Liumbruno Giancarlo Maria, Calteri Deanna, Petropulacos Kyriakoula, Mattivi Andrea, Po Claudio, Macini Pierluigi, Tomasini Ivana, Zucchelli Paolo, Silvestri Anna Rita, Sambri Vittorio, Pupella Simonetta, Catalano Liviana, Piccinini Vanessa, Calizzani Gabriele, Grazzini Giuliano
Centro Nazionale Sangue, Istituto Superiore di Sanità, Roma, Italy.
Blood Transfus. 2008 Oct;6(4):199-210. doi: 10.2450/2008.0016-08.
The Chikungunya virus (CHIKV) is transmitted by Aedes mosquitoes and recently caused a massive epidemic on La Réunion Island, in the Indian Ocean. Between July and September 2007 it caused the first autochthonous epidemic outbreak in Europe, in the Region of Emilia-Romagna in the north-east of Italy.
After the first reports of an unusually high number of patients with a febrile illness of unknown origin in two contiguous villages, an outbreak investigation was carried out to identify the primary source of infection, the modes of transmission and the dynamics of the epidemic. An active surveillance system was also implemented. Laboratory diagnosis was performed through serology and polymerase chain reaction (PCR) analysis. Blood donation was discontinued in the areas involved from September to October 2007 and specific precautionary blood safety and self-sufficiency measures were adopted by the regional health and blood authorities and the National Blood Centre. An estimate method to early assess the risk of viraemic blood donations by asymptomatic donors was developed, as a tool for "pragmatic" risk assessment and management, aiming at providing a reliable order of magnitude of the mean risk of CHIKV transmission through blood transfusion.
Two hundred and seventeen cases of CHIKV infection were identified between 4th July and 28th September. The disease was fairly mild in most of the cases. The precautionary measures adopted in the blood system caused a considerable reduction of the collection of blood components and of the delivery of plasma to the pharmaceutical industry for contract manufacturing. The estimated risk of CHIKV transmission through blood transfusion peaked in the third week of August.
ACHIKV epidemic poses considerable problems for public health authorities, who not only need good routine programmes of vector control and epidemiological surveillance but also local and national emergency plans to sustain the blood supply, so as to promptly deal with the potentially severe effects of an epidemic outbreak, especially when affected areas locally require a significant blood inventory and at the same time represent a critical resource for other areas depending on external supplies of blood components.
基孔肯雅病毒（CHIKV）通过伊蚊传播，最近在印度洋的留尼汪岛引发了大规模疫情。2007年7月至9月间，该病毒在意大利东北部的艾米利亚 - 罗马涅大区引发了欧洲首例本土疫情爆发。
在两个相邻村庄首次报告出现异常大量不明原因发热疾病患者后，开展了疫情调查，以确定感染的主要来源、传播方式和疫情动态。还实施了主动监测系统。通过血清学和聚合酶链反应（PCR）分析进行实验室诊断。2007年9月至10月，相关地区停止献血，地区卫生部门、血液部门及国家血液中心采取了特定的预防性血液安全和自给自足措施。开发了一种早期评估无症状献血者病毒血症献血风险的估算方法，作为“务实”风险评估和管理的工具，旨在提供通过输血传播基孔肯雅病毒平均风险的可靠量级。
7月4日至9月28日期间共确诊217例基孔肯雅病毒感染病例。大多数病例病情较为轻微。血液系统采取的预防措施导致血液成分采集量大幅减少，以及交付给制药行业用于合同生产的血浆量减少。通过输血传播基孔肯雅病毒的估计风险在8月第三周达到峰值。
基孔肯雅病毒疫情给公共卫生当局带来了相当大的问题，当局不仅需要良好的常规病媒控制和流行病学监测计划，还需要地方和国家应急计划来维持血液供应，以便迅速应对疫情爆发可能产生的严重影响，特别是当受影响地区当地需要大量血液库存，同时又作为依赖外部血液成分供应的其他地区的关键资源时。
