Publications by authors named "Maria B Valli"

Article Synopsis
  • Enteroviruses (EVs) are common worldwide pathogens, primarily impacting children and causing a range of illnesses, including aseptic meningitis, but their true prevalence and epidemiology remain poorly understood.
  • Research focused on the Lazio region over a decade revealed changes in EV infection trends, particularly influenced by the SARS-CoV-2 pandemic, with a return to pre-pandemic circulation patterns by 2022 but with shifts in dominant strains identified.
  • Ongoing studies are essential to understand the pathogenic potential of prevalent strains and to identify any new recombinant variants.
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Since spring 2022, the global epidemiology of the monkeypox virus (MPXV) has changed. The unprecedented increase of human clade II MPXV cases worldwide heightened concerns about this emerging zoonotic disease. We analysed the positivity rates, viral loads, infectiousness, and persistence of MPXV DNA for up to 4 months in several biological samples from 89 MPXV-confirmed cases.

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Article Synopsis
  • A recent rise in monkeypox (MPXV) cases among humans, particularly among men who have sex with men, has led researchers to investigate potential sexual transmission routes.
  • A study analyzed skin and genital lesion samples from 35 patients using a new molecular syndromic virus panel, finding that 23 tested positive for MPXV but also revealed significant rates of coinfections with other viruses and sexually transmitted infections.
  • These findings emphasize the importance of comprehensive testing for sexually transmitted infections in high-risk populations to ensure accurate diagnosis and effective treatment.
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  • Enterovirus (EV) and parechovirus (HPeV) are prevalent in newborns and are primary causes of aseptic meningitis in infants under 1 year.
  • A study compared 10 infants with HPeV meningitis to 8 with EV meningitis, revealing significantly higher serum C-reactive protein (CRP), white blood cell (WBC), and lymphocyte levels in the EV group.
  • Despite these differences, clinical symptoms alone cannot differentiate between the two infections, and real-time polymerase chain reaction remains the most reliable diagnostic method.
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  • The COVID-19 pandemic has led to rapid mutations of the virus SARS-CoV-2, resulting in the emergence of new variants that affect public health.
  • The Lazio region has established a genomic sequencing laboratory network (WGSnet-Lazio) to closely monitor these variants and work alongside an epidemiological surveillance center (SERESMI).
  • Data collected from February 2020 to October 2022 show that this sequencing effort is effective for understanding variant circulation and supporting public health efforts during the pandemic.
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During the 2022-outbreak, peculiar clinical presentations of Mpox have been described, some of which can make the diagnosis of the disease extremely challenging. Here we report a case series of fourteen patients with Mpox pharynogotonsillar involvement (PTI) seen at National Institute for Infectious Diseases, "Lazzaro Spallanzani", in Rome, Italy from May to September 2022. All included patients were men who have sex with men (median age 38 years) reporting unprotected sex within three weeks from symptoms onset.

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We report two cases of SARS-CoV-2 recombinant variant XE detected in nasopharyngeal swabs (NPS) of hospitalized patients with no evident epidemiological link in Lazio, Central Italy. Whole-Genome Sequencing (WGS) performed on an Ion Torrent GSS5 platform according to Italian flash surveys showed genomes corresponding to the PANGOLIN unclassified lineage and the Nextclade XE clade. Further analyses were then carried out to investigate more deeply the genetic characteristics of these XE-like sequences.

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Severe neurological disorders and vascular events during COVID-19 have been described. Here, we describe the first case of a female patient infected with the SARS-CoV-2 BA.2 Omicron variant of concern with meningitis with newly diagnosed central demyelinating disease.

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Article Synopsis
  • The study focused on analyzing a recombinant strain of Enterovirus, identified as Echovirus 11 (E-11), which was linked to serious and fatal infections in a healthcare setting.
  • Researchers utilized various methods, including qRT-PCR and genome sequencing, to characterize the virus and confirm it was a chimeric strain resulting from recombination with Coxsackievirus B.
  • The findings suggest that the unique genetic structure of this E-11 strain could be responsible for its increased virulence and potential to cause epidemics, highlighting the need for ongoing surveillance of such recombinant viruses.
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A descriptive analysis of common respiratory pathogens (CRPs) detected in nasopharyngeal swabs (NPSs) from hospitalized patients with influenza-like illness during the fall seasons of the past three years, 2019-2021, in the Lazio region, Italy, was conducted to assess whether or not CRP circulation changed because of COVID-19 during the fall season. The results observed in a total of 633 NPSs subjected to molecular diagnosis for CRPs by multiplex PCR assay during the autumn seasons (exactly from week 41 to week 50) were compared with each other. In 2019, in 144 NPSs, the more represented CRPs were rhinovirus/enterovirus (7.

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COVID-19 pandemic is a dramatic health, social and economic global challenge. There is urgent need to maximize testing capacity. Rapid Antigen Tests (RAT) represent good candidates for point-of-care and mass surveillance testing to rapidly identify SARS-CoV-2-infected people, counterbalancing lower sensitivity vs.

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Article Synopsis
  • The study analyzed COVID-19 patients in a hospital in Italy to explore factors influencing prolonged SARS-CoV-2 RNA shedding and viral clearance.
  • It found that patients with comorbidities, lymphopenia, or moderate/severe respiratory issues had lower chances of viral clearance, with a median viral shedding duration of 18 days.
  • Achieving viral clearance significantly improved clinical recovery rates and reduced the risk of death or the need for mechanical ventilation, emphasizing the necessity for timely hospital admission for symptomatic patients.
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We report phylogenetic and mutational analysis by NGS of six SARS-CoV-2 strains from patients flying from Bangladesh to Italy (July 2020). Data suggest that no further circulation of such imported strains occurred in Italy, stating the efficacy of early screening at the point of entry and supporting the importance of molecular epidemiology in monitoring the efficacy of control measures.

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In Italy, the first SARS-CoV-2 infections were diagnosed in Rome, Lazio region, at the end of January 2020, but sustained transmission occurred later, since the end of February. From 1 February to 12 April 2020, 17,164 nasopharyngeal swabs were tested by real time PCR for the presence of SARS-CoV-2 at the Laboratory of Virology of National Institute for Infectious Diseases "Lazzaro Spallanzani" (INMI) in Rome. In the same period, coincident with the winter peak of influenza and other respiratory illnesses, 847 samples were analyzed by multiplex PCR assay for the presence of common respiratory pathogens.

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In Italy in 2016, acute flaccid myelitis developed in a woman who had received a hematopoietic stem cell transplant. Enterovirus D68 viral genome was detected in respiratory and cerebrospinal fluid samples, and the viral protein 1 sequence clustered with lineage B3. Immunocompromised adults may be at risk for enterovirus D68-associated neurologic complications.

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Here, we report a patient who developed diplopia secondary to a right cranial nerve III and IV palsy, as well as fever and headache. Cerebrospinal fluid analysis (CSF) showed high varicella-zoster virus (VZV)-DNA viral load (>300,000,000 copies/ml). VZV antibodies in CSF was ≥1:16.

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In March/April 2009, a new pandemic influenza A virus (A(H1N1)pdm09) emerged and spread rapidly via human-to-human transmission, giving rise to the first pandemic of the 21th century. Influenza virus may be present in the infected host as a mixture of variants, referred to as quasi-species, on which natural and immune-driven selection operates. Since hemagglutinin (HA) and non-structural 1 (NS1) proteins are relevant in respect of adaptive and innate immune responses, the present study was aimed at establishing the intra-host genetic heterogeneity of HA and NS1 genes, applying ultra-deep pyrosequencing (UDPS) to nasopharyngeal swabs (NPS) from patients with confirmed influenza A(H1N1)pdm09 infection.

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In 2009 an influenza A epidemic caused by a swine origin H1N1strain, unusual in human hosts, has been described. The present research is aimed to perform the first phylogenetic investigation on the influenza virus A (H1N1) strains circulating in Montenegro, from December 1, 2009, when the first case of death due to H1N1 was confirmed, and the epidemic began causing a total of four fatalities. The phylogenetic analysis of the strains circulating showed the absence of a pure Montenegrin cluster, suggesting the occurrence of multiple re-introductions in that population from different areas till as far as the early 2010.

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Article Synopsis
  • During the 2009 pandemic, researchers at the Virology Laboratory in Rome used a CDC-developed RT-PCR method to diagnose influenza A/H1N1 (H1N1pdm).
  • A new multiplex RT-PCR from Astra Diagnostics, combined with Siemens Healthcare's extraction system, was tested on 76 nasopharyngeal swabs that had varying results from the CDC method.
  • The RealStar system successfully identified all previously confirmed H1N1pdm and H3N2 samples, and it was able to subtype 37.9% of untyped samples, though it found that 62.1% of samples labeled as influenza A-positive by the CDC were actually negative.
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  • The study examined the impact of clinical factors and antiviral treatment on viral shedding in patients with the A/H1N1pdm infection.
  • Among 39 hospitalized patients analyzed, pneumonia was more common in older patients, and antiviral treatment significantly reduced viral RNA levels, though it had a limited effect on shedding duration.
  • Initiating antiviral therapy within two days of symptom onset correlated with a reduced duration of viral shedding, but no drug resistance mutations were found in the patient group.
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The first patient with influenza A/H1N1-related pneumonia was admitted to an Italian ICU at the end of August 2009. Until then, despite the international alarm, the level of awareness was low and very few Italian hospitals were equipped with ECMOs. Moreover the PCR test for A H1N1 virus was sporadically available and the emergency departments of even the largest institutions could rely only on the rapid test for the urgent screening of patients with pneumonia and respiratory failure.

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Molecular testing of 270 consecutive nasopharyngeal swab samples taken in May and June 2009 and 274 samples from patients hospitalized between July and December 2009 showed similar findings of respiratory viruses, with influenza A pandemic virus H1N1/09 being the most represented, followed by human parainfluenza virus type 3 and rhinoviruses. Statistical analyses suggested virus cocirculation in the absence of viral interference.

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Article Synopsis
  • Influenza A(H1N1)v emerged as a global pandemic in 2009, though it was generally mild in severity.
  • Important evolutionary changes that enabled the virus to effectively infect humans happened quickly, even before the end of April 2009.
  • Among the various clades that developed, clade 7 later dominated and replaced earlier strains prior to the majority of worldwide cases.
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