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Networking of public health and clinical laboratories: a successful strategy to uncover promptly two enterovirus D68 outbreaks in Lombardy region (northern Italy), July 2021-November 2022
1
Department of Biomedical Sciences for Health, University of Milan, Italy
2
Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
3
Fondazione IRCCS Ca’ Ganda Ospedale Maggiore Policlinico, Milano, Italy
4
Microbiology and Virology Laboratory, ASST “Papa Giovanni XXIII”, Bergamo, Italy
5
Laboratorio di Microbiologia e Virologia ASST Cremona, Italy
6
S.C. Microbiologia Clinica- ASST Grande Ospedale Metropolitano Niguarda, Italy
7
Department of Medicine and Surgery, University of Insubria, Varese, Italy; Laboratory of Microbiology, ASST Sette Laghi, Varese, Italy
8
S.C. Microbiologia, ASST Monza, Monza, Italy
9
Laboratory Medicine Department, Asst Bergamo Est, Bergamo Italy
10
Direzione Generale Welfare Regione Lombardia, Milano, Italy
11
Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A268
ABSTRACT
Background:
In Lombardy (a region in northern Italy, 10 million inhabitants), a network of public health and clinical laboratories was established to tackle and respond to emerging human infectious diseases. This study aimed at: 1) detecting and investigating the role of EVD68 in respiratory infections in Lombardy from July-2021 to November-2022; 2) describing the epidemiological features of EVD68.
Methods:
From July-2021 to November-2022, respiratory samples were collected from: i) outpatients with influenza-like illness (ILI) in the framework of influenza surveillance network, ii) inpatients with severe acute respiratory infection (SARI) in 8 hospitals in Lombardy. Samples were tested for EV-RNA by all virological laboratories; the EV-positive sample were promptly tested for EVD68 by 2 second-level laboratories.
Results:
347 laboratory-confirmed EV-positive samples were detected: 139 from ILI and 208 from SARIs. EVD68 was identified in 38.6% (n=134) of EV-positive specimens. EVD68-positive individuals had a median age of 3 years (IQR: 4.5 years). EVD68-positive rate among SARI cases was statistically higher than that observed in ILIs (46.2% vs. 27.3%; p<0.0001), with a risk of infection from EVD68 3-fold higher (OR:3.0; 95%CI:1.9-4.8) in SARIs than in ILIs. EVD68 circulated with two consecutive epidemic waves. The first wave –accounting for 25% of EVD68s- started in September-2021, peaked at end of November, ended in March-2022; the second wave –accounting for 72.6% of EVD68s- started in July-2022, reached a peak in the beginning of October-2022 and is still ongoing.
Conclusion:
The tight collaboration and close networking of public health and clinical laboratories allowed disclosing in real-time two EVD68 outbreaks in Lombardy over the last year. A greater contribution of EVD68 was observed in SARIs than in ILIs. Collaboration and networking of public health and clinical laboratory through molecular surveillance need to be advocated and endorsed as a successful key strategy to uncover and respond to emerging pathogens.
In Lombardy (a region in northern Italy, 10 million inhabitants), a network of public health and clinical laboratories was established to tackle and respond to emerging human infectious diseases. This study aimed at: 1) detecting and investigating the role of EVD68 in respiratory infections in Lombardy from July-2021 to November-2022; 2) describing the epidemiological features of EVD68.
Methods:
From July-2021 to November-2022, respiratory samples were collected from: i) outpatients with influenza-like illness (ILI) in the framework of influenza surveillance network, ii) inpatients with severe acute respiratory infection (SARI) in 8 hospitals in Lombardy. Samples were tested for EV-RNA by all virological laboratories; the EV-positive sample were promptly tested for EVD68 by 2 second-level laboratories.
Results:
347 laboratory-confirmed EV-positive samples were detected: 139 from ILI and 208 from SARIs. EVD68 was identified in 38.6% (n=134) of EV-positive specimens. EVD68-positive individuals had a median age of 3 years (IQR: 4.5 years). EVD68-positive rate among SARI cases was statistically higher than that observed in ILIs (46.2% vs. 27.3%; p<0.0001), with a risk of infection from EVD68 3-fold higher (OR:3.0; 95%CI:1.9-4.8) in SARIs than in ILIs. EVD68 circulated with two consecutive epidemic waves. The first wave –accounting for 25% of EVD68s- started in September-2021, peaked at end of November, ended in March-2022; the second wave –accounting for 72.6% of EVD68s- started in July-2022, reached a peak in the beginning of October-2022 and is still ongoing.
Conclusion:
The tight collaboration and close networking of public health and clinical laboratories allowed disclosing in real-time two EVD68 outbreaks in Lombardy over the last year. A greater contribution of EVD68 was observed in SARIs than in ILIs. Collaboration and networking of public health and clinical laboratory through molecular surveillance need to be advocated and endorsed as a successful key strategy to uncover and respond to emerging pathogens.
| ISSN: | 2654-1459 |
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