The climate change and the antibiotic resistance they open the doors to one new wave of virus which we will have to deal with, starting from this 2024, the year in which, among other things, Italy will host the G7, an occasion in which the great big names of the world will necessarily have to place the topic of health at the center of the debate. After the pandemic, the challenge for the next few years is not just Covid, but it is and will increasingly be pathogens never seen before in Europe, or in any case considered very rare.
They explained it well to Adnkronos Roberto Parrella, new president of SimitItalian Society of Infectious and Tropical Diseases and director of the Respiratory Infectious Diseases Unit of the Cotugno hospital in Naples, Matteo Bassettidirector of infectious diseases at the San Martino polyclinic hospital in Genoa, e Francesco Vaiadirector of Prevention at the Ministry of Health.
Speaking of Covid (here are the most widespread symptoms now), the battle cannot yet be said to have been won. “When the WHO declared the end of the state of emergency for Sars-CoV-2, a series of measures and obligations were eliminated – explains Parrella – And this may have generated a false expectation in the population” (here’s where they are masks are still mandatory until June 30, 2024).
The problem now is that the virus circulates and mixes with other potentially dangerous respiratory viruseslike theinfluencewhich is hitting particularly hard this year, with millions of Italians in bed and emergency rooms in disarray in several cities.
On Covid, the data increased in November, reaching 1,000 hospitalized with symptoms and 307 deaths, therefore around 40 per day. “Today, Covid and other respiratory viruses can be confused and overlap.” As often happens with respiratory diseases attributed to various infectious agents, viral and bacterial, such as Mycoplasma pneumoniae and the respiratory syncytial virus (RSV) in children, which causes the dreaded bronchiolitis.
But Parrella reassures: “These are numbers which however should not scare us, but lead us to face a situation which today is more delicate for the fragile who are exposed to more risks than the entire population”. Hence the need to vaccinate the fragile and immunosuppressed categories.
The problem of antibiotic resistance
The problem today is having to deal with more infections and more and more often with antibiotic-resistant bacteria, as Prof. also explained in an interview with QuiFinanza. Fabrizio Pregliasco. Bassetti defines it as a “real plague”, given that they occur almost every year 5 million deaths in the world and at least 40 thousand in Italy alone. “A theme that brings together many different sectors – explains Bassetti to Adnkronos – from that of human medicine, that of veterinary medicine, that of agriculture, because antibiotics are used in many different fields and a new awareness is needed on the part of everyone that this is the real problem from now to the next 20-25 years.”
In the short term there are few new antibiotics capable of defeating so-called superbugs, super powerful bacteria with potentially disruptive violence that resist any type of therapy. “We must make the most of what we have available by trying to use them as best as possible when they are needed, with a whole series of recommendations also to the population to use them at the correct dosage, at the correct rate of administration, when they are really needed”.
However, there is also a need for antibiotic resistance new awareness on the part of doctors“because too frequently they use these drugs lightly and the lightness with which many doctors use these antibiotics does not perhaps account for the magnitude of the problem” Bassetti further underlines.
As Parrella explains, there is a national plan to combat antibiotic resistance which includes 4 areas: training, information, transparency and research-innovation, and then national and international cooperation. “The pillars are surveillance and monitoring of antibiotics and abuse-related bacterial infections.”
Another virus that we will have to fight is theswine flu, of which we unfortunately already have memories. This year there was the first case of H2N1 swine flu in England. Swine flu already caused a pandemic in 2009 which caused millions of cases around the world with many deaths, “it was an emergency” explains Bassetti.
The H2N1 virus does not appear to have the characteristics of becoming a pandemic, he says, “but this too must absolutely be kept under close observation, because as far as swine flu is concerned, it would be an infection that evidently comes from the animal world. So zoonoses, in general, are an important problem because they are infections that pass to humans from the animal world and this must be carefully monitored”.
Dengue, West Nile, avian and other climate viruses
The other viruses to which we will have to be increasingly careful are the “tropical” ones, connected to a climate that is “distant” for us but which are also arriving in Italy and the Old Continent due to the high temperatures which also bring with them dangerous insects: 2023 was the hottest year in history.
There Dengue, for example, more commonly known as mosquito malaria. “In Italy, Dengue has become a practically indigenous disease and therefore risks becoming endemic in our country too” warns Bassetti. “The temperatures to which we have become accustomed in recent years have meant that mosquitoes are present not only in the summer months, but also in many other months, both spring and autumn”.
Same goes for the West Nile virusanother mosquito-borne disease: another zoonosis that arrives via an intermediate host.
“Moreover, among the potential viral problems the one to watch most carefully is theavian: cases of avian flu continue to be reported in different animals, in mammals and other types of animals, it is clear that every time this virus affects a new animal, it mutates and we know what the changes of this type of virus mean. The future scenario, therefore, is unfortunately full of infectious problems.”
A new generation of infectious disease specialists will be born
The question at this point is: will we have a generation of doctors in the future capable of studying, understanding and intervening on emerging infectious diseases? “We ended the Simit congress with careful participation on these issues, from antibiotic resistance to zoonoses – concludes Parrella – A new generation of infectious disease specialists will be born ready to counter this type of emergency and I see them very energetic, ready to take action and raise awareness among the population”.
But a cultural change is needed, highlights Francesco Vaia. We need “a systemic vision, which involves large sectors of society, from schools to the family, from the workplace to the world of the third sector. A proactive approach, which takes into account the complexity of the interventions required and which actively moves to promote the health of citizens throughout our life-course: it is never too early, it is never too late and is never enough for prevention.”
Starting from the little onesbecause, Vaia concludes, it has been shown that habits acquired during childhood have lasting repercussions on health, throughout the individual’s life, as in the case of childhood overweight and obesity, up to the elderly.