Romina Pausilli

BACKGROUND: Following substantial progress towards measles elimination after the COVID-19 pandemic, Italy experienced a marked increase in measles cases in 2024. AIM: Our aim was to describe measles epidemiology in Italy, October 2023–March 2025, and assess vaccination coverage, surveillance performance at national and regional levels, and temporal patterns of transmission. METHODS: Numbers of measles cases and outbreaks were reviewed. Vaccination coverage and surveillance indicators were described at national and regional levels. Measles variants were classified by genotype and Distinct Sequence Identifier (DSId). Temporal transmission patterns of measles variants were assessed nationally and regionally to identify sustained transmission chains (≥ 12 consecutive months). RESULTS: In total, 1,311 measles cases were reported, with 178 outbreaks. Cases’ median age was 30.9 years (IQR: 15.6–39.8); 601 were female (45.8%) and 710 male (54.2%). Only 3.1% (38/1,230) were fully vaccinated. In 2024, the first-dose vaccination coverage increased to 94.77% (95% CI: 94.70–94.84%) nationally, while second-dose coverage declined to 84.45% (95% CI: 84.35–84.55%). Among all cases, 12.1% (n = 158) were imported/importation-related, 64.1% (n = 841) were of unknown origin and 52.8% had DSId data available (n = 692), with high regional heterogeneity. Twenty-five measles variants were identified. One variant (D8–5963) showed sustained national transmission for over 12 months, meeting criteria for re-established endemic transmission, although no single region showed uninterrupted ≥ 12-month circulation. CONCLUSION: Measles resurgence in Italy was marked by persistent immunity gaps, heterogeneous surveillance performance, and sustained national circulation of a D8 variant, indicating loss of near-elimination status. Strengthening vaccination strategies and enhancing molecular surveillance is urgently needed to restore progress towards measles elimination.

Background and Aims: Owing to their distinct features, genetic/genomic technologies have traditionally been assessed using tailored approaches, with no standardized methodology emerging to date. The Health Technology Assessment (HTA) Core Model (version 3.0), adopted within the European Union HTA Regulation, is a rigorous framework for health technology assessment, but its suitability for genetic/genomic testing remains unclear. This study examined whether the Model could serve as a standardized framework for the evaluation of genetic/genomic applications. Methods: A search was conducted to identify evaluation frameworks for genetic/genomic applications (PROSPERO CRD42023429403), and a critical analysis was performed. The methodological characteristics of the identified frameworks, including their assessment domains and components, were systematically compared to the domains and issues of the HTA Core Model. Findings were synthesized narratively. Results: Overall, 24 evaluation frameworks for genetic/genomic testing were analysed: half were based on the ACCE model, four on the HTA approach, one combined both methodologies, and seven were heterogeneous in structure. Only one framework covered all relevant assessment aspects but lacked validation. Conversely, the HTA Core Model captured all core questions and addressed every identified assessment component, although with varying degrees of coverage (Cohen's κ between researchers: 0.71, 95% CI: 0.59–0.82). Conclusion: Existing frameworks for genetic/genomic technologies are fragmented and mostly incomplete. As the HTA Core Model encompasses all relevant components of these technologies, it may offer a suitable basis for standardizing their evaluation process. Future research could integrate it with a few genomic‐specific items to maximize its exhaustiveness.