The first alarm he had arrived close to the carnival in Brazil, with the risk of a further surge in transmission of cases Dengue. But now also in Italia surveillance has increased, in particular on people and goods arriving from the South America and in particular by himself Brazil and fromArgentinawho are experiencing a critical moment for the spread of the disease transmitted by Zanzara Aedes aegypti but also from Tiger mosquito. The interview with the expert Claudio Venturelli of the ASL Emilia-Romagna.
Dengue alarm in Italy, the move of the Ministry of Health
The director general of the Ministry of Health, Francesco Vaia, has ordered an increase in border surveillance on everything coming from countries where “the risk of contracting the disease is frequent and continuous”, referring precisely to the Dengue fever.
Confirming the emergency picture are the numbers arriving from South America, with Brazil counting over half a million cases (512.353), according to the Ministry, with a total number that is quadrupled compared to last year (128.842).
Francesco Vaia, director general of the Ministry of Health
Confirmed deaths have been 75but it is estimated that in 50% of cases who has Dengue could be asymptomatic.
Vaccine arriving at Spallanzani, planes disinfected
Meanwhile, in the third week of February the Vaccine will also be available at the hospital Spallanzani Of Roma, after that latest tests led toestero they demonstrated theeffectiveness.
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In the meantime it has been raised toFiumicino airport the level of supervision towards planes coming and of imported goods especially from Brazil and Argentina.
Among the measures envisaged is careful monitoring “on aircraft disinfection” and the evaluation of any ordinances for extraordinary interventions of surveillance, sanitization e disinfestation.
All measures arranged by Francesco Vaia and forwarded to the Maritime, Air and Border Health Offices.
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The interview with Claudio Venturelli
Although the risk of transmission is not direct from human to human, is the possibility that a mosquito bites a person with Dengue and subsequently a healthy one, transmitting the responsible virus, very high?
“Exact. The problem with Brazil, meanwhile, is that it is hot there at the moment, being in the northern hemisphere. Furthermore, in January there was a peak of epidemic which is very worrying, with a 48% increase in cases. Furthermore, the carnival attracts many people and by going there the risk of falling ill with Dengue increases. But let’s clarify that the passage of the disease is not direct: man acts as a reservoir, if the mosquito bites him he too becomes ill and, within just 2 or 3 dayscan then transmit the virus to another human stinging him.”
How?
“With each of its meals, the mosquito can transmit the disease through the saliva which he uses for anesthetize and don’t let your sting be felt on the skin. The passage of the disease occurs like this, but not through saliva from person to person, not even through a kiss of uno sneeze. The only risk of direct human transmission is with organ donationspossibly via the bags of blood of donors, this is the greatest concern.”
Italy records indigenous epidemics, i.e. cases of people who have never traveled abroad to places at risk. In 2023 there were 82: how can they be explained?
“Yes, last summer several cases occurred in Emilia-Romagna, in particular in Bologna, and especially in the province of Lodi as well as a Piacenza. It was a surprise that led us to two considerations: the first is that the Tiger mosquito, which in the past was considered not very competent in transmission – while the one considered most capable of transmitting the disease is the Temples of the Egyptians –, but over time it has become so, increasing the risk. The second hypothesis, but less plausible, is that it may also have arrived in Italy via another mosquito, which has not yet been intercepted. But it seems less likely because i system of detection they are quite effective”.
Now, however, the alarm does not arrive in the summer: is it a risk that no longer knows seasonality?
“In summer, in fact risk is greater, but one cannot fail to consider that there have been variations climatic. For example, last year the first reports dated back to late spring, thanks to the greater rainfall and humidity. However, it must be considered that the diffusion of the zanzara Aedes (the one also responsible for the transmission of yellow fever, ndr) also to Cipro, a Madeira in Portugal, in Georgia, in short, it is starting to invade Europe”.
Spallanzani will be the first institute to make the vaccine available, which according to the New England Journal it would be able to protect up to 80% of all subjects. Last September the Italian Medicines Agency (Aifa) gave the green light to the possibility of immunization, for those who have not had previous exposure to the virus and without the need to carry out a pre-vaccination test. It involves 2 doses, but it is expensive and paid for by the citizen, in short not passed through the National Health Service. Who is the vaccine recommended for?
“The vaccine is certainly advisable for those who have to travel to areas most at riskjust like the South America the right Asian areas. It must be said that until a few months ago there was still a lack of availability, so even those who had requested it had not always been able to get vaccinated. In any case, they exist asymptomatic subjectsin which therefore the symptoms are not evident nor the associated risks, while among the most fragile ones are children, those with pathologies that lower the immune system and the elderly”.
The symptoms of Dengue are high fever, joint pain, muscle pain, sometimes in and around the eyes and in some cases even bleeding, which must lead to seeing a doctor. But are there other measures to protect yourself?
“For those who don’t have to leave, I would say that there are no particular critical issues regarding Dengue. In general, however, the rules for protection against mosquitoes apply, such as empty and avoid stagnation of water, without which the mosquito cannot colonize. Interventions would also be necessary public outbreakssuch as road manholes, where they can be used larvicidi effective against eggs and young mosquitoes. For adult ones, however, more caution is needed: There are few effective molecules and some mosquitoes are becoming resistanttherefore they should be used properly, to avoid finding ourselves without weapons with which to defend ourselves”.
Photo source: ANSA