by Cristina Marrone
A circular from the Ministry of Health invites borders to increase vigilance. Checks have already begun at Fiumicino. The director of Prevention Vaia: «We want to prevent the Aedes Aegipty mosquito from arriving»
Due to the global increase in Dengue cases, Italy is raising the alert level against the infectious disease, also called bone-breaking fever, transmitted by mosquitoes and especially characteristic of tropical countries. In particular, in Brazil, cases have exceeded half a million with 300 confirmed deaths and a state of emergency has been declared in four states. Argentina is also a concern, with 39,544 confirmed cases and 19 deaths. Now they want the mosquito vector of the disease to arrive in Italy too
Declared objective: to prevent the arrival of the Aedes aegypti mosquito
The Italian Ministry of Health sent a circular inviting the Maritime, Air and Border Health Offices to «raise the levels of vigilance towards carriers coming from and goods imported from countries where the risk of contracting the disease is frequent and continuous» . And at Fiumicino airport the disinfestation of planes coming from countries at risk of Dengue has already begun with the control of the goods.
The note recalls the International Health Regulations which «provide that the airport/port area and the surrounding 400 meters are kept free from sources of infection and contamination, therefore also rodents and insects». The instruction is also given to carefully monitor the disinsection of aircraft and to evaluate the opportunity to issue orders to carry out extraordinary interventions for the surveillance of populations of vectors and other pests and for disinfestation. In practice, the ambitious objective Italy is aiming for is to block the arrival of the Aedes aegypti mosquito, typical of tropical regions, which is the most effective mosquito in transmitting Dengue. «The circulars refer to Aedes Aegipty, as it is the specific vector mosquito of Zika and also of the Dengue virus. Among other things, our country is one of the few, if not the only one in Europe, that has these measures at the border” confirms the director of Prevention of the Ministry of Health Francesco Vaia. «This mosquito is not present in our territory – underlines Vaia – and the objective is to prevent its arrival in Italy».
How dengue is transmitted
Dengue is a tropical infectious disease caused by four variants of the same virus that is transmitted through mosquito bites. The most effective mosquito in transmission is the Aedes aegypti, typical of tropical regions (it does not exist in Italy, in Europe it is present only on the island of Madeira and in an area of the Black Sea) but also the tiger mosquito (Aedes albopictus) already reported in all of southern Europe and present in Italy since 1990 can contribute to the contagion, 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, so one can get sick several times. There is no direct contagion between humans, even if humans are the main host of the virus. The virus circulates in the blood of the infected person for 2-7 days, and in this period the mosquito can pick it up and transmit it to others. To be transmitted, the disease therefore requires mosquitoes (which bite an infected person): since it is not transmitted from person to person it is easier to block the transmission chain.
Symptoms
Symptoms may appear just under a week after the bite: high fever, severe headaches, muscle pain, acute headaches, nausea, vomiting. In extreme cases (1-5%) breathing difficulties and multi-organ failure may occur, in some cases fatal. Dengue has a very low mortality rate, around 1% of cases, which however rises to 40% when the disease becomes complicated in the haemorrhagic form. In approximately 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 that can result in bleeding. Diagnosis is normally made based on symptoms, but can be more accurate by looking for the virus or specific antibodies in blood samples.
The vaccine is also available in Italy
There is no specific therapy for Dengue but only drugs to combat the symptoms, for example antipyretics and rehydration treatments. A live attenuated recombinant tetravalent vaccine has recently become available that is effective against all four serotypes of the virus. The vaccine against dengue fever will be available from next week at the Spallanzani hospital in Rome and in other centers specialized in tropical diseases where it will be possible to obtain it at the user’s expense. The vaccine is also available to those who have not had previous exposure to the virus. It can be administered to subjects from 4 years of age and 2 doses are sufficient to achieve immunization.
The spread of dengue in Italy
In recent years, 100-150 cases of imported Dengue have occurred annually, but in 2023 there have been 362 cases, of which 82 indigenous cases in specific areas (only one victim), in particular in Lombardy and Lazio, where a person with Dengue from an endemic country stayed. This increase in indigenous cases, in areas where the disease is not as rooted as Italy, may be linked to climate change, the increase in mosquito circulation and floods, which favor the growth of mosquitoes. France had already reported three outbreaks of indigenously transmitted Dengue fever in 2022, confirming that the disease is spreading to previously virgin areas of the globe. According to the World Health Organization, the incidence of Dengue has increased 30 times in the world in the last 50 years: more than half the population is at risk and it is expected that due to climate change another billion people will be exposed to the disease .
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February 14, 2024 (changed February 14, 2024 | 2:05 pm)
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