#Spanishflu in #Italy: new #data, new questions (Infez Med., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Infez Med. 2018 Mar 1;26(1):97-106.

Spanish flu in Italy: new data, new questions.

Fornasin A1, Breschi M2, Manfredini M3.

Author information: 1 Department of Economics and Statistics, University of Udine, Italy. 2 Department of Economics and Business, University of Sassari, Italy. 3 Department of Life Sciences, University of Parma, Italy.



This paper proposes a new estimate for the number of victims of Spanish flu in Italy and highlights some aspects of mortality closely linked to the First World War. The sources used are official death statistics and the Albo d’oro, a roll of honor of the Italians fallen in the First World War. The new estimate of deaths from the flu is 410,000 for 1918, which should be raised to 466,000 when the numbers are taken up to 1920. Deaths from Spanish flu among the military were about 70,000. The time sequence of deaths recognizes two distinct peaks, one in October and one in November 1918. Between these two peaks, the lowest number of deaths falls in the week of the armistice between Italy and Austria-Hungary (signed 4 November 1918). This suggests links between Spanish flu and WWI that cannot be merely explained in terms of movement of people and contagion.

PMID: 29525806[Indexed for MEDLINE] Free full text

Keywords: Pandemic Influenza; Spanish Flu; H1N1; Italy; Society; Wars.



#Pathogenesis and genetic characteristics of novel #reassortant low-pathogenic #avian #influenza #H7 viruses isolated from migratory #birds in the Republic of #Korea in the winter of 2016-2017 (Emerg Microbes Infect., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Emerg Microbes Infect. 2018 Nov 15;7(1):182. doi: 10.1038/s41426-018-0181-3.

Pathogenesis and genetic characteristics of novel reassortant low-pathogenic avian influenza H7 viruses isolated from migratory birds in the Republic of Korea in the winter of 2016-2017.

Lee YN1, Cheon SH1, Lee EK1, Heo GB1, Bae YC2, Joh SJ2, Lee MH1, Lee YJ3.

Author information: 1 Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, 39660, Republic of Korea. 2 Avian Disease Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, 39660, Republic of Korea. 3 Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, 39660, Republic of Korea. leeyj700@korea.kr.



In this study, we characterized H7 subtype low-pathogenicity (LP) influenza A viruses (IAVs) isolated from wild bird habitats in the Republic of Korea from 2010 to early 2017. Through national surveillance, 104 H7 IAVs were isolated, accounting for an average of 14.9% of annual IAV isolations. In early 2017, H7 subtypes accounted for an unusually high prevalence (43.6%) of IAV detections in wild birds. Phylogenetic analysis revealed that all the viruses isolated in the winter of 2016-2017 fell within cluster II of group C, belonging to the Eurasian lineage of H7 IAVs. Notably, cluster II of group C included the H7 gene from the highly pathogenic H7N7 IAV that was detected in northeastern Italy in April of 2016. Through a gene-constellation analysis, the H7 LPIAVs that we isolated constituted ≥11 distinct genotypes. Because the viruses belonging to the genotypes G2.1 and G1 were observed most frequently, we compared the replication and transmission of representative viruses to these genotypes in specific-pathogen-free chickens. Notably, the representative G2.1 strain was capable of systemic replication and efficient transmission in chickens (as evidenced by virus isolation and histopathological examination) without any clinical signs except mortality (in one infected chicken). The efficient subclinical viral replication and shedding of the G2.1 virus in chickens may facilitate its silent spread among poultry after introduction. Given that wild birds harbor novel strains that could affect poultry, our results highlight the need for enhanced IAV surveillance in both wild birds and poultry in Eurasia.

PMID: 30442892 DOI: 10.1038/s41426-018-0181-3

Keywords: Avian Influenza; H7N7; Reassortant Strain; Wild Birds; Poultry; Italy; S. Korea.


Full #genome characterization of two novel Alpha- #coronavirus species from #Italian #bats (Virus Res., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Virus Res. 2018 Nov 14. pii: S0168-1702(18)30585-9. doi: 10.1016/j.virusres.2018.11.007. [Epub ahead of print]

Full genome characterization of two novel Alpha-coronavirus species from Italian bats.

Luca S1, Lelli D2, Faccin F2, Canziani S2, Di Bartolo I3, Vaccari G4, Moreno A2.

Author information: 1 Dept. of Sciences, University Roma Tre, Viale Guglielmo Marconi 446, 00146 Rome, Italy; Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. 2 Department of Virology, Istituto Zooprofilattico Sperimentale Lombardia ed Emilia Romagna, Via Antonio Bianchi 9, 25124, Brescia, Italy. 3 Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. 4 Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. Electronic address: gabriele.vaccari@iss.it.



Coronaviruses (CoVs) have been detected worldwide in several bat species, which are considered the main reservoir. The attention to the high diversity of CoVs hosted by bats has increased during the last decade due to the high number of human infections caused by two zoonotic Beta-CoVs, SARS-CoV and MERS-CoV, that cause several respiratory diseases. Among coronaviruses, two Alpha-CoV strains (HuCoV-229E and HuCoV-NL63) cause mild respiratory disease that can change to severe disease in children, elderly and individuals affected by illnesses. Phylogenetic analysis conducted on bat Alpha-CoV strains revealed their evolutive correlation to human strains, suggesting their origin in bats. The genome of CoVs is characterized by a high frequency of mutations and recombination events, increasing their ability to switch hosts and their zoonotic potential. In this study, three strains of Alpha-CoV genera detected in Italian bats (Pipistrellus kuhlii) were fully sequenced by Next Generation Sequencing (NGS) and characterized. The complete genome analysis showed the correlation of the Italians strains with a Chinese strain detected in 2013 and, based on CoV molecular species demarcation, two new Alpha-CoV species were established. The analysis of a fragment of the RNA-dependent RNA polymerase (RdRp) showed the correlation of the Italian strains with CoVs was only detected in the bat Pipistrellus genera (Pipistrellus kuhlii and Pipistrellus Pipistrellus) in European countries.

KEYWORDS: Alpha-CoV viruses; Bats; Full genome sequencing; Italy

PMID: 30447246 DOI: 10.1016/j.virusres.2018.11.007

Keywords: Coronavirus; Alphacoronavirus; Italy; Bats.


#Severe atypical #HFMD in #adults due to #Coxsackievirus A6: #clinical presentation and Phylogenesis of CV-A6 Strains (J Clin Virol., abstract)

[Source: Science Direct, full page: (LINK). Abstract, edited.]

Journal of Clinical Virology / Available online 17 November 2018 / In Press, Accepted Manuscript

Severe atypical hand-foot-and-mouth disease in adults DUE TO Coxsackievirus A6: clinical presentation and PHYLOGENESIS of CV-A6 STRAINS

F. Broccolo {a1}; F. Drago {b1}; G. Ciccarese {b}; A. Genoni {c}; A. Puggioni {c}; GM Rosa {d}; A. Parodi {b}; H.Manukyan {e}; M. Laassri {e}; K. Chumakov {e}; A. Toniolo {c}

{a} Department of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Monza, Italy; {b} DISSAL Department of Dermatology, IRCCS San Martino-IST, Genoa, Italy; {c} Clinical Microbiology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy; {d} Department of Internal Medicine, Cardiology, Ospedale Policlinico San Martino, Genoa, Italy; {e} Office for Vaccines Research and Review, FDA Center for Biologics Evaluation and Research, Silver Spring, MD, USA

Received 26 July 2018, Revised 10 November 2018, Accepted 16 November 2018, Available online 17 November 2018.

DOI: https://doi.org/10.1016/j.jcv.2018.11.003



  • Typically, HFMD is a mild pediatric illness associated with group-A enteroviruses.
  • In Italy, unrelated adult cases of severe HFMD were caused by coxsackievirus A6.
  • Italian CV-A6 strains and that of a German child mapped into a single cluster.
  • The Italian and German strains were close to previous Chinese and Japanese strains.
  • CV-A6 is spreading worldwide with skin manifestations in both children and adults.




Typically, hand-foot-and-mouth disease (HFMD) is a mild childhood illness associated with coxsackievirus (CV)-A16, CV-A6, enterovirus (EV)-A71.


To identify the viral agents associated with severe cases of atypical HFMD in Italy.

Study design

Epidemiologically unrelated cases of severe atypical HFMD admitted to the Emergency Room (ER) of IRCCS San Martino IST (Genoa, Italy) in 2014-2016 were investigated. Serologic screening for viral positivity was performed against exanthem-inducing agents. Ten cases with serology indicative of recent EV infection were selected. Molecular assays were used to detect viral genomes in blood [EVs, Parvovirus B19 (PVB19), herpesviruses (CMV; EBV, HHV-6, -7, -8)].


CV-A6 was detected in 10 cases of severe atypical HFMD. Two cases were also infected with PVB19. Herpesviruses were not detected. Phylogenetic analysis mapped the CV-A6 strains into a single cluster related to two recent isolates from a German and an Asian child. Fever, systemic symptoms, severe vasculitis-like rash, and enanthem were predominant at presentation. Spontaneous recovery occurred in 1-3 weeks.


CV-A6 is emerging as a frequent cause of severe atypical HFMD in Italian adults. This viral agent is disseminating worldwide. Dermatologists must identify the manifold alterations caused by EVs and understand the diagnostic power of current virology methods.

Keywords: hand foot and mouth disease – enterovirus – coxsackievirus – CV-A6 – atypical – exanthem

{1} These authors contributed equally to the work.

© 2018 Elsevier B.V. All rights reserved.

Keywords: HFMD; Enterovirus; Coxsackievirus A6; Italy.


Molecular #identification of #Betacoronavirus in #bats from #Sardinia (#Italy): first detection and phylogeny (Virus Genes., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Virus Genes. 2018 Nov 13. doi: 10.1007/s11262-018-1614-8. [Epub ahead of print]

Molecular identification of Betacoronavirus in bats from Sardinia (Italy): first detection and phylogeny.

Lecis R1,2, Mucedda M3, Pidinchedda E3, Pittau M4,5, Alberti A4,5.

Author information: 1 Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100, Sassari, Italy. rlecis@uniss.it. 2 Mediterranean Centre for Disease Control, University of Sassari, Via Vienna 2, 07100, Sassari, Italy. rlecis@uniss.it. 3 Centro Pipistrelli Sardegna, Via G. Leopardi 1, 07100, Sassari, Italy. 4 Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100, Sassari, Italy. 5 Mediterranean Centre for Disease Control, University of Sassari, Via Vienna 2, 07100, Sassari, Italy.



Bats may be natural reservoirs for a large variety of emerging viruses, including mammalian coronaviruses (CoV). The recent emergence of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) in humans, with evidence that these viruses may have their ancestry in bats, highlights the importance of virus surveillance in bat populations. Here, we report the identification and molecular characterization of a bat β-Coronavirus, detected during a viral survey carried out on different bat species in the island of Sardinia (Italy). Cutaneous, oral swabs, and faecal samples were collected from 46 bats, belonging to 15 different species, and tested for viral presence. Coronavirus RNA was detected in faecal samples from three different species: the greater horseshoe bat (Rhinolophus ferrumequinum), the brown long-eared bat (Plecotus auritus), and the European free-tailed bat (Tadarida teniotis). Phylogenetic analyses based on RNA-dependent RNA polymerase (RdRp) sequences assigned the detected CoV to clade 2b within betacoronaviruses, clustering with SARS-like bat CoVs previously reported. These findings point to the need for continued surveillance of bat CoV circulating in Sardinian bats, and extend the current knowledge on CoV ecology with novel sequences detected in bat species not previously described as β-Coronavirus hosts.

KEYWORDS: Bats; Coronavirus; RNA-dependent RNA polymerase; Rhinolophus ferrumequinum; Sardinia

PMID: 30426315 DOI: 10.1007/s11262-018-1614-8

Keywords: Coronavirus; Betacoronavirus; SARS; Bats; Italy.


Association of #immunoglobulin GM allotypes with #longevity in long-living individuals from Southern #Italy (Immunity & Ageing, abstract)

[Source: Immunity & Ageing, full page: (LINK). Abstract, edited.]

Research / Open Access

Association of immunoglobulin GM allotypes with longevity in long-living individuals from Southern Italy

Annibale A. Puca, Anna Ferrario, Anna Maciag, Giulia Accardi, Anna Aiello, Caterina Maria Gambino, Giuseppina Candore, Calogero CarusoEmail author, Aryan M. Namboodiri and Janardan P. Pandey

Immunity & Ageing / 201815:26 / DOI: https://doi.org/10.1186/s12979-018-0134-7

©  The Author(s). 2018

Received: 6 July 2018 – Accepted: 19 October 2018 – Published: 6 November 2018

The Commentary to this article has been published in Immunity & Ageing 2018 15:25




The aim of this study was to analyse the role of GM allotypes, i.e. the hereditary antigenic determinants expressed on immunoglobulin polypeptide chains, in the attainment of longevity. The role played by immunoglobulin allotypes in the control of immune responses is well known as well as the role of an efficient immune response in longevity achievement. So, it is conceivable that particular GM allotypes may contribute to the generation of an efficient immune response that supports successful ageing, hence longevity.


In order to show if GM allotypes play a role in the achievement of longevity, we typed the DNA of 95 Long-living individuals (LLIs) and 96 young control individuals (YCs) from South Italy for GM3/17 and GM23+/− alleles.


To demonstrate the role of GM allotypes in the attainment of longevity we compared genotype and allele frequencies of GM allotypes between LLIs and YCs. A global chi-square test (3 × 2) shows that the distribution of genotypes at the GM 3/17 locus is highly significantly different in LLIs from that observed in YCs (p < 0.0001). The 2 × 2 chi-square test shows that the carriers of the GM3 allele contribute to this highly significant difference. Accordingly, GM3 allele is significantly overrepresented in LLIs. No significant differences were instead observed regarding GM23 allele.


These preliminary results show that GM3 allotype is significantly overrepresented in LLIs. To best of our knowledge, this is the first study performed to assess the role of GM allotypes in longevity. So, it should be necessary to verify the data in a larger sample of individuals to confirm GM role in the attainment of longevity.

Keywords: GM allotypes – HMCV – HSV-1 – Immune response – Longevity

Keywords: Genetics; Longevity; Italy.


Attributable #deaths and #disability-adjusted life-years caused by #infections with #antibiotic-resistant bacteria in the #EU and the #EEA in 2015: a population-level modelling analysis (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis

Alessandro Cassini, MD,  Liselotte Diaz Högberg, PhD, Diamantis Plachouras, PhD, Annalisa Quattrocchi, PhD, Ana Hoxha, MSc, Gunnar Skov Simonsen, PhD, Mélanie Colomb-Cotinat, PhD, Mirjam E Kretzschmar, PhD, Brecht Devleesschauwer, PhD, Michele Cecchini, PhD, Driss Ait Ouakrim, PhD, Tiago Cravo Oliveira, PhD, Marc J Struelens, PhD, Carl Suetens, MD, Dominique L Monnet, PhD, theBurden of AMR Collaborative Group †

Open Access / Published: November 05, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30605-4




Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).


We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.


From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.


Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.


European Centre for Disease Prevention and Control.

Keywords: Antibiotics; Drugs Resistance; EU; Excess mortality.