West Nile virus outbreak in the Lombardy region, northern Italy, summer 2013.

In the summer of 2013, an outbreak of West Nile virus (WNV) infection occurred in the Lombardy, a region of northern Italy to the west of districts affected by WNV in previous years. Eighteen cases of human WNV infection were diagnosed--10 cases of acute WNV neuroinvasive disease and eight of WNV fever. In the same period, WNV was detected in birds (one crow) in horses (11 cases) and from mosquitoes (six pools).

Comparative evaluation of eight commercial human cytomegalovirus IgG avidity assays.

BACKGROUND: The interpretation of a positive IgM antibody result to human cytomegalovirus (HCMV) in a pregnant woman is of major importance for the correct management of the pregnancy. Determination of HCMV-specific IgG avidity is considered an useful approach for distinguishing IgM antibody due to primary HCMV infection from IgM antibody elicited during non-primary infection. OBJECTIVE: Comparative evaluation of eight commercial HCMV IgG avidity assays currently available in Europe. STUDY DESIGN: A panel of 198 sequential samples collected from 65 pregnant women at 0-90, 91-180, and >180 days after the onset of primary HCMV infection was retrospectively tested by Abbott, BioMérieux, Bio-Rad, DiaSorin, Diesse, Euroimmun, Radim, and Technogenetics HCMV IgG avidity assays according to the manufacturer's instructions. RESULTS: None of the 198 samples tested yielded identical scores by the kits under evaluation. The Euroimmun and Radim assays showed the best correlation with expected results in terms of low (0-90 days), intermediate (90-180 days) and high (>180 days) avidity results, respectively. The best accuracy in diagnosing a recent (<90 days after the onset) or non-recent (>180 days after the onset) primary HCMV infection was shown by Radim followed by Euroimmun and Diesse. The best correlation with a well established in-house developed HCMV IgG avidity assay was shown by Radim. CONCLUSIONS: HCMV IgG avidity kits need to be improved and standardized. In the meantime, highly specific IgM assays are preferable for screening purposes in pregnant women.

The ICF and labour policies project: the first Italian nation-wide experience of ICF implementation in the Labour Sector.

PURPOSE: To describe the first Italian experience of ICF implementation in the Labour Sector by a Ministerial body, and the development of the International Classification of Functioning, Disability and Health (ICF)-based worker checklist. METHODS: Nation-wide training was provided. ICF-based worker checklist was developed by linking Italian legislative procedures and schedules to the ICF, and by adding standard ICF checklist's categories. When a third-level ICF category was linked, the corresponding second-level one was included in the worker checklist too. RESULTS: Eighty-four ICF categories were linked and five were added due to rolling-up procedure: 15 from body functions, 65 from activities and participation and 4 from environmental factors. In total, the dedicated ICF-based worker checklist is composed of 183 ICF categories, 34 of whom are at the third level and 89 from the domain of activities and participation. CONCLUSIONS: The inclusion of the standard ICF checklist's items aimed to complement the information contained in the ministerial schedule, in which ICF categories from environmental factors domain are underrepresented. Future directions include the development of an ICF-based company checklist and an application tool for matching the information derived from the worker and the company ICF-based checklists.

Towards a common disability assessment framework: theoretical and methodological issues for providing public services and benefits using ICF.

PURPOSE: To report on the preliminary results of an Italian project on the implementation of an ICF-based protocol for providing public services and benefits for persons with disabilities. METHODS: The UN Convention on the Rights of persons with disabilities (UNC) was mapped to the ICF, and core elements were implemented in an ICF-based evaluation protocol. A person-environment interaction classification (PEIC) tree was also developed for defining evaluation outputs. RESULTS: The PEIC and the ICF-based protocol are the guideline and the data interpretation source, respectively, for providing public services and benefits. They enable to assign persons to different services, from surveillance and monitoring to facilitator provision or sustain over time, to barrier removal or to the reorganisation of environmental factors provision. A detailed description of the target intervention is made available through the implementation of a protocol, which points out the effect of personal support and other environmental factors. CONCLUSIONS: The detailed description of functioning and disability provided by our methodology can help policy makers and administrators in decision making, on the basis of a description of real needs, and in targeting person-tailored interventions.

Clinical evaluation of a chemiluminescence immunoassay for determination of immunoglobulin g avidity to human cytomegalovirus.

Clinical evaluation of a novel fully automated chemiluminescence immunoassay for determination of immunoglobulin G avidity to human cytomegalovirus (HCMV) showed 92.8% sensitivity and 84.7% specificity in detecting a recent (< or =90 days) primary HCMV infection. The assay appears useful for accurately diagnosing recent primary HCMV infections.

Diagnosis and outcome of preconceptional and periconceptional primary human cytomegalovirus infections.

Primary human cytomegalovirus (HCMV) infection occurring in pregnant women within 3 months before (preconceptional) or within 4 weeks after (periconceptional) the last menstrual period represents an as-yet-undefined risk to the fetus. One (9.1%) of 11 newborns born to 12 women with preconceptional infection was subclinically infected (1 aborted fetus was not examined for infection). Of 20 pregnancies in women with periconceptional infection, 7 were terminated before 12 weeks of gestation (aborted fetus was not examined), 1 was terminated at 23 weeks after prenatal diagnosis of congenital infection, and 12 continued to term. Of those 12, 3 resulted in newborns who were congenitally infected. Thus, in the periconceptional group, intrauterine transmission occurred in 4 (30.8%) of 13 pregnancies for which the virologic outcome was known. One newborn was symptomatic at birth, and disseminated HCMV infection was diagnosed in an aborted fetus. Periconceptional primary HCMV infection seems to bear a higher risk of unfavorable outcome than preconceptional infection, and counseling should be adjusted accordingly.