Prevalence of tuberculosis infection among teen-agers in Tuscany.

Introduction: In Tuscany, Tuberculosis incidence is more than triplicate from 1982 to the beginning of the third millennium. The impact of this trend on open population is not known, as updated studies on Tuberculosis prevalence are not available. Tuberculin skin test provides the currently most widely used tool for assessing Tuberculosis transmission in a community and the prevalence of infection as well.

[Retrospective study of tuberculosis in the Province of Siena].

We report here the results of a retrospective study carried out on 200 tuberculosis cases admitted to the Hospital of Siena during the period 1994-2003. For each case, epidemiological, clinical and microbiological data were collected in order to analyze the trend of tuberculosis over the years and to compare our experience with similar studies. Indigenous patients were significantly older than immigrants (60.

Epidemiology of streptococcus group A in school aged children in Pemba.

Background: In Pemba (Zanzibar) all the risk factors which favour Group A Streptococci spreading, infections and late sequelae are present, though GAS epidemiology is unknown.

Objective: To determine the prevalence of GAS pharyngeal carriers among school-aged-children.

Design: Community-based cross sectional study, carried out at the end of the dry season (January-February 2001).

Phlebotomus-transmitted toscana virus infections of the central nervous system: a seven-year experience in Tuscany.

Toscana virus (TOSv) is a recently discovered Phlebotomus-transmitted human pathogen involved in acute infections of the central nervous system (CNS) occurring during the summer in natural foci in Italy. The purpose of this prospective study was to investigate the role of this virus in 170 patients with meningitis-meningoencephalitis of suspected viral origin, admitted to the Departments of Infectious Diseases at the Siena Hospital from 1990 to 1996. Infections caused by tick-borne encephalitis virus (TBEv) and TOSv or other neurotropic viruses were routinely diagnosed by means of conventional virological methods.

Toscana virus infections of the central nervous system in children: a report of 14 cases.

Objective: To evaluate the pathogenicity of a recently discovered arthropod-transmitted bunyavirus (Toscana virus) on the CNS in children and to provide information on the epidemiologic and clinical aspects of Toscana virus infection.

Study Design: Case-series analysis of children hospitalized with clinical and cerebrospinal fluid examination compatible with a CNS disease of viral origin.

Methods: Cerebrospinal fluid, acute, and convalescent sera were investigated for conventional neurotropic viruses and for Toscana and tickborne encephalitis viruses.

Evidence of Toscana virus infections without central nervous system involvement: a serological study.

In central Italy, acute lymphocytic meningitis and meningoencephalitis due to a Phlebotomus transmitted virus (Phlebovirus Toscana, TOSv) occurring throughout the summer are frequently observed. Several serum specimens of patients hospitalized with a clinical picture of viral meningitis/meningoencephalitis showed anti TOS-IgG reactivity suggestive of a previous infection occurring at an unknown time in the past. This observation led us to design a serological investigation of 83 household contacts of 46 summertime CNS infection patients (index cases) with the purpose of evaluating the percentage of both IgG and IgM in seropositive healthy individuals, living, like the index cases, in areas at high risk of phlebotomine sandfly bites.

[Roseola infantum. Some epidemiologic, clinical and diagnostic aspects revisited. Personal experience].

Seventy-five children aged less than 3 yrs, affected by Roseola infantum (maculopapular rash following an acute onset illness characterized by high fever for 2-5 days) were included in this study, 40% of them were admitted with urgency to our clinic for febrile convulsions. Several bacterial or viral agents other than HHV6 were isolated from more than 10% of the children; the role of HHV6 was studied with an immunofluorescence test (IFA) for specific antibodies (seroconversion); 25 single serum samples of the acute phase and 30 acute and convalescent paired sera were available; high positivity was shown in three preexanthematous samples; a serological evidence of HHV6 infection was obtained in only 9 of the 30 paired sera; a coinfection was shown in two subjects belonging to the last group; viral or bacterial agents other than HHV6, were demonstrated in 4 seronegative children. In our experience, the etiologic role of HHV6 in exanthema subitum is not always confirmed; we cannot explain the controversy of our results compared with those of Japanese literature.

Decline of HBsAg antibodies after immunization with hepatitis B vaccines and after natural infection.

The long-term persistence of anti-HBsAg above 10 mUI is conventionally believed to protect against natural infection with hepatitis B virus, while it is not yet clear what is the clinical significance of the fall to below 10 mUI in antibody levels. In our opinion, an important method for evaluating the effectiveness of the vaccine lies in comparing the duration of vaccine-immunity with that following the disease, the later being held to provide life-long protection. In this view, we examined the sera samples of 69 subjects (56 healthy people, and 13 drug-addicts) previously affected from HBV infection looking for anti-HBsAg with an Elisa method.

Development of immunoglobulin M-antibodies after rubella immunization with RA27/3 attenuated live vaccine in teen-agers: remaining problems.

Four-hundred-fourty-two rubella seronegative teen-agers living in Siena and the surroundings were vaccinated with RA 27/3 live attenuated rubella over a two years period (1985-1987). One-hundred-twenty seven vaccinees' sera were randomly selected for the rubella specific antibodies of the IgM class detection with two Elisa Methods; the sera were collected 10 and 30 days after the challenge; in 58 girls a serum sample was also obtained 1 yr later. None of the sera showed reactivity for RF.

Intrafamilial hepatitis A outbreak: projection on the community in an area of Tuscany.

In 1988, 3 intrafamilial cases of hepatitis A occurred in a little town in the nearby of Siena: shellfishes were probably responsible for the index case, close contacts for the two secondary cases, characterized by a very long incubation period (above 60 days). An inapparent infection was detected in one household contact. No other cases of hepatitis A have been observed in that area since the intrafamilial outbreak until now.

Impact of hepatitis A in Siena: a "traveller's disease"?

Over a period of seven years (from 1980 to 1987) 58 acute viral hepatitis A cases were admitted to the Departments for Infectious Diseases. This number represents 10.76% of all viral hepatitis patients.

Seroepidemiological research on hepatitis A (HA) in the city of Siena.

The circulation of Hepatitis A Virus in the city of Siena and the tight neighbouring area appears to be fairly rare. In fact, the number of cases suffering from Hepatitis A, admitted into the Clinic of Infectious Diseases of the University of Siena, has been 33 out of 4,905 patients (yrs 1975-1985). Of these, only 6 were patients resident in Siena.

[Role of viruses in acute gastroenteritis].

In a two years screening carried out on Florentine children we confirmed that Rotaviruses are the most important ethiological agents of acute gastroenteritis in infants less than two years old, irrespective of sex. We had evidence that Rotavirus diarrhea does not occur with the same incidence every year. Rotavirus gastroenteritis is characterized by profuse diarrhea, vomiting, fever and often by respiratory symptoms.

[Progress in cerebrospinal fluid diagnostic studies contributed by cytocentrifugation].

Immunological studies in cerebrospinal fluid of acute viral and tubercular meningitidis, and other inflammatory diseases of CNS require a strict cellular detection and identification, that may be reached by cytocentrifugation. Several cases are reported, in which cytocentrifugation was obtained by Shandon-Elliott cytocentrifuge. Some morphological aspects are discussed, as the presence of high levels of "reticulomonocytes" in encephalitis, plasma-cells in acute disorders, activated lymphocytes in viral meningitis.

Immunological studies in cerebrospinal fluid of acute viral and tubercular meningitis.

The Authors studied the immunological characteristics of lymphocytes in cerebrospinal fluid, from children affected by acute viral or tubercular meningitis. A reduced P.H.