Abstract
We describe the geographical and temporal distribution of West Nile neuroinvasive diseases (WNND) cases in Italy from 2008 to 2011. The increasing number of confirmed human cases from eight in 2008 to 18 in 2009 and the occurrence of the virus in a larger geographical area in 2009 (moving from east to west) prompted the Ministry of Health to publish, in spring 2010, a national programme for WNND human surveillance, comprising veterinary and vector surveillance. Subsequently, in 2011, a new national plan on integrated human surveillance of imported and autochthonous vector-borne diseases (chikungunya, dengue and West Nile disease) was issued. Between 2008 and 2011, 43 cases of WNND were reported from five regions in Italy with a case fatality rate of 16%. The incidence of WNND during the entire study period was 0.55 per 100,000 population (range: 0.06–0.23 per 100,000). During 2011, two new regions (Friuli-Venezia Giulia and Sardinia) reported confirmed cases in humans. Integrated human, entomological and animal surveillance for West Nile virus is a public health priority in Italy and will be maintained during 2012.
Highlights
West Nile Virus (WNV) infection was first identified in Italy in 1998, when the disease was detected in horses in Tuscany, with no rise in human neurological cases detected at the time [1]
Italian regions to adopt the operative procedure for entomological, sentinel bird and horse surveillance in coordination with the West Nile Disease (WND) National Reference Laboratory of the Public Veterinarian Health Department (Istituto Zooprofilattico Sperimentale) in Teramo, and the National Reference Laboratory for Vector Surveillance of the National Institute of Health (Istituto Superiore di Sanità, ISS) [3]
This evidence prompted the immediate implementation of a WNV surveillance plan for human surveillance of West Nile neuroinvasive disease (WNND) in the two affected regions in June 2008 [5,6,7,8]
Summary
West Nile Virus (WNV) infection was first identified in Italy in 1998, when the disease was detected in horses in Tuscany, with no rise in human neurological cases detected at the time [1]. In summer 2005, WNV activity was detected again in the north-eastern part of Italy in sentinel chicken [4] whereas in summer 2008, WNV was confirmed in horses with neurological symptoms in the regions Veneto and Emilia-Romagna. This evidence prompted the immediate implementation of a WNV surveillance plan for human surveillance of West Nile neuroinvasive disease (WNND) in the two affected regions in June 2008 [5,6,7,8]. In 2009, the number of human WNND cases increased to a total of 18 in that year and included new wet areas surrounding the Po river (nine cases in Emilia-Romagna, seven in Veneto and two in Lombardy) [5,6,7]
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