Botulism in Italy

Sunday, March 30th, 2014

The following background information of botulism in Italy was abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] (primary references are available on request).

Botulism has been a notifiable disease in Italy since 1975. Mean disease rates are similar to those reported in the United States – see graph [3] :

Botulism-Italy

Vegetable preserves are implicated in 57% of cases, and ham and sausage in 15%. Recent outbreaks have been related to mushrooms in oil, pickled olives, fresh-cheese mascarpone and roasted eggplant in oil.

In 2012, a man in England acquired botulism from imported Italian olives.

Three cases of wound botulism were reported during 1988 to 1998; and the first report of wound botulism in an injecting drug user was published in 2010.

26 cases of infant botulism (and 3 of adult intestinal botulism) were reported during 1984 to 2006 (including 6 cases due to Clostridium butyricum toxin). Type A botulism accounted for 4 casers and type B for 17.

Only two outbreaks (5 cases, 1 fatal) of botulism were reported in Italy during 1903 to 1922. Five outbreaks were reported in 1998 alone.

Notable outbreaks:
1993 – Outbreaks (7 cases, in two outbreaks) of botulism were associated with commercially prepared roasted eggplant in oil.
1995 (publication year) – An outbreak was associated with consumption of home-cured ham.
1996 – An outbreak (8 cases) was ascribed to “tiramisu” which contained contaminated mascarpone cream cheese.
2004 – An outbreak (25 cases, 0 fatal) was caused by green olives served by a restaurant in Molise.
2011 – An outbreak (3 cases, 1 fatal) of botulism in Finland was caused by imported jarred olives from Italy.

References:
1. Berger SA. Infectious Diseases of Italy, 2014. 544 pages, 114 graphs, 3390 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-italy/
2. Berger SA. Botulism: Global Status, 2014. 86 pages, 90 graphs, 704 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/botulism-global-status/
3. Gideon graph tool – http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMed

Salmonellosis in Italy

Sunday, July 22nd, 2012

The following background data on salmonellosis in Italy are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Since 1990, decreasing rates of salmonellosis in Italy have been paralleled by a relative decrease in cases caused by Salmonella enteritidis – see graph [3] The number of salmonellosis outbreaks has also declined, from a high of 552 (3,495 cases) in 1992, to 107 (575 cases) in 2010.

Prevalence surveys:
19.2% of childhood diarrhea episodes in Italy
7.3% of pediatric hospitalizations for diarrhea in Rome (1985 publication)
22.9% of children with gastroenteritis presenting to a single hospital (Sondrio Province, Lombardi, 2003 to 2006)
34% of foodborne outbreaks in the Piedmont region (1,250 outbreaks of salmonellosis during 2002 to 2009)
11.1% of patients with acute diarrhea (2005)
0% of cheeses (2004)
0% of ready-to-eat salads from process lots (2006 to 2008)
2.2% of foods of animal origin (2001 to 2002)

Notable outbreaks:
1966 (publication year) – An outbreak of typhoid (302 cases) and other Salmonella infection s (60 cases) was reported.
1966 – An outbreak of Salmonella typhimurium infection was reported in Biella.
1974 (publication year) – An outbreak of Salmonella agona infection was reported.
1974 (publication year) – An outbreak of Salmonella typhimurium infection was reported.
1974 (publication year) – An outbreak of Salmonella enteritidis infection was reported in the area of Paterno (Catania).
1975 – An outbreak (23 cases) of Salmonella oranienburg infection in Rome was associated with a commercial air flight.
1982 – An outbreak (245 cases) of Salmonella napoli infection in England and Wales was caused by contaminated chocolate bars imported from Italy.
1987 – An outbreak of Salmonella typhimurium infection was reported in Palermo.
1987 – Outbreaks (2 outbreaks) of Salmonella enterica subsp. enterica serovar Kottbus infection were reported in Lombardy.
1987 to 1988 – An outbreak (110 cases) of Salmonella wien infection was reported in a neonatal unit in Palermo.
1987 to 1988 – An outbreak of Salmonella typhimurium infections in Isernia was related to consumption of salsicce.
1989 to 1991 – Outbreaks of Salmonella enterica subsp. enterica serovar Bovismorbificans were reported in southern Italy.
1991 – Outbreaks (33 outbreaks) of egg-related Salmonella enteritidis infection were reported in northern and central Italy.
1993 (publication year) – An outbreak of Salmonella enteritidis infection was reported in a nursing home.
1994 – An outbreak (448 cases) of Salmonella hadar infection was associated with a canteen at a building site in central Italy.
1995 – An outbreak (83 cases) of Salmonella enterica Typhimurium infection in the Lombardy region was ascribed to contaminated salami.
1997 – An outbreak (29 cases, 12 hospitalized, 1 fatal) of Salmonella hadar infection was reported from a restaurant in Rimini – ascribed to roast rabbit.
1997 – An outbreak of Salmonella enteritidis PT3 infection was reported in northeastern Sardinia.
1998 (publication year) – An outbreak of Salmonella enteritidis PT4 infection in southern Italy was related to consumption of an egg-based dessert.
1998 – An outbreak (7 infants) of Salmonella bongori infection was reported in Sicily – source unknown.
1998 – An outbreak (9 cases) of Salmonella enteritidis infection was related to consumption of a commercially produced cheese.
1998 – An outbreak (13 cases) of Salmonella blockley infection in Germany was caused by eel imported from Italy.
1998 – An outbreak (several hundred cases) of Salmonella enteritidis infection in Benvenuto was associated with iced cake served at a religious festival.
1998 – An outbreak of Salmonella enteritidis infection among Japanese travelers returning from Italy was related to consumption of scrambled eggs in a hotel in Rome.
2000 (publication year) – An outbreak (113 cases) of Salmonella enteritidis infection in Bari was associated with an egg-based ice cream served at a wedding party.
2004 – An outbreak (63 cases) of Salmonella typhimurium DT 104A infection in the Rome region was associated with traditional pork salami.
2005 – An outbreak (22 cases) of Salmonella typhimurium DT 104 infection in Denmark was caused by raw beef carpacio imported from Italy.
2005 – An outbreak (153 cases) of Salmonella enterica serotype enteritidis infection was reported among school children in Florence.
2005 – An outbreak of Salmonella enterica serovar. enteritidis infection in Bari was ascribed to contaminated rice arancini.
2006 – An outbreak (13 cases) of Salmonella typhimurium infection in Sweden was caused by contaminated salami imported from Italy.
2007 – An outbreak (56 cases) of salmonellosis related to contaminated spaghetti at a hotel in Spain involved tourists from France, Italy, Spain, Romania, Czech Republic and Albania.
2007 – An outbreak (16 cases) of Salmonella enteritidis infection in Sicily was associated with eggs used to prepare pastry for a barbecue.
2008 – An outbreak (30 cases) of salmonellosis was reported among British tourists at a hotel in Brescia.
2010 – An outbreak (500 cases) of Salmonella enterica infection in France was related to ingestion of contaminated hamburger imported from Italy.
2011 – An outbreak of Salmonella enterica serovar. Strathcona infections in Denmark (43 cases), Germany (14 cases) and Austria (1 case) was related to contaminated tomatoes imported from Italy.
2012 (publication year) – An outbreak of Salmonella enterica subspecies enterica serovar Berta infection was reported.

References:
1. Berger SA. Infectious Diseases of Italy, 2012. 486 pages, 113 graphs, 2696 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-italy/
2. Berger SA. Salmonellosis: Global Status.; Gideon e-books, 252 pages, 300 graphs, 2297 references. http://www.gideononline.com/ebooks/disease/salmonellosis-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Legionellosis in Italy

Wednesday, September 14th, 2011

Rates of legionellosis in Italy and surrounding countries have increased dramatically since 2000, while the number of travel-associated cases in Italy has almost tripled during this period. [1,2] See graphs:

A tutorial for the Gideon graph tool is available at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

References:
1. Berger SA. Infectious Diseases of Italy, 2011. 472 pp, 111 graphs, 2235 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-italy/
2. Berger SA. Legionellosis: Global Status, 2011. 90 pp, 106 graphs, 755 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/legionellosis-global-status/

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Malaria in Italy

Saturday, November 7th, 2009

A recent case in the Lake Fondi region reminds us that the potential for malaria transmission persists in Europe. In fact, sporadic reports of cryptic, airport- and locally-acquired malaria have appeared in the Italian literature in recent years. The following review of malaria in Italy was abstracted from GIDEON.

Historical background

  • Malaria was eradicated from Sardinia during 1946 to 1950, through massive application (267 metric tons) of DDT.
  • A single endemic case (Plasmodium vivax in Palma di Montechiaro, Sicily) was reported in 1956; with sporadic cases in the area of Palermo during 1962.
  • The country was declared ‘malaria-free’ in 1970.
  • A single case of autochthonous malaria (P. vivax) was reported in Maremma (Tuscany) in 1997 – Anopheles labranchiae was implicated as the vector.

Although disease rates have increased in recent years, imported malaria continues to be less common than in neighboring France and Switzerland.

Mal-Italy1
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Viral Gastroenteritis in Italy

Friday, June 26th, 2009

A recent episode in Brescia is the latest of several outbreaks of viral gastroenteritis in Italy. The following background information is abstracted from GIDEON:

Primary references are available on request.

Prevalence surveys:
Adenoviruses account for 7% of pediatric hospitalizations in Rome for diarrhea, Rotavirus 18.2%, Astrovirus 1% (1987 to 1989)
Adenoviruses account for 17.6% of pediatric hospitalizations in Rome for diarrhea, Rotavirus 26.7%, non-polio Enteroviruses 8.5%, Coronaviruses 1.8%, Parvoviruses 0.9% (1985 publication)
Adenoviruses account for 6% of pediatric hospitalizations in Sicily for diarrhea, Rotavirus 25.1%, Astrovirus 7%, Norovirus 18.6% (2003)
Adenoviruses are found in 6.2% of pediatric patients with acute diarrhea (2005)
Noroviruses account for 10.4% of hospitalized pediatric gastroenteritis cases in northern Italy (2002)
Noroviruses were the most frequently involved viruses (23.7%) in sporadic acute diarrhea among hospitalized children and were more common in children >5 years (37%) than in children <5 years (10%). The frequency of Rotavirus, enteric Adenovirus and Astrovirus was 12.2%, 1.6% and 2.4%, respectively. (Brescia, 2007 publication)
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Brucellosis more common in Italy than neighbors

Tuesday, January 22nd, 2008

Quoted in ProMED:

An ongoing epizootic in Campania highlights the fact that human brucellosis is more common in Italy than in any contiguous countries. I’ve compared regional disease rates on the graph.

Update: In an additional ProMED note, other countries were added to the comparison:

In comparing brucellosis rates in Italy to those of neighboring countries, the moderator suggested that data should also be expanded to include Spain, Portugal, Greece, and Cyprus.

Rates for the latter are contrasted on this graph.

Measles in Italy

Wednesday, April 4th, 2007

Regarding the recent outbreak in Apulia, gradual decreases in measles rates may reflect the fact that vaccine coverage for Italy has exceded 80% only since 2002. Click on graph: Graph of Measles in Italy
Outbreaks of measles in Italy:
1996 to 1997 – An outbreak (1,642 cases seen at one hospital) was reported in Palermo.
2002 – An outbreak (24,000 clinical cases; 368 hospitalized; 13 encephalitis; 3 fatal) was reported in Campania. The rate among children below age 15 years was 3,750 per 100,000.
2003 – An outbreak (1,217 cases) was reported in Calabria and Puglia.
2003 – An outbreak (26 cases) was reported in South Tyrol.
2006 – An outbreak (40 cases) was reported in Grosseto.
2006 – Outbreaks (187 cases in 3 outbreaks) were reported in the Roma / Sinti populations of South Tyrol (17 cases), Sardinia (9 cases) and Lazio (161 cases).