Italy in Crisis
Creators: name: Lawrence Broxmeyer, MD
Publisher: name: figshare
Year: 2020
Subjects: subject: 110802 Medical Infection Agents (incl. Prions)
subject: FOS: Health sciences
subject: FOS: Health sciences

description: Bullet Point Summary:<br>• The community of Chinese people in Italy has grown rapidly in the past ten years. Official statistics indicate there are at least 320,794 Chinese citizens in Italy. Milan, in Northern Italy where COVID-19 first struck, has the largest Chinese population in Italy. <br>• Before there was a COVID-19 Coronavirus, there was and still is a tuberculosis global Pandemic, a Pandemic which presently kills someone approximately every 21 seconds — about 1.5 million or more in 2018 alone [ https://www.tballiance.org/why-new-tb-drugs/global-pandemic]. It is still treatable, but only if looked for and considered. By 2013, Faccini et al reported in Emerging Infectious Diseases, an outbreak of tuberculosis, Beijing strain, in a primary school in Milan, Italy which was eventually traced to include 15 schoolchildren with active TB and 173 with latent infection.<br>• The coronavirus, AKA Covid-19, first appeared in Lombardy and Veneto. [See Map Figure 1]. Italy's first victim was a 76-year-old woman who was found dead at her home 50 km. (30 miles) south of Milan, in Lombardy, on Thursday, March 12, 2020 and tested positive for the coronavirus. A 78-year-old man died of the infection in a hospital near Padua, in Veneto, during the next evening.<br>• Traditionally, Italy has a low incidence of tuberculosis (TB); and in 2008, the incidence of notified cases was only 7.6/100,000 population. Yet even by 2009, in Milan, the largest urban area and the birthplace of Italian COVID-19, in Lombardy, the incidence climbed steeply to 20.44/100,000 population. By 2019, Cuomo et al attributed this to rising immigration patterns.<br>• With the sharp increase in tuberculosis statistics, the basis of what would happen to Northern Italy had been laid, the tripling of an “underlying” tubercular medical condition that could provide fertile grounds to foster a second pandemic pathogen. But what would happen next in Northern Italy was an event that no one could have foreseen.<br>• On January 22nd, 2020, Customs authorities from the Guardia di Finanza in the northern Italian city of Padua seized and burnt nearly 10 tons of Chinese pig meat, potentially infected with African swine fever. By the end of 2019, half of China’s swine herd —250 million pigs, were dead. Padua is located in the Veneto region of Italy. The coronavirus, AKA Covid-19, first appeared in Lombardy (Milan) and Veneto (Padua). Swine fever is deadly among pigs, though it poses no risk to humans. <br>• But if Italy thought it had incinerated its problems away by burning tainted Chinese pig meat, much of which probably originated from Wuhan’s vast pig reservoir, it had another thought coming. Now, infectious particles were circulating through the air of Northern Italy. Furthermore, if Swine fever posed no risk to humans, what did pose a risk is a common disease in pigs called Mycobacterium avium (AKA MAC or fowl tuberculosis), a non-tubercular mycobacteria (NTM). In one study, the incidence of Mycobacterium avium (fowl tuberculosis) in a pig population was an astonishing 81%. As reported by some workers, M. avium isolates from swine represent a major threat to human beings. And the similarity of the IS1245 RFLP [restriction fragment length polymorphism (RFLP)] patterns of the human and porcine isolates indicated a close genetic relatedness, suggesting that M. avium is transmitted between pigs and humans. Such M. avium infection can occur wherever the right “underlying pulmonary conditions” exist, which can be an event as simple as a childhood or reactivated tubercular infection, or merely tying up the lungs with an excess of dust or particulate matter.<br>• Thus, just before the event attributed to COVID-19 in Northern Italy began, a deadly combination of rising TB rates followed by the introduction of porcine [from pigs] M. avium [also called fowl tuberculosis] into the environment would eventually first bring the Italian Northern provinces, and then the entire peninsula to its knees. This precise series of events led to the Great Pandemic of 1918 at Fort Funston and the Chinese episode at Wuhan, a major player in China’s pig industry.<br>• Mycobacterium avium complex (MAC) or mycobacterium avium is a poorly understood disease which fulfills almost all of those characteristic signs and symptoms attributed to the latest “novel” Coronavirus. In general Mycobacterium avium is a milder disease then Mycobacterium tuberculosis. The most common type of nontuberculous mycobacterial lung infection that causes pulmonary disease in the United States are due to the group of bacteria in the M. avium complex (MAC).<br>• When it appears in the lungs, Mycobacterium avium favors an older population with an underlying condition. As with COVID-19, not all people with a nontuberculous mycobacterial lung infection such as M. avium need to be treated. On the other hand, if it disseminates or spreads systemically, the patient can present with fever or high fever, diarrhea, fatigue, shortness of breath, chronic or recurrent sore throat and cough……….most of which have been reported in Coronavirus patients.<br>• Non-tubercular-mycobacteria (NTM) such as Mycobacterium avium can be asymptomatic or can cause symptoms similar to tuberculosis, such as cough, fever, fatigue, and weight loss. <br>• It is projected that the present Italian outbreak and outbreaks worldwide will follow the timetable of Yang’s Wuhan study, which describes an annual TB surge in Wuhan as being fueled by increased transmission in the winter; peaking in March, with a second smaller peak in September.<br><br><br><br>