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Rossi B, Barreca F, Benvenuto D, Braccialarghe N, Campogiani L, Lodi A, Aguglia C, Cavasio RA, Giacalone ML, Kontogiannis D, Moccione M, Malagnino V, Andreoni M, Sarmati L, Iannetta M. Human Arboviral Infections in Italy: Past, Current, and Future Challenges. Viruses 2023; 15:v15020368. [PMID: 36851582 PMCID: PMC9963149 DOI: 10.3390/v15020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Arboviruses represent a public health concern in many European countries, including Italy, mostly because they can infect humans, causing potentially severe emergent or re-emergent diseases, with epidemic outbreaks and the introduction of endemic circulation of new species previously confined to tropical and sub-tropical regions. In this review, we summarize the Italian epidemiology of arboviral infection over the past 10 years, describing both endemic and imported arboviral infections, vector distribution, and the influence of climate change on vector ecology. Strengthening surveillance systems at a national and international level is highly recommended to be prepared to face potential threats due to arbovirus diffusion.
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Affiliation(s)
- Benedetta Rossi
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Filippo Barreca
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Domenico Benvenuto
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Neva Braccialarghe
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Laura Campogiani
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Alessandra Lodi
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Camilla Aguglia
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | | | - Maria Laura Giacalone
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Dimitra Kontogiannis
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Martina Moccione
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Vincenzo Malagnino
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Massimo Andreoni
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Loredana Sarmati
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Marco Iannetta
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Correspondence:
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Riccò M, Zaniboni A, Satta E, Ranzieri S, Cerviere MP, Marchesi F, Peruzzi S. West Nile Virus Infection: A Cross-Sectional Study on Italian Medical Professionals during Summer Season 2022. Trop Med Infect Dis 2022; 7:tropicalmed7120404. [PMID: 36548659 PMCID: PMC9786547 DOI: 10.3390/tropicalmed7120404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022] Open
Abstract
West Nile virus (WNV) has progressively endemized in large areas of continental Europe, and particularly in Northern Italy, in the Po River Valley. During summer season 2022, Italy experienced an unprecedented surge in incidence cases of WNV infections, including its main complications (West Nile fever (WNF) and West Nile neuroinvasive disease (WNND)). As knowledge, attitudes, and practices (KAP) of medical professionals may be instrumental in guaranteeing a prompt diagnosis and an accurate management of incident cases, we performed a cross-sectional study specifically on a sample of Italian medical professionals (1 August 2022-10 September 2022; around 8800 potential recipients). From a total of 332 questionnaires (response rate of 3.8%), 254 participating medical professionals were eventually included in the analyses. Knowledge status of participants was unsatisfying, as most of them exhibited knowledge gaps on the actual epidemiology of WNV, with similar uncertainties on the clinical features of WNF and WNND. Moreover, most of participants substantially overlooked WNV as a human pathogen when compared to SARS-CoV-2, TB, and even HIV. Interestingly, only 65.4% of respondents were either favorable or highly favorable towards a hypothetical WNV vaccine. Overall, acknowledging a higher risk perception on WNV was associated with individual factors such as reporting a seniority ≥ 10 years (adjusted odds ratio [aOR] 2.39, 95% Confidence interval [95%CI] 1.34 to 4.28), reporting a better knowledge score (aOR 2.92, 95%CI 1.60 to 5.30), having previously managed cases of WNV infections (aOR 3.65, 95%CI 1.14 to 14.20), being favorable towards a hypothetic vaccine (aOR 2.16, 95%CI 1.15 to 4.04), and perceiving WNV infections as potentially affecting daily activities (aOR 2.57, 95%CI 1.22 to 5.42). In summary, substantial knowledge gaps and the erratic risk perception collectively enlighten the importance and the urgency for appropriate information campaigns among medical professionals, and particularly among frontline personnel.
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Affiliation(s)
- Matteo Riccò
- Occupational Health and Safety Service on the Workplace/Servizio di Prevenzione e Sicurezza Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
- Correspondence: or ; Tel.: +39-339-2994343 or +39-522-837587
| | | | - Elia Satta
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | | | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, 42016 Guastalla, Italy
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Dengue Fever in Italy: The "Eternal Return" of an Emerging Arboviral Disease. Trop Med Infect Dis 2022; 7:tropicalmed7010010. [PMID: 35051126 PMCID: PMC8782038 DOI: 10.3390/tropicalmed7010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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Ayukekbong JA, Oyero OG, Nnukwu SE, Mesumbe HN, Fobisong CN. Value of routine dengue diagnosis in endemic countries. World J Virol 2017; 6:9-16. [PMID: 28239567 PMCID: PMC5303857 DOI: 10.5501/wjv.v6.i1.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/24/2016] [Accepted: 12/09/2016] [Indexed: 02/05/2023] Open
Abstract
Dengue is one of the most common arthropod-borne viral diseases in humans and it is a leading cause of illness and death in the tropical and subtropical regions of the world. It is thought to account for 400 million cases annually among approximately 3.97 billion people at risk of infection in 128 endemic countries. Despite the global prevalence of the disease, the availability of a vaccine is limited in most countries in the endemic areas. Most endemic countries in South America, South East Asia and Africa serve as attractive touristic sites for people from non-endemic countries who become infected and export the virus to dengue-free regions. Dengue fever typically resembles malaria and in endemic countries most cases of dengue are treated as presumptive malaria. Consequently, routine dengue diagnosis among persons with fever will offer early treatment and reduce the burden of the disease. Also, routine testing among travellers from endemic countries will reduce importation and prevent the geographical expansion of dengue. In this essay, we seek to highlight the usefulness of routine dengue testing in endemic countries.
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Buonsenso D, Barone G, Onesimo R, Calzedda R, Chiaretti A, Valentini P. The re-emergence of dengue virus in non-endemic countries: a case series. BMC Res Notes 2014; 7:596. [PMID: 25186647 PMCID: PMC4174650 DOI: 10.1186/1756-0500-7-596] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 08/22/2014] [Indexed: 11/10/2022] Open
Abstract
Background Dengue has been designated a major international public health problem by the World Health Organization. It is endemic in most tropical and sub-tropical countries, which are also popular tourist destinations. Travelers are at significant risk of acquiring the disease and also contribute to its spread to non-endemic countries where the vector is present. Children represent a particular susceptible category, since they have a higher risk than adults of developing severe dengue. Case presentation We describe 3 cases of imported dengue fever in Italy in three children (two born in the Philippines and one of Bangladeshi ethnicity) who acquired dengue fever during a recent travel to Southeast Asia, initially not-recognized because of the low index of suspicion of physicians not working in dengue endemic areas. Clinical presentations, differential diagnosis and management of these children are presented and discussed. Conclusions Due to global urbanization and increased air travel, it is nowadays important that physicians who practice outside of traditionally dengue endemic areas are adept at the recognition of potentially fatal reemerging infectious diseases such as dengue. Electronic supplementary material The online version of this article (doi:10.1186/1756-0500-7-596) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danilo Buonsenso
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Catholic University A, Gemelli Hospital, L,go A, Gemelli 8, 00168 Rome, Italy.
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Sambri V, Capobianchi MR, Cavrini F, Charrel R, Donoso-Mantke O, Escadafal C, Franco L, Gaibani P, Gould EA, Niedrig M, Papa A, Pierro A, Rossini G, Sanchini A, Tenorio A, Varani S, Vázquez A, Vocale C, Zeller H. Diagnosis of west nile virus human infections: overview and proposal of diagnostic protocols considering the results of external quality assessment studies. Viruses 2013; 5:2329-48. [PMID: 24072061 PMCID: PMC3814591 DOI: 10.3390/v5102329] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 08/28/2013] [Accepted: 09/09/2013] [Indexed: 01/14/2023] Open
Abstract
West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD).
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Affiliation(s)
- Vittorio Sambri
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-331-8687352
| | - Maria R. Capobianchi
- National Institute for Infectious Diseases (INMI) “L. Spallanzani”, Rome 00149, Italy; E-Mail:
| | - Francesca Cavrini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Rémi Charrel
- UMR_D 190 “Emergence des Pathologies Virales”, APHM Public Hospitals of Marseille, EHESP French School of Public Health & IHU Mediterranee Infection, IRD French Institute of Research for Development, Aix Marseille University, 13005, Marseille, France; E-Mail: (R.C.)
| | - Olivier Donoso-Mantke
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Camille Escadafal
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Leticia Franco
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Paolo Gaibani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Ernest A. Gould
- UMR_D 190 “Emergence des Pathologies Virales”, APHM Public Hospitals of Marseille, EHESP French School of Public Health & IHU Mediterranee Infection, IRD French Institute of Research for Development, Aix Marseille University, 13005, Marseille, France; E-Mail: (R.C.)
- NERC Centre for Ecology and Hydrology, Wallingford, Oxon OX10 8BB, UK; E-Mail: (E.A.G.)
| | - Matthias Niedrig
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece; E-Mail:
| | - Anna Pierro
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Giada Rossini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Andrea Sanchini
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden
| | - Antonio Tenorio
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Stefania Varani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Ana Vázquez
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Caterina Vocale
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Herve Zeller
- European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden; E-Mail:
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Abstract
PURPOSE OF REVIEW Dengue virus (DENV) and chikungunya virus (CHIKV) cause significant morbidity in many world regions and their epidemiology, pathogenesis, vector issues, and control and prevention continue to fascinate researchers. This review focuses on the progress in these areas in the past 2 years. RECENT FINDINGS Recent studies have highlighted the features of the epidemiology of DENV and CHIKV in Africa, some places of transmission being detected through travelers as sentinels. Autochthonous transmission of both viruses has been documented in France, raising concern regarding the potential for outbreaks where a competent vector, Aedes albopictus, is present. Some aspects of immune response following DENV and CHIKV infections have been elucidated. New diagnostic techniques for DENV have been explored as well as treatment for CHIKV. Research on Wolbachia as a means of biologic control of mosquito-borne infections including DENV and CHIKV has made significant progress. SUMMARY These studies further our understanding of the evolving DENV and CHIKV epidemiology and potential transmission in nonendemic regions, and can contribute to the assessment of travelers. The new information on immunological responses to these viruses influences the vaccine development. Risk factors for severe disease and new therapeutic options could improve current treatment. Finally, research on Wolbachia holds promise in these two important vector-borne viral infections.
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Gasperi G, Bellini R, Malacrida AR, Crisanti A, Dottori M, Aksoy S. A new threat looming over the Mediterranean basin: emergence of viral diseases transmitted by Aedes albopictus mosquitoes. PLoS Negl Trop Dis 2012; 6:e1836. [PMID: 23029593 PMCID: PMC3459824 DOI: 10.1371/journal.pntd.0001836] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Giuliano Gasperi
- Dipartimento di Biologia e Biotecnologie, Università di Pavia, Pavia, Italy
| | - Romeo Bellini
- Medical and Veterinary Entomology, Centro Agricoltura Ambiente “G. Nicoli”, Crevalcore, Bologna, Italy
| | - Anna R. Malacrida
- Dipartimento di Biologia e Biotecnologie, Università di Pavia, Pavia, Italy
| | - Andrea Crisanti
- Division of Molecular and Cell Biology, Imperial College, London, United Kingdom
- Dipartimento di Medicina Sperimentale, Università di Perugia, Italy
| | - Michele Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Brescia, Italy
| | - Serap Aksoy
- Yale School of Public Health, Department of Epidemiology and Public Health, New Haven, Connecticut, United States of America
- * E-mail:
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Current world literature. Curr Opin Allergy Clin Immunol 2012; 12:211-7. [PMID: 22382450 DOI: 10.1097/aci.0b013e3283520fda] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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