Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

Abstract

Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

Seroprevalence of Crimean Congo Hemorrhagic Fever Virus in Occupational Settings: Systematic Review and Meta-Analysis

“…As recently stressed by reports from hyperendemic areas [ 10 , 17 , 54 ], including the occupational report by Atim et al [ 54 ], a radical paradigm shift is, therefore, conceivable when pondering the CCHF-associated actual burden of disease. Similar to other vector-borne diseases such as West Nile Fever [ 66 , 67 , 68 , 69 , 70 , 71 , 72 ], Dengue [ 73 , 74 , 75 , 76 ], and Tick-Borne Encephalitis [ 77 , 78 , 79 , 80 , 81 ], CCHF should be understood as a relatively rare occurrence following CCHFV infection, while majority of cases either go unnoticed or misunderstood as “summer flu” [ 82 ]. Far from dismissing the potential significance of this pathogen, a more appropriate appraisal of CCHFV in the evolving landscape of vector-borne diseases underlines the role of occupational physicians and medical surveillance in occupational settings as instrumental in improving our appropriate understanding of the CCHF epidemiology [ 83 , 84 , 85 ].…”

West Nile Virus Infection: A Cross-Sectional Study on Italian Medical Professionals during Summer Season 2022

“…Fifth, it is important to stress that the epidemiology of WNV in Italy should be ascertained in the more complex framework of flavivirus infections, whose understanding may be scarcely appreciable for professionals not involved in the prevention of infectious diseases, and particularly when dealing with laboratory diagnosis [2,19,39,105,106]. Flavivirus are structurally quite similar, which leads to some crossreactivity upon infection [107].…”

Observation‐driven exponential smoothing

“…It is most prevalent in tropical and subtropical regions, with over 100 countries experiencing endemic dengue transmission and approximately half of the world's population being at risk of contracting dengue (Roy & Bhattacharjee, 2021). Nevertheless, in Europe, dengue mostly remains a pathogen associated with international travel, being a relatively common source of fever in travellers returning from South and Southeast Asia and Latin America, see Riccò et al (2022) and the references therein. The surveillance of dengue fever in Europe is coordinated by the European Center of Disease Control (ECDC).…”