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Pennino F, Fiorilla C, Sorrentino M, Armonia U, Parisi A, Mirizzi PD, Di Lillo M, De Silva O, Montuori P, Triassi M, Nardone A. Investigating Awareness Regarding Travel-Related Infectious Disease Prevention in a Metropolitan Area. Trop Med Infect Dis 2023; 8:476. [PMID: 37888604 PMCID: PMC10611143 DOI: 10.3390/tropicalmed8100476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
The rise in international travel has led to an increase in travel-related infectious diseases. It is predicted that by 2030, the number of international travelers will reach 1.8 billion, with over 250 million people affected globally. This issue also has an economic impact, as the eradication of travel-related infectious diseases leads to a loss of USD 12 billion in tourism. To understand the association between demographic variables and knowledge, attitude, and behaviors related to travel-related infectious diseases, a cross-sectional survey-based study was conducted among 1191 individuals in the metropolitan city of Naples, Italy. Multiple linear regression was performed over three models. The results revealed that knowledge about travel-related infectious diseases was positively associated with age, female gender, non-smoking habits, being single, and higher education attainment. The attitude towards travel-related infectious diseases was positively associated with being female, non-smoking habits, being single, higher education attainment, and a higher level of knowledge. A statistically significant association was observed between behaviors and non-smoking habits and between higher levels of knowledge and attitudes. To address this issue, public health programs could be implemented to improve behaviors in the general population. Overall, this study provides valuable information about the determinants of knowledge, attitude, and behaviors related to travel-related infectious diseases in the general population.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini No. 5, 80131 Naples, Italy
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Overbosch FW, Schinkel J, Matser A, Koen G, Prange I, Prins M, Sonder GJB. Dengue, chikungunya and Zika virus infections among Dutch travellers to Suriname: a prospective study during the introduction of chikungunya and Zika virus, 2014 to 2017. Euro Surveill 2023; 28:2200344. [PMID: 36695478 PMCID: PMC9837856 DOI: 10.2807/1560-7917.es.2023.28.2.2200344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BackgroundSuriname, a country endemic for dengue virus (DENV), is a popular destination for Dutch travellers visiting friends and relatives and tourist travellers. Chikungunya and Zika virus (CHIKV, ZIKV) were introduced in 2014 and 2015, respectively. Data on infection risks among travellers are limited.AimWe aimed to prospectively study incidence rate (IR) and determinants for DENV, ZIKV and CHIKV infection in adult travellers to Suriname from 2014 through 2017.MethodsParticipants kept a travel diary and were tested for anti-DENV, anti-ZIKV and anti-CHIKV IgG antibodies (Euroimmun). Selected samples were subjected to an in-house DENV and ZIKV PRNT50. The IR (infections/1,000 person-months of travel) and IR ratio and determinants for infection were calculated.ResultsTravel-acquired infections were found in 21 of 481 participants: 18 DENV, four ZIKV and two CHIKV, yielding an IRDENV of 47.0 (95% CI: 29.6-74.6), IRZIKV of 11.6 (95% CI: 4.4-31.0) and IRCHIKV of 5.6 (95% CI: 1.4-22.2)/1,000 person-months. In nine DENV and three ZIKV infected participants, infections were PRNT50-confirmed, yielding a lower IRDENV of 23.3 (95% CI: 12.1-44.8) and an IRZIKV of 8.4 (95% CI: 2.7-26.1) per 1,000 person-months. Tourist travel was associated with DENV infection. ZIKV and CHIKV infections occurred soon after their reported introductions.ConclusionsDespite an overestimation of serologically confirmed infections, Dutch travellers to Suriname, especially tourists, are at substantial risk of DENV infection. As expected, the risk of contracting ZIKV and CHIKV was highest during outbreaks. Cross-reaction and potential cross-protection of anti-DENV and -ZIKV antibodies should be further explored.
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Affiliation(s)
- Femke W Overbosch
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, the Netherlands
| | - Janke Schinkel
- Department of Medical Microbiology, Laboratory of Clinical Virology, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, the Netherlands
| | - Amy Matser
- Department of Infectious Diseases Research and Prevention, Public Health Service (GGD), Amsterdam, the Netherlands,Department of Internal Medicine, Amsterdam Infection and Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands
| | - Gerrit Koen
- Department of Medical Microbiology, Laboratory of Clinical Virology, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, the Netherlands
| | - Irene Prange
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, the Netherlands
| | - Maria Prins
- Department of Infectious Diseases Research and Prevention, Public Health Service (GGD), Amsterdam, the Netherlands,Department of Internal Medicine, Amsterdam Infection and Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands
| | - Gerard JB Sonder
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, the Netherlands,Department of Internal Medicine, Amsterdam Infection and Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands
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3
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Velo E, Balestrino F, Kadriaj P, Carvalho DO, Dicko A, Bellini R, Puggioli A, Petrić D, Michaelakis A, Schaffner F, Almenar D, Pajovic I, Beqirllari A, Ali M, Sino G, Rogozi E, Jani V, Nikolla A, Porja T, Goga T, Fălcuă E, Kavran M, Pudar D, Mikov O, Ivanova-Aleksandrova N, Cvetkovikj A, Akıner MM, Mikovic R, Tafaj L, Bino S, Bouyer J, Mamai W. A Mark-Release-Recapture Study to Estimate Field Performance of Imported Radio-Sterilized Male Aedes albopictus in Albania. Front Bioeng Biotechnol 2022; 10:833698. [PMID: 36051578 PMCID: PMC9424856 DOI: 10.3389/fbioe.2022.833698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/24/2022] [Indexed: 11/14/2022] Open
Abstract
The pathogen transmitting Aedes albopictus mosquito is spreading rapidly in Europe, putting millions of humans and animals at risk. This species is well-established in Albania since its first detection in 1979. The sterile insect technique (SIT) is increasingly gaining momentum worldwide as a component of area-wide-integrated pest management. However, estimating how the sterile males will perform in the field and the size of target populations is crucial for better decision-making, designing and elaborating appropriate SIT pilot trials, and subsequent large-scale release strategies. A mark-release-recapture (MRR) experiment was carried out in Albania within a highly urbanized area in the city of Tirana. The radio-sterilized adults of Ae. albopictus Albania strain males were transported by plane from Centro Agricoltura Ambiente (CAA) mass-production facility (Bologna, Italy), where they were reared. In Albania, sterile males were sugar-fed, marked with fluorescent powder, and released. The aim of this study was to estimate, under field conditions, their dispersal capacity, probability of daily survival and competitiveness, and the size of the target population. In addition, two adult mosquito collection methods were also evaluated: BG-Sentinel traps baited with BG-Lure and CO2, (BGS) versus human landing catch (HLC). The overall recapture rates did not differ significantly between the two methods (2.36% and 1.57% of the total male released were recaptured respectively by BGS and HLC), suggesting a similar trapping efficiency under these conditions. Sterile males traveled a mean distance of 93.85 ± 42.58 m and dispersed up to 258 m. Moreover, they were observed living in the field up to 15 days after release with an average life expectancy of 4.26 ± 0.80 days. Whether mosquitoes were marked with green, blue, yellow, or pink, released at 3.00 p.m. or 6.00 p.m., there was no significant difference in the recapture, dispersal, and survival rates in the field. The Fried competitiveness index was estimated at 0.28. This mark-release-recapture study provided important data for better decision-making and planning before moving to pilot SIT trials in Albania. Moreover, it also showed that both BG-traps and HLC were successful in monitoring adult mosquitoes and provided similar estimations of the main entomological parameters needed.
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Affiliation(s)
- Enkelejda Velo
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
- *Correspondence: Enkelejda Velo, ; Wadaka Mamai,
| | - Fabrizio Balestrino
- Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, Vienna, Austria
- Centro Agricoltura Ambiente (Italy), Crevalcore, Italy
| | - Përparim Kadriaj
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | | | - Ahmadou Dicko
- Statistics for Development–STATS4D, Sacre Coeur III, Dakar, Senegal
| | - Romeo Bellini
- Centro Agricoltura Ambiente (Italy), Crevalcore, Italy
| | | | - Dusan Petrić
- Faculty of Agriculture, University of Novi Sad, Vojvodina, Serbia
| | - Antonios Michaelakis
- Scient.Directorate of Entomology and Agricultural Zoology, Benaki Phytopathological Institute, Kifissia, Greece
| | | | - David Almenar
- Empresa de Transformación Agraria S.A., S.M.E, M.P. (TRAGSA), Paterna, Spain
| | - Igor Pajovic
- Biotechnical Faculty, University of Montenegro, Podgorica, Montenegro
| | | | | | - Gjergji Sino
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Elton Rogozi
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Vjola Jani
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | | | - Tanja Porja
- Department of Physics, Faculty of Natural Sciences, “MeteoAlb” Politechnic University of Tirana, Tirana, Albania
| | - Thanas Goga
- Aide to the Prime Minister, Albania Department of Risk Communication and Community Engagement, WHE Balkan Hub, WHO Regional Office for Europe, Belgrade, Serbia
| | - Elena Fălcuă
- “Cantacuzino” National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Mihaela Kavran
- Faculty of Agriculture, University of Novi Sad, Vojvodina, Serbia
| | - Dubravka Pudar
- Faculty of Agriculture, University of Novi Sad, Vojvodina, Serbia
| | - Ognyan Mikov
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Aleksandar Cvetkovikj
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Muhammet Mustafa Akıner
- Department of Biology, Faculty of Arts and Sciences Department of Biology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Rados Mikovic
- Veterinary Diagnostics Laboratory, Podgorica, Montenegro
| | - Lindita Tafaj
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Silva Bino
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Jeremy Bouyer
- Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, Vienna, Austria
| | - Wadaka Mamai
- Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, Vienna, Austria
- Institute for Agricultural Research for Development (IRAD), Yaounde, Cameroon
- *Correspondence: Enkelejda Velo, ; Wadaka Mamai,
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4
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Muja-Bajraktari N, Kadriaj P, Zhushi-Etemi F, Sherifi K, Alten B, Petrić D, Velo E, Schaffner F. The Asian tiger mosquito Aedes albopictus (Skuse) in Kosovo: First record. PLoS One 2022; 17:e0264300. [PMID: 35290988 PMCID: PMC8923454 DOI: 10.1371/journal.pone.0264300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
The Asian tiger mosquito, Aedes albopictus, is an invasive mosquito species that is considered a potential vector of about 22 arboviruses, among which dengue, chikungunya and Zika. Here we report the first record of Aedes albopictus in the territory of the Republic of Kosovo. The first finding, in July 2020, was driven by a photo of an adult mosquito published by a citizen in social media. The subsequent field investigation in July 2020 confirmed the presence of adult mosquitoes by human landing catch and collection of eggs in ovitraps at the village Zhur. Monitoring was performed for 7 weeks with ovitraps and BG-Sentinel adult traps at 36 sampling stations from 7 localities, in the Southern part of Kosovo, on the border with Albania. Fifty-two out of 81 ovitrap samples resulted positive for the presence of Ae. albopictus. A total of 2,711 eggs are collected in 22 out 36 stations and a total of 78 adults from 4 out 4 stations with BG Sentinel trap and 15 adults with handled electric aspirator. Our finding shows that the tiger mosquito is expanding its geographical range in the Balkans, southeastern Europe.
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Affiliation(s)
- Nesade Muja-Bajraktari
- Department of Biology, Faculty of Mathematics and Natural Sciences, University" Hasan Prishtina", Prishtina, Republic of Kosovo
| | - Përparim Kadriaj
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Ferdije Zhushi-Etemi
- Department of Biology, Faculty of Mathematics and Natural Sciences, University" Hasan Prishtina", Prishtina, Republic of Kosovo
| | - Kurtesh Sherifi
- Department of Veterinary Medicine, Faculty of Agriculture and Veterinary, University" Hasan Prishtina", Prishtina, Republic of Kosovo
| | - Bulent Alten
- VERG Laboratories, Ecology Division, Biology Department, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Dusan Petrić
- Laboratory for Medical and Veterinary Entomology, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Enkelejda Velo
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
- * E-mail:
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5
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Barzon L, Gobbi F, Capelli G, Montarsi F, Martini S, Riccetti S, Sinigaglia A, Pacenti M, Pavan G, Rassu M, Padovan MT, Manfrin V, Zanella F, Russo F, Foglia F, Lazzarini L. Autochthonous dengue outbreak in Italy 2020: clinical, virological and entomological findings. J Travel Med 2021; 28:6354471. [PMID: 34409443 PMCID: PMC8499737 DOI: 10.1093/jtm/taab130] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND In August 2020, in the context of COVID-19 pandemics, an autochthonous dengue outbreak was identified for the first time in Italy. METHODS Following the reporting of the index case of autochthonous dengue, epidemiological investigation, vector control and substances of human origin safety measures were immediately activated, according to the national arbovirus surveillance plan. Dengue cases were followed-up with weekly visits and laboratory tests until recovery and clearance of viral RNA from blood. RESULTS The primary dengue case was identified in a young woman, who developed fever after returning from Indonesia to northern Italy, on 27 July 2020. She spent the mandatory quarantine for COVID-19 at home with relatives, six of whom developed dengue within two weeks. Epidemiological investigation identified further five autochthonous dengue cases among people who lived or stayed near the residence of the primary case. The last case of the outbreak developed fever on 29 September 2020. Dengue cases had a mild febrile illness, except one with persistent asthenia and myalgia. DENV-1 RNA was detected in blood and/or urine in all autochthonous cases, up to 35 days after fever onset. All cases developed IgM and IgG antibodies which cross-reacted with West Nile virus (WNV) and other flaviviruses. Sequencing of the full viral genome from blood samples showed over 99% nucleotide identity with DENV-1 strains isolated in China in 2014-2015; phylogenetic analysis classified the virus within Genotype I. Entomological site inspection identified a high density of Aedes albopictus mosquitoes, which conceivably sustained local DENV-1 transmission. Aedes koreicus mosquitoes were also collected in the site. CONCLUSIONS Areas in Europe with high density of Aedes mosquitoes should be considered at risk for dengue transmission. The presence of endemic flaviviruses, such as WNV, might pose problems in the laboratory diagnosis.
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Affiliation(s)
- Luisa Barzon
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy.,Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy
| | - Federico Gobbi
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Gioia Capelli
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, Padova, Italy
| | - Fabrizio Montarsi
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, Padova, Italy
| | - Simone Martini
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Entostudio s.r.l., Viale del Lavoro, 66, 35020 Ponte San Nicolò, Padova, Italy
| | - Silvia Riccetti
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy
| | - Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy
| | - Giacomina Pavan
- Department of Microbiology, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Mario Rassu
- Department of Microbiology, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Maria Teresa Padovan
- Department of Public Health, Azienda AULSS8 Berica, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Vinicio Manfrin
- Department of Infectious Diseases, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Francesca Zanella
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Direzione Prevenzione, Sicurezza Alimentare Veterinaria, Dorsoduro, 3493 - Rio Nuovo - 30123 Venice, Italy
| | - Francesca Russo
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Direzione Prevenzione, Sicurezza Alimentare Veterinaria, Dorsoduro, 3493 - Rio Nuovo - 30123 Venice, Italy
| | - Felice Foglia
- Department of Public Health, Azienda AULSS8 Berica, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Luca Lazzarini
- Department of Infectious Diseases, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
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6
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Mayton EH, Hernandez HM, Vitek CJ, Christofferson RC. A Method for Repeated, Longitudinal Sampling of Individual Aedes aegypti for Transmission Potential of Arboviruses. INSECTS 2021; 12:292. [PMID: 33801709 PMCID: PMC8065608 DOI: 10.3390/insects12040292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/21/2022]
Abstract
Mosquito-borne viruses are the cause of significant morbidity and mortality worldwide, especially in low- and middle-income countries. Assessing risk for viral transmission often involves characterization of the vector competence of vector-virus pairings. The most common determination of vector competence uses discreet, terminal time points, which cannot be used to investigate variation in transmission aspects, such as biting behavior, over time. Here, we present a novel method to longitudinally measure individual biting behavior and Zika virus (ZIKV) transmission. Individual mosquitoes were exposed to ZIKV, and from 9 to 24 days post-exposure, individuals were each offered a 180 μL bloodmeal every other day. Biting behavior was observed and characterized as either active probing, feeding, or no bite. The bloodmeal was then collected, spun down, serum collected, and tested for ZIKV RNA via qRT-PCR to determine individuals' vector competence over time. This included whether transmission to the bloodmeal was successful and the titer of expectorated virus. Additionally, serum was inoculated onto Vero cells in order to determine infectiousness of positive recovered sera. Results demonstrate heterogeneity in not only biting patterns but expectorated viral titers among individual mosquitoes over time. These findings demonstrate that the act of transmission is a complex process governed by mosquito behavior and mosquito-virus interaction, and herein we offer a method to investigate this phenomenon.
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Affiliation(s)
- E. Handly Mayton
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Heather M. Hernandez
- Center for Vector-Borne Diseases, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; (H.M.H.); (C.J.V.)
| | - Christopher J. Vitek
- Center for Vector-Borne Diseases, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; (H.M.H.); (C.J.V.)
| | - Rebecca C. Christofferson
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
- Center for Computation and Technology, Louisiana State University, Baton Rouge, LA 70803, USA
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7
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Buonfrate D, Requena-Mendez A, Bisoffi Z. Travel, infections, and the importance of networking in the global health perspectives. THE LANCET REGIONAL HEALTH. EUROPE 2021; 1:100006. [PMID: 35104302 PMCID: PMC8454783 DOI: 10.1016/j.lanepe.2020.100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Dora Buonfrate
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Ana Requena-Mendez
- Barcelona Institute for Global Health (Hospital Clínic, Universitat de Barcelona), Barcelona, Spain
- Department of Medicine, Karolinska Institutet, Solna 17176, Stockholm, Sweden
| | - Zeno Bisoffi
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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8
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Vellere I, Lagi F, Spinicci M, Mantella A, Mantengoli E, Corti G, Colao MG, Gobbi F, Rossolini GM, Bartoloni A, Zammarchi L. Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus. Microorganisms 2020; 8:microorganisms8111731. [PMID: 33158274 PMCID: PMC7716211 DOI: 10.3390/microorganisms8111731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chikungunya (CHIKV), Dengue (DENV), and Zika (ZIKV) viruses present significant clinical and epidemiological overlap, making an accurate and rapid diagnosis challenging. Timely activation of preventive vector control measures is crucial to avoid outbreaks in non-endemic settings. Diagnosis is based on combination of serological and molecular assays which could be time consuming and sometimes disappointing. METHODS We report the results of a retrospective case-control study carried out at a tertiary teaching hospital in Italy, including all febrile subjects returning from tropical countries during the period 2014-2019. Controls were travelers with other febrile illnesses who tested negative in laboratory analysis for CHIKV, DENV, ZIKV arbovirosis. A score weighted on the regression coefficients for the independent predictors was generated. RESULTS Ninety patients were identified: 34 cases (22 DENV, 4 CHIKV, and 8 ZIKV) and 56 controls. According to our results, myalgia, cutaneous rash, absence of respiratory symptoms, leukopenia, and hypertransaminasemia showed the strongest association with arbovirosis. Combining these variables, we generated a scoring model that showed an excellent performance (AUC 0.93). The best cut-off (>=2) presented a sensitivity of 82.35% and specificity of 96.43%. CONCLUSION A handy and simple score, based on three clinical data (myalgia, cutaneous rash and absence of respiratory symptoms) and two laboratory results (leukopenia and hypertransaminasemia), provides a useful tool to help diagnose arboviral infections and appropriately activate vector control measures in order to avoid local transmission.
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Affiliation(s)
- Iacopo Vellere
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Antonia Mantella
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
| | - Elisabetta Mantengoli
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Giampaolo Corti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Maria Grazia Colao
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Federico Gobbi
- Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, Italy;
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (I.V.); (F.L.); (M.S.); (A.M.); (G.C.); (G.M.R.); (A.B.)
- Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy
- Correspondence: ; Tel.: +39-0557949431
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