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The emergence of new SARS-CoV-2 variants and their rapid spread pose a threat to both human and animal health and may conceal unknown risks. This report describes an Italian human-to-cat outbreak of SARS-CoV-2 lineage B.1.1.7 (the Alpha variant) . On March 7th, 2021, approximately ten days after COVID-19 appeared in the family, the onset of respiratory signs in a cat by COVID-19-affected owners led to an in-depth diagnostic investigation, combining clinical and serological data with rt-qPCR-based virus detection and whole genome sequencing. The Alpha variant was confirmed first in the owners and a few days later in the cat that was then monitored weekly: the course was similar with one-week lag time in the cat. In addition, based on comparative analysis of genome sequences from our study and from 200 random Italian cases of Alpha variant, the familial cluster was confirmed. The temporal sequence along with the genomic data support a human-to-animal transmission. Such an event emphasizes the importance of studying the circulation and dynamics of SARS-CoV-2 variants in humans and animals to better understand and prevent potential spillover risks or unwarranted alerts involving our pet populations., Highlights • Respiratory signs in a household cat ten days after the appearance of COVID-19 in the family led to a thorough investigation. • The Alpha variant (B.1.1.7) was first detected in owners and one week later in the cat which showed a similar course. • A familial cluster was confirmed based on a comparative sequence analysis of the study subjects and 200 Italian random cases. • The temporal sequence together with the genomic data support human-to-animal transmission. • The human epidemic, the easy crossing of species barriers and the abundance of pets suggest monitoring for spillover risks.

CHIKV has become an emerging public health concern in the temperate regions of the Northern Hemisphere as a consequenceof the expansion of the endemic areas of its vectors (mainly Aedes aegypti and Aedes albopictus). In 2017, a new outbreak of CHIKV was detected in Italy with three clusters of autochthonous transmission in the Lazio Region (central Italy), in the cities of Anzio, Rome, and Latina and a secondary cluster in the Calabria Region (south Italy). Given the climate characteristics of Italy, sporadic outbreaks mostly driven by imported cases followed by autochthonous transmission could occur during the summer season. This highlights the importance of a well-designed surveillance system, which should promptly identify autochthonous transmission. The use of a surveillance system integrating different surveillance tools, including entomological surveillance in a one health approach, together with education of the health care professionals should facilitate the detection, response, and control of arboviruses spreading.

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.

Background. Chlamydia trachomatis (C.t.) is one of the most common STD spread in Europe and in developed Countries. According to international studies, the highest prevalence is observed among asymptomatic, sexually active, young women, 15-24 aged. Objectives. The aim of the present study was to determine the prevalence and risk factors for genital infection with C.t. in young women under 25 aged attending to family planning clinics of Turin to active screening programs to be cost-effective in reducing the spread of C.t. infection. Study design. All the unrolled women between June 2008-December 2010, were tested for C.t. infection, using Real time PCR, on a vaginal specimen. A kit and a socio-demographic, behavioral and clinical-gynaecological questionnaire were provided to the participating clinics. Results. The study included 1831 women, of whom 31% 19 aged. The prevalence was 7.3% and was significantly associated being non Italian, having had more lifetime sexual partners and more than 1 partner in the previous six months. Conclusion. Our results are representative of general young female population of Turin. Data are comparable with those of other international studies. The high rate of infection provides information useful to plan health care interventions, like to extend the C.t. free test, not only to young women attending to STD centers but also to those one attending to family planning clinics and to promote prevention interventions to sensitize, not only youth population, on the spread of C.t. and other STD, but also family doctors and gynaecologists in order to reduce the diffusion of infections and relate complications.

Background: This work aims to analyze trends of syphilis infections in the Piedmont Region (Italy) between 2002 and 2008, and to evaluate risk factors for infection. Methods: Syphilis trends were described according to socio-demographic characteristics, sexual behavior, condom use, number of partners and HIV infection. Independent risk factors for syphilis among men having sex with men (MSM), men having sex with women (MSW), and women were identified through logistic regression comparing cases with 12,773 negative patients. Results: Between 2002 and 2008, 1,046 cases of syphilis were diagnosed, with peaks in 2004 and 2007. The risk of a syphilis diagnosis was independently associated with being older than 24, having a low education level, homosexual behavior, HIV self-reported infection (for MSM and MSW), number of partners (for MSW and women) and non- consistent condom use (for women). Conclusions: Recent outbreaks suggest that the attention to syphilis can’t be lowered. Screening, treatment of cases and notification of partners should be reinforced and integrated with sexual health education and counselling in high-risk environments. Surveillance data must be continuously collected.

Background Knowledge of the proportion of recent HIV infections (RHI) is important for epidemiologic purposes to assess HIV transmission patterns and evaluate the impact of prevention interventions. The aim of this study was to analyze the characteristics of persons with RHI and to monitor the trend of RHI over time. Methods In the period 2003-2004 and in 2007-2008, serum samples from individuals newly diagnosed with HIV infection were collected in the Infectious Diseases Hospital in Turin. All serum samples were tested for the HIV antibody avidity index (AI); samples with an AI ≤ 0.80 were defined as RHI (≤ 6 months from seroconversion). Results In the study period, 432 serum samples were collected from newly diagnosed HIV individuals. The number of persons with RHI was 113 (26.2%), and the proportion of RHI significantly increased from 22.1% in 2003-2004 to 30.8% in 2007-2008 (p-value < 0.05). The proportion of RHI was higher among MSM compared to heterosexual individuals (33.0% vs. 21.0%, p-value = 0.06). The median age of persons with RHI was similar between MSM (35 years) and heterosexual persons (34 years), as well as between 2003-2004 and 2007-2008 (35 years). A significantly higher proportion of persons who underwent a previous HIV test was observed among RHI (51.3%) compared to those with an established infection (28.5%) (p < 0.001). The proportion of RHI among MSM increased from 25.5% in 2003-2004 to 40.7% in 2007-2008, whereas remained almost stable among heterosexual persons and injecting drug users. Disaggregating by reasons of HIV testing, different proportions of RHI were found: 34.8% among those exposed to unprotected sexual intercourse, 24.5% among injecting drug users, and 11.5% among those screened during pregnancy or blood donation. Discussion RHI have increased over time in Turin, especially among MSM. However, no changes were observed in the age of HIV acquisition by sexual orientation and time period. The identification of RHI can be affected by the frequency of HIV testing and this bias should be considered in estimating HIV incidence.