Volume 28, Issue 2, 2020
Editorial
SARS-CoV-2 invades the West. How to face a COVID-19 epidemic in Lombardy, Northern Italy?
Rizzi Marco,
Castelli Francesco,
Latronico Nicola,
Focà Emanuele
Not available
Videoconferences of Infectious Diseases: An educational tool that transcends borders. A useful tool also for the current COVID-19 pandemic.
Gonzales_Zamora Jose A.,
Alave Jorge,
De Lima-Corvino Daniela F.,
Fernandez Anmary
Not available
Genomic Epidemiology and its importance in the study of the COVID-19 pandemic
Rodríguez-Morales Alfonso J.,
Balbin-Ramon Graciela J.,
Rabaan AliA.,
Sah Ranjit,
Dhama Kuldeep,
Paniz-Mondolfi Alberto,
Pagliano Pasquale,
Esposito Silvano
Not available
Review
Vademecum for the treatment of people with COVID-19. Edition 2.0, 13 March 2020
SIMIT Lombardy Section
The spread of COVID-19 epidemic in Italy, and particularly in Lombardy determined the need to standardize the therapeutic approach in order to offer the same indications for all hospitals in Lombardy. However, no specific drug has been previously approved for the COVID-19 treatment.
The Lombardy Section of the Italian Society of Infectious and Tropical Diseases provided this “vademecum” with the aim to explore the current evidence about the drugs likely to be efficacious in the treatment of COVID-19. Moreover, a multidisciplinary group including critical care specialists has been created in order to provide indications about supporting measures and the use of steroids. A new grading scale has been proposed to help patients’ stratification according to the severity of the respiratory conditions. Lastly, a collaborating group with immunologists and rheumatologists has been built with the aim of providing some guidance about the use of tocilizumab, a promising option for the treatment of the hyperinflammatory state occurring in most patients affected by COVID-19.
Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period
Ozma Mahdi Asghari,
Maroufi Parham,
Khodadadi Ehsaneh,
Köse Şükran,
Esposito Isabella,
Ganbarov Khudaverdi,
Dao Sounkalo,
Esposito Silvano,
Zeinalzadeh Elham,
Dal Tuba,
Kafil Hossein Samadi
The novel coronavirus SARS-CoV-2 (Covid-19), spreading from Wuhan, China, is one of the causes of respiratory infections that can spread to other people through respiratory particles, and can cause symptoms such as fever, dry cough, shortness of breath, anorexia, fatigue and sore throat in infected patients. This review summarizes current strategies on the diagnosis. Additionally, treatments, infection prevention and control of the SARS-CoV-2 are addressed. In addition to the respiratory system, this virus can infect the digestive system, the urinary system and the hematological system, which causes to observe the virus in the stool, urine and blood samples in addition to throat sample. The SARS-CoV-2 causes changes in blood cells and factors and makes lung abnormalities in patients, which can be detected by serological, molecular, and radiological techniques by detecting these changes and injuries. Radiological and serological methods are the most preferred among the other methods and the radiological method is the most preferred one which can diagnose the infection quickly and accurately with fewer false-negatives, that can be effective in protecting the patient's life by initiating treatment and preventing the transmission of infection to other people.
Exploring the genetics, ecology of SARS-COV-2 and climatic factors as possible control strategies against COVID-19
Abdullahi Idris Nasir,
Emeribe Anthony Uchenna,
Mustapha Jelili Olaide,
Fasogbon Samuel Ayobami,
Ofor Igri Bassey,
Opeyemi Imodoye Sikiru,
Obi-George Chibueze,
Sunday Animasaun Olawale,
Nwofe Justin,
The world has been thrown into pandemonium due to the recent Coronavirus Disease-19 (COVID-19) pandemic. Early available clinical data have indicated that geriatric persons cum those with comorbidity such as cardiovascular, metabolic and immunological disorders suffered severe form of COVID-19. All countries and territories of the world are currently exploring available strategies to control the pandemic with the hope to significantly minimize its morbidity and mortality rate. This present study critically reviewed available and latest research progress on the genetics and ecology of SARS-CoV-2, as well as the influence of climatic factors on the spread of COVID-19, and thus, discussed how these concepts could be harnessed for COVID-19 control and further scientific advancements in resolving the pandemic.
SARS-CoV-2, SARS-CoV, and MERS-COV: A comparative overview
Rabaan Ali A.,
Al-Ahmed Shamsah H.,
Haque Shafiul,
Sah Ranjit,
Tiwari Ruchi,
Malik Yashpal Singh,
Dhama Kuldeep,
Yatoo M. Iqbal ,
Bonilla-Aldana D. Katterine,
Rodriguez-Morales Alfonso J.
The recent outbreak of SARS-CoV-2 that started in Wuhan, China, has now spread to several other countries and is in its exponential phase of spread. Although less pathogenic than SARS-CoV, it has taken several lives and taken down the economies of many countries. Before this outbreak, the most recent coronavirus outbreaks were the SARS-CoV and the MERS-CoV outbreaks that happened in China and Saudi Arabia, respectively. Since the SARS-CoV-2 belongs to the same family as of SARS-CoV and MERS-CoV, they share several similarities. So, this review aims at understanding the new scenario of SARS-CoV-2 outbreak and compares the epidemiology, clinical presentations, and the genetics of these coronaviruses. Studies reveal that SARS-CoV-2 is very similar in structure and pathogenicity with SARS-CoV, but the most important structural protein, i.e., the spike protein (S), is slightly different in these viruses. The presence of a furin-like cleavage site in SARS-CoV-2 facilitates the S protein priming and might increase the efficiency of the spread of SARS-CoV-2 as compared to other beta coronaviruses. So, furin inhibitors can be targeted as potential drug therapies for SARS-CoV.
Protection and disinfection policies against SARS-CoV-2 (COVID-19)
Fathizadeh Hadis,
Maroufi Parham,
Momen-Heravi Mansooreh,
Dao Sounkalo,
Köse Şükran,
Ganbarov Khudaverdi,
Pagliano Pasquale,
Espsoito Silvano,
Kafil Hossein Samadi
In late December 2019, reports from China of the incidence of pneumonia with unknown etiology were sent to the World Health Organization (WHO). Shortly afterwards, the cause of this disease was identified as the novel beta-coronavirus, SARS-CoV-2, and its genetic sequence was published on January 12, 2020. Human-to-human transmission via respiratory droplets and contact with aerosol infected surfaces are the major ways of transmitting this virus. Here we attempted to collect information on virus stability in the air and on surfaces and ways of preventing of SARS-CoV-2 spreading.
Improving the efficacy of Chloroquine and Hydroxychloroquine against SARS-CoV-2 may require Zinc additives - A better synergy for future COVID-19 clinical trials
Shittu Mujeeb Olushola,
Afolami Olufemi Ifeoluwa
The recent outbreak of coronavirus disease 2019 (COVID-19), is now officially declared as a pandemic by the World Health Organization. As of now, there is no known effective pharmaceutical agent against the SARS-CoV-2 virus. However, several precautionary measures have been prescribed to prevent further spread of the virus, which include avoidance of social gatherings, proper handwashing, frequently disinfecting of used items and surfaces and so on. More recent studies have highlighted the possibility of treating patients infected with the novel SARS-CoV-2 virus with chloroquine and hydroxychloroquine, of which mechanism of action is not completely understood. We seek to draw the attention of the scientific community to the possibility of drastically reducing the effects of the virus on the affected patients and improving clinical trials outcome through the synergistic action of zinc and chloroquine in patients suffering from the coronavirus disease.
Update on treatment of COVID-19: ongoing studies between promising and disappointing results
Esposito Silvano,
Noviello Silvana,
Pagliano Pasquale
The COVID-19 pandemic represents the greatest global public health crisis since the pandemic influenza outbreak of 1918. We are facing a new virus, so several antiviral agents previously used to treat other coronavirus infections such as SARS and MERS are being considered as the first potential candidates to treat COVID-19. Thus, several agents have been used by the beginning of the current outbreak in China first and all over the word successively, as reported in several different guidelines and therapeutic recommendations. At the same time, a great number of clinical trials have been launched to investigate the potential efficacy therapies for COVID-19 highlighting the urgent need to get as quickly as possible high-quality evidence.
Through PubMed, we explored the relevant articles published on treatment of COVID-19 and on trials ongoing up to April 15, 2020.
Clinical aspects of Ebola virus disease: a review
Batra Simran,
Ochani Rohan Kumar,
Diwan Mufaddal Najmuddin,
Yasmin Farah,
Qureshi Suha Safi,
Bhimani Sameer,
Shaikh Shehryar,
Tariq Muhammad Ali,
Ashraf Ahmed,
Farooqi Hamza Ahmed,
Dodani Sunil Kumar
Ebola Virus Disease (EVD), also known as Ebola Hemorrhagic Fever (EHF), initially emerged over 40 years ago in the Democratic Republic of Congo. Endemic to Africa, outbreaks have been recorded in six African countries since its detection in 1976. Fruit bats are believed to be the natural hosts of Ebola viruses (EBoV), with humans and other mammals serving as accidental hosts. Transmission of EBoV has been reported in various ways, including human to human transmission through close contact with blood and bodily fluids. The virus has an incubation period ranging from two to twenty-one days, followed by a multitude of clinical manifestations such as the sudden onset of high fever, chills and myalgia depicting a flu-like syndrome. It is usually diagnosed based on several clinical symptoms such as the sudden onset of illness, high fevers for less than three weeks, and at least two hemorrhagic symptoms despite no predisposing factors. This generally provides enough evidence for clinicians to consider EHF and begin supportive treatment until the virus is confirmed through laboratory findings. Management of patients involves supportive care such as maintaining fluid along with electrolyte balance, blood pressure and oxygen saturation. This also includes treating complications arising from secondary infections. The main options include: prophylactic strategies, anti-viral therapy for EVD, immunotherapies, vaccines, and ZMapp. Finally, the key to managing EBoV epidemics is to stop the transmission of disease in the most severely affected population, as prevention has become of utmost importance to alleviate the significant physical and economic burden.
Original article
Risk factors for hepatitis B and C among healthy population: a community-based survey from four districts of Southern Italy
Serraino Riccardo,
Mazzitelli Maria,
Greco Giuseppe,
Serapide Francesca,
Scaglione Vincenzo,
Marascio Nadia,
Trecarichi Enrico Maria,
Tort Carlo
In Southern Italy, viral hepatitis B and C still represent an important public health problem, with a serious social impact, and significant economic consequences. The objective of our community-based study was to assess the prevalence of risk factors and access to the test for viral hepatitis to get information for guiding prevention and screening strategies in our setting. The study was conducted among population of four selected districts in Southern Italy during May 2019. An anonymous structured questionnaire consisting of multiple-choice questions was administered by trained research assistants in order to assess any possible risk factor for HCV or HBV acquisition, and if any screening was previously performed. Six-hundred participants were included: 367 (61.2%) were females, with a mean age of 51 years (standard deviation, SD: 18 years). The three most frequent risk factors were: dental treatments in 425/600=70.8% (of whom 76/425=17.8% were previously tested), unprotected sexual intercourses in 340/600=56.6% (of whom 54/340=15.8% were previously tested), and injections with glass syringes in 162/600=27% (of whom 32/162=19.7% were previously tested). Only 47/502 (9.3%) patients who were never been tested, did not report any risk factors for HCV or HBV acquisition, while 433 (86.2%) reported at least one risk factor, 293 (58.3%) at least two, 97 (19.3%) at least three, 16 (3.1%) at least four, and 2 reported to have at least five risk factors for HBV/HCV acquisition. Our study shows that access to the HBV and HCV tests by the general population in these four selected districts is very limited (only 16.3 % of the participants underwent a screening test), especially in people with risk factors.
Perinatal transmission in Human Immunodeficiency Virus infection: a cross-sectional study from a tertiary care center in North India
Kodan Parul,
Gupta Nitin,
Ratna Sumol,
Ramprasad Aishwarya,
Ranjan Sanjay,
Nischal Neeraj,
Soneja Manish,
Wig Naveet
Perinatal transmission of Human Immunodeficiency Virus (HIV) infection is an important mode of transmission in developing countries. The aim of this study was to evaluate the epidemiology of perinatal transmission of HIV infection in pregnant women living with HIV/Acquired Immune Deficiency Syndrome [AIDS]. A cross-sectional study was conducted in which HIV positive females who were pregnant at any time between April 2015 and July 2017 were interviewed and their case records analyzed. The collected data were entered and analyzed using Stata v11. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation [SD] for continuous variables. In all, 51 women were included in the study, 41 of whom had little knowledge concerning the transmission mode of HIV and its prevention. A total of 28 of these females were diagnosed with HIV during their pregnancy (First trimester-4, second trimester -18 and third trimester -6). A total of four babies delivered by these women were diagnosed with HIV. All the four babies were delivered by mothers who were diagnosed with HIV in or after the second trimester of the pregnancy. There is a need to create awareness amongst pregnant women about the importance of antenatal checkups.
Knowledge, attitude and practice of medical students towards HIV patients in their pre-clinical and post-clinical years in Karachi, Pakistan: a dual-center cross-sectional study
Batra Simran,
Memon Zahid Ali,
Ochani Rohan Kumar,
Awan Sana,
Bhimani Simran,
Siddiqui Yumna,
Mohiuddin Asher,
Farooqi Hamza Ahmed
The human immunodeficiency virus (HIV) is currently a global threat with an estimated 38.6 million people affected with HIV worldwide. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), since 2004 the total number of cases of HIV in Pakistan has risen from 2700 to 130,000. In light of the rising burden of HIV/AIDS across the country, it is essential that medical students possess appropriate knowledge regarding the subject. Therefore, we aimed to assess the knowledge, attitude and practice of medical students towards HIV patients in their pre-clinical and post-clinical years in Karachi, Pakistan. A cross-sectional study was conducted among 518 pre-clinical (year 1 and 2) and post-clinical (year 3, 4, and 5) medical students from two medical schools in Karachi during the months of October – December 2019. Similar numbers of participants were taken from each year. Data were analyzed using SPSS. Descriptive statistics were used to report frequencies and proportions for categorical responses. Chi-square and Kruskal-Wallis tests were used as the primary statistical tests. About 55% of participants were female, and most belonged to the Islamic faith. More than half of the participants learned about HIV from books (315/518), followed by medical personnel (287/518). A quarter (134/518) of the participants believed HIV could be transmitted by sharing saliva, more than half of whom consisted of pre-clinical year students. Over half the participants (60.4%) knew that there was a difference between HIV and AIDs, most of whom belonged to the 5th year group. When detecting HIV, only about 30% of participants knew about indirect fluorescent antibody. Regarding attitudes, one-third would not be friends with a person diagnosed with HIV/AIDS. As a medical officer, a large majority (76.6%; n=397/518) of the participants would be anxious or somewhat anxious. Two-thirds believed that treating an HIV patient can make them contract HIV, and a majority of participants (333/518) did not feel adequately prepared to deal with the psycho-social problems of an HIV/AIDS patient. Finally, regarding practice, only one-third of the participants were willing to treat an HIV/AIDS patient, most of whom belonged to the pre-clinical 2nd year group and fewer to the post-clinical 3rd year group. Knowledge amongst medical students regarding HIV/AIDS was generally high, although there are some knowledge inadequacies which require more emphasis in the medical school curriculum. However, contrasting with the level of knowledge, in terms of attitude the majority were anxious or somewhat anxious when treating an HIV patient, and only one-third were willing to treat a patient with HIV.
Risk factors for mortality in patients with Coronavirus Disease 2019 (COVID-19) in Bolivia: An analysis of the first 107 confirmed cases
Escalera-Antezana Juan Pablo,
Lizon-Ferrufino Nicolas Freddy,
Maldonado-Alanoca Americo,
Alarcón-De-la-Vega Gricel,
Alvarado-Arnez Lucia Elena,
Balderrama-Saavedra María Alejandra,
Bonilla-Aldana D. Katterine,
Rodríguez-Morales Alfonso J.,
LANCOVID on behalf of
The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charité, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (≥60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ≥60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.
Imported dengue fever: a 16-years retrospective analysis in Milan (Italy) and a brief review of the European literature
Pagani Gabriele,
Zanchetta Nadia,
Galimberti Laura,
Oreni Letizia,
Passerini Simone,
Giacomelli Andrea,
Cordier Laura,
Gismondo Maria Rita,
Rizzardini Giuliano,
Galli Massimo,
Antinori Spinello
Dengue Fever (DF), transmitted by Aedes mosquitoes, is the most common arthropod-borne infection, it is almost ubiquitous in tropical and subtropical areas with an estimate of 360 million infections per year. A competent vector (A. albopictus) is present in most of Southern Europe and is endemic in Italy. We conducted a 16-year retrospective study of probable/confirmed dengue fever observed at the Department of Infectious Diseases of Luigi Sacco Hospital in Milan, Italy. Overall 122 patients were included in the study, 106 with probable and 16 with proven diagnosis of dengue fever. Most patients (91%) were Italian, with a median age of 35 years (IQR 29-46 years) and similar gender distribution, travelling for tourism (80%). Asia (mainly South East Asia and Indian Subcontinent) was the most frequent travel destination (55%), followed by Central America and the Caribbeans (22%). August-September was the peak season of presentation (42.6%). The majority of our diagnoses were based on serology alone. The most common signs and symptoms were fever (99,2%), maculopapular rash (50,8%), headache (50,8%), arthralgias (50,8%) and myalgias (46,7%). Leukopenia (77%), thrombocytopenia (81%) and altered LDH, AST and ALT (respectively 60,6%, 54,1% and 45,9%) were the most common laboratory test’s abnormalities. No cases of severe DF were recorded. Our epidemiological and clinical findings are largely in accordance with most recent studies about imported DF in Europe. Although very similar in presentation to other arthropod-borne illnesses, some clinical features may help in differentiating DF from other causes of fever in the returning traveler.
Case report
Acute septic elbow monoarthritis with associated Neisseria gonorrhoeae bacteraemia: an uncommon presentation of an old disease
Piazza Michael J.,
Gonzales-Zamora Jose A.
Neisseria gonorrhoeae is an uncommon present-day cause of septic arthritis. It is generally seen in the younger patient population and is often difficult to isolate in the lab. Blood cultures performed as routine work are usually negative, and when positive tend to be seen in the classic form of disseminated gonococcal infection. Here we report a case of acute septic monoarthritis, associated with N. gonorrhoea bacteraemia, in a 67-year-old male patient with multiple chronic comorbidities, who presented with acute pain and swelling at his left elbow, and no associated skin changes. Arthrocentesis findings were consistent with septic arthritis. Blood cultures drawn on admission grew N. gonorrhoeae. Synovial fluid culture was sterile but did exhibit Gram-negative cocci on Gram stain. The patient was started on IV antibiotics, and later underwent incision and drainage with subsequent improvement in symptoms.
We thus present an unusual form of disseminated gonococcal infection in the setting of: epidemiology, physical presentation, as well as microbiologic findings. Although less common, DGI should be considered in the differential for septic join in the older adult population, and a sexual history should be obtained in all patients. This patient ultimately had an excellent outcome given his prompt presentation after symptom onset and immediate initiation of medical therapy.
Listeria infection after treatment with alemtuzumab: a case report and literature review. Would antibiotic prophylaxis be considered?
Mazzitelli Maria,
Barone Stefania,
Greco Giuseppe,
Serapide Francesca,
Valentino Paola,
Giancotti Alda,
Costa Chiara,
Pisani Vincenzo,
Quirino Angela,
Liberto Maria Carla,
Matera Giovanni,
Gambardella Antonio,
Trecarichi Enrico Maria,
Torti Carlo
Few cases of complicated infections with Listeria monocytogenes (LM) have been reported to date in patients with multiple sclerosis (MS) treated with alemtuzumab. Primary prevention strategies may be suggested in such patients to avoid infections. However, these may be ineffective because patients may already be carriers of LM. We report herein a case of bloodstream infection due to LM in a 25-year-old woman with MS treated with alemtuzumab. We searched the UMC/WHO Vigibase system for all reported cases of LM in patients treated with alemtuzumab and found 29 cases overall up to 21 July 2019. We also performed a literature review of MS cases with LM on alemtuzumab, in order to evaluate epidemiology, clinical characteristics, and outcome of this complication. Since the published cases (N=8) were mainly reported in recent years but more cases were found in the UMC/WHO Vigibase system (although not necessarily in patients with MS), we hypothesize that this complication is more frequent than currently believed and may become even more important in the future. Therefore, it is worth reaching a consensus on appropriate algorithms to stratify individuals by risk so as to implement targeted prevention strategies (whether primary or secondary).
Severe respiratory failure in an immunocompetent host with invasive pulmonary aspergillosis and H1N1 influenza
Saccaro Luigi Francesco,
Galfo Valentina,
Ferranti Simone,
Russo Alessandro,
Menichetti Francesco
Invasive pulmonary aspergillosis (IPA) is a life-threatening condition that usually occurs in immunocompromised hosts. However, according to recent reports it can affect immunocompetent hosts with severe influenza infection due to viral-dependent disruption of respiratory immune defenses. We present the case of a 61-year-old Caucasian man admitted to the Emergency Department with respiratory failure and fever, who was diagnosed with H1N1 influenza and IPA. Because of his poor general conditions, he was treated with a double antifungal scheme, although this lies outside the suggested treatment guidelines. This choice turned out to be extremely effective. He was discharged after one month and his clinical conditions showed rapid improvement, with nearly complete normalization of the radiological pattern in three months. IPA remains a life-threatening condition, even in immunocompetent hosts, and should therefore always be suspected; if necessary, a combined treatment should rapidly be started. We report this case as the interest in influenza-associated IPA is high, both due to the clinical severity of this condition, which is treatable if identified early, and the emerging importance of respiratory infections caused by viruses belonging to the SARS family, such as SARS-CoV-2.
Multiple neurocysticercosis and aneurismal subarachnoid hemorrhage: case presentation and systematic literature review
Meregildo Rodriguez Edinson Dante
Neurocysticercosis (NCC) is a global health problem. In more developed countries, NCC is mainly a disease affecting immigrants. In developing countries, NCC is the most common parasitic disease of the nervous system and the main cause of acquired epilepsy. NCC is also an unrecognized cause of strokes and could account for 4%-12% of strokes. Here, I report a case of a 58-year-old woman who presented to the emergency department (ED) with severe headache, vomiting, and sudden loss of consciousness. Multiple NCC and Fisher grade 4 aneurysmal subarachnoid hemorrhage (SAH) were demonstrated by neuroimaging. This patient evolved favorably with albendazole and corticosteroids. This case exemplifies that NCC must be considered in the differential diagnosis of stroke in younger and middle-aged patients, especially if they do not have classical cardiovascular risk factors and come from endemic regions for cysticercosis.
The Infections in the History of Medicine
Alexandroupolis (Dedeagatch): A city born of infections and the first documented death of the Italian civilian Giuseppe Bigheti
Kyrkoudis Theodoros,
Tsoucalas Grigorios,
Fiska Aliki
The choice of Dedeagatch as the place where the station of the Adrianoupolis-Constantinople railway line was to be built was the reason for the foundation of the Greek city of Alexandroupolis (originally under the Ottoman government). The population grew in its early years mainly due to the settlement by railway and construction workers. Meanwhile, poverty, poor hygiene and environmental conditions led to a series of epidemics and various sporadic cases of infections such as malaria, typhoid fever, scarlet fever and tuberculosis, infections which marked the early history of Alexandroupolis. The first documented death due to typhoid fever in the area, namely that of the Italian civilian Giuseppe Bigheti, is mentioned in the paper.
The plague in Bologna in the year 1527
Sabbatani Sergio,
Fiorino Sirio,
Manfredi Roberto
In the year 1527, following the invasion of Italy by Landsknechts, who were headed by Georg von Frundsberg, the bubonic plague appeared in the country. These soldiers were part of an army that Charles V sent to invade Italy in order to subjugate the Italian states which had adhered to the League of Cognac. In Bologna during the year 1527 believers held a procession from the Sanctuary of the Madonna del Soccorso, through the city, as far as the Church of San Rocco. The reason for this practice was linked with the plague epidemic. After some cases of plague observed in the Borgo di San Pietro district the miracle of the interruption of the epidemics, thanks to the intervention of Our Lady, was narrated by the faithfuls. Later, after several decades, it was reported by several authors from Bologna, who were not witnesses to the facts, that the epidemic had involved 12,000 out of a total population of around 60,000 inhabitants at that time.
We re-evaluated this situation starting from the demographic data concerning the citizens in Bologna during the 15th, 16th and 17th centuries. Furthermore, we performed a search in the State Archives in the city of Bologna in order to find any public notices from the city authorities in the year 1527 aiming to counteract a plague epidemic. Our investigation found no elements to support the outbreak of this disease. Throughout the 16th century, until 1590, the population grew significantly, and no public notices were issued or specific laws enacted to deal with the plague until the year 1557. However, it remains possible that in the area in question, some episodes of plague occurred, but it was fortunately a micro-epidemic, which involved a very poor area of the city. Then this disease was self-limited.
However, in our opinion, this episode proved very important, since in this district of Bologna, and around a wooden image of the Madonna del Soccorso, a confraternity took place, and its activities continued until the year 1798. This group of citizens also played a major role in many charitable activities to aid the inhabitants of Bologna, during a difficult historical period, namely the Protestant Reformation, and contributed to strengthen the faith of Catholic believers.
Letters to the editor
The seXY side of COVID-19: what is behind female protection?
Antonello Roberta Maria,
Dal Bo Eugenia,
De Cristofaro Paolo,
Luzzati Roberto,
Di Bella Stefano
Not available
