The Surveillance of Chikungunya Virus in a Temperate Climate: Challenges and Possible Solutions from the Experience of Lazio Region, Italy

Vairo, Francesco; Pietrantonj, Carlo Di; Pasqualini, Chiara; Mammone, Alessia; Lanini, Simone; Nicastri, Emanuele; Castilletti, Concetta; Ferraro, Federica; Bari, Virginia Di; Puro, Vincenzo; Scognamiglio, Paola; Di, Antonino; Capobianchi, Maria Rosaria; Ippolito, Giuseppe

doi:10.3390/v10090501

Cited by 18 publications

(15 citation statements)

References 40 publications

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“…This highlights the importance of an integrated surveillance system that should promptly identify autochthonous transmission. The integration of the passive surveillance with different surveillance tools (such as laboratory-based surveillance, syndromic surveillance, novel data stream) [36] combined with entomological surveillance should facilitate the detection, response and control of arboviruses spreading, including CHIKV.…”

Section: Discussionmentioning

confidence: 99%

Local transmission of chikungunya in Rome and the Lazio region, Italy

et al. 2018

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On September 7, 2017, three potentially autochthonous cases of chikungunya were notified in the Lazio region. An Outbreak investigation based on established surveillance system data and molecular analysis of viral variant(s) were conducted. Epidemiological analysis suggested the occurrence of 3 main foci of local transmission. The major focus involved 317 cases with epidemiological link with the area of Anzio. The other two foci occurred in Rome (80 cases) and Latina (8 cases). Cumulative incidence in Anzio and Latina were 331.4 and 7.13 per 100,000 residents, respectively. Cumulative incidences ranged from 1.4 to 14.3/100,000 residents in Rome. This is the first report of a chikungunya outbreak involving a densely populated urban area in a western country. The outbreak probably started in Anzio, spread by continuity to neighbouring villages, and then to the metropolitan area of Rome and to the Latina area favoured by the touristic nature of the Anzio area.

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Section: Discussionmentioning

confidence: 99%

Local transmission of chikungunya in Rome and the Lazio region, Italy

et al. 2018

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“…Following the geographical expansion of one of its vector species, Aedes albopictus, several CHIKV outbreaks have been documented in temperate regions [7][8][9][10][11][12], and many urban areas of Southern Europe have a non-negligible risk of CHIKV outbreaks [13][14][15]. Therefore, general practitioners and public health authorities need to be prepared to face this emerging arboviral risk [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of the 2007 and 2017 Italian chikungunya outbreaks and implication for public health response

et al. 2020

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Chikungunya virus (CHIKV) is a mosquito-borne infection that is emerging in temperate areas of Europe, following the expansion of one of its vector species, Aedes albopictus. Although CHIKV fever is a self-limiting disease, with a clinical syndrome often resolving within few days, it can also cause severe sequelae, including chronic polyarthralgia lasting up to 5 years. Additionally, CHIKV outbreaks may limit blood bank donations, adding economic burden on the health system. Public health authorities in Europe need to increase their preparedness against this emerging threat. Two large CHIKV outbreaks occurred in Italy in 2007 and 2017, with hundreds of cases and significant geographical spread. The aim of this paper is to review and compare the 2 Italian outbreaks in terms of available estimates of key epidemiological features, patient clinical presentation, virus and immunological characteristics, and public health response. Recommendations for public health and future directions for research are also discussed and highlighted. Key results Both outbreaks started in small towns, but cases were also detected in nearby larger cities where transmission was limited to small clusters. The time spans between the first and the last symptom onsets were similar between the 2 outbreaks, and the delay from the symptom onset of the index case and the first case notified was considerable. Comparable infection and transmission rates were observed in laboratory. The basic reproductive number (R 0) was estimated in the range of 1.8-6 (2007) and 1.5-2.6 (2017). Clinical characteristics were similar between outbreaks, and no acute complications were reported, though a higher frequency of ocular symptoms, myalgia, and rash was observed in 2017. Very little is known about the immune mediator profile of CHIKV-infected patients during the 2 outbreaks. Regarding public health responses, after the 2007 outbreak, the Italian Ministry of Health PLOS NEGLECTED TROPICAL DISEASES

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“…No obstante, en los últimos 5 años los brotes epidémicos inesperados, explosivos y de rápida expansión han seguido aconteciendo en otras partes del mundo (caso de la epidemia de virus zika en América, 2015-2017). La Europa mediterránea parece asistir a una muy lenta —si bien inexorable— endemización caracterizada por un patrón de pequeños brotes con transmisión autóctona limitada a partir de un caso importado cuando existe una conjunción de circunstancias epidemiológicas, entomológicas y ecológicas favorables, que generalmente acontecen durante el semestre mayo-octubre 13 .…”

Section: Discussionunclassified

Vigilancia epidemiológica intensificada de arbovirosis: primer caso de dengue autóctono en Cataluña (España), zona Metropolitana Norte de Barcelona, 2018-2019

et al. 2021

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Objetivo Valorar los resultados obtenidos por una red de vigilancia epidemiológica y asistencial de arbovirosis compuesta por médicos y profesionales de enfermería de hospital y atención primaria (AP) formados en su identificación, confirmación diagnóstica y manejo clínico. Emplazamiento Zona Sanitaria Metropolitana Norte de Barcelona (1.400.000 habitantes; Cataluña, España) durante un año natural. Participantes Diecisiete médicos (7 de AP y 10 hospitalarios) más 4 enfermeros/as de AP. Tipo de estudio Estudio observacional prospectivo. Mediciones principales Se definieron variables demográficas, epidemiológicas (caso autóctono/importado, sospechoso/probable/confirmado) y asistenciales (síntomas, perfil serológico, periodo virémico). Resultados De los 34 pacientes identificados cumplían criterios de estudio 26 (76,5%) casos; de ellos, se confirmó alguna arbovirosis en 14 (53,8%): 13 fiebres dengues más 1 chikungunya. No se registraron casos de fiebre de zika. Existían antecedentes de viaje a zonas endémicas (23; 88,4%), pero no en 3 casos (11,6%), en los que se consideró la posibilidad de una transmisión autóctona; de ellos, se confirmó un caso de dengue. La incidencia estimada de arbovirosis fue de 0,4 (IC 95%: 0,33-0,51) casos × 10.000 hab./año, que, comparada con la incidencia estimada en la misma área geográfica durante el periodo 2009-2013 (0,19 casos × 10.000 hab./año; IC 95%: 0,07-0,31), mostró un incremento significativo (p = 0,044). Los pacientes en periodo de viremia al momento de la primera visita médica fueron 11 (42,3%). Conclusiones Un programa de vigilancia epidemiológica intensificada definido a nivel de AP y hospitalario es capaz de detectar significativamente más casos de arbovirosis importadas y transmitidas autóctonamente. Posiblemente asistimos a un aumento en la incidencia de arbovirosis importadas, por lo que las medidas encaminadas a su identificación y confirmación deben reforzarse.

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The Surveillance of Chikungunya Virus in a Temperate Climate: Challenges and Possible Solutions from the Experience of Lazio Region, Italy

Cited by 18 publications

References 40 publications

Local transmission of chikungunya in Rome and the Lazio region, Italy

Local transmission of chikungunya in Rome and the Lazio region, Italy

A comparative analysis of the 2007 and 2017 Italian chikungunya outbreaks and implication for public health response

Vigilancia epidemiológica intensificada de arbovirosis: primer caso de dengue autóctono en Cataluña (España), zona Metropolitana Norte de Barcelona, 2018-2019

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