Flavivirusi u Italiji / Flaviviruses in Italy

Giovanni Savini, Federica Iapaolo, Federica Monaco

ENG.

Flavivirusi u Italiji

Klima svijeta mijenja se dosad neviđenom brzinom. Iako je to složen fenomen i teško je predvidjeti njegove cjelovite utjecaje, dobro je poznato da utječe na pojavu bolesti, posebno vektorskih bolesti (VBD).

Potencijalni utjecaj klimatskih promjena na raspodjelu vektora i učestalost VBD-a razlog je za značajnu i neposrednu zabrinutost. Dokazi da su se promjene u fenologiji i rasprostranjenosti širokog spektra vrsta artropoda dogodile kao odgovor na klimatske promjene širom svijeta, jasni su. Nijedna zemlja ili regija nije imuna na negativan utjecaj klimatskih promjena. Italija je također osjetljiva na klimatske promjene i očekuje se da će se incidencija VBD-a u zemlji povećati sljedećih godina. Nekoliko slučajeva različitih VBD-a nedavno je dokumentirano u zemlji i očito je da su one igrale presudnu ulogu u nastanku i širenju bolesti ljudi i životinja, posebno onih koje prenose vektori poput Zapadnog Nila, Usutu, Chikungunya, bolesti plavog jezika, itd. Virus Zapadnog Nila (WNV) i Usutu virus (USUV) pripadaju rodu flavivirusa. To je vrlo heterogen virusni rod koji uključuje važne ljudske patogene i nekoliko virusnih sojeva s nepoznatim zoonotskim potencijalom.
Predstavit će se rezultati integriranih sustava nadzora WNV i USUV u Italiji od 2008. do 2020., uključujući one iz ljeta 2018. koje je karakterizirao nagli porast slučajeva WNV u Europskoj regiji, ukupno 1503 slučaja i 181 smrtni slučaj , mnogo više od onih zabilježenih u prethodnih pet godina.

U Italiji epidemija 2018. uzrokuje 450 slučajeva ili groznice Zapadnog Nila ili neuroinvazivnih bolesti.
Zahvaljujući integriranom nadzornom sustavu “Jedno zdravlje” u okviru nacionalnog plana pripravnosti i djelovanja, provedene su sigurnosne mjere uoči prvog slučaja u ljudi u svakoj pogođenoj provinciji. Integracija nadzornih aktivnosti i multidisciplinarni pristup bili su od temeljne važnosti u pružanju potpore provedbi i/ili jačanju preventivnih mjera usmjerenih na smanjenje rizika od prijenosa WNV-a kroz doniranje krvi, tkiva i organa i provedbi daljnjih mjera za suzbijanje vektora.
Od 2020. aktivnosti nadzora WNV-a i USUV-a uključene su u Nacionalni plan za prevenciju, nadzor i odgovor na arboviruse 2020-2025. Plan u jedinstveni dokument integrira mjere nadzora koje će se provoditi na nacionalnoj razini za autohtone i uvezene arboviruse, promičući suradnički, multisektorski i transdisciplinarni pristup koji djeluje na lokalnoj, regionalnoj, nacionalnoj i globalnoj razini s ciljem postizanja optimalnih zdravstvenih ishoda prepoznajući međusobnu povezanost ljudi, životinja, biljaka i njihovog zajedničkog okoliša (pristup “Jedno zdravlje”).

HRV.

Vector-borne diseases in the WHO European Region

Giovanni Savini, Federica Iapaolo, Federica Monaco

The world’s climate is changing at an unprecedented rate. Although it is a complex phenomenon and its full-scale impacts are hard to predict, it is well known that it affects the emergence of diseases particularly vector-borne diseases (VBDs). The potential impact of climate change on vector distribution and VBD incidence is of very significant and immediate concern. Evidences that changes in the phenology and distribution of a wide range of arthropod species have occurred in response to climate change worldwide, are clear. No country or region is immune from the negative impact of climate change. Italy is also vulnerable to climatic changes and it is expected that the incidence of VBD in the country will increase in the next coming years. Several cases of different VBDs have been recently documented in the country and it clearly appears that it has been playing a crucial role in emerging and spreading human and animal diseases particularly those transmitted by vectors such as West Nile, Usutu, Chikungunya, Bluetongue etc. West Nile (WNV) and Usutu (USUV) viruses belong to the Flavivirus genus. It is a highly heterogeneous viral genus that includes important human pathogens and several viral strains with unknown zoonotic potential. The results of the WNV and USUV integrated veterinary and human surveillance systems in Italy from 2008 to 2020 will be presented including those of the summer of 2018 which was characterised by a sharp increase in WNV cases in the European Region, totalling 1503 cases and 181 deaths, much more than those recorded in the previous five years.

In Italy, the 2018 epidemic causes 450 cases of either West Nile fever and neuroinvasive diseases.
Thanks to a „One Health” integrated surveillance system in the framework of a national preparedness and response plan, safety measures were enforced ahead of the first human case in each affected province. The integration of surveillance activities and a multidisciplinary approach have been fundamental in supporting implementation of and/or strengthening preventive measures aimed at reducing the risk of transmission of WNV through blood, tissues and organ donation and to implementing further measures for vector control. From 2020, WNV and USUV surveillance activities have been included in the National Plan for Prevention, Surveillance and Response to Arbovirus 2020- 2025. The Plan integrates in a unique document the surveillance measures to be implemented at the national level for autochthonous and imported arboviruses, promoting a collaborative, multisectoral, and transdisciplinary approach working at the local, regional, national, and global levels with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment (”One Health” approach).