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C Germinario

Publications and source records attributed to C Germinario.

At least 19 recordsLinked to original sources
PubMed2005

An outbreak of hepatitis A in Southern Italy: the case for vaccinating food handlers.

We report an outbreak of hepatitis A that occurred in the city of Bari (Apulian region) in June 2002. Overall, 26 cases were observed over a 4-week period. These were traced back to the index case, a food handler who prepared various food products for sale over the counter at a store in the district (OR 5.36, CI 95% 1.58-19.25). Laboratory investigations confirmed that the outbreak was due to a point source and identified a new genotype IB variant. There is a possible indication for administration of hepatitis A vaccine to food handlers, although further evidence of an acceptable cost-benefit ratio needs to be ascertained.

Case-Control Studies↗
PubMed2005

Determinants of acquiring hepatitis A virus disease in a large Italian region in endemic and epidemic periods.

Viral hepatitis A is endemic in Puglia region (southeast Italy). Over the last 13 years, annual incidence rates have ranged from 4 to 138 per 100,000 inhabitants and periodical regional epidemics have been described. Between 1 January 1996 and 31 December 1997 over 11,000 cases of hepatitis A were reported accounting for an annual incidence rate over 130/100,000. To identify exposures during the epidemics, a case-control study was performed in two different rounds and since 1997, an enhanced surveillance system has permitted the monitoring of exposures of subsequent cases. Raw seafood consumption was identified as the major risk factor for hepatitis A. Adjusted odds ratio and 95% confidence intervals for this exposure from the first round of the case-control study was 38.6 (12.2-122.4) and for the second round for consumption of raw mussels it was 30.7 (16.0-52.0). Hepatitis A epidemiology in Puglia is consistent with an endemic situation sustained by locally contaminated seafood consumed raw and by the recurrence of large epidemics, where size is influenced by the accumulation of susceptible subjects in the population.

Adolescent↗
PubMed2004

Surveillance of influenza in Apulia, Italy, 1999-2000, 2000-2001, 2001-2002, and 2002-2003 seasons.

BACKGROUND: The objective of this study was to evaluate, within the Italian National Influenza Epidemiological and Virological Surveillance, the rate of vaccination coverage, the incidence of Influenza Like-Illness (ILI), the incidence of Acute Respiratory Illness (ARI), and to identify the virus strains circulating in Apulia from 1999 to 2003. METHODS: Vaccination coverage rates were calculated based on the number of doses administered to individuals > 65 years of age. Every week, sentinel physicians reported ILI and ARI cases having occurred among their patients. Voluntary general practitioners (GPs) and paediatricians (Ps) collected oropharyngeal swab samples from patients suspected with ILI. Influenza viruses were isolated and identified by cell culture (MDCK cells) and RT-PCR. Virological surveillance was carried out by the ISS, in collaboration with a network of peripheral laboratories. RESULTS: In Apulia, vaccination coverage progressively increased to 68.6% during the 2002-2003 season. The analysis of ILI cases showed higher incidence rates during the 1999-2000 and 2002-2003 seasons. ARI rates appeared to have a more constant trend. ILI and ARI incidence rates were higher in the 0-14 year age group. CONCLUSION: The increase in vaccination coverage rates and implementation of the network of clinical, and epidemiological and virological surveillance are fundamental for the control and prevention of influenza.

Adult↗
PubMed2003

Prevalence rates of viral hepatitis infections in refugee Kurds from Iraq and Turkey.

BACKGROUND: Since little is known about the burden of viral hepatitis in Kurds, the prevalence of infection with hepatitis A virus (HAV), hepatitis E virus (HEV), hepatitis B virus (HBV) and hepatitis C virus (HCV) was investigated in a sample of refugee Kurds from Iraq and Turkey. PATIENTS AND METHODS: A cross-sectional study was carried out. Serological markers to hepatitis viruses were determined for 1,005 subjects from all age-groups of which 36.6% were from Turkey and 63.4% from Iraq. RESULTS: Overall seroprevalence for anti-HAV was 94.4% and 14.8% for anti-HEV. A significantly higher prevalence for anti-HEV was found among Iraqis (17.5%) compared to Turkish immigrants (10.0%). The prevalence of hepatitis B surface antigen (HBsAg) and total anti-HBc (core) was 6.8% and 35.6% in Turkish Kurds and 2.2% and 12.7% in Iraqis, respectively. Only 10% of children aged up to 10 years and 2.8% of subjects aged 11-20 years had been vaccinated against HBV, the majority of them coming from Iraq. One subject was confirmed as positive for anti-HCV (0.1%) and HCV-RNA and analysis showed a 4c/4d genotype. CONCLUSION: This survey shows a high prevalence of enterically transmitted viral hepatitis in Kurds. HBV infection is moderately endemic, while the prevalence of HCV infection is low. There is a need for a universal immunization strategy for HBV in the Kurd population.

Adult↗
PubMed2002

Detection of hepatitis A virus in mussels from different sources marketed in Puglia region (South Italy).

Hepatitis A virus (HAV) infection is endemic in Puglia (South Italy). Epidemiological studies indicate that shellfish consumption, particularly mussels, is a major risk factor for HAV infection, since these products are eaten raw or slightly cooked. Nested reverse transcriptase-polymerase chain reaction (RT-PCR) has been shown to be a sensitive technique for the detection of HAV in mussels. The aim of the present study was to detect the presence of HAV in a large sample of mussels by nested RT-PCR and to confirm the presence of infectious viral particles in positive samples by cell culture infection and RT-PCR confirmation. Two hundred and ninety samples of mussels from different sources were collected between December 1999 and January 2000. One hundred samples were collected before being subjected to depuration, 90 after depuration, and 100 were sampled in different seafood markets. HAV-RNA was detected in 20 (20.0%) of non-depurated mussels, in 10 (11.1%) of depurated samples, and in 23 (23.0%) of samples collected in the shellfish markets, without any significant difference in the prevalence of positive samples by collection sources (chi2 = 4.79, p = 0.09). Of the 53 samples found positive by nested RT-PCR, 18 (34.0%) resulted positive by cell culture assay. No relationship between viral contamination and bacterial contamination was found (p = 0.41). This study confirms the usefulness of molecular techniques in detecting HAV in shellfish and, thus, for the screening of a large sample of naturally contaminated mussels. Improved shellfish depuration methods are needed to obtain virus-safe shellfish and reduce the risk for public human health.

Animals↗
PubMed2001

Prevalence of hepatitis virus infections in Kosovar refugees.

OBJECTIVES: To assess the prevalence of viral hepatitis infections in a sample of Kosovar refugees having arrived in southern Italy as a result of the 1999 war in the Balkans. METHODS: The 526 subjects who enrolled on voluntary basis from all age groups were tested for the prevalence of serologic markers for hepatitis virus types A, B, C, D, and E (HAV, HBV, HCV, HDV, HEV). RESULTS: Among the 526 refugees, the prevalence of total anti-HAV antibodies was 81%. A relevant finding was the presence of total anti-HAV antibodies in 61% of the children up to 10 years of age. The prevalence of anti-HEV antibodies was 2.5% among the subjects. Fifteen subjects (2.9%) were positive for hepatitis B surface antigen (HBsAg), whereas 17.5% tested positive for anti-hepatitis B core antigen (anti-HBc). In children up to 10 years of age, the prevalence of HBsAg and anti-HBc was found to be 0.4% and 6%, respectively. In subjects aged 11 to 20 years, 4.2% tested positive for HBsAg and 20.2% for anti-HBc. In the age group 21 to 30 years, 7.1% of the subjects were found to be HBsAg carriers, whereas 25.9% were found to be positive for anti-HBc. Among the refugees over 30 years of age, the prevalence of HBsAg was 4.2%, whereas anti-HBc was 43.7%. None of the refugees tested positive for anti-HDV. The prevalence of anti-HCV antibodies was 0.7%. CONCLUSIONS: The results of this seroepidemiologic study indicate a high circulation of HAV in the Kosovar population, whereas the prevalence of HEV antibodies was low and comparable to that of other European countries. The HBV infection seems to be at an intermediate level of endemicity and an immunization policy against HBV infection, through vaccination of all newborns and children before adolescence, may be advisable. Results of this study indicate that the level of endemicity of HCV infection in the Kosovar population is low.

Adolescent↗
PubMed2000

Hepatitis A and B in children and adolescents--what can we learn from Puglia (Italy) and Catalonia (Spain)?

Viral hepatitis remains a major contributor to the global disease burden. Mass immunisation strategies against hepatitis B have been adopted by more than 90 developing and industrialised countries. Countries with low hepatitis A endemicity are experiencing cyclical outbreaks and an epidemiological shift, with larger numbers of individuals at risk of infection at an older age, resulting in increased morbidity. The high cost of outbreaks in these countries has made immunisation strategies cost-effective. The development of a vaccine against hepatitis A and a combined vaccine against hepatitis A and hepatitis B offers potentially exciting opportunities for a preventative approach in areas of both low and high endemicity. Existing mass immunisation programmes against hepatitis B will facilitate the adoption of joint strategies illustrated by the examples of Puglia (Italy) and Catalonia (Spain).

Adolescent↗
PubMed2000

From hepatitis B to hepatitis A and B prevention: the Puglia (Italy) experience.

The incidence of hepatitis B virus infection in Italy is 10 per 100, 000 population, with most cases occurring in young adults. Vaccination against hepatitis B has been compulsory since 1991 for all newborns and 12-year-olds. In the Puglia region, this programme has reduced the incidence of hepatitis B from 7.4 per 100,000 population in 1990 to 2.4 per 100,000 population in 1996. The number of notified cases of hepatitis B in Puglia decreased from 212 in 1992 to 73 in 1997. As 50% of these cases occurred in young adults, the main aim of the current vaccination programme is to achieve high coverage rates among teenagers and young adults within the next few years. Although the incidence of hepatitis A is only about 5 per 100, 000 overall in Italy, Puglia is an area of intermediate endemicity with a seroprevalence of antibodies to hepatitis A virus (anti-HAV) of about 40% in 18-year-olds. The incidence of hepatitis A is up to 30 per 100,000 between the periodic outbreaks that occur every 2-4 years. Most notified cases occur in adolescents and young adults. The last outbreak of about 11,000 cases of hepatitis A in the Puglia region occurred in 1996-1997, mainly in the summer months in towns with harbours or near the coast. The most important risk factor was initially consumption of raw seafood, but later was personal contact, probably between children. A vaccination programme against hepatitis A was initiated in Puglia in 1997, aiming to vaccinate all infants of 15-18 months and all 12-year-olds against hepatitis A. Infants receive monovalent hepatitis A vaccine with the first dose of mumps/measles/rubella vaccine. Monovalent hepatitis vaccine can be given with the second and third doses of hepatitis B vaccine in 12-year-olds, but use of combined hepatitis A and B vaccine is recommended to aid compliance and reduce the commitment of physician/nurse time. Vaccination can be performed in school.

Adolescent↗
PubMed2000

HBV, HCV and HDV infections in Albanian refugees in Southern Italy (Apulia region).

The seroprevalence of hepatitis B, C and D markers was assessed in a sample of 670 Albanian refugees in Southern Italy in 1997. The mean age was 25 years (S.D. = 12.3). Of study subjects 62.1% (95% CI: 58.4-65.7) were positive for anti-HBc antibodies and 13.6% (95% CI: 10.9-16.1) for HBsAg. The prevalence of anti-HBs was 47.6% (95% CI: 43.8-51.3). Among HBsAg carriers the prevalence of HBeAg was 7.7% (95% CI: 2.2-13.1). The highest carrier rate for HBsAg (25.5%; 95% CI: 16.7-34.3) was found in the age group 21-25 years. A relevant finding was a prevalence of HBsAg of 8.1% in children 10 years and under. The prevalence of anti-HCV antibodies was 0.3% (95% CI: 0.0-0.7) while only one of the HBsAg carriers was positive for anti-HDV (1.1%, 95% CI: 0-3.2). In Albania, hepatitis B infection represents a public health priority that should be addressed by a universal vaccination campaign.

Adolescent↗
PubMed1999

Direct detection of Clostridium perfringens enterotoxin in patients' stools during an outbreak of food poisoning.

An outbreak of diarrhoea in a hotel affected 25 time keepers attending the 1997 Mediterranean Games. Epidemiological investigation implicated a 'pasta al ragù' consumed at the hotel's restaurant and Clostridium perfringens food poisoning was identified by direct detection of C. perfringens enterotoxin in patients' stools. This report confirms that a careful evaluation of epidemiological features, together with the availability of direct and rapid laboratory methods, may lead to a prompt identification of C. perfringens food poisoning.

Adolescent↗
PubMed1996

HTLV-I and HTLV-II infections in subjects at risk for HIV-I infection from southeastern Italy (Apulia region).

To assess the prevalence of HTLV-I and HTLV-II infections in different groups at risk for HIV-I infection, a study on 867 subjects was carried out by means of serological and PCR analyses. Serum specimens were collected from 268 intravenous drug users (IVDU), 66 homosexual men, 248 subjects with sexually transmitted diseases (STD), 105 thalassemics and 180 hemophiliacs. Sera from 3 IVDU and a sample from an STD patient were confirmed as HTLV-II seropositive; a thalassemic patient was seropositive for HTLV-I; a homosexual man, though confirmed as HTLV-I/II-seroreactive, could not be typed by serological methods. No hemophiliac was found to be HTLV-I/II-reactive. All 3 HTLV-II-seroreactive IVDU and the HTLV-I-infected thalassemic were confirmed by PCR; an additional sample from an IVDU, indeterminate by Western blot, was confirmed to be positive for HTLV-II by PCR. Subtyping of HTLV-II samples indicated the presence of II/b subtype in all 4 cases. Up to now, the reservoir for HTLV-II infection in southeastern Italy is mainly represented by IVDU, while HTLV-I infection seems to be sporadic.

Blotting, Western↗
PubMed1996

An outbreak of hepatitis A in Puglia, Italy, 1996.

In the region of Puglia, in the south east of Italy (population: 4 million), the number of notifications of hepatitis A virus (HAV) infection increases in a two yearly cycle. In 1992 a very large outbreak was observed, but no epidemiological investigation

Journal Article↗
PubMed1994

Modified western blot with recombinant antigens for serological differentiation between HTLV-I and HTLV-II.

Some epidemiological and clinical features of HTLV-I and HTLV-II infections remain unclear due to the inability to confirm and distinguish between the two retroviruses. Since HTLV-I and HTLV-II have a high degree of genomic and aminoacid sequence homology, serologic crossreactions are frequent, making it difficult to establish an accurate serologic diagnosis. To confirm and differentiate HTLV-I/II infections, different serologic confirmatory assays were compared. Fourteen serum samples from 11 IVDU, a bisexual subject, a polytransfused and an ATL patient were examined. The sera repeatedly reactive by Elisa and indeterminate with a conventional Western Blot with viral lysate, were retested by new modified Western Blots containing recombinant antigens. All sera from IVDU but one were confirmed and typed as HTLV-II while serum from ATL was serologically typed as HTLV-I. Serum from the polytransfused patient was not confirmed while serum from the bisexual remained indeterminate. These findings suggest that recombinant antigens are useful for serological diagnosis of HTLV-I/II infections.

Blotting, Western↗
PubMed1993

Prevalence of hepatitis virus infections in Albanian refugees.

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection. One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood. The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections. Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.

Adolescent↗