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Article ; Online: Adherence to Mediterranean Diet and Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis.

Nucci, Daniele / Nardi, Mariateresa / Cinnirella, Andrea / Campagnoli, Emanuela / Maffeo, Manuel / Perrone, Pier Mario / Shishmintseva, Viktoriia / Grosso, Francesca Maria / Castrofino, Ambra / Castaldi, Silvana / Romanò, Luisa / Gianfredi, Vincenza

International journal of environmental research and public health

2023 Volume 20, Issue 3

Abstract: Pancreatic cancer (PC) represents the 6th cause of cancer death. Although the aetiology of PC is not completely understood, numerous risk factors have been identified in association with this cancer, among them diet. However, little is known about the ... ...

Abstract	Pancreatic cancer (PC) represents the 6th cause of cancer death. Although the aetiology of PC is not completely understood, numerous risk factors have been identified in association with this cancer, among them diet. However, little is known about the association between the Mediterranean Diet (MedDiet) and the risk of PC. For this reason, we conducted a systematic review with meta-analysis according to the PRISMA guidelines, searching on three databases (PubMed/MEDLINE, Scopus, and EMBASE). The protocol was registered in PROSPERO. Both fixed and random effect models were performed. The Effect size was reported as a hazard ratio (HR) with a 95% Confidence Interval (CI). A total of eight articles were included. The methodological quality of the included meta-analyses was high. Our results show that a higher adherence to the MedDiet is associated with a lower risk of PC [HR:0.82 (0.76-0.88)
MeSH term(s)	Humans ; Diet, Mediterranean ; Risk Factors ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/prevention & control ; Incidence ; Pancreatic Neoplasms
Language	English
Publishing date	2023-01-29
Publishing country	Switzerland
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20032403
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A comparative study between the incidence and epidemiological features of Influenza-Like Illness and laboratory-confirmed COVID-19 cases in the Italian epicenter (Lombardy).

Grosso, Francesca / Castrofino, Ambra / Del Castillo, Gabriele / Galli, Cristina / Binda, Sandro / Pellegrinelli, Laura / Bubba, Laura / Cereda, Danilo / Tirani, Marcello / Gramegna, Maria / Bella, Antonino / Castaldi, Silvana / Pariani, Elena

Journal of infection and public health

2021 Volume 14, Issue 5, Page(s) 674–680

Abstract: Introduction: In Lombardy, the influenza surveillance system relies on sentinel physicians that weekly report data on the number of Influenza-Like Illness (ILI) and a part of them also collect nasopharyngeal samples for virologic analyses. This study ... ...

Abstract	Introduction: In Lombardy, the influenza surveillance system relies on sentinel physicians that weekly report data on the number of Influenza-Like Illness (ILI) and a part of them also collect nasopharyngeal samples for virologic analyses. This study aims at comparing the ILI incidence of 2019-2020 influenza season with the incidence of COVID-19 cases in order to better understand the current epidemic and to evaluate whether the implementation of ILI surveillance system could succeed in early detection and monitoring of COVID-19 diffusion. Methods: The distribution of ILI cases in the seasons 2017-2018, 2018-2019 and 2019-2020 was taken in consideration and the curve trends were compared and analyzed according to geographical areas, age groups and time differences. Results: The curve trends presented a similar pattern up to the 9th week; in fact, a reduction in the ILI incidence rate was observed in the 2017-2018 and 2018-2019 season but in the 2019-2020 an increase in the reported ILI emerged. The relation between the numbers reported by 2019-2020 ILI surveillance and those reported for COVID-19 is supported by the curve trends, the correspondence between age groups, the correspondence by geographical location, and also by the results of the nasopharyngeal swab tests performed. Discussion: The influenza surveillance system is an effective tool for early detection of COVID-19. It may provide timely and high-quality data evaluating the SARS-CoV-2 burden among population with ILI. Implementation of the system has to be prioritized in order to identify any future novel respiratory pathogen with pandemic potential.
MeSH term(s)	COVID-19 ; Humans ; Incidence ; Influenza, Human/epidemiology ; Italy/epidemiology ; Laboratories ; SARS-CoV-2 ; Seasons ; Sentinel Surveillance
Language	English
Publishing date	2021-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2021.02.003
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Influenza Vaccination Campaign during the COVID-19 Pandemic: The Experience of a Research and Teaching Hospital in Milan.

Perrone, Pier Mario / Biganzoli, Giacomo / Lecce, Maurizio / Campagnoli, Emanuela Maria / Castrofino, Ambra / Cinnirella, Andrea / Fornaro, Federica / Gallana, Claudia / Grosso, Francesca Maria / Maffeo, Manuel / Shishmintseva, Viktoriia / Pariani, Elena / Castaldi, Silvana

International journal of environmental research and public health

2021 Volume 18, Issue 11

Abstract: Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of ... ...

Abstract	Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year's in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04-1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24-1.69) and newborn workers (PR: 1.41; 95% CI: 1.20-1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.
MeSH term(s)	Attitude of Health Personnel ; COVID-19 ; Health Personnel ; Hospitals, Teaching ; Humans ; Immunization Programs ; Infant, Newborn ; Influenza Vaccines ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Italy/epidemiology ; Pandemics/prevention & control ; SARS-CoV-2 ; Surveys and Questionnaires ; Vaccination
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2021-05-30
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18115874
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: 2019 Influenza Vaccination Campaign in an Italian Research and Teaching Hospital: Analysis of the Reasons for Its Failure.

Maffeo, Manuel / Luconi, Ester / Castrofino, Ambra / Campagnoli, Emanuela Maria / Cinnirella, Andrea / Fornaro, Federica / Gallana, Claudia / Perrone, Pier Mario / Shishmintseva, Viktoriia / Pariani, Elena / Castaldi, Silvana

International journal of environmental research and public health

2020 Volume 17, Issue 11

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Child ; Cross-Sectional Studies ; Female ; Health Personnel ; Hospitals, Teaching ; Humans ; Immunization Programs/organization & administration ; Infant, Newborn ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/adverse effects ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Italy/epidemiology ; Male ; Middle Aged ; Program Evaluation ; Vaccination/standards ; Vaccination/statistics & numerical data ; Vaccination Coverage/statistics & numerical data ; Young Adult
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2020-05-30
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17113881
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Association of Age With Likelihood of Developing Symptoms and Critical Disease Among Close Contacts Exposed to Patients With Confirmed SARS-CoV-2 Infection in Italy.

Poletti, Piero / Tirani, Marcello / Cereda, Danilo / Trentini, Filippo / Guzzetta, Giorgio / Sabatino, Giuliana / Marziano, Valentina / Castrofino, Ambra / Grosso, Francesca / Del Castillo, Gabriele / Piccarreta, Raffaella / Andreassi, Aida / Melegaro, Alessia / Gramegna, Maria / Ajelli, Marco / Merler, Stefano

JAMA network open

2021 Volume 4, Issue 3, Page(s) e211085

Abstract: Importance: Solid estimates of the risk of developing symptoms and of progressing to critical disease in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are key to interpreting coronavirus disease 2019 (COVID-19) ... ...

Abstract	Importance: Solid estimates of the risk of developing symptoms and of progressing to critical disease in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are key to interpreting coronavirus disease 2019 (COVID-19) dynamics, identifying the settings and the segments of the population where transmission is more likely to remain undetected, and defining effective control strategies. Objective: To estimate the association of age with the likelihood of developing symptoms and the association of age with the likelihood of progressing to critical illness after SARS-CoV-2 infection. Design, setting, and participants: This cohort study analyzed quarantined case contacts, identified between February 20 and April 16, 2020, in the Lombardy region of Italy. Contacts were monitored daily for symptoms and tested for SARS-CoV-2 infection, by either real-time reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs or retrospectively via IgG serological assays. Close contacts of individuals with laboratory-confirmed COVID-19 were selected as those belonging to clusters (ie, groups of contacts associated with an index case) where all individuals were followed up for symptoms and tested for SARS-CoV-2 infection. Data were analyzed from February to June 2020. Exposure: Close contact with individuals with confirmed COVID-19 cases as identified by contact tracing operations. Main outcomes and measures: Age-specific estimates of the risk of developing respiratory symptoms or fever greater than or equal to 37.5 °C and of experiencing critical disease (defined as requiring intensive care or resulting in death) in SARS-CoV-2-infected case contacts. Results: In total, 5484 case contacts (median [interquartile range] age, 50 [30-61] years; 3086 female contacts [56.3%]) were analyzed, 2824 of whom (51.5%) tested positive for SARS-CoV-2 (median [interquartile range] age, 53 [34-64] years; 1604 female contacts [56.8%]). The proportion of infected persons who developed symptoms ranged from 18.1% (95% CI, 13.9%-22.9%) among participants younger than 20 years to 64.6% (95% CI, 56.6%-72.0%) for those aged 80 years or older. Most infected contacts (1948 of 2824 individuals [69.0%]) did not develop respiratory symptoms or fever greater than or equal to 37.5 °C. Only 26.1% (95% CI, 24.1%-28.2%) of infected individuals younger than 60 years developed respiratory symptoms or fever greater than or equal to 37.5 °C; among infected participants older than 60 years, 6.6% (95% CI, 5.1%-8.3%) developed critical disease. Female patients were 52.7% (95% CI, 24.4%-70.7%) less likely than male patients to develop critical disease after SARS-CoV-2 infection. Conclusions and relevance: In this Italian cohort study of close contacts of patients with confirmed SARS-CoV-2 infection, more than one-half of individuals tested positive for the virus. However, most infected individuals did not develop respiratory symptoms or fever. The low proportion of children and young adults who developed symptoms highlights the possible challenges in readily identifying SARS-CoV-2 infections.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/physiopathology ; COVID-19 Nucleic Acid Testing ; COVID-19 Serological Testing ; Carrier State/epidemiology ; Chest Pain/epidemiology ; Chest Pain/physiopathology ; Child ; Child, Preschool ; Contact Tracing ; Cough/epidemiology ; Cough/physiopathology ; Critical Illness ; Disease Progression ; Dyspnea/epidemiology ; Dyspnea/physiopathology ; Female ; Fever/epidemiology ; Fever/physiopathology ; Humans ; Infant ; Infant, Newborn ; Italy/epidemiology ; Male ; Middle Aged ; Pharyngitis/epidemiology ; Pharyngitis/physiopathology ; Quarantine ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Tachypnea/epidemiology ; Tachypnea/physiopathology ; Young Adult
Language	English
Publishing date	2021-03-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.1085
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Pressure on the Health-Care System and Intensive Care Utilization During the COVID-19 Outbreak in the Lombardy Region of Italy: A Retrospective Observational Study in 43,538 Hospitalized Patients.

American journal of epidemiology

2021 Volume 191, Issue 1, Page(s) 137–146

Abstract: During the spring of 2020, the coronavirus disease 2019 (COVID-19) epidemic caused an unprecedented demand for intensive-care resources in the Lombardy region of Italy. Using data on 43,538 hospitalized patients admitted between February 21 and July 12, ... ...

Abstract	During the spring of 2020, the coronavirus disease 2019 (COVID-19) epidemic caused an unprecedented demand for intensive-care resources in the Lombardy region of Italy. Using data on 43,538 hospitalized patients admitted between February 21 and July 12, 2020, we evaluated variations in intensive care unit (ICU) admissions and mortality over the course of 3 periods: the early phase of the pandemic (February 21-March 13), the period of highest pressure on the health-care system (March 14-April 25, when numbers of COVID-19 patients exceeded prepandemic ICU bed capacity), and the declining phase (April 26-July 12). Compared with the early phase, patients aged 70 years or more were less often admitted to an ICU during the period of highest pressure on the health-care system (odds ratio (OR) = 0.47, 95% confidence interval (CI): 0.41, 0.54), with longer ICU delays (incidence rate ratio = 1.82, 95% CI: 1.52, 2.18) and lower chances of dying in the ICU (OR = 0.47, 95% CI: 0.34, 0.64). Patients under 56 years of age had more limited changes in the probability of (OR = 0.65, 95% CI: 0.56, 0.76) and delay to (incidence rate ratio = 1.16, 95% CI: 0.95, 1.42) ICU admission and increased mortality (OR = 1.43, 95% CI: 1.00, 2.07). In the declining phase, all quantities decreased for all age groups. These patterns may suggest that limited health-care resources during the peak phase of the epidemic in Lombardy forced a shift in ICU admission criteria to prioritize patients with higher chances of survival.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/therapy ; Comorbidity ; Delivery of Health Care/statistics & numerical data ; Humans ; Intensive Care Units/statistics & numerical data ; Italy/epidemiology ; Middle Aged ; Pandemics ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Sex Factors ; Time Factors
Language	English
Publishing date	2021-10-15
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2937-3
ISSN	1476-6256 ; 0002-9262
ISSN (online)	1476-6256
ISSN	0002-9262
DOI	10.1093/aje/kwab252
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Influenza surveillance system and Covid-19

Castrofino, A. / Del Castillo, G. / Grosso, F. / Barone, A. / Gramegna, M. / Galli, C. / Tirani, M. / Castaldi, S. / Pariani, E. / Cereda, D.

The European Journal of Public Health. 2020 Sep 30|30(Suppl 5): ckaa165.354

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #843349
Database	COVID19

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Article: COVID-19 serological testing for Healthcare Workers in Lombardy, Italy

Del Castillo, G. / Castrofino, A. / Grosso, F. / Barone, A. / Crottogini, L. / Toso, C. / Pellegrinelli, L. / Pariani, E. / Castaldi, S. / Cereda, D.

European Journal of Public Health

Abstract: Issue COVID-19 pandemic began in Italy on February 20th, 2020 Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients Therefore, we implemented a prevention policy ... ...

Abstract	Issue COVID-19 pandemic began in Italy on February 20th, 2020 Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients Therefore, we implemented a prevention policy for HCW screening through serological and RT-PCR testing Description of the problem HCW screening for SARS-CoV-2 infection is essential for prevention and control of the pandemic Lombardy's Healthcare authorities settled a screening process for HCWs divided into three steps: 1) body temperature assessment at the beginning and the end of work shift, if fever > 37 5 °C was present the HCW was sent back home and a nasopharyngeal swab was performed;2) progressive recruitment for serological testing;3) on those positive to IgG a nasopharyngeal swab was performed and tested for viral RNA by RT-PCR Results Among 79185 HCW tested, 9589 (12%) were positive on serological IgG testing Of the 9589 positive a nasopharyngeal swab was performed on 6884 Of these 358 (5%) tested positive and the remaining 6526 (95%) negative to RT-PCR We calculated a Positive Predictive Value of 5 2% The rate of positive serological tests for each Healthcare facility varied between 0% and 78% Five percent of all facilities, belonging to Brescia, Bergamo and Cremona area, reported a positivity rate higher than 40% in HCWs A second cluster (18% of all facilities), involving the same geographical area, reported a rate between 20% and 40%, whereas the remaining facilities (76%) of the region a rate <20% Lessons Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs especially in a high infection prevalence setting Key messages Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs Infection prevention in HCW may benefit from a screening campaign especially in high prevalence settings
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #814132
Database	COVID19

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Article ; Online: COVID-19 serological testing for Healthcare Workers in Lombardy, Italy

Del Castillo, G / Castrofino, A / Grosso, F / Barone, A / Crottogini, L / Toso, C / Pellegrinelli, L / Pariani, E / Castaldi, S / Cereda, D

European Journal of Public Health

2020 Volume 30, Issue Supplement_5

Abstract: Abstract Issue COVID-19 pandemic began in Italy on February 20th, 2020. Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients. Therefore, we implemented a ... ...

Abstract	Abstract Issue COVID-19 pandemic began in Italy on February 20th, 2020. Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients. Therefore, we implemented a prevention policy for HCW screening through serological and RT-PCR testing. Description of the problem HCW screening for SARS-CoV-2 infection is essential for prevention and control of the pandemic. Lombardy's Healthcare authorities settled a screening process for HCWs divided into three steps: 1) body temperature assessment at the beginning and the end of work shift, if fever > 37.5 °C was present the HCW was sent back home and a nasopharyngeal swab was performed; 2) progressive recruitment for serological testing; 3) on those positive to IgG a nasopharyngeal swab was performed and tested for viral RNA by RT-PCR. Results Among 79185 HCW tested, 9589 (12%) were positive on serological IgG testing. Of the 9589 positive a nasopharyngeal swab was performed on 6884. Of these 358 (5%) tested positive and the remaining 6526 (95%) negative to RT-PCR. We calculated a Positive Predictive Value of 5.2%. The rate of positive serological tests for each Healthcare facility varied between 0% and 78%. Five percent of all facilities, belonging to Brescia, Bergamo and Cremona area, reported a positivity rate higher than 40% in HCWs. A second cluster (18% of all facilities), involving the same geographical area, reported a rate between 20% and 40%, whereas the remaining facilities (76%) of the region a rate <20%. Lessons Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs especially in a high infection prevalence setting. Key messages Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs. Infection prevention in HCW may benefit from a screening campaign especially in high prevalence settings.
Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckaa165.351
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Influenza surveillance system and Covid-19

Castrofino, A / Del Castillo, G / Grosso, F / Barone, A / Gramegna, M / Galli, C / Tirani, M / Castaldi, S / Pariani, E / Cereda, D

European Journal of Public Health

2020 Volume 30, Issue Supplement_5

Abstract: Abstract The clinical presentation of symptomatic SARS-CoV-2 not only includes viral pneumonia, but also milder illness overlapping with influenza-like illness (ILI), allowing a potential tracking of the infection in the framework of the national ... ...

Abstract	Abstract The clinical presentation of symptomatic SARS-CoV-2 not only includes viral pneumonia, but also milder illness overlapping with influenza-like illness (ILI), allowing a potential tracking of the infection in the framework of the national influenza surveillance system (SS). By comparing the data recorded by the influenza SS in 2019-20 season to those collected for the previous years, we want to evaluate whether the implementation of ILI SS could succeed in early detection and monitoring of Covid-19 diffusion. We analyzed the data recorded by the influenza SS and we compared the distribution of ILI incidence rate by week for 2017-18, 2018-19 and 2019-20 season in order to understand whether the SS detected any abnormality coinciding with Covid-19 outbreak. The distribution of ILI cases in the three seasons presented a similar pattern up to the 9th week; after then, a reduction in the ILI incidence rate was observed in the 2017-18 and the 2018-19 season while an increase was detected for 2019-20. During 2019-20 season, three major characteristics stand out: i) at the beginning of Covid-19 epidemic (7th-9th week) 9,17/1000 cases were reported; ii) during the recognition of the COVID-19 outbreak (9th-10th week) 6,36/1000 cases; iii) during the spread of Covid-19 (10th-11th week) an unexpected increase to 7,72/1000 cases. Additionally, their geographical distribution was concentrated in the areas known to be most affected by the epidemic. The influenza SS enabled us to detect the introduction and distribution of COVID-19. Implementation of the system should be prioritized in order to early identify new waves of Covid-19 but also any future novel respiratory pathogen. In order to empower the SS, it would be advisable to increase the population coverage about 2% which is the actual standard. Key messages The influenza surveillance system detected the first wave of Covid-19 in Lombardy Region, Italy. The influenza surveillance system should be implemented in order to bring a benefit both to the current situation and in sight of future public health challenges.
Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckaa165.354
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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