To determine whether patient-to-doctor transmission of measles occurred in an emergency department (ED) despite isolation precautions and full personal protective equipment (PPE) during the COVID-19 pandemic, an epidemiological and molecular investigation was carried out following the identification of two subsequent cases. The N fragment was used to identify the closest whole measles genome present in the GenBank nr database and, subsequently, this was used as a reference for the reconstruction of the entire MeV sequence in the two cases studied. Seven measles-susceptible healthcare workers were on duty the day of admission of the patient, wearing full PPE. The infected doctor neither visited the patient nor entered the isolation room. The patient wore a facial respirator. No breaches in infection control procedures, or other cases among contacts, patients and healthcare workers were identified. Molecular analysis provided evidence of patient-to-worker transmission: the two B3 genome sequences showed only one mutation and no sequences of other countries were identified as phylogenetically related. Isolation precautions and full PPE were widely implemented in the ED during the COVID-19 pandemic; however, this did not prevent nosocomial transmission of measles. Vaccination of healthcare workers and enhanced ventilation should complement other preventive measures to protect workers and patients.

Legionnaires’ disease (LD) is an atypical pneumonia sustained by Legionella bacteria. The epidemiological LD scenario in the urban area of Rome (Italy) is unique, moving from facing the COVID-19 pandemic, first capital city in Europe, to the preparation of the 2025 Catholic Jubilee, starting on from December 24, 2024. To provide key determinants for risk assessment in the setting of public health and clinical preparedness activities, we analysed data on LD cases collected from Regional Lazio Surveillance Systems during the 2017-2024 interval period.

The mitigation measures adopted to reduce the spread of COVID-19 have not only impacted the transmission of respiratory infections but also other infectious diseases. In this study, we explored the effect of the pandemic on the epidemiology of Central Nervous System (CNS) infections by conducting a retrospective analysis of diagnostic data obtained from cerebrospinal fluids (CSFs) collected before, during, and after the pandemic from patients with acute-suspected neuro-infectious syndrome. The samples were analyzed using a meningitis/encephalitis molecular syndromic panel. A total of 4203 CSFs were split into three groups: pre-pandemic (August 2018–February 2020), pandemic (March 2020–March 2022) and post-pandemic (April 2022–March 2024). Each pathogen was statistically assessed individually, comparing one group vs. another. Results showed that viral pathogens were the most frequently detected across all groups; however, Streptococcus pneumoniae was the single most identified pathogen. Comparison of the pre-pandemic and pandemic groups by statistical analysis showed a significant reduction in neuro-infections caused by enterovirus, S. pneumoniae and N. meningitidis, while the other pathogens were not affected. In conclusion, a reduction in CNS infections caused by respiratory and close-contact-transmitted pathogens, including both viral and bacterial agents, was observed during the period when COVID-19 containment measures were in effect.

To determine whether patient-to-doctor transmission of measles occurred in an emergency department (ED) despite isolation precautions and full personal protective equipment (PPE) during the COVID-19 pandemic, an epidemiological and molecular investigation was carried out following the identification of two subsequent cases. The N fragment was used to identify the closest whole measles genome present in the GenBank nr database and, subsequently, this was used as a reference for the reconstruction of the entire MeV sequence in the two cases studied. Seven measles-susceptible healthcare workers were on duty the day of admission of the patient, wearing full PPE. The infected doctor neither visited the patient nor entered the isolation room. The patient wore a facial respirator. No breaches in infection control procedures, or other cases among contacts, patients and healthcare workers were identified. Molecular analysis provided evidence of patient-to-worker transmission: the two B3 genome sequences showed only one mutation and no sequences of other countries were identified as phylogenetically related. Isolation precautions and full PPE were widely implemented in the ED during the COVID-19 pandemic; however, this did not prevent nosocomial transmission of measles. Vaccination of healthcare workers and enhanced ventilation should complement other preventive measures to protect workers and patients.