@article {10553, title = {Towards measles elimination in Italy: Virological surveillance and genotypes trend (2013-2015).}, journal = {Virus Res}, volume = {236}, year = {2017}, month = {2017 05 15}, pages = {24-29}, abstract = {

In accordance with the goal of the World Health Organization Regional Office for Europe, the Italian National Measles and Rubella Elimination Plan aimed to interrupt indigenous measles transmission in Italy by the end of 2015. However, from 2013 to 2015, Italy experienced high measles burden with 4902 measles cases (49.3\% laboratory-confirmed) reported to the enhanced measles surveillance system (cumulative incidence in the triennium reference period: 2.4/100,000 population). The measles elimination goal was not reached. Laboratory surveillance of measles circulating genotypes is performed by the Measles and Rubella National Reference Laboratory (NRL) at the Italian National Institute of Health (Istituto Superiore di Sanit{\`a} - ISS), in Rome. Samples received from 1 January 2013-31 December 2015 were analysed. Those positive for measles genome by molecular tests were sequenced and phylogenetically analysed. Phylogenetic analysis performed by NRL identified that genotypes D4 and D8 were endemic and co-circulated in 2011-2013: study results show that genotype D4 disappeared during 2013. Sporadic cases were associated to genotype B3 during 2011-2013, which became endemic in Italy during 2014 and co-circulated with D8 until 2015. Sporadic cases were found belonging to genotypes D9 and H1 all over the period in exam. Similar trend has been observed in European WHO Region.

}, keywords = {Adolescent, Adult, Aged, Child, Child, Preschool, Disease Outbreaks, Female, Genotype, Humans, Infant, Italy, Male, Measles, Measles virus, Middle Aged, Molecular Epidemiology, Phylogeny, RNA, Viral, Sentinel Surveillance, Young Adult}, issn = {1872-7492}, doi = {10.1016/j.virusres.2017.05.009}, author = {Magurano, Fabio and Baggieri, Melissa and Filia, Antonietta and Del Manso, Martina and Lazzarotto, Tiziana and Amendola, Antonella and D{\textquoteright}Agaro, Pierlanfranco and Chironna, Maria and Ansaldi, Filippo and Iannazzo, Stefania and Bucci, Paola and Marchi, Antonella and Nicoletti, Loredana} } @article {3538, title = {A randomized trial of hyperimmune globulin to prevent congenital cytomegalovirus.}, journal = {N Engl J Med}, volume = {370}, year = {2014}, month = {2014 Apr 3}, pages = {1316-26}, abstract = {

BACKGROUND: Congenital infection with human cytomegalovirus (CMV) is a major cause of morbidity and mortality. In an uncontrolled study published in 2005, administration of CMV-specific hyperimmune globulin to pregnant women with primary CMV infection significantly reduced the rate of intrauterine transmission, from 40\% to 16\%.

METHODS: We evaluated the efficacy of hyperimmune globulin in a phase 2, randomized, placebo-controlled, double-blind study. A total of 124 pregnant women with primary CMV infection at 5 to 26 weeks of gestation were randomly assigned within 6 weeks after the presumed onset of infection to receive hyperimmune globulin or placebo every 4 weeks until 36 weeks of gestation or until detection of CMV in amniotic fluid. The primary end point was congenital infection diagnosed at birth or by means of amniocentesis.

RESULTS: A total of 123 women could be evaluated in the efficacy analysis (1 woman in the placebo group withdrew). The rate of congenital infection was 30\% (18 fetuses or infants of 61 women) in the hyperimmune globulin group and 44\% (27 fetuses or infants of 62 women) in the placebo group (a difference of 14 percentage points; 95\% confidence interval, -3 to 31; P=0.13). There was no significant difference between the two groups or, within each group, between the women who transmitted the virus and those who did not, with respect to levels of virus-specific antibodies, T-cell-mediated immune response, or viral DNA in the blood. The clinical outcome of congenital infection at birth was similar in the two groups. The number of obstetrical adverse events was higher in the hyperimmune globulin group than in the placebo group (13\% vs. 2\%).

CONCLUSIONS: In this study involving 123 women who could be evaluated, treatment with hyperimmune globulin did not significantly modify the course of primary CMV infection during pregnancy. (Funded by Agenzia Italiana del Farmaco; CHIP ClinicalTrials.gov number, NCT00881517; EudraCT no. 2008-006560-11.).

}, keywords = {Adult, Amniocentesis, Cytomegalovirus, Cytomegalovirus Infections, Female, Fetal Diseases, Humans, Immunoglobulins, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious}, issn = {1533-4406}, doi = {10.1056/NEJMoa1310214}, author = {Revello, Maria Grazia and Lazzarotto, Tiziana and Guerra, Brunella and Spinillo, Arsenio and Ferrazzi, Enrico and Kustermann, Alessandra and Guaschino, Secondo and Vergani, Patrizia and Todros, Tullia and Frusca, Tiziana and Arossa, Alessia and Furione, Milena and Rognoni, Vanina and Rizzo, Nicola and Gabrielli, Liliana and Klersy, Catherine and Gerna, Giuseppe} }