2023年意大利伦巴第大区登革热疫情：“同一个健康”视角

The 2023 dengue outbreak in Lombardy, Italy: A one-health perspective.

作者信息

Rovida Francesca, Faccini Marino, Molina Granè Carla, Cassaniti Irene, Senatore Sabrina, Rossetti Eva, Scardina Giuditta, Piazza Manuela, Campanini Giulia, Lilleri Daniele, Paolucci Stefania, Ferrari Guglielmo, Piralla Antonio, Defilippo Francesco, Lelli Davide, Moreno Ana, Vezzosi Luigi, Attanasi Federica, Soresini Marzia, Barozzi Manuela, Cerutti Lorenzo, Paglia Stefano, Regazzetti Angelo, Marcacci Maurilia, Di Donato Guido, Farioli Marco, Manica Mattia, Poletti Piero, Lavazza Antonio, Bonini Maira, Merler Stefano, Baldanti Fausto, Cereda Danilo

机构信息

Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; SC Microbiology and Virology, IRCCS Policlinico San Matteo, Pavia, Italy.

Department of Hygiene and Health Prevention, Health Protection Agency, Metropolitan Area of Milano, Milano, Italy.

出版信息

Travel Med Infect Dis. 2025 Mar-Apr;64:102795. doi: 10.1016/j.tmaid.2025.102795. Epub 2025 Jan 2.

DOI:10.1016/j.tmaid.2025.102795

PMID:39755224

Abstract

INTRODUCTION

Here we reported the virological, entomological and epidemiological characteristics of the large autochthonous outbreak of dengue (DENV) occurred in a small village of the Lombardy region (Northern Italy) during summer 2023.

METHODS

After the diagnosis of the first autochthonous case on August 18, 2023, public health measures, including epidemiological investigation and vector control measures, were carried out. A serological screening for DENV antibodies detection was offered to the population. In the case of positive DENV IgM, a second sample was collected to detect DENV RNA and verify seroconversion. Entomological and epidemiological investigations were also performed. A modeling analysis was conducted to estimate the dengue generation time, transmission potential, distance of transmission, and assess diagnostic delays.

RESULTS

Overall, 416 subjects participated to the screening program and 20 were identified as DENV-1 cases (15 confirmed and 5 probable). In addition, DENV-1 infection was diagnosed in 24 symptomatic subjects referred to the local Emergency Room Department for suggestive symptoms and 1 case was identified through blood donation screening. The average generation time was estimated to be 18.3 days (95 % CI: 13.1-23.5 days). R was estimated at 1.31 (95 % CI: 0.76-1.98); 90 % of transmission occurred within 500m. Entomological investigations performed in 46 pools of mosquitoes revealed the presence of only one positive pool for DENV-1.

DISCUSSION

This report highlights the importance of synergic surveillance, including virological, entomological and public health measures to control the spread of arboviral infections.

摘要

引言

在此，我们报告了2023年夏季在意大利北部伦巴第地区一个小村庄发生的登革热（DENV）大规模本地暴发的病毒学、昆虫学和流行病学特征。

方法

在2023年8月18日诊断出首例本地病例后，采取了公共卫生措施，包括流行病学调查和病媒控制措施。对人群进行了登革热病毒抗体检测的血清学筛查。如果登革热病毒IgM呈阳性，则采集第二份样本以检测登革热病毒RNA并验证血清转化。还进行了昆虫学和流行病学调查。进行了模型分析，以估计登革热的代时、传播潜力、传播距离，并评估诊断延迟。

结果

总体而言，416名受试者参与了筛查计划，其中20人被确定为登革热病毒1型病例（15例确诊，5例可能）。此外，在因疑似症状转诊至当地急诊室的24名有症状受试者中诊断出登革热病毒1型感染，1例通过献血筛查确定。估计平均代时为18.3天（95%置信区间：13.1 - 23.5天）。R估计为1.31（95%置信区间：0.76 - 1.98）；90%的传播发生在500米范围内。在46组蚊子中进行的昆虫学调查显示，仅发现一组登革热病毒1型阳性。