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Clinical and epizootiological study of a leptospirosis outbreak due to Leptospira canicola in a feedlot : case report  [cached]
I. Yeruham,M. Bernstein,S. Perl,S. Irlin
Journal of the South African Veterinary Association , 2012, DOI: 10.4102/jsava.v68i3.886
Abstract: This report describes the epizootiology, clinical presentation, diagnosis and treatment of an outbreak of leptospirosis caused by Leptospira canicola in feedlot calves. The infection appeared to be of high morbidity with a cumulative clinical incidence of 15.6 %, cumulative subclinical incidence of 39 % and high mortality (8.3 %). Clinical disease was diagnosed in 4-8-month-old calves, while subclinical infection occurred in 9-12-month-old calves. Subclinical infection was based on serological evidence only. The zoonotic aspects of the infection are emphasised.
Clinical aspects of an outbreak of papillomatous digital dermatitis in a dairy cattle herd : case report  [cached]
I. Yeruham,S. Perl
Journal of the South African Veterinary Association , 2012, DOI: 10.4102/jsava.v69i3.830
Abstract: Digital skin lesions and lameness of several weeks duration, with a morbidity rate of 28.3 %, was reported in a group of 60 Holstein-Israeli dairy cows in various stages of lactation. A clinical survey was performed to monitor recovery and to confirm eradication of bovine papillomatous digital dermatitis in the herd. The combined effects of intensive individual treatment of the 4 lame cattle with procaine penicillin and metronidazole, and subjecting all animals in the herd to a foot bath with a solution composed of formaldehyde and sodium hydroxide twice a week for 12 weeks, were found to achieve a dramatic positive response in all affected cows in the herd. During a 1-year follow-up period no recurrence and/or new cases have been diagnosed.
Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012  [PDF]
Luisa Barzon,Monia Pacenti,Elisa Franchin,Silvana Pagni,Enrico Lavezzo,Laura Squarzon,Thomas Martello,Francesca Russo,Loredana Nicoletti,Giovanni Rezza,Concetta Castilletti,Maria Rosaria Capobianchi,Pasquale Salcuni,Margherita Cattai,Riccardo Cusinato,Giorgio Palù
Viruses , 2013, DOI: 10.3390/v5112825
Abstract: Human cases of West Nile virus (WNV) disease have been reported in Italy since 2008. So far, most cases have been identified in north-eastern Italy, where, in 2012, the largest outbreak of WNV infection ever recorded in Italy occurred. Most cases of the 2012 outbreak were identified in the Veneto region, where a special surveillance plan for West Nile fever was in place. In this outbreak, 25 cases of West Nile neuroinvasive disease and 17 cases of fever were confirmed. In addition, 14 WNV RNA-positive blood donors were identified by screening of blood and organ donations and two cases of asymptomatic infection were diagnosed by active surveillance of subjects at risk of WNV exposure. Two cases of death due to WNND were reported. Molecular testing demonstrated the presence of WNV lineage 1 in all WNV RNA-positive patients and, in 15 cases, infection by the novel Livenza strain was ascertained. Surveillance in other Italian regions notified one case of neuroinvasive disease in the south of Italy and two cases in Sardinia. Integrated surveillance for WNV infection remains a public health priority in Italy and vector control activities have been strengthened in areas of WNV circulation.
Norovirus gastroenteritis general outbreak associated with raw shellfish consumption in South Italy
Rosa Prato, Pier Lopalco, Maria Chironna, Giovanna Barbuti, Cinzia Germinario, Michele Quarto
BMC Infectious Diseases , 2004, DOI: 10.1186/1471-2334-4-37
Abstract: A retrospective cohort study was performed in order to assess risk factors associated with illness. All households where a case occurred were included in the study. Faecal specimens were collected from ill individuals. NV-specific RT-PCR was performed. Eleven samples of mussels were collected from fish-markets involved in the outbreak. A nested PCR was used for mussel samples.One hundred and three cases, detected by means of active surveillance, met the case definition. Raw shellfish eating was the principal risk factor for the disease, as indicated by the analytic issues (Risk Ratio: 1.50; IC 95%: 1.18 – 1.89; p < 0.001). NVs were found by means of RT-PCR of all the stool specimens from the 24 patients tested. Eleven samples of shellfish from local markets were tested for the presence or NVs; six were positive by nested PCR and genotypes were related to that found in patients' stools.This is the first community outbreak caused by NVs related to sea-food consumption described in Italy. The study confirms that the present standards for human faecal contamination do not seem to be a reliable indicator of viral contaminants in mussels.Norovirus (NV, previously "Norwalk-like viruses"), one of four genera in the Caliciviridae family, includes a group of morphologically similar but genetically different single-stranded RNA viruses. NVs represent the most important cause of non-bacterial gastroenteritis worldwide. In industrialised countries NVs may be responsible for up to 80% of all outbreaks of gastroenteritis [1]. Outbreaks may affect all age groups and generally occur in crowded communities such as restaurants, tourist resorts, hospitals, schools and nursing homes.Contaminated food or water commonly represents the main source of infection. Epidemics spread by the faecal-oral route, even if transmission may also occur through direct person-to-person contact or aerosolised viral particles.The incubation period of NV gastroenteritis is 24–48 hours and symptoms include vo
Epidemiological and virological investigation of a Norovirus outbreak in a resort in Puglia, Italy
Caterina Rizzo, Ilaria Di Bartolo, Marilina Santantonio, Maria Coscia, Rosa Monno, Danila De Vito, Franco Ruggeri, Giovanni Rizzo
BMC Infectious Diseases , 2007, DOI: 10.1186/1471-2334-7-135
Abstract: A matched case control study was conducted, on 19 July 2005, for investigating risk factors, using a structured questionnaire on food consumption. A multivariate analysis was conducted to estimate the adjusted Odds Ratios. Laboratory and environmental investigation were also performed.On the day of the study 41 cases were identified and 41 controls were enrolled. Controls were matched for age and gender. The mean age of the cases was 26 years old, and 58% were female. The clinical pattern of the disease was characterised by the presence of diarrhoea (95%), vomiting (70%), abdominal pain (51%) and fever (32%). Of the 41 cases included in the study, the majority (65%) were residents of Northern Italian regions. No food samples were available for testing. The matched univariate analysis revealed that cases were more likely to have consumed raw mussels, eggs or ice cubes made of tap water than controls. In the multivariate conditional logistic regression analysis, having eaten raw mussels or ice became more strongly associated with illness.All of the 20 faecal samples collected were tested for NoVs. Eighteen stools (90% of total examined) were positive by RT-PCR, and sequence analysis performed onto 3 samples confirmed the presence of a GGII NoV. No test specific for NoV was performed on water or food samples.The most likely hypothesis supported by the findings of the epidemiological investigation was that illness was associated with raw mussels and ice, made with tap water. These hypothesis could not be confirmed by specific microbiologic testing for NoV in food or ice. The lack of clear knowledge of NoV as a major causative agent of epidemic outbreaks of gastroenteritis in Italy is due to the absence of timely reporting of the cases to the local public health offices and the uncommon practice of saving clinical samples for virological analysis after bacteriological testing.Norovirus (NoV) constitutes one of the four genera of the Caliciviridae family [1]. Based on the
An outbreak of gastroenteritis in a holiday resort in Italy: epidemiological survey, implementation and application of preventive measures  [PDF]
Giacomo Migliorati,Vincenza Prencipe,Alessandro Ripani,Cristina Di Francesco
Veterinaria Italiana , 2008,
Abstract: A major gastroenteritis outbreak was reported in a vacation resort in Central Italy in 2003. A total of 183 cases were identified. The case-control study identified a statistically significant correlation between the disease and sea bathing, use of sanitary facilities in bungalows and of common showers. Stool samples taken from people affected were found positive for Norovirus (68%, 13 of 19 samples), Rotavirus (38%, 1 of 14 samples) and Campylobacter (7%, 3 of 8 samples). Environmental investigations revealed serious faecal contamination of the groundwater and the presence of Norovirus in the seawater near the resort. The mixing of groundwater and seawater with the non-drinking water system - which was also found to be connected to the drinking water system - had a primary role in the onset and spread of infection within the village. The complete absence of any gastroenteritis epidemics among the site guests since 2006 demonstrates the effectiveness of the environmental corrective measures taken.
Clinical Aspects of Dermatitis Associated with Dirofilaria repens in Pets: A Review of 100 Canine and 31 Feline Cases (1990–2010) and a Report of a New Clinic Case Imported from Italy to Dubai  [PDF]
Walter Tarello
Journal of Parasitology Research , 2011, DOI: 10.1155/2011/578385
Abstract: Cutaneous dirofilariasis is a parasitic disease caused by the mosquito-borne filarial nematodes Dirofilaria (Nochtiella) repens, living in the subcutaneous tissue of dogs, cats, wild carnivores, and humans. Cases have been recently reported also from Germany, Czech Republic, Hungary, Ukraine, Russia, Austria, Switzerland, France, The Netherlands, and the Middle East. D. repens is not widely known to cause chronic pruritic dermatitis in animals. Dermatological signs observed in 100 canine clinic cases were pruritus (100%), erythema (79%), papulae (62%), focal or multifocal alopecia (55%), hyperkeratosis (18%), crusting (14%), nodules (12%), acantosis (5%), and eczema (3%). Signs other than dermatological were conjunctivitis (46%), anorexia (35%), vomiting (26%), fever (25%), lethargy (20%), and lymph-adenomegaly (10%). A case imported from Italy to Dubai is described. The opportunistic role of D. repens might explain the presence of asymptomatic carriers, the concurrent observation of nondermatological signs, and the development of dermatitis in a subgroup of parasitized dogs. 1. Introduction Two main filarial parasites affect domestic carnivorous in Europe: Dirofilaria immitis, a parasite of the cardiovascular system, and Dirofilaria (Nochtiella) repens, a parasite of the subcutaneous connective tissue of dogs, cats, wild carnivores, and humans [1]. Aside these, pets can be less frequently infected by Acanthocheilonema (syn. Dipetalonema) reconditum and Cercopithifilaria (syn. Acanthocheilonema) grassii [2]. Subcutaneous dirofilariasis due to Dirofilaria repens is endemic in Southern and Eastern Europe, and many parts of Africa and Asia [1]. Dogs, cats, and wild carnivores are final hosts of D. repens and constitute the only source of accidental infestation for humans, in the presence of a competent population of mosquito vectors, including the Asian tiger mosquito Aedes albopictus and Culex pipiens [3]. Human cases have been recorded mainly in Italy, France, Spain, and Sri Lanka [3]. During the recent years, animal and human infection with D. repens has been detected in new areas of the world, including the Alps [4], Ukraine [5], the Middle East [6–8], and Germany [9]. Strict quarantine regulations seldom prevent propagation of D. repens, because the infection becomes patent only after 6–10 months and the adult parasite can live 2–4 years in the subcutaneous tissues of dogs [10, 11]. In infected cats [12–14] and dogs [15–17], diagnosis is based upon the presence of pruritic skin lesions, the finding of D. repens microfilariae, and a negative test for
CASE: a framework for computer supported outbreak detection
Baki Cakici, Kenneth Hebing, Maria Grünewald, Paul Saretok, Anette Hulth
BMC Medical Informatics and Decision Making , 2010, DOI: 10.1186/1472-6947-10-14
Abstract: Based on case information, such as diagnosis and date, different statistical algorithms for detecting outbreaks can be applied, both on the disease level and the subtype level. The parameter settings for the algorithms can be configured independently for different diagnoses using the provided graphical interface. Input generators and output parsers are also provided for all supported algorithms. If an outbreak signal is detected, an email notification is sent to the persons listed as receivers for that particular disease.The framework is available as open source software, licensed under GNU General Public License Version 3. By making the code open source, we wish to encourage others to contribute to the future development of computer supported outbreak detection systems, and in particular to the development of the CASE framework.In this paper, we describe the design and implementation of a computer supported outbreak detection system called CASE (named after the protagonist of the William Gibson novel Neuromancer), or Computer Assisted Search for Epidemics. The system is currently in use at the Swedish Institute for Infectious Disease Control (SMI) and performs daily surveillance using data obtained from SmiNet [1], the national notifiable disease database in Sweden.Computer supported outbreak detection is performed in two steps:1 A statistical method is automatically applied to a collection of case reports in order to detect an unusual or unexpected number of cases for a particular disease.2 An investigation by a human expert (an epidemiologist) is performed to determine whether the detected irregularity denotes an actual outbreak.The main function of a computer supported outbreak detection system is to warn for potential outbreaks. In some cases, the system might be able to detect outbreaks earlier than human experts. Additionally, it might detect certain outbreaks that human experts would have overlooked. However, the system does not aim to replace human experts
Transmission Potential of Chikungunya Virus and Control Measures: The Case of Italy  [PDF]
Piero Poletti,Gianni Messeri,Marco Ajelli,Roberto Vallorani,Caterina Rizzo,Stefano Merler
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0018860
Abstract: During summer 2007 Italy has experienced an epidemic caused by Chikungunya virus – the first large outbreak documented in a temperate climate country – with approximately 161 laboratory confirmed cases concentrated in two bordering villages in North–Eastern Italy comprising 3,968 inhabitants. The seroprevalence was recently estimated to be 10.2%. In this work we provide estimates of the transmission potential of the virus and we assess the efficacy of the measures undertaken by public health authorities to control the epidemic spread. To such aim, we developed a model describing the temporal dynamics of the competent vector, known as Aedes albopictus, explicitly depending on climatic factors, coupled to an epidemic transmission model describing the spread of the epidemic in both humans and mosquitoes. The cumulative number of notified cases predicted by the model was 185 on average (95% CI 117–278), in good agreement with observed data. The probability of observing a major outbreak after the introduction of an infective human case was estimated to be in the range of 32%–76%. We found that the basic reproduction number was in the range of 1.8–6 but it could have been even larger, depending on the density of mosquitoes, which in turn depends on seasonal meteorological effects, besides other local abiotic factors. These results confirm the increasing risk of tropical vector–borne diseases in temperate climate countries, as a consequence of globalization. However, our results show that an epidemic can be controlled by performing a timely intervention, even if the transmission potential of Chikungunya virus is sensibly high.
Environmental Correlates of H5N2 Low Pathogenicity Avian Influenza Outbreak Heterogeneity in Domestic Poultry in Italy  [PDF]
Lapo Mughini-Gras, Lebana Bonfanti, Paolo Mulatti, Isabella Monne, Vittorio Guberti, Paolo Cordioli, Stefano Marangon
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0086788
Abstract: Italy has experienced recurrent incursions of H5N2 avian influenza (AI) viruses in different geographical areas and varying sectors of the domestic poultry industry. Considering outbreak heterogeneity rather than treating all outbreaks of low pathogenicity AI (LPAI) viruses equally is important given their interactions with the environment and potential to spread, evolve and increase pathogenicity. This study aims at identifying potential environmental drivers of H5N2 LPAI outbreak occurrence in time, space and poultry populations. Thirty-four environmental variables were tested for association with the characteristics of 27 H5N2 LPAI outbreaks (i.e. time, place, flock type, number and species of birds affected) occurred among domestic poultry flocks in Italy in 2010–2012. This was done by applying a recently proposed analytical approach based on a combined non-metric multidimensional scaling, clustering and regression analysis. Results indicated that the pattern of (dis)similarities among the outbreaks entailed an underlying structure that may be the outcome of large-scale, environmental interactions in ecological dimension. Increased densities of poultry breeders, and increased land coverage by industrial, commercial and transport units were associated with increased heterogeneity in outbreak characteristics. In areas with high breeder densities and with many infrastructures, outbreaks affected mainly industrial turkey/layer flocks. Outbreaks affecting ornamental, commercial and rural multi-species flocks occurred mainly in lowly infrastructured areas of northern Italy. Outbreaks affecting rural layer flocks occurred mainly in areas with low breeder densities in south-central Italy. In savannah-like environments, outbreaks affected mainly commercial flocks of galliformes. Suggestive evidence that ecological ordination makes sense genetically was also provided, as virus strains showing high genetic similarity clustered into ecologically similar outbreaks. Findings were informed by hypotheses about how ecological interactions among poultry populations, viruses and their environments can be related to the observed patterns of H5N2 LPAI occurrence. This may prove useful in enhancing future interventions by developing site-specific, ecologically-grounded strategies.
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