Capelli G, Baldelli R, Ferroglio E, Genchi C, Gradoni L, Gramiccia M, Maroli M, Mortarino M, Pietrobelli M, Rossi L, Ruggiero M
Università di Padova.
Parassitologia. 2004 Jun;46(1-2):193-7.
Canine leishmaniasis (CanL) due to Leishmania infantum is a disease of great veterinary importance and a serious public health problem. In humans, L. infantum causes visceral (VL) and cutaneous leishmaniasis (CL) and the distribution of VL overlaps that of CanL. Currently, VL is considered by WHO as an emerging zoonosis in southern Europe. The dog is the only domestic reservoir of the infection and phlebotomine sandflies are the only proven vectors of leishmaniasis for dogs and humans. CanL is endemic in Italy, particularly in central and southern regions, including islands. Until 1983, all regions of northern Italy but Liguria and some territories of Emilia Romagna were considered free from CanL. From early '90s new stable foci of CanL have appeared, most of them located within classical endemic areas including territories of Emilia Romagna, Tuscany, Umbria, Marche, and Abruzzi regions. But the most relevant aspect, from an epidemiological point of view, has been the appearance of stable CanL foci in northern Italy, namely in Veneto and Piedmont regions. In these two foci, entomological surveys showed the presence of P. perniciosus and of a second phlebotomine vector, P. neglectus, which may have played a role in the CanL diffusion in some parts of northern Italy. Furthermore, in these areas, autochthonous human VL cases have occurred. There is therefore a realistic risk that CanL infection could rapidly spread through northern latitudes and a surveillance activity is strongly needed. For this reason, in October 2002, thanks to the collaboration and support of Intervet Italia, the network "LeishMap" was created, with the main purpose of monitoring the spread of CanL and vectors in northern Italy. LeishMap consists of scientific and sanitary institutions with proven experience both in field surveys and diagnostic methodologies on CanL and phlebotomine vector. It is organised in 4 Operational Units (OU), represented by researchers of the Veterinary Faculties of the University of Bologna, Padua, Milan and Turin, under the scientific coordination of the MIPI Department, ISS of Rome and with the collaboration of private and public veterinarians operating in the regions under study. During the first year of activity, each OU was involved in the serological and entomological surveillance of several territories in the respective regions, where recent autochthonous CanL cases were registered. The studies have involved five regions, namely Valle D'Aosta, Piedmont, Lombardia, Veneto, Trentino-Alto Adige and Emilia Romagna. In the Symposium 6 of this Congress we report detailed results of a retrospective analysis of data concerning CanL and vectors in northern Italy till 2002 and the preliminary results of 2003 on the seroprevalence rates observed in foci studied and on the entomological surveys carried out. In summary, the results outlined that already known foci of CanL are expanding from the original sites. Several new foci have been identified and many others are at high risk of evolving toward a stable endemicity. P. perniciosus has been found in all but one the suspected new foci. In Emilia Romagna region P. perfiliewi was identified in 2 areas and in one was the only species present. The occurrence of P. neglectus was confirmed in three regions, Veneto, Lombardia and Piedmont. In conclusion, from the 2002-2003 LeishMap activities it appears that further monitoring activities are necessary to identify new endemic foci of CanL, this representing the prerequisite for the implementation of programs for leishmaniasis control in northern Italy.
由婴儿利什曼原虫引起的犬利什曼病(CanL)是一种具有重要兽医意义的疾病,也是一个严重的公共卫生问题。在人类中,婴儿利什曼原虫可导致内脏利什曼病(VL)和皮肤利什曼病(CL),VL的分布与CanL重叠。目前,世界卫生组织将VL视为南欧一种新出现的人畜共患病。狗是该感染的唯一家养宿主,白蛉是犬类和人类利什曼病唯一经证实的传播媒介。CanL在意大利呈地方性流行,特别是在中部和南部地区,包括各岛屿。直到1983年,意大利北部除利古里亚以及艾米利亚-罗马涅的一些地区外,其他所有地区都被认为没有CanL。自90年代初以来,出现了新的CanL稳定疫源地,其中大多数位于传统的流行地区,包括艾米利亚-罗马涅、托斯卡纳、翁布里亚、马尔凯和阿布鲁齐等地区。但从流行病学角度来看,最相关的方面是意大利北部出现了稳定的CanL疫源地,即威尼托和皮埃蒙特地区。在这两个疫源地,昆虫学调查显示存在有害白蛉以及第二种白蛉传播媒介——疏忽白蛉,它们可能在意大利北部部分地区的CanL传播中发挥了作用。此外,在这些地区还出现了本地感染的人类VL病例。因此,CanL感染确实有迅速向北纬地区传播的风险,强烈需要开展监测活动。出于这个原因,2002年10月,在意大利英特威公司的合作与支持下,创建了“LeishMap”网络,其主要目的是监测CanL及其传播媒介在意大利北部的传播情况。LeishMap由在CanL和白蛉传播媒介的实地调查及诊断方法方面具有丰富经验的科研和卫生机构组成。它分为4个业务单元(OU),由博洛尼亚大学、帕多瓦大学、米兰大学和都灵大学兽医学院的研究人员代表,在罗马ISS的MIPI部门的科学协调下,并与在所研究地区开展工作的公私兽医合作。在活动的第一年,每个OU都参与了各自地区几个有近期本地CanL病例记录的地区的血清学和昆虫学监测。这些研究涉及五个地区,即瓦莱达奥斯塔、皮埃蒙特、伦巴第、威尼托、特伦蒂诺-上阿迪杰和艾米利亚-罗马涅。在本次大会的研讨会6中,我们报告了对意大利北部直至2002年的CanL和传播媒介数据的回顾性分析的详细结果,以及2003年在所研究疫源地观察到的血清阳性率和所开展的昆虫学调查的初步结果。总之,结果表明,已知的CanL疫源地正在从原始地点向外扩展。已发现了几个新的疫源地,还有许多其他疫源地有演变为稳定地方性流行的高风险。除一个疑似新疫源地外,在所有其他疫源地都发现了有害白蛉。在艾米利亚-罗马涅地区,在2个地区发现了佩氏白蛉,在其中1个地区它是唯一存在的白蛉物种。在威尼托、伦巴第和皮埃蒙特三个地区证实存在疏忽白蛉。总之,从2002 - 2003年LeishMap的活动来看,似乎有必要开展进一步的监测活动以确定CanL的新的地方性疫源地,这是在意大利北部实施利什曼病控制项目的前提条件。