Season In Italy Research Articles

Influenza epidemiology and vaccine effectiveness during the 2023/2024 season in Italy: A test-negative case-control study

In order to support policymakers in allocating resources, we aimed to assess vaccine effectiveness (VE) of inactivated influenza vaccines (IIVs) available for Italian adults in the 2023/2024 season. A hospital-based test-negative case-control study was conducted in Genoa between mid-October 2023 and mid-April 2024. Adult (≥18 years) inpatients with prescription of a polymerase chain reaction test for influenza were eligible. Of 1,664 adults analyzed, most (82%) of which were ≥65 years, 114 (6.9%) tested positive for influenza A. Most (92%) cases were caused by subclades 6B.1A.5a.2a and 6B.1A.5a.2a.1 of the A(H1N1)pdm09 subtype. In older adults aged ≥65 years vaccination was effective at 51% (95% CI: 8%, 74%) against any influenza A and 49% (95% CI: 2%, 73%) against A(H1N1)pdm09. Compared with non-vaccinated older adults, VE point estimates for the adjuvanted and, especially, high-dose IIVs were higher than those for the standard-dose non-adjuvanted IIV. The 2023/2024 seasonal influenza vaccination proved moderately effective in preventing hospitalization for laboratory-confirmed influenza. Being more appropriate for older adults, local policymakers and vaccinating physicians should maximize adoption of the enhanced IIVs.

The Hospital Burden of Flu in Italy: a retrospective study on administrative data from season 2014–2015 to 2018–2019

BackgroundEvery year in Italy, influenza affects about 4 million people. Almost 5% of them are hospitalised. During peak illness, enormous pressure is placed on healthcare and economic systems. This study aims to quantify the clinical and economic burden of severe influenza during 5 epidemic seasons (2014–2019) from administrative claims data.MethodsPatients hospitalized with a diagnosis of influenza between October 2014, and April 2019, were analyzed. Clinical characteristics and administrative information were retrieved from health-related Administrative Databases (ADs) of 4 Italian Local Health Units (LHUs). The date of first admission was set as the Index Date (ID). A follow-up period of six months after ID was considered to account for complications and re-hospitalizations, while a lookback period (2 years before ID) was set to assess the prevalence of underlying comorbidities.ResultsOut of 2,333 patients with severe influenza, 44.1% were adults ≥ 65, and 25.6% young individuals aged 0–17. 46.8% had comorbidities (i.e., were at risk), mainly cardiovascular and metabolic diseases (45.3%), and chronic conditions (24.7%). The highest hospitalization rates were among the elderly (≥ 75) and the young individuals (0–17), and were 37.6 and 19.5/100,000 inhabitants/year, respectively. The average hospital stay was 8 days (IQR: 14 − 4). It was higher for older individuals (≥ 65 years, 11 days, [17 − 6]) and for those with comorbidities (9 days, [16 − 6]), p-value < 0.001. Similarly, mortality was higher in elderly and those at risk (p-value < 0.001). Respiratory complications occurred in 12.7% of patients, and cardiovascular disorders in 5.9%. Total influenza-related costs were €9.7 million with hospitalization accounting for 95% of them. 47.3% of hospitalization costs were associated with individuals ≥ 65 and 52.9% with patients at risk. The average hospitalisation cost per patient was € 4,007.ConclusionsThis retrospective study showed that during the 2014–2019 influenza seasons in Italy, individuals of extreme ages and those with pre-existing medical conditions, were more likely to be hospitalized with severe influenza. Together with complications and ageing, they worsen patient’s outcome and may lead to a prolonged hospitalization, thus increasing healthcare utilization and costs. Our data generate real-world evidence on the burden of influenza, useful to inform public health decision-making.

Phylodynamic and Evolution of the Hemagglutinin (HA) and Neuraminidase (NA) Genes of Influenza A(H1N1) pdm09 Viruses Circulating in the 2009 and 2023 Seasons in Italy.

The influenza A(H1N1) pdm09 virus, which emerged in 2009, has been circulating seasonally since then. In this study, we conducted a comprehensive genome-based investigation to gain a detailed understanding of the genetic and evolutionary characteristics of the hemagglutinin (HA) and neuraminidase (NA) surface proteins of A/H1N1pdm09 strains circulating in Italy over a fourteen-year period from 2009 to 2023 in relation to global strains. Phylogenetic analysis revealed rapid transmission and diversification of viral variants during the early pandemic that clustered in clade 6B.1. In contrast, limited genetic diversity was observed during the 2023 season, probably due to the genetic drift, which provides the virus with a constant adaptability to the host; furthermore, all isolates were split into two main groups representing two clades, i.e., 6B.1A.5a.2a and its descendant 6B.1A.5a.2a.1. The HA gene showed a faster rate of evolution compared to the NA gene. Using FUBAR, we identified positively selected sites 41 and 177 for HA and 248, 286, and 455 for NA in 2009, as well as sites 22, 123, and 513 for HA and 339 for NA in 2023, all of which may be important sites related to the host immune response. Changes in glycosylation acquisition/loss at prominent sites, i.e., 177 in HA and 248 in NA, should be considered as a predictive tool for early warning signs of emerging pandemics, and for vaccine and drug development.

Epidemiology and molecular analyses of respiratory syncytial virus in the 2021-2022 season in northern Italy.

Human respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection among infants and young children worldwide, with seasonal peaks in January and February. This study aimed to characterize the RSV samples from a pediatric cohort in the 2021-2022 season in Italy. In total, 104 samples were collected from pediatric patients attending the "Vittore Buzzi" Children's Hospital in Milan, Italy in the 2021-2022 season. RT-PCR and next-generation sequencing were used to discriminate subgroups and obtain whole genomes. Maximum likelihood and Bayesian phylogenetic methods were used to analyze Italian sequences in the European contest and date Italian clusters. The median age was 78 days, and 76.9% of subjects required hospitalization, with a higher proportion of patients under 3 months of age. An equal proportion of subgroups A (GA2.3.5) and B (GB5.0.5a) was found, with significant differences in length of hospitalization, days of supplemental oxygen treatment, and intravenous hydration duration. Phylogeny highlighted 26 and 37 clusters containing quite the total of Italian sequences for RSV-A and -B, respectively. Clusters presented a tMRCA between December 2011-February 2017 and May 2014-December 2016 for A and B subgroups, respectively. Compared to European sequences, specific mutations were observed in Italian strains. These data confirmed a more severe clinical course of RSV-A, particularly in young children. This study permitted the characterization of recent Italian RSV whole genomes, highlighting the peculiar pattern of mutations that needs to be investigated further and monitored.

Characterization of an influenza B virus isolated from a fatal case of myocarditis in a pediatric patient in Italy

Influenza B is one of the infective agents that can cause rapid and fatal myocarditis in children. Here, we describe a fatal case of myocarditis in a previously healthy child, after infection with an influenza B/Victoria-lineage virus during the 2022–23 epidemic season in Italy. Influenza B virus was isolated also in a second case, a younger family member showing only a mild influenza-like illness. Genotypic and phenotypic analyses have been performed on both virus samples and results showed that HA1 sequences were identical and genetically and antigenically related to other B viruses circulating in 2022–23 season in Italy. However, a D129N substitution was found in the receptor binding domain of the HA of the two viruses, not detected in other circulating viruses in Italy but only in a proportion of those circulating in other European countries. Phenotypic analyses assessed the susceptibility towards either neuraminidase inhibitors and baloxavir. Annual influenza vaccination remains one of the best interventions to prevent complications such as myocarditis, particularly in children.

Time lapses between distribution of influenza vaccines to health authorities and their administration by General Practitioners (GPs) to older adults: a retrospective study over five influenza seasons in Italy

ABSTRACTBackgroundDelays in influenza vaccine delivery and administration can hinder vaccine coverage and protection. This study examines the differentials in distributing and administering adjuvanted trivalent (aTIV) and quadrivalent influenza vaccines (aQIV) to older adults in Italy’s primary care setting and its potential impact on hospitalization risk over 5 epidemic seasons.MethodsUsing a primary care database, individuals aged ≥ 65 years were selected. The proportion of vaccine distribution to regional authorities and subsequent administration by GPs was estimated using census data. Using quantile (median) regression, we examined the relationship between velocities of vaccine distribution and administration (doses/week) and the incidence of hospitalizations.ResultsOver the 5 influenza seasons, the velocity of distribution and administration of aTIV/aQIV ranged 341–833 and 152–270 median doses/week; no trend was yielded for the difference between these velocities (p = 0.189) or vaccine coverage (p = 0.142). An association was observed for each differential dose/week between distributed and administered vaccines and all-cause hospitalizations with a 10% increase in 2017–2018, 54% in 2018–2019, and 12% in 2020–2021 season.ConclusionsThese findings highlight the importance of minimizing the time lapse between vaccine distribution and administration to mitigate the impact of influenza and address factors that contribute to vaccination barriers.

Respiratory syncytial virus: can we still believe that after pandemic bronchiolitis is not a critical issue for public health?

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection among infants and young children, resulting in annual epidemics worldwide. Since the beginning of the COVID-19 pandemic, non-pharmacological interventions were applied, interfering with the circulation of most respiratory viruses, including RSV. The aim of this study is to analyze the RSV infection trend among hospitalized infants during the actual epidemic season (2022–2023) in comparison with the last pre-pandemic season (2018–2019), in order to outline whether significant differences emerge due to COVID-19 pandemia. We retrospectively reviewed medical data on infants hospitalized at the Bambino Gesù Children’s Hospital with diagnosis of bronchiolitis in the current epidemic season and in the last pre-pandemic season, 2018–2019. RSV remains the main etiological agent of bronchiolitis in terms of frequency and severity of infections in the ongoing epidemic season. The first RSV case of the 2022–2023 season was detected at week 42 vs week 47 in the 2018–2019 season. The length of epidemic season was of 17 weeks in 2022–2023 vs 18 weeks in 2018–2019. Comparing the two seasons, age at admission was significantly higher in the current season (median age 2022–2023 65 days vs median age 2018–2019 58 days), but the disease severity was similar. Conclusions: The 2022–2023 bronchiolitis season in Italy started earlier than the usual pre-pandemic seasons but seasonality pattern may be going back to the pre-pandemic one. This season was not more severe than the previous ones. The impact of RSV disease on health care systems and costs remains a critical issue.What is Known:• RSV is one of the major leading causes of hospitalization among children aged less than 3 months. SarsCOV2 pandemic interfered with the seasonal circulation of most respiratory viruses, Including RSV.What is New:• The 2022–2023 bronchiolitis season in Italy started and peaked earlier than the usual pre-pandemic seasons but seasonality pattern may be realigning to the pre-pandemic one. The impact of RSV disease on health care systems and costs is concerning.

Epidemiology and Burden of Influenza in Children 0-14 Years Over Ten Consecutive Seasons in Italy.

In Europe, influenza vaccination coverage in the pediatric population is low. This study describes the influenza incidence and associated healthcare utilization in the pediatric population in Italy. Deidentified data from electronic medical records for children 0-14 years old seen by >150 family pediatricians in the Pedianet network in Italy were evaluated for 10 influenza seasons spanning 2010-2020. Incidence of influenza (cases per 1000 person-months), related sequelae and associated healthcare resource use were determined using diagnostic, prescription and medical examination data. Over 10 seasons, an average of 8892 influenza cases (range, 4700-12,419; total 88,921) were diagnosed in a cohort of 1,432,384 children 0-14 years of age. Influenza vaccination coverage was 3.6% among children with an influenza diagnosis and 6.8% among children without. Influenza-related healthcare resource utilization included 1.58 family pediatrician visits per influenza episode and 220 ED and 111 hospital admissions, with the highest resource usage among children 1-4 years and lowest among children <6 months old. The most common influenza complications were acute otitis media (2.9% of influenza cases) and pneumonia (0.5%). Antibiotics were prescribed in 38.7% of influenza cases; no antiviral agents were prescribed. One intensive care unit admission and 2 cases requiring ventilatory support were documented. No influenza-related deaths were reported. Pediatric influenza vaccination was low despite the burden and healthcare use related to seasonal influenza in the pediatric population during a 10-year period in Italy.

Detection of fixed football matches based on the theory of conformal predictors using the modified Stepanets indicator function

An urgent issue of modern football competitions is the detection of fixed matches. Known methods for predicting the outcome of a match by analyzing bets on a match or analyzing the actions of football players on the field use a large amount of data that is not always available. To overcome this obstacle, there can be applied a method for detecting suspicious fixed match results based on conformal predictors and power martingales, which uses publicly available public data. But in practice, this method does not always detect such matches with high precision. An improved method for determining a suspicious match is proposed, based on the theory of conformal predictors using a modified Stepanets indicator function, which is compared with a threshold. The modified Stepanets indicator function is applied to the power martingale and shows the relative change in the martingale value of the current match compared to the previous match. The threshold value was determined experimentally according to the criterion of the maximum of the F1 metric. Data from the 2013–2014 season of the French II League were used as a training sample, and data from the 2014–2015 season of Serie B in Italy were used as a test sample. Team clustering was performed on all samples. For each of the formed classes of matches on both samples, the measure of non-conformity, the degree of non-conformity, the power martingale, and the modified Stepanets indicator function were calculated. The resulting indicators of precision metrics and F1 are higher (average values of metrics P=0.84, F1=0.87) than the same indicators of martingale and p-value rules (average values of metrics P=0.75, F1=0.78), applied to the same data. The proposed method reveals 4 out of 5 matches of the 2014–2015 Serie B season in Italy, which are considered fixed according to information from official Italian law enforcement sources

On the lookout for influenza viruses in Italy during the 2021-2022 season: Along came A(H3N2) viruses with a new phylogenetic makeup of their hemagglutinin

AimsTo assess influenza viruses (IVs) circulation and to evaluate A(H3N2) molecular evolution during the 2021-2022 season in Italy. Materials and methods12,393 respiratory specimens (nasopharyngeal swabs or broncho-alveolar lavages) collected from in/outpatients with influenza illness in the period spanning from January 1, 2022 (week 2022-01) to May 31, 2022 (week 2022-22) were analysed to identify IV genome and were molecularly characterized by 12 laboratories throughout Italy. A(H3N2) evolution was studied by conducting an in-depth phylogenetic analysis of the hemagglutinin (HA) gene sequences. The predicted vaccine efficacy (pVE) of vaccine strain against circulating A(H3N2) viruses was estimated using the sequence-based Pepitope model. ResultsThe overall IV-positive rate was 7.2% (894/12,393), all were type A IVs. Almost all influenza A viruses (846/894; 94.6%) were H3N2 that circulated in Italy with a clear epidemic trend, with 10% positivity rate threshold crossed for six consecutive weeks from week 2022-11 to week 2022-16. According to the phylogenetic analysis of a subset of A(H3N2) strains (n=161), the study HA sequences were distributed into five different genetic clusters, all of them belonging to the clade 3C.2a, sub-clade 3C.2a1 and the genetic subgroup 3C.2a1b.2a.2. The selective pressure analysis of A(H3N2) sequences showed evidence of diversifying selection particularly in the amino acid position 156. The comparison between the predicted amino acid sequence of the 2021-2022 vaccine strain (A/Cambodia/e0826360/2020) and the study strains revealed 65 mutations in 59 HA amino acid positions, including the substitution H156S and Y159N in antigenic site B, within major antigenic sites adjacent to the receptor-binding site, suggesting the presence of drifted strains. According to the sequence-based Pepitope model, antigenic site B was the dominant antigenic site and the p(VE) against circulating A(H3N2) viruses was estimated to be -28.9%. Discussion and conclusionAfter a long period of very low IV activity since public health control measures have been introduced to face COVID-19 pandemic, along came A(H3N2) with a new phylogenetic makeup. Although the delayed 2021-2022 influenza season in Italy was characterized by a significant reduction of the width of the epidemic curve and in the intensity of the influenza activity compared to historical data, a marked genetic diversity of the HA of circulating A(H3N2) strains was observed. The identification of the H156S and Y159N substitutions within the main antigenic sites of most HA sequences also suggested the circulation of drifted variants with respect to the 2021-2022 vaccine strain. Molecular surveillance plays a critical role in the influenza surveillance architecture and it has to be strengthened also at local level to timely assess vaccine effectiveness and detect novel strains with potential impact on public health.

Exploring the drop in flu cases during the 2020–2021 season: The Italian case study

To explore the 2020-2021 influenza season by describing the case of Italy. FluNet was searched for Italian data on virological samples. French, German, and Spanish data were collected for comparison. InfluNet was used for Italian epidemiological data on influenza-like illness (ILI). Data were extracted for the period from the 42nd week of 2020 to the 16th week of 2021 and for the previous 5-year period. The Containment and Health Index were used to describe the containment measures. Among 6818 samples, 0% were positive in Italy in the 2020-2021 season (28.8% in the previous 5-year period; the percentage change in the total number of tested specimens was -51.3%). In France, Germany, and Spain, the percentage change was -23%, -7%, and -61%, respectively. The Italian ILI incidence remained below the baseline levels (mean 0.0144/100,000 inhabitants; range 0.0085-0.0204). In the previous 5-year period, the mean incidence was 0.041/100,000 inhabitants. With the increase in containment measures, a deflection of ILI incidence was described (P=.015). Despite the reduced number of collected specimens compared to previous seasons and a slight rise in influenza vaccination rates, containment measures represent the most likely factor that helped to reduce cases in the 2020-2021 influenza season in Italy.

Rapid increase in neuroinvasive West Nile virus infections in humans, Italy, July 2022.

As in 2018, when a large West Nile virus (WNV) epidemic occurred, the 2022 vector season in Italy was marked by an early onset of WNV circulation in mosquitoes and birds. Human infections were limited until early July, when we observed a rapid increase in the number of cases. We describe the epidemiology of human infections and animal and vector surveillance for WNV and compare the more consolidated data of June and July 2022 with the same period in 2018.

West Nile Virus Lineage 2 Overwintering in Italy.

In January 2022, West Nile virus (WNV) lineage 2 (L2) was detected in an adult female goshawk rescued near Perugia in the region of Umbria (Italy). The animal showed neurological symptoms and died 15 days after its recovery in a wildlife rescue center. This was the second case of WNV infection recorded in birds in the Umbria region during the cold season, when mosquitoes, the main WNV vectors, are usually not active. According to the National Surveillance Plan, the Umbria region is included amongst the WNV low-risk areas. The necropsy evidenced generalized pallor of the mucous membranes, mild splenomegaly, and cerebral edema. WNV L2 was detected in the brain, heart, kidney, and spleen homogenate using specific RT-PCR. Subsequently, the extracted viral RNA was sequenced. A Bayesian phylogenetic analysis performed through a maximum-likelihood tree showed that the genome sequence clustered with the Italian strains within the European WNV strains among the central-southern European WNV L2 clade. These results, on the one hand, confirmed that the WNV L2 strains circulating in Italy are genetically stable and, on the other hand, evidenced a continuous WNV circulation in Italy throughout the year. In this report case, a bird-to-bird WNV transmission was suggested to support the virus overwintering. The potential transmission through the oral route in a predatory bird may explain the relatively rapid spread of WNV, as well as other flaviviruses characterized by similar transmission patterns. However, rodent-to-bird transmission or mosquito-to-bird transmission cannot be excluded, and further research is needed to better understand WNV transmission routes during the winter season in Italy.

Change Detection Techniques with Synthetic Aperture Radar Images: Experiments with Random Forests and Sentinel-1 Observations

This work aims to clarify the potential of incoherent and coherent change detection (CD) approaches for detecting and monitoring ground surface changes using sequences of synthetic aperture radar (SAR) images. Nowadays, the growing availability of remotely sensed data collected by the twin Sentinel-1A/B sensors of the European (EU) Copernicus constellation allows fast mapping of damage after a disastrous event using radar data. In this research, we address the role of SAR (amplitude) backscattered signal variations for CD analyses when a natural (e.g., a fire, a flash flood, etc.) or a human-induced (disastrous) event occurs. Then, we consider the additional pieces of information that can be recovered by comparing interferometric coherence maps related to couples of SAR images collected between a principal disastrous event date. This work is mainly concerned with investigating the capability of different coherent/incoherent change detection indices (CDIs) and their mutual interactions for the rapid mapping of “changed” areas. In this context, artificial intelligence (AI) algorithms have been demonstrated to be beneficial for handling the different information coming from coherent/incoherent CDIs in a unique corpus. Specifically, we used CDIs that synthetically describe ground surface changes associated with a disaster event (i.e., the pre-, cross-, and post-disaster phases), based on the generation of sigma nought and InSAR coherence maps. Then, we trained a random forest (RF) to produce CD maps and study the impact on the final binary decision (changed/unchanged) of the different layers representing the available synthetic CDIs. The proposed strategy was effective for quickly assessing damage using SAR data and can be applied in several contexts. Experiments were conducted to monitor wildfire’s effects in the 2021 summer season in Italy, considering two case studies in Sardinia and Sicily. Another experiment was also carried out on the coastal city of Houston, Texas, the US, which was affected by a large flood in 2017; thus, demonstrating the validity of the proposed integrated method for fast mapping of flooded zones using SAR data.

Epidemiology, Microbiology and Severity of Bronchiolitis in the First Post-Lockdown Cold Season in Three Different Geographical Areas in Italy: A Prospective, Observational Study.

The aim of this study was to understand the epidemiology, disease severity, and microbiology of bronchiolitis in Italy during the 2021–2022 cold season, outside of lockdowns. Before COVID-19, the usual bronchiolitis season in Italy would begin in November and end in April, peaking in February. We performed a prospective observational study in four referral pediatric centers located in different geographical areas in Italy (two in the north, one in the center and one in the south). From 1 July 2021 to 31 January 2022, we collected all new clinical diagnoses of bronchiolitis in children younger than two years of age recording demographic, clinical and microbiological data. A total of 657 children with a clinical diagnosis of bronchiolitis were enrolled; 56% children were admitted and 5.9% required PICU admission. The first cases were detected during the summer, peaking in November 2021 and declining into December 2021 with only a few cases detected in January 2022. RSV was the commonest etiological agent, while SARS-CoV-2 was rarely detected and only since the end of December 2021. Disease severity was similar in children with RSV vs. non-RSV bronchiolitis, and in those with a single infectious agent detected compared with children with co-infections. The 2021–2022 bronchiolitis season in Italy started and peaked earlier than the usual pre-pandemic seasons, but had a shorter duration. Importantly, the current bronchiolitis season was not more severe when data were compared with Italian published data, and SARS-CoV-2 was rarely a cause of bronchiolitis in children younger than 24 months of age.

Italian flu season 2020-2021: reasons for the drop and insights for the future

BackgroundHaving seen the trend of 2020 flu season in the Southern hemisphere, the objectives of this study were to describe the trend of 2020-21 flu season in Italy, relating it with containment measures undertaken due to COVID-19, and to provide insights for next flu seasons and prevention of airborne diseases.MethodsWe collected data on Italian influenza virological samples on FluNet. We also collected French, German and Spanish data as a comparison. Data on Italian ILI (influenza-like illness) surveillance system were assessed with InfluNet. We used the Containment and Health Index of the Oxford COVID-19 Government Response Tracker (OxCGRT) to evaluate the impact of containment measures on Italian ILI incidence (Spearman's correlation).ResultsNo sample out of 6818 tested positive to influenza virus in Italy in 2020-21 flu season; 21.6% of the samples tested positive to SARS-CoV-2. France, Germany and Spain registered a maximum of 0.10% of positive samples to influenza virus. In Italy the mean of positive samples to influenza virus in seasons from 2015-16 to 2019-20 was 28.8%; the mean number of processed samples in those seasons was 14008. ILI incidence in Italy remained at interseasonal levels during all flu season (mean 1.44/1000; range 0.85-2.04). According to the Containment and Health Index, with increasing containment measures a deflection of ILI incidence in Italy was described (p = 0.015).ConclusionsContainment measures, along with rise of seasonal flu vaccination, are the most likely factors to explain the drop in cases in Italian 2020-21 flu season. The reduction of cases in neighbouring countries lower the role of the downsizing of Italian surveillance system seen in 2020-21 compared to seasons from 2015-16 to 2019-20. Rules and conducts may perpetrate the benefit on the decreased disease activity seen in 2020-21 flu season.Key messages Containment measures and flu vaccinations are the most impacting factors on the drop of influenza cases in 2020-21 in Italy.Though the Italian surveillance system was downsized in 2020-21, the experience of neighbouring countries suggests that the decreased flu activity was factual.

The Impact of Cheering on Sports Performance: Comparison of Serie A Statistics Before and During COVID-19

Background: The role of cheering in home advantage in sports performance is unclear. As anti-coronavirus disease 2019 (COVID-19) restrictive measures have prevented crowds from entering stadiums, analysis of the past two football seasons can reveal important details.Objective: This paper aims to compare the last two football seasons in Italy with the previous six, highlighting changes due to the absence of cheering.Methods: We compared the average percentages of points obtained in home matches from 2013 to 2019 with those in the timelapse 2019-2021. The same operation was performed with referee statistics, such as fouls, penalties, and cards awarded against home teams. To do this, we used Welch's t-test and percentage increases. Pearson and Spearman's correlations were searched between the percentages of points collected in home matches and total points earned from 2013 to 2021.Results: The average percentage of points collected by teams in home matches dropped by 8% (Welch’s t = −4.3). The negative correlations between home collected points and total points in 2013-2019 timelapse have significantly diminished during the last two seasons (Welch’s t = 6.2), approaching zero. Penalties against home teams have increased by 30% (Welch’s t = 2.6), reaching 51.4%.Conclusions: This research provides statistical evidence supporting the crowd’s impact on sports and refereeing performance in Serie A. However, our results also suggest that part of the home advantage is linked to factors independent of the audience. Future research can deepen the above phenomena from a theoretical-psychological point of view.

Monitoring Cyanobacterial Blooms during the COVID-19 Pandemic in Campania, Italy: The Case of Lake Avernus.

Cyanobacteria are ubiquitous photosynthetic microorganisms considered as important contributors to the formation of Earth’s atmosphere and to the process of nitrogen fixation. However, they are also frequently associated with toxic blooms, named cyanobacterial harmful algal blooms (cyanoHABs). This paper reports on an unusual out-of-season cyanoHAB and its dynamics during the COVID-19 pandemic, in Lake Avernus, South Italy. Fast detection strategy (FDS) was used to assess this phenomenon, through the integration of satellite imagery and biomolecular investigation of the environmental samples. Data obtained unveiled a widespread Microcystis sp. bloom in February 2020 (i.e., winter season in Italy), which completely disappeared at the end of the following COVID-19 lockdown, when almost all urban activities were suspended. Due to potential harmfulness of cyanoHABs, crude extracts from the “winter bloom” were evaluated for their cytotoxicity in two different human cell lines, namely normal dermal fibroblasts (NHDF) and breast adenocarcinoma cells (MCF-7). The chloroform extract was shown to exert the highest cytotoxic activity, which has been correlated to the presence of cyanotoxins, i.e., microcystins, micropeptins, anabaenopeptins, and aeruginopeptins, detected by molecular networking analysis of liquid chromatography tandem mass spectrometry (LC-MS/MS) data.

COVID-19 restrictive measures are changing the flu season in Italy.

COVID-19 restrictive measures are changing the flu season in Italy.

Flu vaccination among health workers in Italy: results from the nationwide surveillance PASSI 2015-18

Abstract Background Influenza causes a significant health and socio-economic burden every year. Healthcare workers (HCWs) are at higher risk of exposure to respiratory pathogens than general population, including seasonal influenza virus, with potential threats to their health and patients' safety. We aimed to estimate the adherence to flu vaccination of health workers in 2015-2018 seasons in Italy. Methods We analyzed data collected between 2015 and 2018 from the Italian Behavioral Risk Factor Surveillance System (PASSI). PASSI collects data on health behaviors in the adults (18-64 years) through telephonic administration of standardized questionnaires to a representative sample of Italian population. The answers related to flu vaccination refer to the vaccination campaign preceding the interview Results Preliminary data show that overall 11.9% (CI 10.3% - 13.7%) of HCWs reported to have been vaccinated vs 7.2% (CI 6.9% - 7.5%) of the total population sample. Physicians showed a higher overall adherence compared to other healthcare professionals (22.4% [CI 18% - 27.5%] vs 9% [CI 7.4% - 10.9%], respectively). Differences of adherence were found also across age groups: 18.3% [CI 15% - 22.2%] of respondents between 50-64 years reported to have received a vaccination compared to 10% (CI 7.9% - 12.5%) and 4.3% (CI 2.8% - 6.4%) of 35-49 years and 18-34 years age groups, respectively. The annual influenza vaccination coverage for people working in healthcare has increased over the years (9.8% in 2015 vs 14.1% in 2018). Conclusions Although coverage rates are increasing over time, adherence to influenza vaccination is still too low, especially among younger HCWs and non-medical HCWs. Strategic actions, such as local and national programs to increase self-awareness of being an at-high-risk category for contracting and transmitting infections and/or mandatory vaccination, should be adopted to sharply achieve an optimal coverage rate for HCWs. Key messages Adherence to seasonal influenza vaccination is still very low among Italian HCWs. A participatory attitude towards vaccination for HCWs should be pursued. Monitoring and reporting process should be improved to provide further detailed evidence for adopting targeted programs.