Gradoni L, Pizzuti R, di Martino L, Gramiccia M, Pempinello R, Gaeta G B, Ferrara M, Scotti S, Altieri S
Department of Parasitology, Istituto Superiore di Sanità, Rome, Italy.
Epidemiol Infect. 1993 Oct;111(2):297-306. doi: 10.1017/s0950268800057009.
Although human visceral leishmaniasis (VL) is a notifiable disease in Italy, there is evidence that the actual number of cases is far higher than that notified. A programme for active surveillance of VL in the 14 Italian endemic regions was launched by the Istituto Superiore di Sanità. We report data collected during a 3-year period of active surveillance in Campania, a south Tyrrhenian region covering 4.5% of the Italian territory. Out of 120 clinically suspected cases referred to medical and diagnostic references centres, there were 52 confirmed VL cases (17.3/year), i.e. 10-fold more than previously notified. Most of the infection sites were in rural areas or peripheral districts of towns in hilly parts of Naples province. An epidemic cluster of 10 cases was identified in a microfocus of Caserta province. The biochemical analysis of 23 Leishmania stocks showed a zymodeme composition indicating Campania as an old and well-established focus of VL. The data obtained emphasize that the present notification system for VL in Italy is inadequate.
尽管人类内脏利什曼病（VL）在意大利属于应报告疾病，但有证据表明实际病例数远高于报告数。意大利高级卫生研究所启动了一项在意大利14个流行地区对VL进行主动监测的计划。我们报告了在坎帕尼亚进行的为期3年主动监测期间收集的数据，坎帕尼亚是第勒尼安海南部的一个地区，占意大利领土的4.5%。在转诊至医疗和诊断参考中心的120例临床疑似病例中，有52例确诊为VL病例（每年17.3例），即比之前报告的病例数多10倍。大多数感染地点位于那不勒斯省丘陵地区的农村或城镇周边地区。在卡塞塔省的一个小范围内发现了一个由10例病例组成的流行集群。对23株利什曼原虫菌株的生化分析显示，酶谱组成表明坎帕尼亚是一个古老且成熟的VL疫源地。所获得的数据强调，意大利目前的VL通报系统是不完善的。
