Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful microorganisms, including viruses such as Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). The US Food and Drug Administration (FDA) and the European Medical Agency (EMA) have already authorized monoclonal antibodies of anti-SARS-CoV-2 to treat mild to moderate CoronaVIrus Disease-2019 (COVID-19) in patients at risk of developing severe disease. More recently, monoclonal antibodies anti-SARS-CoV-2 have been authorized for primary and secondary prophylaxis in patients at high risk of severe disease for background comorbidity. Primary or pre-exposure prophylaxis prevents COVID-19 in unexposed people, whereas secondary or postexposure prophylaxis prevent COVID-19 in recently exposed people to individuals with laboratory-confirmed SARS-CoV-2. This review focuses briefly on therapeutic indications of currently available monoclonal antibodies for COVID-19 pre- and postexposure prophylaxis and on the efficacy of convalescent plasma.

Chagas disease (CD) is a parasitic infection endemic in Latin America and also affects patients in Western countries due to migration flows. This has a significant impact on health services worldwide due to its high morbidity and mortality burden. This paper aims to share our experience at the National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, in Rome, Italy, where to date, a total of 47 patients—mainly Bolivian women—diagnosed with CD have received treatment with benznidazole, with all but one presenting with chronic disease. Most of the patients were recruited through the first extensive screening program held in 2014 at our Institute. About a quarter of our patients showed adverse effects to benznidazole, including a case of severe drug-induced liver injury, but 83% completed a full course of treatment. In addition to the description of our cohort, the paper reports a brief overview of the disease compiled through a review of the existing literature on CD in non-endemic countries. The growing prevalence of CD in Western countries highlights the importance of screening at-risk populations and urges public concern and medical awareness about this neglected tropical disease. There are still many unanswered questions that need to be addressed to develop a personalized approach in treating patients.

Aero-medical evacuation has been considered as a feasible and safe treatment option during COVID pandemic, particularly when the needs of affected patients exceed what local clinics and hospitals are supposed to provide. In this article, we analyzed the clinical course of 17 patients medically evacuated to the “L. Spallanzani” Institute in Rome, Italy from foreign countries, mainly Africa and Eastern Europe, who had COVID-19 pneumonia with, or without, coinfections such as malaria, HIV, tuberculosis and microbiologically confirmed sepsis syndrome. The aero-medical evacuation of patients with infectious diseases has become one of the greatest medical achievements we have reached during this pandemic; in fact, only two patients with life threatening coinfections have died. Although logistically difficult and cost consuming, medical evacuation should be considered as a treatment option more than a single extraordinary measure, especially among complex cases that require specific technical and human resources.

Congenital malaria (CM) is uncommon in both malaria-endemic and non-endemic countries. It may be caused by any Plasmodium spp., although Plasmodium falciparum and Plasmodium vivax are the more frequent etiologic agents. We report a case of delayed diagnosis of CM by P. vivax in a newborn of an Eritrean primigravida. The mother developed pregnancy-related immunodepression and varicella-zoster viral infection 9 days before natural delivery; therefore, the child was admitted in the neonatal intensive care unit (NICU) to administer specific varicella-zoster immunoglobulin prophylaxis and for clinical monitoring. During the NICU stay, the newborn presented a febrile syndrome with vomiting, anemia, and thrombocytopenia. A P. vivax severe malaria diagnosis was made by detecting trophozoites in the thick and thin blood smears. The infant was successfully treated with intravenous artesunate and clindamycin. Our experience suggests that malaria diagnostic tests need to be included in routine blood analyses in newborns with febrile syndrome from mothers with an epidemiologic link to malaria-endemic areas.

Over the past decade, outdoor recreational activities—including ecotourism, wildlife observation, adventure travel, and expedition cruising—have expanded at an unprecedented pace

OBJECTIVE To describe epidemiology of viral hepatitis (including HAV, HBV and HCV) among men who have sex with men (MSM) aged between 18 and 45 years and living in Lazio, an Italian Region with about 5.9 million inhabitants whose main city is Rome. METHODS A sero-survey (cross-sectional study) was conducted as part of a screening and prevention campaign for improving control of viral hepatitis in Lazio. The study enrolled 1,100 MSM people participating to the campaign. Outcome measures were serology for HAV (anti-HAV IgG and anti-HAV IgM), serology for HBV (anti-HBs, anti-HBc and HBsAg), and serology for HCV (anti-HCV). Participants’ epidemiological features were assessed for potential association with outcomes. RESULTS We found a very low prevalence of immunity against HAV and a significant exposure to high-risk behaviours, suggesting that gay community of Lazio is an ideal setting for HAV outbreaks. Prevalence of different serology profiles for HBV suggests that waning immunity and escape to mandatory vaccination still represent a significant issue in patients older than 35 years. Moreover, waning immunity suggests that patients who were vaccinated at birth may show low antibody levels. Consistently with other studies, prevalence of HCV infection was very low among young MSM. CONCLUSION Tailored vaccine programme aimed at immunizing MSM are critical to improve control of HAV in our setting. Findings on HBV epidemiology suggest that there is a need to define a clear strategy to recover patients who escaped vaccination and inform clinicians on the need to booster subjects with low immunity and high risk of exposure, such as MSM. Finally, MSM in Lazio do not represent a special group for HCV neither in terms of risk of infection nor in terms of potential issues for therapy access.