To review the scientific evidence on the effectiveness of interventions to promote attendance to breast and cervical cancer screening among lower socioeconomic groups. METHODS: We performed a computerized literature search looking for relevant papers published between 1997 and 2006. Papers were classified into three groups based on the type of intervention evaluated: (1) implementation of organized population screening programs; (2) different strategies of enhancing attendance within an organized program; (3) local interventions in disadvantaged populations. RESULTS: The available evidence supports the hypothesis that while organized population screening programs are successful in increasing overall participation rates, they may not per se substantially reduce social inequalities. Some strategies were consistently found to enhance access to screening among lower socioeconomic groups, including cost-reducing interventions (e.g. offering free tests and eliminating geographical barriers), a greater involvement of primary-care physicians and individually tailored pro-active communication that addresses barriers to screening. CONCLUSIONS: Evidence from studies suggests that the attendance of deprived women to cancer screening can be improved with organized screening programs tailored to their needs. The same may apply to the prevention of adverse outcomes of other health conditions, such as hypertension, hypercholesterolemia, and diabetes.
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Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Promoção da Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Itália , Pobreza , Marketing Social , Fatores SocioeconômicosRESUMO
In 2019, the area of the European Union (EU) affected by African swine fever (ASF) expanded progressively in a southwestern direction from Baltic and eastern countries. The disease can severely affect and disrupt regional and international trade of pigs and pork products with serious socioeconomic damages to the pig industry. Lombardy is one of the most important European pig producers and the introduction of ASF into the pig population could adversely affect the entire sector. A study was carried out to identify the farms and territories in the region most at risk of ASF introduction to plan preventive measures. The pig holdings were identified through a descriptive analysis of pig movements and Social Network Analysis (SNA), while, for the identification of the most exposed municipalities, an assessment of risk factors was carried out using the ranking of summed scores attributed to the Z-score. From the analysis, it was found that 109 municipalities and 297 pig holdings of the region were potentially more at risk, and these holdings were selected for target surveillance. This information was provided to veterinary authority to target surveillance in pig farms, in order to early detect a possible incursion of ASF and prevent its spread.
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BACKGROUND: West Nile virus (WNV) transmission was much greater in 2018 than in previous seasons in Europe. Focusing on Emilia-Romagna region (northern Italy), we analyzed detailed entomological and epidemiological data collected in 2013-2018 to quantitatively assess environmental drivers of transmission and explore hypotheses to better understand why the 2018 epidemiological season was substantially different than the previous seasons. In particular, in 2018 WNV was detected at least two weeks before the observed circulation in 2013-2017 and in a larger number of mosquito pools. Transmission resulted in 100 neuroinvasive human cases in the region, more than the total number of cases recorded between 2013 and 2017. METHODOLOGY: We used temperature-driven mathematical models calibrated through a Bayesian approach to simulate mosquito population dynamics and WNV infection rates in the avian population. We then estimated the human transmission risk as the probability, for a person living in the study area, of being bitten by an infectious mosquito in a given week. Finally, we translated such risk into reported WNV human infections. PRINCIPAL FINDINGS: The estimated prevalence of WNV in the mosquito and avian populations were significantly higher in 2018 with respect to 2013-2017 seasons, especially in the eastern part of the region. Furthermore, peak avian prevalence was estimated to have occurred earlier, corresponding to a steeper decline towards the end of summer. The high mosquito prevalence resulted in a much greater predicted risk for human transmission in 2018, which was estimated to be up to eight times higher than previous seasons. We hypothesized, on the basis of our modelling results, that such greater WNV circulation might be partially explained by exceptionally high spring temperatures, which have likely helped to amplify WNV transmission at the beginning of the 2018 season.
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Culex/virologia , Temperatura , Febre do Nilo Ocidental/epidemiologia , Animais , Aves/virologia , Feminino , Humanos , Incidência , Mordeduras e Picadas de Insetos/epidemiologia , Itália/epidemiologia , Modelos Teóricos , Mosquitos Vetores/virologia , Estações do Ano , Febre do Nilo Ocidental/transmissão , Vírus do Nilo Ocidental/isolamento & purificaçãoRESUMO
BACKGROUND: The loss of a normal airway is devastating. Attempts to replace large airways have met with serious problems. Prerequisites for a tissue-engineered replacement are a suitable matrix, cells, ideal mechanical properties, and the absence of antigenicity. We aimed to bioengineer tubular tracheal matrices, using a tissue-engineering protocol, and to assess the application of this technology in a patient with end-stage airway disease. METHODS: We removed cells and MHC antigens from a human donor trachea, which was then readily colonised by epithelial cells and mesenchymal stem-cell-derived chondrocytes that had been cultured from cells taken from the recipient (a 30-year old woman with end-stage bronchomalacia). This graft was then used to replace the recipient's left main bronchus. FINDINGS: The graft immediately provided the recipient with a functional airway, improved her quality of life, and had a normal appearance and mechanical properties at 4 months. The patient had no anti-donor antibodies and was not on immunosuppressive drugs. INTERPRETATION: The results show that we can produce a cellular, tissue-engineered airway with mechanical properties that allow normal functioning, and which is free from the risks of rejection. The findings suggest that autologous cells combined with appropriate biomaterials might provide successful treatment for patients with serious clinical disorders.
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Broncomalácia/fisiopatologia , Condrócitos/citologia , Engenharia Tecidual/métodos , Traqueia/transplante , Adulto , Broncomalácia/terapia , Cadáver , Feminino , Humanos , Período Pós-Operatório , Testes de Função Respiratória , Traqueia/citologiaRESUMO
African swine fever (ASF) is one of the most severe diseases of pigs and has a drastic impact on pig industry. Wild boar populations play the role of ASF genotype II virus epidemiological reservoir. Disease surveillance in wild boar is carried out either by testing all the wild boar found sick or dead for virus detection (passive surveillance) or by testing for virus (and antibodies) all hunted wild boar (active surveillance). When virus prevalence and wild boar density are low as it happens close to eradication, the question on which kind of surveillance is more efficient in detecting the virus is still open. We built a simulation model to mimic the evolution of the host-parasite interaction in the European wild boar and to assess the efficiency of different surveillance strategies. We constructed a deterministic SIR model, which estimated the probability to detect the virus during the 8 years following its introduction, using both passive and active surveillance. Overall, passive surveillance provided a much larger number of ASF detections than active surveillance during the first year. During subsequent years, both active and passive surveillance exhibited a decrease in their probability to detect ASF. Such decrease, though, was more pronounced for passive surveillance. Under the assumption of 50% of carcasses detection, active surveillance became the best detection method when the endemic disease prevalence was lower than 1.5%, when hunting rate was >60% and when population density was lower than 0.1 individuals/km2. In such a situation, though, the absolute probability to detect the disease was very low with both methods, and finding almost every carcass is the only way to ensure virus detection. The sensitivity analysis shows that carcass search effort is the sole parameter that increases proportionally the chance of ASF virus detection. Therefore, an effort should be made to promote active search of dead wild boar also in endemic areas, since reporting wild boar carcasses is crucial to understand the epidemiological situation in any of the different phases of ASF infection at any wild boar density.