Five patients are from Castiglione d’Adda (Lombardy) but the Ministry of Health does not rule out new cases of indigenous transmission. Symptoms of the disease and the role of climate change in the spread
I am for now six native cases of dengue
(therefore not related to travel to endemic areas for the infection) confirmed by the Ministry of Health in Italy: one in Lazio and the other five in Lombardy, all reported in August. The patients have therefore contracted the infectious disease in Italy, transmitted by a bite Aedes mosquito also known as bone-breaking fever due to the intense pain it causes. Another 79 reported cases are imported: these are people who have returned to Italy after having traveled to areas where the disease is endemic.
The outbreak of Castiglione d’Adda
As stated in a circular from the Ministry of Health which provides new indications on the strengthening of surveillance systems, the first case concerned a 73-year-old man from Castiglione d’Adda in the province of Lodi which on August 3 began to suffer from joint pain, muscle pain, rash and fever above 39 degrees. She had never traveled abroad. The second case concerned a 42-year-old man residing in Rome with the same symptoms starting on 2 August. He also had not traveled to dengue endemic areas. Four other cases were reported on August 28, always in Castiglione d’Adda and always with the same characteristics. At the moment – the circular explains – the occurrence of further autochthonous cases of dengue cannot be excludedparticularly in areas that have observed autochthonous cases, or secondary to cases imported from countries with viral circulation, therefore the Regions are recommended to follow the indications of the Arbovirus Surveillance Plan (PNA), ensure communications between the veterinary services and of human prevention and strengthen the surveillance system. All patients are doing better and have been start prophylaxis and disinfection in the places involved.
Outbreaks in France
In Italy, dozens of cases of Dengue are reported every year, but in general they are infections contracted abroad: they affect travelers returning from Latin America, South East Asia and Africa, where this infection is endemic (but not even the United States, especially the southern states, are immune to it) . Only in 2020, 11 autochthonous cases had been reported in Italy, the bulletins of other years speak only of imported cases. Already France last year had signaled three outbreaks of indigenously transmitted dengue fever, confirming that the disease is spreading in hitherto virgin areas of the globe. Many scientists are convinced that dengue outbreaks will become more frequent in the coming years due to the extreme weather conditions with frequent showers and humid weather. According to the WHO, the incidence of dengue in the world has increased 30 times in the last 50 years: more than half of the population at risk and it is expected that due to climate change another billion people will be exposed to the disease.
How dengue is transmitted
Dengue one infectious disease caused by four variants of the same virus which is transmitted through the mosquito bites who in turn stung an infected person. The most effective mosquito in transmission is there Aedes aegyptitypical of tropical regions (in Italy it does not exist, in Europe it is present only on the island of Madeira and in an area of the Black Sea) but also there tiger mosquito (Aedes albopictus) already reported throughout southern Europe and present in Italy since 1990, it can contribute to the infection, albeit in a less effective way. Unfortunately, having contracted dengue only protects the person against the virus that caused it but not against the other three viral types. There is no direct contagion between humans, although man is the main host of the virus. At the moment it seems unlikely that the disease will spread massively thanks to surveillance by health authorities in Europe. Furthermore, the disease, as mentioned, needs mosquitoes to be transmitted and is not transmitted from person to person: for this reason it is easier to block the transmission chain.
Symptoms
At a distance of less than a week after the puncture symptoms may appear: high fever, severe headache, body aches, sharp headaches, nausea, vomiting. In extreme cases (1-5%) breathing difficulties and multiple organ failure, in some cases fatal, can occur. Dengue has a very low mortality rate, around 1% of cases, which rises to 40% when the disease complicates into the hemorrhagic form. In about 75% of cases the disease is asymptomatic and goes unnoticed. This happens at least with the first infection while a second infection can trigger heavy immune reactions which can lead to bleeding. There diagnosis normally done based on symptoms, but may be more accurate with the search for the virus or specific antibodies in blood samples.
The vaccines
There are no cures
but they exist two vaccines against the disease. The first one is recommended for those who have already been exposed to the virus (therefore for those who live in endemic areas), otherwise it would lead to an increased risk of serious illness in those who have not contracted the virus. The second one tetravalent vaccine, directed against the four different serotypes of the dengue virus and indicated for travellers. The latter vaccine has been approved by the EMA and has also completed the authorization process in Italy and will soon be available in vaccination centers for those traveling abroad in areas where the disease is endemic. In Honduras, where dengue represents a serious public health problem, a new project to combat dengue has just started: the Aedes aegypti mosquito, vector of the virus, is infected with the natural bacterium Wolbachia which reduces its transmission capacity.
September 1, 2023 (change September 1, 2023 | 14:27)
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