In Italy the circulation of respiratory viruses is at pre-Covid levels. To say it is Pierangelo Clerici, president of the Italian Clinical Microbiologists Association (Amcli), commenting on the data which in recent weeks has seen a significant increase in people suffering from respiratory infections, due to changes in weather conditions and the simultaneous circulation of multiple pathogens. However, although the circulation of influenza viruses has returned to what it was before the pandemic – the experts point out – the trend recorded in our country is not anomalous.
Data in Italy
“According to the data communicated to the Italian system for surveillance of flu-like syndromes RespiVirNet, the incidence in Italy has reached a level of high intensity, with 17.5 cases per thousand assisted. We are therefore witnessing the heaviest winter season of the last 15 years, with a considerable impact on people of all ages, but especially on children and the fragile population. Various respiratory viruses – including influenza viruses (in particular the viral subtype A/H1N1pdm09), Sars-CoV-2, especially the variant of concern JN.1, daughter of the Pirola variant, and the respiratory syncytial virus – are contributing to these numbers and putting pressure on care systems.”
We are faced with a “quite normal” phenomenon for this period of the year – explains Antonio Piralla, virologist at the San Matteo Polyclinic in Pavia and coordinator of the Amcli working group on respiratory viral infections (severe and otherwise). Glivire – The rigid temperatures of these days favor the gathering of people in closed spaces and the appearance of the influenza virus in the cold seasons does not eliminate the circulation of the numerous respiratory viruses (respiratory syncytial virus, rhinovirus, Sars-CoV-2, adenovirus, parainfluenza viruses, etc.) in capable of causing clinical pictures that overlap with those caused by influenza infection and which are transmitted in the same way. The cases of infection with non-flu respiratory viruses have therefore added to those strictly speaking due to the different influenza strains, overloading the receptive capacity” of health facilities.
“Certainly, in the post-pandemic phase – underlines Elena Pariani, epidemiologist-virologist of the State University of Milan and secretary of Glivire – the respiratory viruses have gradually resumed their circulation until reaching the current season where the flu viruses have returned at the levels of the 2019 season. The low participation in the anti-flu and anti-Covid-19 vaccination campaign has contributed to defining the current epidemiological scenario, including numerous access to emergency rooms. It is important to consider that the peak period does not present any abnormalities – he points out – and is in line with what has been reported by other European countries. Furthermore, at the moment, even the surveillance data for serious and complicated forms of influenza do not indicate anomalies and are consistent with the general epidemiological picture”.
“The virological surveillance system – continues Clerici – will guarantee the monitoring of circulating pathogens and will be able to verify through sequencing the presence of variants associated with more serious clinical syndromes which, at the moment, do not appear to be circulating on the basis of what has yet been reported by the European Center for control of infectious diseases (ECDC). Amcli's commitment – he assures – is to promote and support the activities of the clinical microbiology laboratories, from early diagnosis to the genetic sequencing of respiratory viruses, the cornerstone of the molecular surveillance system”.
At the regional reference center for microbiological emergencies Crrem-Uo Microbiologia, Irccs Policlinico Sant'Orsola in Bologna – reports the Amcli – it has been demonstrated that the strains of influenza A subtype H1N1, currently circulating, are phylogenetically correlated with the current vaccine strain A/Victoria/4897/2022 (northern hemisphere). “This and other news on respiratory infections caused by respiratory syncytial virus and Sars-CoV-2 will be discussed tomorrow in Bologna during a meeting promoted by Amcli – announces Tiziana Lazzarotto, virologist at the University of Bologna, director of the Microbiology Unit of Bologna and scientific director of Amcli – The event, characterized by a multidisciplinary approach, will see the participation of institutional representatives from the Emilia Romagna Region and the Higher Institute of Health, clinicians, infectious disease specialists, virologists and microbiologists of Amcli”.
“The aim of the initiative – concludes Lazzarotto – is to share the most recent surveillance data with the various professional figures involved in the control of respiratory viral infections, to understand the impact of vaccination programmes, the prevalence and spread of respiratory diseases; on vaccination strategies, to understand the potential of the new vaccines available; on clinical diagnosis, to understand the harmonized management of patients. Finally on innovative virological diagnosis, to understand the correct execution (in times and ways) and interpretation of laboratory diagnostics”.
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