Recent rapid changes in the spatio‐temporal distribution of West Nile Neuro‐invasive Disease in Italy

Moirano, Giovenale; Richiardi, Lorenzo; Calzolari, Mattia; Merletti, Franco; Maule, Milena

doi:10.1111/zph.12654

Cited by 12 publications

(25 citation statements)

References 29 publications

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“…The spatial model (Fig 3) is in accordance with other studies that reported a high prevalence of WNF within the Danube and Po basins [12,55]. The Danube basin constitutes an important settlement area for migratory birds from Europe, Asia and Africa, and consequently a concentration area for the pathogens carried by migrant birds during their routes along the stopover and feeding areas [56].…”

Section: Spatial Risk Modelsupporting

confidence: 87%

Predicting the spatio-temporal spread of West Nile virus in Europe

et al. 2021

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West Nile virus is a widely spread arthropod-born virus, which has mosquitoes as vectors and birds as reservoirs. Humans, as dead-end hosts of the virus, may suffer West Nile Fever (WNF), which sometimes leads to death. In Europe, the first large-scale epidemic of WNF occurred in 1996 in Romania. Since then, human cases have increased in the continent, where the highest number of cases occurred in 2018. Using the location of WNF cases in 2017 and favorability models, we developed two risk models, one environmental and the other spatio-environmental, and tested their capacity to predict in 2018: 1) the location of WNF; 2) the intensity of the outbreaks (i.e. the number of confirmed human cases); and 3) the imminence of the cases (i.e. the Julian week in which the first case occurred). We found that climatic variables (the maximum temperature of the warmest month and the annual temperature range), human-related variables (rain-fed agriculture, the density of poultry and horses), and topo-hydrographic variables (the presence of rivers and altitude) were the best environmental predictors of WNF outbreaks in Europe. The spatio-environmental model was the most useful in predicting the location of WNF outbreaks, which suggests that a spatial structure, probably related to bird migration routes, has a role in the geographical pattern of WNF in Europe. Both the intensity of cases and their imminence were best predicted using the environmental model, suggesting that these features of the disease are linked to the environmental characteristics of the areas. We highlight the relevance of river basins in the propagation dynamics of the disease, as outbreaks started in the lower parts of the river basins, from where WNF spread towards the upper parts. Therefore, river basins should be considered as operational geographic units for the public health management of the disease.

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Section: Spatial Risk Modelsupporting

confidence: 87%

Predicting the spatio-temporal spread of West Nile virus in Europe

et al. 2021

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“…Data collection: In 2011, national surveillance plan for WNV infections was extensively revised, implementing the publication of periodic surveillance bulletins [ 17 , 19 , 28 ]. Periodic bulletins (available from: ; accessed on 23 April 2021) include the following data: total number of WNV infections reported during the surveillance season (i.e., 15 June to 15 November) irrespective of their actual clinical features, number of WNV infections identified in blood donors, number of WNND cases (both as a total estimate and stratified by province, age group, and month of diagnosis).…”

Section: Methodsmentioning

confidence: 99%

“…Even though the inception of WNV occurred quite lately when compared to other European countries (i.e., 2008), currently Italy includes some among the most heavily affected areas in the European Union. Not coincidentally, in 2010, the Italian Ministry of Health implemented the first National WNV surveillance plan, which integrated veterinary, entomological, and epidemiological data in order to more efficiently monitor the spread of WNV and detect human cases of WNV infection [ 16 , 17 , 18 , 19 , 20 ]. Some earlier reports on the integrated surveillance system have been published [ 16 , 17 , 18 , 19 , 20 ], but all of them predates the transmission season of 2018, in which 1605 confirmed cases reported across European countries nearly doubled the total cases registered in the previous three years combined [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Not coincidentally, in 2010, the Italian Ministry of Health implemented the first National WNV surveillance plan, which integrated veterinary, entomological, and epidemiological data in order to more efficiently monitor the spread of WNV and detect human cases of WNV infection [ 16 , 17 , 18 , 19 , 20 ]. Some earlier reports on the integrated surveillance system have been published [ 16 , 17 , 18 , 19 , 20 ], but all of them predates the transmission season of 2018, in which 1605 confirmed cases reported across European countries nearly doubled the total cases registered in the previous three years combined [ 21 , 22 ]. Moreover, despite the quarantine measures that various EU countries implemented during 2020, the WNV transmission season was associated with remarkable outbreaks both in previously affected and previously spared areas, with a proportion of WNND that largely exceeded the average of previous 5 years [ 12 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, despite the quarantine measures that various EU countries implemented during 2020, the WNV transmission season was associated with remarkable outbreaks both in previously affected and previously spared areas, with a proportion of WNND that largely exceeded the average of previous 5 years [ 12 , 23 ]. As a consequence, an updated and comprehensive reappraisal of surveillance data may be particularly useful to national and local health authorities for the implementation of appropriate response measures, including blood safety, and preventive campaigns focusing on vector control and communication [ 19 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of West Nile Virus Infections in Humans, Italy, 2012–2020: A Summary of Available Evidences

Riccò

Peruzzi

Balzarini³

2021

TropicalMed

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In Italy, human cases of West Nile virus (WNV) infection have been recorded since 2008, and seasonal outbreaks have occurred almost annually. In this study, we summarize available evidences on the epidemiology of WNV and West Nile neuro-invasive disease (WNND) in humans reported between 2012 and 2020. In total, 1145 WNV infection cases were diagnosed; of them 487 (42.5%) had WNND. A significant circulation of the pathogen was suggested by studies on blood donors, with annual incidence rates ranging from 1.353 (95% confidence intervals (95% CI) 0.279–3.953) to 19.069 cases per 100,000 specimens (95% CI 13.494–26.174). The annual incidence rates of WNND increased during the study period from 0.047 cases per 100,000 (95% CI 0.031–0.068) in 2012, to 0.074 cases per 100,000 (95% CI 0.054–0.099) in 2020, peaking to 0.377 cases per 100,000 (95% CI 0.330–0.429) in 2018. There were 60 deaths. Cases of WNND were clustered in Northern Italy, particularly in the Po River Valley, during the months of August (56.7%) and September (27.5%). Higher risk for WNND was reported in subjects of male sex (risk ratio (RR) 1.545, 95% CI 1.392–1.673 compared to females), and in older age groups (RR 24.46, 95% CI 15.61–38.32 for 65–74 y.o.; RR 43.7, 95% CI 28.33–67.41 for subjects older than 75 years), while main effectors were identified in average air temperatures (incidence rate ratio (IRR) 1.3219, 95% CI 1.0053–1.7383), population density (IRR 1.0004, 95% CI 1.0001–1.0008), and occurrence of cases in the nearby provinces (IRR 1.0442, 95% CI 1.0340–1.0545). In summary, an enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

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