Infection with chikungunya virus in Italy: an outbreak in a temperate region

Rezza, Giovanni; Nicoletti, Loredana; Angelini, Raffaella; Romi, Roberto; Finarelli, A C; Panning, Marcus; Cordioli, Paolo; Fortuna, Claudia; Boros, Stefano; Magurano, Fabio; Silvi, Giuliano; Angelini, Paola; Dottori, M.; Ciufolini, M G; Majori, G; Cassone, Antonio

doi:10.1016/s0140-6736(07)61779-6

Cited by 1,324 publications

(1,104 citation statements)

References 16 publications

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“…Today's frequent international travel from one continent to another may facilitate the introduction (spread) of the virus in areas where the vector is present. This has been recently experienced in Italy, where a traveller who returned from India was identified as the most likely source of an outbreak of Chikungunya fever which affected >200 people [21]. Clinicians in developed countries should be aware of this possibility and should consider the risk of a more severe disease in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

et al. 2008

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SUMMARYIn April 2005, an outbreak of Chikungunya fever occurred on the island of Re´union in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever : 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10 . 6 % and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness.

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Section: Discussionmentioning

confidence: 99%

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

et al. 2008

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“…In Africa, the CHIKV E1-226V variant was also implicated outbreaks in Cameroon (107), Gabon (106) and Congo (84). This variant also caused the first European CHIKV outbreak in Italy in 2007 (115). Since 2008, IOL CHIKV strains were also imported into Southeast Asia: Malaysia (119), Singapore (95), Thailand (131), China (152), Cambodia (25) and Bhutan (143).…”

Section: Vectorsmentioning

confidence: 99%

Global epidemiology of Zika and Chikungunya virus human infections

et al. 2017

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Zika virus was discovered in 1947. The first reported case of Zika fever was in a sentinel rhesus monkey in Uganda in 1947, while the first human cases were reported in Nigeria in 1954. Since the first evidence of human infection, Zika was active in several countries in Africa and Asia, as sporadic cases and serological evidence of Zika human infections have been demonstrated in several reports. The outbreak of Zika in Yap Island in 2007 is considered the first emergency of this infection. Since then Zika has spread worldwide with a large ongoing epidemic in South and Central America. A huge concern nowadays is about the relationship between Zika infection and microcephaly and about the sexual transmission of the virus. The first identified outbreak of Chikungunya human infection, with an incidence estimated at 23%, was reported from July 1952 to March 1953 in the Southern Province of the current Tanzania. Since then Chikungunya circulated mainly in continental Africa with limited outbreaks. The virus started to spread east bound involving most of the areas surroundings the Indian Ocean. In 2004/2005 a large outbreak developed in La Reunion a French territory in the Indian Ocean: from this point Chikungunya spread to India and from there, due a viraemic traveller returning from Kerala, to Italy where in the summer of 2007 the first outbreak with local viral transmission in a temperate climate zone occurred. In the following years Chikungunya moved to the Caribbean and South America. Recently also the USA experienced the spread of this virus and a limited outbreak based again on local spreading occurred in the French Department of Var, in August 2017.

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“…Europe Autochthonous transmission has been first documented in 2007 in Italy, with an epidemic causing more than 200 cases (Emilia-Romagna Region) [10]. A seroprevalence survey carried out the following year reported an attack rate of 10 %.…”

Section: Epidemiology Of Chikv By Continentmentioning

confidence: 99%

“…They concluded that CHIKVepidemics can occur mostly where/when average monthly temperatures exceed 20°C. In the Northern Hemisphere, the most probable period is between June and September, as happened in 2007 in Italy [10] when the outbreak started in June (mean monthly temperature around 22°C) and subsided in September when the temperatures fell below 20°C [86]. In Europe, the countries considered at higher risk so far are France and Italy, receiving a large number of potentially viremic visitors each year [86].…”

Section: Surveillance In Non-endemic Areasmentioning

confidence: 99%

“…Since 2000, huge outbreaks have been reported, caused by globalisation (increasing displacement of humans and mosquitoes) and by an evolutionary success related to the adaptation of CHIKV to the mosquito vector [8]. The first wave, started from Kenya in 2005 [9], affected African and Asian countries bordering the Indian Ocean, several islands of the latter and caused autochthonous cases also in continental Europe (Italy 2007 and France 2010) [10,11] and Oceania (2011) [12]. The second wave, started in 2013 in Saint Barthélemy and still ongoing in 2014 [13••, 14], is responsible for several epidemics with autochthonous cases in North, Central and South America [15].…”

Section: Introductionmentioning

confidence: 99%

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Emergence and Surveillance of Chikungunya

et al. 2015

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Chikungunya virus (CHIKV), an arbovirus transmitted by Aedes mosquitoes, causes a disease characterised by fever, headache, skin rash, myalgias and severe arthralgias: the latter can persist for years. Following the first report in Africa in 1952, sporadic epidemics have been registered in Africa and in Asia before 2000. Since 2005, huge outbreaks have been reported, caused by globalisation (increasing displacement of humans and mosquitoes) and by an evolutionary success related to the adaptation of CHIKV to the mosquito vector: Therefore, CHIKV spread also in Europe, Oceania and the Americas. In endemic areas, seroprevalence studies could contribute to early detection of epidemics and to have a real picture of the burden of this disease. In temperate areas where Aedes aegypti and/or Aedes albopictus are present, CHIKV control measures require surveillance of imported and autochthonous cases, rapid diagnosis to detect local outbreaks and entomological surveillance.

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Infection with chikungunya virus in Italy: an outbreak in a temperate region

Cited by 1,324 publications

References 16 publications

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

Global epidemiology of Zika and Chikungunya virus human infections

Emergence and Surveillance of Chikungunya

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