A new human opisthorchiasis outbreak in central Italy: a never-ending story.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-09-26 DOI:10.1007/s15010-024-02340-8

Chiara Papalini, Maria Angeles Gómez-Morales, Alessandra Mercuri, Elisa Stolaj, Maria Grazia Brancaleoni, Igino Fusco Moffa, Giovanni Lo Vaglio, Alessandra Ludovisi, Gianluca Marucci, Daniela Francisci

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Abstract

Purpose: Opisthorchis felineus is a trematode causing a foodborne infection transmitted by raw freshwater fish belonging to Cyprinidae family. Human outbreaks in Italy dated back to 2003-2011 and involved lakes of Central Italy. The aim of this study is to report epidemiological and clinical characteristics of the human opisthorchiasis outbreak occurred in Central Italy in 2022 comparing it with previous events.

Methods: We report cases diagnosed from June to December 2022 in Perugia hospital thanks to serological and molecular tests and direct examination of feces.

Results: Sixty-seven individuals were traced back by epidemiological investigation. Forty-seven received a diagnosis of opisthorchiasis, of which 45 were confirmed cases and two were considered as probable cases. These 47 individuals attended a Trasimeno lakeshore restaurant in May 2022. All but 20 presented symptoms, mostly fever. Sixteen (15 confirmed and 1 probable) cases required hospitalization. Feces examination revealed Opisthorchis spp. eggs in 35/45 (78%) confirmed cases. Thirty individuals underwent to serology and molecular stool test: 5 (16.7%) results positive to the former, 1 (3.3%) to the latter while 4 (13.3%) to both. Laboratory tests, available in 28 patients, showed eosinophilia in 82.1%, increase of alanine aminotransferase, gamma-glutamyl transferase and alkaline phosphatase in 64.3%, 75% and 67.9%, respectively. Because of pharmacy shortage of praziquantel, 22 patients were treated with albendazole, of which 13 failed clearing the parasite.

Conclusion: Opisthorchiasis still represents a challenging diagnosis, in particular for asymptomatic patients. Albendazole may lead to treatment failure. Control measures in known endemic areas should be implemented.

Trial registration: number 27,498/23/ON, approved by Ethical Committee of Umbrian Region in 09.13.2023.

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意大利中部新爆发的人类口蹄疫：一个永无止境的故事。

目的：鲤科生淡水鱼是一种可引起食源性感染的吸虫。意大利的人类疫情爆发可追溯到 2003-2011 年，涉及意大利中部的湖泊。本研究的目的是报告2022年意大利中部爆发的人类口蹄疫疫情的流行病学和临床特征，并将其与之前的疫情进行比较：我们报告了 2022 年 6 月至 12 月在佩鲁贾医院通过血清学和分子检测以及粪便直接检查确诊的病例：通过流行病学调查追溯到 67 人。47人被确诊为口蹄疫患者，其中45人为确诊病例，2人为疑似病例。这 47 人于 2022 年 5 月在特拉西梅诺湖畔的一家餐馆就餐。除 20 人外，其他人都出现了症状，主要是发烧。其中 16 例（15 例确诊，1 例疑似）需要住院治疗。粪便检查发现，35/45（78%）个确诊病例体内有 Opisthorchis spp.30 人接受了血清学和粪便分子检测：前者检测结果呈阳性的有 5 人（16.7%），后者检测结果呈阳性的有 1 人（3.3%），两者均呈阳性的有 4 人（13.3%）。28 名患者的实验室检测结果显示，82.1%的患者出现嗜酸性粒细胞增多，64.3%、75% 和 67.9%的患者出现丙氨酸氨基转移酶、γ-谷氨酰转移酶和碱性磷酸酶升高。由于药房缺乏吡喹酮，22 名患者接受了阿苯达唑治疗，其中 13 人未能清除寄生虫：结论：蛔虫病的诊断仍然具有挑战性，尤其是对无症状的患者而言。阿苯达唑可能导致治疗失败。试验注册号：27,498/23/ON，于 2023 年 9 月 13 日获得翁布里亚大区伦理委员会批准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.