International Journal of Environmental Research and Public Health, 2011
In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eas... more In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eastern Greece (population 100,882 inhabitants), triggered investigations to guide control measures. The outbreak started the first days of June, and peaked in July. A descriptive epidemiological study, a virological characterization of the viral agent identified from cases as well as a phylogenetic analysis was performed. From June 5 to September 3, 2006 (weeks 23-44), 1,640 cases of gastroenteritis (45.2% male and 54.8% female, aged 3 months to 89 years) were reported. The overall attack rate for the period was 16.3 cases/1,000 inhabitants. About 57% of cases observed were under the age of 15 years. Analysis of faecal samples identified Norovirus GII strains. Fifteen different Norovirus GII strains were recorded, presenting a homology of 94.8% (86-97%) to GII strains obtained from GenBank. The long duration of the outbreak suggests an important role of person-to-person transmission, while the emergence of the outbreak was possibly due to contaminated potable water, although no viruses were detected in any tested water samples. This outbreak underscores the need for a national surveillance system for acute non-bacterial gastroenteritis outbreaks.
Two parallel gastroenteritis outbreaks occurred in an elementary school and a neighboring kinderg... more Two parallel gastroenteritis outbreaks occurred in an elementary school and a neighboring kindergarten in Kilkis, Northern Greece in 2012. The aim of the study was the investigation of these two parallel outbreaks as well as their possible source. Two retrospective cohort studies were performed to identify the mode and the vehicle of transmission as well as the possible connection between them. Elementary school and kindergarten populations of 79.9% (119/149) and 51.1% (23/45) respectively, participated in the study. Case definition was satisfied by 65 pupils from the elementary school and 14 from the kindergarten. For elementary school, 53 cases were considered primary cases of the outbreak and were included in the analysis. Based on the results of the multivariate analysis, consumption of tap water was the only statistically significant independent risk factor of gastroenteritis (RR = 2.34, 95% C.I.: 1.55-3.53).; a finding supported by the shape of the epidemic curve which referred to a common point source outbreak with secondary cases. For kindergarten, no statistically significant risk factor was identified, and the epidemic curve supported a person-to-person transmission according univariate analysis. Norovirus GI and GII and human Adenovirus were detected by Real Time PCR in stool samples from seven children of elementary school, but stool samples were not collected by children of the kindergarten. Even though the etiological agent of the outbreak was not verified, combined epidemiological and laboratory results were in favor of a waterborne viral gastroenteritis outbreak at the elementary school, followed by a person to person spread at the kindergarten.
Airborne viruses remain one of the major public health issues worldwide. Detection and quantifica... more Airborne viruses remain one of the major public health issues worldwide. Detection and quantification of airborne viruses is essential in order to provide information regarding public health risk assessment. In this study, an optimized new, simple, low cost method for sampling of airborne viruses using Low Melting Agarose (LMA) plates and a conventional microbial air sampling device has been developed. The use of LMA plates permits the direct nucleic acids extraction of the captured viruses without the need of any preliminary elution step. Molecular detection and quantification of airborne viruses is performed using real-time quantitative (RT-)PCR (Q(RT-)PCR) technique. The method has been tested using Adenoviruses (AdVs) and Noroviruses (NoVs) GII, as representative DNA and RNA viruses, respectively. Moreover, the method has been tested successfully in outdoor experiments, by detecting and quantifying human adenoviruses (HAdVs) in the airborne environment of a wastewater treatment plant. The great advantage of LMA is that nucleic acids extraction is performed directly on the LMA plates, while the eluted nucleic acids are totally free of inhibitory substances. Coupled with QPCR the whole procedure can be completed in less than three (3) hours.
Acute diarrhea remains a major public health issue worldwide, with gastroenteritis agents associa... more Acute diarrhea remains a major public health issue worldwide, with gastroenteritis agents associated with a high morbidity, especially in infants and young children. A 1-year study (2009-2010) of rotavirus (RV)-caused pediatric diarrhea was performed on hospitalized children admitted with symptoms of acute diarrhea to the University Hospital of Patras, Greece. Twenty-nine fecal samples were investigated for RVs, adenoviruses (AdVs), and enteroviruses (EVs) in an attempt to characterize these enteric viruses, which have been implicated in hospitalized diarrhea. A 44.8% (13/29) incidence of viral infection was reported for the viral targets. Monoinfections accounted for 31% (9/29), while bi-infections accounted for 13.4% (4/29). Sequencing of positive samples allowed identification of RVs G4P[8] (2/29), G9P[8] (1/29), and interestingly of the rare type G12P[8] (2/29). AdV types 1, 2, and 6 were also identified in 4/29, 1/29, and 1/29 of the samples, respectively. Regarding the EVs, EV71 (2/29), coxsackievirus A4 (1/29), echovirus 11 (1/29), and EV96 (1/29) were typed. The results of the present study, and specifically the detection of rare RV G12 and EV71 strains, address the need for continuous epidemiological surveys to provide epidemiological pictures of pediatric viral infections circulating in the community.
Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, 2007
... and no food-borne outbreaks caused by norovirus type II had been reported in Greece previousl... more ... and no food-borne outbreaks caused by norovirus type II had been reported in Greece previously ... infections have affected large numbers of people and cause problems for public health [3 ... Center for Disease Control and Prevention, who were responsible for the evaluation of the ...
To determine the good working condition of the biological treatment plant of the University Hospi... more To determine the good working condition of the biological treatment plant of the University Hospital of Patras, Greece, twenty-four raw sewage samples and twenty-four effluent samples were analyzed for the presence of enteroviruses, adenoviruses and Hepatitis A virus (HAV), during the period of March 1995 to March 1996. We used a nested-PRC approach, to increase the sensitivity of the detection.
Water Air and Soil Pollution - WATER AIR SOIL POLLUT, 1998
Non-tuberculosis mycobacteria (NTM) were found in 10 (15.6%) out of 64 examined samples of tap wa... more Non-tuberculosis mycobacteria (NTM) were found in 10 (15.6%) out of 64 examined samples of tap water collected from 64 different points from the water supplies of the five main hospitals of the city of Patras (Peloponnese, Greece), during a six month period. The range of mycobacteria isolated from all the hospital water supplies was from 5-205 CFU L-1. The identification of non-tuberculosis mycobacteria was performed with PCR-Restriction Enzyme Analysis (PCR-REA). The dominant isolates were Mycobacterium chelonae (3), Mycobacterium gordonae (2), Mycobacterium flavescens (1) and Mycobacterium terrae (1). One strain was unidentifiable and another two were lost during subculturing. All examined samples were negative for faecal indicators. The periodical examination of potable water of certain hospital units (such as the ones taking care of immunocompromised hosts, haemodialysis units, endoscopy units, Intensive Care Units etc.) for non-tuberculosis mycobacteria is considered worthwile.
International Journal of Environmental Research and Public Health, 2011
In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eas... more In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eastern Greece (population 100,882 inhabitants), triggered investigations to guide control measures. The outbreak started the first days of June, and peaked in July. A descriptive epidemiological study, a virological characterization of the viral agent identified from cases as well as a phylogenetic analysis was performed. From June 5 to September 3, 2006 (weeks 23-44), 1,640 cases of gastroenteritis (45.2% male and 54.8% female, aged 3 months to 89 years) were reported. The overall attack rate for the period was 16.3 cases/1,000 inhabitants. About 57% of cases observed were under the age of 15 years. Analysis of faecal samples identified Norovirus GII strains. Fifteen different Norovirus GII strains were recorded, presenting a homology of 94.8% (86-97%) to GII strains obtained from GenBank. The long duration of the outbreak suggests an important role of person-to-person transmission, while the emergence of the outbreak was possibly due to contaminated potable water, although no viruses were detected in any tested water samples. This outbreak underscores the need for a national surveillance system for acute non-bacterial gastroenteritis outbreaks.
Two parallel gastroenteritis outbreaks occurred in an elementary school and a neighboring kinderg... more Two parallel gastroenteritis outbreaks occurred in an elementary school and a neighboring kindergarten in Kilkis, Northern Greece in 2012. The aim of the study was the investigation of these two parallel outbreaks as well as their possible source. Two retrospective cohort studies were performed to identify the mode and the vehicle of transmission as well as the possible connection between them. Elementary school and kindergarten populations of 79.9% (119/149) and 51.1% (23/45) respectively, participated in the study. Case definition was satisfied by 65 pupils from the elementary school and 14 from the kindergarten. For elementary school, 53 cases were considered primary cases of the outbreak and were included in the analysis. Based on the results of the multivariate analysis, consumption of tap water was the only statistically significant independent risk factor of gastroenteritis (RR = 2.34, 95% C.I.: 1.55-3.53).; a finding supported by the shape of the epidemic curve which referred to a common point source outbreak with secondary cases. For kindergarten, no statistically significant risk factor was identified, and the epidemic curve supported a person-to-person transmission according univariate analysis. Norovirus GI and GII and human Adenovirus were detected by Real Time PCR in stool samples from seven children of elementary school, but stool samples were not collected by children of the kindergarten. Even though the etiological agent of the outbreak was not verified, combined epidemiological and laboratory results were in favor of a waterborne viral gastroenteritis outbreak at the elementary school, followed by a person to person spread at the kindergarten.
Airborne viruses remain one of the major public health issues worldwide. Detection and quantifica... more Airborne viruses remain one of the major public health issues worldwide. Detection and quantification of airborne viruses is essential in order to provide information regarding public health risk assessment. In this study, an optimized new, simple, low cost method for sampling of airborne viruses using Low Melting Agarose (LMA) plates and a conventional microbial air sampling device has been developed. The use of LMA plates permits the direct nucleic acids extraction of the captured viruses without the need of any preliminary elution step. Molecular detection and quantification of airborne viruses is performed using real-time quantitative (RT-)PCR (Q(RT-)PCR) technique. The method has been tested using Adenoviruses (AdVs) and Noroviruses (NoVs) GII, as representative DNA and RNA viruses, respectively. Moreover, the method has been tested successfully in outdoor experiments, by detecting and quantifying human adenoviruses (HAdVs) in the airborne environment of a wastewater treatment plant. The great advantage of LMA is that nucleic acids extraction is performed directly on the LMA plates, while the eluted nucleic acids are totally free of inhibitory substances. Coupled with QPCR the whole procedure can be completed in less than three (3) hours.
Acute diarrhea remains a major public health issue worldwide, with gastroenteritis agents associa... more Acute diarrhea remains a major public health issue worldwide, with gastroenteritis agents associated with a high morbidity, especially in infants and young children. A 1-year study (2009-2010) of rotavirus (RV)-caused pediatric diarrhea was performed on hospitalized children admitted with symptoms of acute diarrhea to the University Hospital of Patras, Greece. Twenty-nine fecal samples were investigated for RVs, adenoviruses (AdVs), and enteroviruses (EVs) in an attempt to characterize these enteric viruses, which have been implicated in hospitalized diarrhea. A 44.8% (13/29) incidence of viral infection was reported for the viral targets. Monoinfections accounted for 31% (9/29), while bi-infections accounted for 13.4% (4/29). Sequencing of positive samples allowed identification of RVs G4P[8] (2/29), G9P[8] (1/29), and interestingly of the rare type G12P[8] (2/29). AdV types 1, 2, and 6 were also identified in 4/29, 1/29, and 1/29 of the samples, respectively. Regarding the EVs, EV71 (2/29), coxsackievirus A4 (1/29), echovirus 11 (1/29), and EV96 (1/29) were typed. The results of the present study, and specifically the detection of rare RV G12 and EV71 strains, address the need for continuous epidemiological surveys to provide epidemiological pictures of pediatric viral infections circulating in the community.
Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, 2007
... and no food-borne outbreaks caused by norovirus type II had been reported in Greece previousl... more ... and no food-borne outbreaks caused by norovirus type II had been reported in Greece previously ... infections have affected large numbers of people and cause problems for public health [3 ... Center for Disease Control and Prevention, who were responsible for the evaluation of the ...
To determine the good working condition of the biological treatment plant of the University Hospi... more To determine the good working condition of the biological treatment plant of the University Hospital of Patras, Greece, twenty-four raw sewage samples and twenty-four effluent samples were analyzed for the presence of enteroviruses, adenoviruses and Hepatitis A virus (HAV), during the period of March 1995 to March 1996. We used a nested-PRC approach, to increase the sensitivity of the detection.
Water Air and Soil Pollution - WATER AIR SOIL POLLUT, 1998
Non-tuberculosis mycobacteria (NTM) were found in 10 (15.6%) out of 64 examined samples of tap wa... more Non-tuberculosis mycobacteria (NTM) were found in 10 (15.6%) out of 64 examined samples of tap water collected from 64 different points from the water supplies of the five main hospitals of the city of Patras (Peloponnese, Greece), during a six month period. The range of mycobacteria isolated from all the hospital water supplies was from 5-205 CFU L-1. The identification of non-tuberculosis mycobacteria was performed with PCR-Restriction Enzyme Analysis (PCR-REA). The dominant isolates were Mycobacterium chelonae (3), Mycobacterium gordonae (2), Mycobacterium flavescens (1) and Mycobacterium terrae (1). One strain was unidentifiable and another two were lost during subculturing. All examined samples were negative for faecal indicators. The periodical examination of potable water of certain hospital units (such as the ones taking care of immunocompromised hosts, haemodialysis units, endoscopy units, Intensive Care Units etc.) for non-tuberculosis mycobacteria is considered worthwile.
Journal of Sustainable Chemistry and Pharmacy, 2019
At this study a multi-criteria model was developed to examine the available procedures, technique... more At this study a multi-criteria model was developed to examine the available procedures, techniques and methods of handling infectious waste in the large healthcare unit of University Regional General Hospital of Patras, Western Greece. Particularly, this study examined the: a) current legislation and Directives issued for medical waste management at Greece and among the other EU-members, b) contribution of healthcare wastes (HCW) generation rate on social and economic parameters in selected European countries, c) available procedures, techniques, and methods upon the disposal of infectious wastes at the healthcare studied, and, d) propositions for integrated management of such hazardous wastes. Specifically, the Analytic Hierarchy Process (AHP) methodology was applied under pair wise comparison matrices in two stages: 1) the scale factors and the indicators , and 2) the criteria and their sub-criteria. The assessment of these pair wise matrices included the indicators and the sub-criteria. Subsequently, two pair wise comparison matrices, upon a) the "Fulfillment of environmental objectives" indicator and b) the "Energy consumption" sub criterion, were denoted. The AHP methodology yielded good results; however there is still space of improving the environmental performance. The normalized relative weights obtained for the criteria and sub criteria motivated specific actions that have to be handled. Particularly, the results indicated a very good value in environmental management criteria due the values obtained for the commitment towards the environmental policy standards and the waste management procedures. However, further improvements on staff awareness (such as development programs to enhance sensitivity) and more green purchasing suppliers, should be further addressed.
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