Spatiotemporal distribution and determinants of measles incidence during a large outbreak, Italy, September 2016 to July 2018

Background Measles is still endemic in Italy and outbreaks are frequent. From 2016 to 2018, more than 7,000 measles cases were reported to the national integrated measles and rubella surveillance system, the largest outbreak since implementation of this system. Aim We aimed to describe the characteristics and spatiotemporal distribution of measles cases in Italy and explore determinants of incidence at municipality level. Methods We performed a retrospective observational study, mapping by municipality all measles cases reported to the national surveillance system with symptom onset between 1 September 2016 and 31 July 2018. We also analysed measles–mumps-rubella (MMR) vaccination coverage (VC) data (2000–2017) for the first and second dose, collected from the Ministry of Health. We used regression analysis to explore factors associated with measles incidence at municipality level. Results We analysed 7,854 cases, 3,927 (50%) female. Median age was 26 years; 475 cases (6%) were younger than 1 year. The outbreak occurred in two epidemic waves. The first started in central/northern regions (end of 2016), the second (mostly within 2018) was concentrated in southern regions. In 2016 and 2017, national VC was below 95% for both MMR doses. In 2017, only one region reported VC above 95% for the first dose. At municipality level, incidence was associated with higher urbanisation, less deprivation and fewer adults. Conclusion The spread of measles between September 2016 and July 2018 in Italy indicates the need to improve VC and to explore further how societal and other parameters might be linked to incidence.

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"Bacterial Meningitis in children and adolescents: an observational study based on the national surveillance system"

BMC Infectious Diseases ◽

10.1186/1471-2334-5-103 ◽

2005 ◽

Vol 5 (1) ◽

Cited By ~ 18

Author(s):

Félix O Dickinson ◽

Antonio E Pérez

Keyword(s):

Bacterial Meningitis ◽

Observational Study ◽

Children And Adolescents ◽

Surveillance System ◽

National Surveillance ◽

Meningitis In Children ◽

National Surveillance System

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Factors associated with tuberculosis by HIV status in the Brazilian national surveillance system: a cross sectional study

BMC Infectious Diseases ◽

10.1186/1471-2334-14-415 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 11

Author(s):

Thiago Nascimento do Prado ◽

Angélica Espinosa Miranda ◽

Fernanda Mattos de Souza ◽

Elias dos Santos Dias ◽

Lorena Kellen Fernandes Sousa ◽

...

Keyword(s):

Surveillance System ◽

Cross Sectional Study ◽

National Surveillance ◽

Sectional Study ◽

Hiv Status ◽

Cross Sectional ◽

Factors Associated ◽

System A ◽

National Surveillance System

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Hospital discharges-based search of acute flaccid paralysis cases 2007–2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction

BMC Public Health ◽

10.1186/s12889-019-7617-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Paola Stefanelli ◽

◽

Stefania Bellino ◽

Stefano Fiore ◽

Stefano Fontana ◽

...

Keyword(s):

Surveillance System ◽

Acute Flaccid Paralysis ◽

Polio Eradication ◽

Flaccid Paralysis ◽

National Surveillance ◽

Hospital Discharges ◽

Diagnostic Codes ◽

Northern Regions ◽

Afp Surveillance ◽

National Surveillance System

Abstract Background Acute flaccid paralysis (AFP) surveillance has been adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Hereby, to evaluate the completeness of the ascertainment of AFP cases in Italy, a hospital-discharges based search was carried out. Methods AFP cases occurring between 2007 and 2016 among children under 15 years of age were searched in the Italian Hospital Discharge Records (HDR) database using specific ICD-9-CM diagnostic codes. AFP cases identified between 2015 and 2016 were then compared with those notified to the National Surveillance System (NSS). Results Over a 10-year period, 4163 hospital discharges with diagnosis of AFP were reported in Italy. Among these, 956 (23.0%) were acute infective polyneuritis, 1803 (43.3%) myopathy, and 1408 (33.8%) encephalitis, myelitis and encephalomyelitis. During the study period, a decreasing trend was observed for all diagnoses and overall the annual incidence rate (IR) declined from 5.5 to 4.5 per 100,000 children. Comparing NSS with HDR data in 2015–2016, we found a remarkable underreporting, being AFP cases from NSS only 14% of those recorded in HDR. In particular, the acute infective polyneuritis cases reported to NSS accounted for 42.6% of those detected in HDR, while only 0.9% of myopathy cases and 13.1% of encephalitis/myelitis/encephalomyelitis cases have been notified to NSS. The highest AFP IRs per 100,000 children calculated on HDR data were identified in Liguria (17.4), Sicily (5.7), and Veneto (5.1) Regions; regarding the AFP notified to the NSS, 11 out of 21 Regions failed to reach the number of expected cases (based on 1/100,000 rate), and the highest discrepancies were observed in the Northern Regions. Overall, the national AFP rate was equal to 0.6, therefore did not reach the target value. Conclusions AFP surveillance data are the final measure of a country’s progress towards polio eradication. The historical data obtained by the HDR have been useful to assess the completeness of the notification data and to identify the Regions with a low AFP ascertainment rate in order to improve the national surveillance system.

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Building a National Surveillance System for Malpractice Claims

Health Services Research ◽

10.1111/1475-6773.12623 ◽

2016 ◽

Vol 51 ◽

pp. 2642-2648 ◽

Cited By ~ 6

Author(s):

Michelle M. Mello ◽

David M. Studdert

Keyword(s):

Surveillance System ◽

National Surveillance ◽

Malpractice Claims ◽

National Surveillance System

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Healthcare-associated infections in high-risk neonates: Temporal trends in a national surveillance system

Early Human Development ◽

10.1016/j.earlhumdev.2021.105394 ◽

2021 ◽

pp. 105394

Author(s):

Ralciane P. Menezes ◽

Sávia G.O. Melo ◽

Murilo B. Oliveira ◽

Felipe F. Silva ◽

Priscila G.V. Alves ◽

...

Keyword(s):

High Risk ◽

Surveillance System ◽

Temporal Trends ◽

Healthcare Associated Infections ◽

National Surveillance ◽

Healthcare Associated ◽

National Surveillance System

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Reducing neonatal nosocomial bloodstream infections through participation in a national surveillance system

Journal of Hospital Infection ◽

10.1016/j.jhin.2006.12.020 ◽

2007 ◽

Vol 65 (4) ◽

pp. 319-325 ◽

Cited By ~ 79

Author(s):

F. Schwab ◽

C. Geffers ◽

S. Bärwolff ◽

H. Rüden ◽

P. Gastmeier

Keyword(s):

Surveillance System ◽

Bloodstream Infections ◽

National Surveillance ◽

National Surveillance System

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Human dirofilariasis due to Dirofilaria repens in Ukraine, an emergent zoonosis: epidemiological report of 1465 cases

Acta Parasitologica ◽

10.2478/s11686-013-0187-x ◽

2013 ◽

Vol 58 (4) ◽

Cited By ~ 43

Author(s):

Rusłan Sałamatin ◽

Tamara Pavlikovska ◽

Olga Sagach ◽

Svitlana Nikolayenko ◽

Vadim Kornyushin ◽

...

Keyword(s):

Skin Lesion ◽

Surveillance System ◽

Mammary Glands ◽

Dirofilaria Repens ◽

National Surveillance ◽

Registration System ◽

Western Ukraine ◽

Human Dirofilariasis ◽

Analysis Point ◽

National Surveillance System

AbstractThe filarial nematode Dirofilaria repens is currently considered to be one of the most extensively spreading human and animal parasites in Europe. In Ukraine, reporting cases of dirofilariasis has been mandatory since 1975, and the disease was included in the national surveillance system for notifiable diseases. Up until December 31st 2012, a total of 1533 cases have been registered, with 1465 cases occurring within the previous 16 years. Most of the cases of dirofilariasis were registered in 6 regions: Kyiv, and the Donetsk, Zaporizhzhya, Dnipropetrovsk, Kherson and Chernihiv oblasts. In the years 1997–2002 the highest incidence rate was noted in the Kherson oblast in the south of the country (9.79 per 100 000 people), and the lowest in western Ukraine (0.07–1.68 per 100 000 people). D. repens infections were registered in all oblasts. Parasitic lesions were most often located in the head, the subconjunctival tissue and around the eyes. D. repens lesions were also found in the limbs, torso, male sexual organs, and female mammary glands. Dirofilariasis was diagnosed in persons aged from 11 months to 90 years old, most often among people between 21–40 years of age. Most patients had only one parasitic skin lesion; the majority of isolated nematodes were female. The results of our analysis point to a constant increase in D. repens dirofilariasis incidence in humans in Ukraine. Despite educational efforts, infections have become more frequent and the territory in which the disease occurs has enlarged to encompass the whole of Ukraine. Nevertheless, the Ukrainian sanitary-epidemiological services managed to achieve some measure of success, e.g. by creating a registration system for D. repens infections and establishing proper diagnostics for the disease.

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