ABSTRACT
BACKGROUND: In Italy, the incidence of Invasive Meningococcal Disease (IMD) was around 0.28 per 100,000 over the last years. Since the risk IMD is usually high among infants aged less than 1 year, we decided to evaluate the trend of IMD cases reported between 2006 and 2014 in this age group. In particular, the study aim was to describe the main characteristics of IMD cases in infants following the introduction of MCC vaccine (2005) and to estimate the number of cases which are potentially preventable through early vaccination. METHODS: The National Surveillance System of Bacterial Meningitis was established in 1994 and in 2007 was extended to all invasive bacterial diseases. Clinical data and isolates and/or clinical samples are collected from hospitalized patients throughout the country. IMD cases are reported by clinicians to the local health authorities, and samples are sent to the Reference Laboratory at the Istituto Superiore di Sanità for further characterization and storage at -80°C. In particular, serogroup identification is obtained by agglutination with commercial antisera or by multiplex PCR. RESULTS: The annual incidence for infants <1 year old remained rather stable of 3.6 per 100,000, with several upward and downward oscillations and a peak in 2010. The incidence of IMD among infants was more than 10 times higher than the overall rate of IMD observed in Italy. Finally, serogroup B was more frequently detected among infants aged <1 year, accounting for 65% of the total (p<0.01). CONCLUSIONS: During the study period, IMD incidence reported among infants aged less than one year old was 10 times higher than the overall rate, and serogroup B was the most commonly detected over time. The long-term impact of meningococcal C conjugate vaccine and the effect of the introduction of meningococcal B vaccination among infants need to be evaluated.
Subject(s)
Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/prevention & control , Meningococcal Vaccines/administration & dosage , Meningococcal Vaccines/immunology , Neisseria meningitidis/immunology , Neisseria meningitidis/isolation & purification , Serotyping , Epidemiological Monitoring , Female , Humans , Incidence , Infant , Infant, Newborn , Italy/epidemiology , Male , Meningitis, Meningococcal/microbiology , Multiplex Polymerase Chain ReactionABSTRACT
A measles outbreak occurred in February 2014 on a ship cruising the western Mediterranean Sea. Overall 27 cases were reported: 21 crew members, four passengers.For two cases the status crew or passenger was unknown. Genotype B3 was identified. Because of different nationalities of cases and persons on board,the event qualified as a cross-border health threat. The Italian Ministry of Health coordinated rapid response.Alerts were posted through the Early Warning and Response System.
Subject(s)
Disease Outbreaks , Measles/epidemiology , Ships , Humans , Mediterranean Sea , Sentinel Surveillance , TravelABSTRACT
SUMMARY: We describe the epidemiological trends and spatial distribution of human brucellosis in Italy over 13 years (1998-2010). In the study period 8483 cases were notified in Italy, with a relevant decrease (-89%) from 1998 to 2010. Most cases were notified in southern Italy (Campania, Apulia, Calabria, Sicily). In these regions we observed relevant differences in the risk of brucellosis at province level. Cases were distributed with a seasonal pattern, male patients represented 60% of the cases and no significant differences were observed between age groups. We modelled the underreporting rate that ranged between 2 and 21 (average 12·5). According to our estimates the true number of cases would have ranged from 41 821 to 155 324 providing a far more severe picture of human brucellosis in Italy than the one provided by the surveillance system.
Subject(s)
Brucellosis/epidemiology , Adult , Aged, 80 and over , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Population Surveillance , Time Factors , Young AdultABSTRACT
On 31 May 2013, the first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in Italy was laboratory confirmed in a previously healthy adult man, who developed pneumonia with moderate respiratory distress after returning from a holiday in Jordan. Two secondary cases were identified through contact tracing, among family members and colleagues who had not previously travelled abroad. Both secondary cases developed mild illness. All three patients recovered fully.
Subject(s)
Contact Tracing , Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Pneumonia, Viral/virology , Adult , Coronavirus/genetics , Coronavirus Infections/transmission , Coronavirus Infections/virology , DNA, Viral/analysis , Humans , Infant , Italy , Jordan , Male , Middle Aged , Pneumonia, Viral/transmission , Real-Time Polymerase Chain Reaction , Syndrome , TravelABSTRACT
We describe a cluster of four cases of invasive meningococcal disease that occurred on a cruise ship sailing along the Italian coast in October 2012. All four cases were hospitalised with severe illness and one of them died. This report illustrates the importance of rapid implementation of emergency control measures such as administration of prophylaxis to all crew members and passengers to prevent the spread of the disease in such a close environment.
Subject(s)
Meningococcal Infections/diagnosis , Neisseria meningitidis, Serogroup C/isolation & purification , Adult , Anti-Infective Agents/therapeutic use , Cerebrospinal Fluid/microbiology , Female , Hospitalization , Humans , Italy/epidemiology , Male , Meningococcal Infections/drug therapy , Meningococcal Infections/epidemiology , Meningococcal Infections/microbiology , Microbial Sensitivity Tests , Middle Aged , Multilocus Sequence Typing , Neisseria meningitidis, Serogroup C/drug effects , Neisseria meningitidis, Serogroup C/genetics , Severity of Illness Index , Ships/statistics & numerical data , Tandem Repeat Sequences , Travel , Treatment OutcomeABSTRACT
We describe the geographical and temporal distribution of West Nile neuroinvasive diseases (WNND) cases in Italy from 2008 to 2011. The increasing number of confirmed human cases from eight in 2008 to 18 in 2009 and the occurrence of the virus in a larger geographical area in 2009 (moving from east to west) prompted the Ministry of Health to publish, in spring 2010, a national programme for WNND human surveillance, comprising veterinary and vector surveillance. Subsequently, in 2011, a new national plan on integrated human surveillance of imported and autochthonous vector-borne diseases (chikungunya, dengue and West Nile disease) was issued. Between 2008 and 2011, 43 cases of WNND were reported from five regions in Italy with a case fatality rate of 16%. The incidence of WNND during the entire study period was 0.55 per 100,000 population (range: 0.060.23 per 100,000). During 2011, two new regions (Friuli-Venezia Giulia and Sardinia) reported confirmed cases in humans. Integrated human, entomological and animal surveillance for West Nile virus is a public health priority in Italy and will be maintained during 2012.
Subject(s)
Population Surveillance , West Nile Fever/epidemiology , Aged, 80 and over , Female , Humans , Italy/epidemiology , Meningoencephalitis/virology , Sentinel Surveillance , West Nile virus/immunologyABSTRACT
In Italy, the arrival of the 2009 pandemic influenza A(H1N1) virus triggered an integrated response that was mainly based on the 2006 National Pandemic Preparedness and Response Plan. In this article we analyse the main activities implemented for epidemiological surveillance, containment and mitigation of the pandemic influenza and the lesson learned from this experience. Overall, from week 31 (27 July 2 August) of 2009 to week 17 (26 April 2 May) of 2010, we estimate that there were approximately 5,600,000 cases of influenza-like illness (ILI) who received medical attention (with almost 2,000 laboratory-confirmed cases of pandemic influenza from May to October 2009). A total of 1,106 confirmed cases were admitted to hospital for serious conditions, of whom 532 were admitted to intensive care units. There were 260 reported deaths due to pandemic influenza. Approximately 870,000 first doses of the pandemic vaccine were administered, representing a vaccine coverage of 4% of the target population. One of the possible reasons for the low uptake of the pandemic vaccine in the target population could be the communication strategy adopted, for both the general population and healthcare workers, which turned out to be a major challenge. Active involvement of all health professionals (at local, regional and national level) in influenza pandemic preparedness and response should be encouraged in the future.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Mass Vaccination/organization & administration , Pandemics , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Communication , Disaster Planning , Female , Health Education , Hospitalization , Humans , Incidence , Infant , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Italy/epidemiology , Male , Middle Aged , Seasons , Sentinel Surveillance , Sex Distribution , Young AdultABSTRACT
Haemagglutinin sequences of pandemic influenza A(H1N1) viruses circulating in Italy were examined, focusing on amino acid changes at position 222 because of its suggested pathogenic relevance. Among 169 patients, the D222G substitution was detected in three of 52 (5.8%) severe cases and in one of 117 (0.9%) mild cases, whereas the D222E mutation was more frequent and evenly distributed in mild (31.6%) and severe cases (38.4%). A cluster of D222E viruses among school children confirms reported human-to-human transmission of viruses mutated at amino acid position 222.
Subject(s)
Amino Acid Substitution/genetics , Hemagglutinins/genetics , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human/epidemiology , Pandemics , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Female , Humans , Infant , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/transmission , Influenza, Human/virology , Italy/epidemiology , Male , Middle Aged , Mutation , Population Surveillance , Reverse Transcriptase Polymerase Chain Reaction , Severity of Illness Index , Sex Distribution , Young AdultABSTRACT
As of 7 July 2009, a total of 158 laboratory-confirmed cases of influenza A(H1N1)v were reported in Italy, from half of the 21 Italian regions. To date all cases have had symptoms consistent with seasonal influenza and no severe or fatal cases have been reported. An active surveillance of cases has been set up in Italy in order to undertake appropriate measures to slow down the spread of the new virus. This report describes the routine and enhanced surveillance currently ongoing in Italy.
Subject(s)
Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Sentinel Surveillance , Adult , Age Distribution , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/classification , Influenza, Human/prevention & control , Influenza, Human/virology , Italy/epidemiology , Male , Middle Aged , Serotyping , Travel , Young AdultABSTRACT
In recent years emerging and re-emerging infections, as well as the risk of bioterrorist events, have attracted increasing attention from health authorities because of the epidemic potential that renders some of them a real public health challenge. These highly infectious diseases (HIDs) are occurring more and more frequently in Europe, and despite the many initiatives in place to face them, many unsolved problems remain, and coordinated efforts for dealing with HIDs appear mandatory. Whereas uncoordinated measures would lead to only partial and poor responses to these emerging threats, networking represents a valuable approach to these diseases, in order to: (i) ensure a rapid and effective response; (ii) stimulate complementarity and prevent duplication; (iii) promote international cooperation, exchange of experience, good practice and protocols; and (iv) support the less prepared countries in the European Community.
Subject(s)
Communicable Disease Control/methods , Communicable Diseases, Emerging/epidemiology , Communicable Diseases/epidemiology , International Cooperation , European Union , Humans , Information ServicesABSTRACT
An initiative of active prevention, to promote an influenza vaccination programme, has been carried out in the Ministry of Health of Rome, Directorate General of Health Prevention: during October 2004 influenza vaccine has been actively offered to all the employees; 46 out of the 129 workers (about 36% of the total) accepted to be vaccinated. Afterward, the propensity to get influenza of the vaccinated has been compared with that of a control group, operating in the same setting, but not vaccinated. Taking into account that the groups in question is far too small, the statistical results showed that influenza vaccination of healthy working adults did not reduce the rates of influenza-like-illness (ILI), in addition, the difference between average duration of disease in unvaccinated persons was not statistically significant.
Subject(s)
Health Personnel , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Vaccination/statistics & numerical data , Adult , Cost of Illness , Cost-Benefit Analysis , Data Collection , Health Surveys , Humans , Influenza Vaccines/standards , Influenza, Human/economics , Influenza, Human/epidemiology , Italy/epidemiology , Treatment OutcomeSubject(s)
Disease Notification/statistics & numerical data , Disease Outbreaks/statistics & numerical data , Mandatory Reporting , Pregnancy Complications, Infectious/epidemiology , Pregnancy/statistics & numerical data , Risk Assessment/methods , Rubella Syndrome, Congenital/epidemiology , Adult , Female , Humans , Incidence , Italy/epidemiology , Population Surveillance , Risk FactorsABSTRACT
Three clusters of measles cases occurred between June and September 2006, in the Roma/Sinti populations in three different Italian regions: the Bolzano-South Tyrol in northern Italy; Lazio in central Italy; and the island of Sardinia in the southwest.
Subject(s)
Disease Outbreaks/statistics & numerical data , Measles/epidemiology , Adolescent , Adult , Child , Child, Preschool , Cluster Analysis , Diseases in Twins , Female , Humans , Infant , Infectious Disease Transmission, Patient-to-Professional , Italy/epidemiology , Male , Measles/transmission , Measles Vaccine , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Roma , Romania/ethnology , Rome/epidemiology , VaccinationABSTRACT
Severe clinical conditions are due to invasive diseases that are not routinely reported in a routine surveillance system, in Italy. Nevertheless we can estimate the incidence of invasive diseases considering the surveillance system of bacterial meningitis, the Hospital Discharge Registry and the laboratory-based surveillance, this is useful to outline the trend of S. pneumoniae infections. We report the results of some Italian studies on the pneumococcal infections together with some international studies.
Subject(s)
Population Surveillance , Preventive Health Services/supply & distribution , Streptococcal Infections/epidemiology , Child, Preschool , Europe/epidemiology , Humans , Incidence , Infant , Streptococcal Infections/prevention & control , Streptococcal Vaccines/administration & dosage , United States/epidemiologyABSTRACT
In 1994, the Italian Ministry of Health implemented a National Surveillance System to obtain data on the incidence of bacterial meningitis and its causative agents, including Haemophilus influenzae type b (Hib). As a consequence, case reporting of Hib meningitis is increasing year by year; in 1996, there were 126 notifications, of which 73% were in children under 2 years of age. Although underreporting still exists, parallel prospective or retrospective epidemiological surveys conducted in some Italian Regions allowed for partial correction of the incidence of Hib meningitis (up to 18.5/100,000 population in 1994).