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Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012
Department of Molecular Medicine, University of Padova, Padova I-35121, Italy
Regional Reference Laboratory for Infectious Diseases, Microbiology and Virology Unit, Padova University Hospital, Padova I-35128, Italy
Department of Public Health and Screening, Veneto Region, Venice I-30123, Italy
Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome I-00161, Italy
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Rome I-00149, Italy
Department of Public Health and Innovation, Ministry of Health, Rome I-00144, Italy
* Authors to whom correspondence should be addressed.
Received: 2 November 2013; in revised form: 20 November 2013 / Accepted: 20 November 2013 / Published: 22 November 2013
Abstract: Human cases of West Nile virus (WNV) disease have been reported in Italy since 2008. So far, most cases have been identified in north-eastern Italy, where, in 2012, the largest outbreak of WNV infection ever recorded in Italy occurred. Most cases of the 2012 outbreak were identified in the Veneto region, where a special surveillance plan for West Nile fever was in place. In this outbreak, 25 cases of West Nile neuroinvasive disease and 17 cases of fever were confirmed. In addition, 14 WNV RNA-positive blood donors were identified by screening of blood and organ donations and two cases of asymptomatic infection were diagnosed by active surveillance of subjects at risk of WNV exposure. Two cases of death due to WNND were reported. Molecular testing demonstrated the presence of WNV lineage 1 in all WNV RNA-positive patients and, in 15 cases, infection by the novel Livenza strain was ascertained. Surveillance in other Italian regions notified one case of neuroinvasive disease in the south of Italy and two cases in Sardinia. Integrated surveillance for WNV infection remains a public health priority in Italy and vector control activities have been strengthened in areas of WNV circulation.
Keywords: West Nile virus; surveillance; West Nile neuroinvasive disease; West Nile fever; blood donor screening; molecular testing
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Barzon, L.; Pacenti, M.; Franchin, E.; Pagni, S.; Lavezzo, E.; Squarzon, L.; Martello, T.; Russo, F.; Nicoletti, L.; Rezza, G.; Castilletti, C.; Capobianchi, M.R.; Salcuni, P.; Cattai, M.; Cusinato, R.; Palù, G. Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012. Viruses 2013, 5, 2825-2839.
Barzon L, Pacenti M, Franchin E, Pagni S, Lavezzo E, Squarzon L, Martello T, Russo F, Nicoletti L, Rezza G, Castilletti C, Capobianchi MR, Salcuni P, Cattai M, Cusinato R, Palù G. Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012. Viruses. 2013; 5(11):2825-2839.
Barzon, Luisa; Pacenti, Monia; Franchin, Elisa; Pagni, Silvana; Lavezzo, Enrico; Squarzon, Laura; Martello, Thomas; Russo, Francesca; Nicoletti, Loredana; Rezza, Giovanni; Castilletti, Concetta; Capobianchi, Maria R.; Salcuni, Pasquale; Cattai, Margherita; Cusinato, Riccardo; Palù, Giorgio. 2013. "Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012." Viruses 5, no. 11: 2825-2839.