Risk factors for Chlamydia trachomatis infection in adolescents: results from a representative population-based survey

On 31 May 2013, the first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in Italy was laboratory confirmed in a previously healthy adult man, who developed pneumonia with moderate respiratory distress after returning from a holiday in Jordan. Two secondary cases were identified through contact tracing, among family members and colleagues who had not previously travelled abroad. Both secondary cases developed mild illness. All three patients recovered fully. confirmed the first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in a patient, hospitalised in Florence (Tuscany region), Italy, who had just spent a vacation in Amman, Jordan. Two secondary cases of MERS-CoV were subsequently detected among close contacts. We here report the public health investigation carried out and the identification and follow-up of the three patients' contacts. The index case was a previously healthy man in his mid-40s who had returned to Florence on 25 May 2013, following a 40-day holiday in Jordan (Figure). The patient developed influenza-like symptoms the previous day, while in Jordan, and was symptomatic on the flight back to Italy and while back at work in a hotel on 27 May. On 28 May, because of worsening symptoms , he visited the emergency room of a local hospital (Hospital A) in Florence and was admitted later the same day to the Infectious and Tropical Diseases Unit of a second hospital (Hospital B), in the same city. His symptoms at that time were fever (38 °C), cough and difficult breathing. A chest radiograph revealed signs of pneumonia, with bilateral lung infiltrates. The following day, testing for MERS-CoV was carried out (real-time polymerase chain reaction (PCR) to detect the regions upstream of the E gene (upE region)) on upper respiratory samples (nasopharyngeal swabs) at the Regional reference laboratory for Influenza at the University of Florence and MERS-CoV infection was diagnosed. This result was confirmed by the National Influenza Centre [1]. On 29 May, as soon as the clinicians began to suspect a MERS-CoV infection, the staff of Hospital B complied with all infection control procedures, according to the Health Protection Agency (HPA) (now Public Health England) infection control advice for suspected or confirmed novel coronavirus cases [2]. In particular, the patient was isolated in a negative-pressure room and staff wore protective clothing and performed hand hygiene. Attempts were made at the Regional reference laboratory for Influenza in Florence to isolate the virus in Vero cells, …