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Imported arboviral infections in Italy, July 2014-October 2015: a National Reference Laboratory report.

Abstract

BACKGROUND

Imported cases of infections due to Dengue (DENV) and Chikungunya (CHIKV) viruses and, more recently, Zika virus (ZIKV) are commonly reported among travelers returning from endemic regions. In areas where potentially competent vectors are present, the risk of autochthonous transmission of these vector-borne pathogens is relatively high. Laboratory surveillance is crucial to rapidly detect imported cases in order to reduce the risk of transmission. This study describes the laboratory activity performed by the National Reference Laboratory for Arboviruses (NRLA) at the Italian National Institute of Health in the period from July 2014 to October 2015.

METHODS

Samples from 180 patients visited/hospitalized with a suspected DENV/CHIKV/ZIKV infection were sent to the NRLA from several Italian Hospitals and from Regional Reference Laboratories for Arboviruses, in agreement with the National Plan on human surveillance of vector-borne diseases. Both serological (ELISA IgM test and Plaque Reduction Neutralization Test-PRNT) and molecular assays (Real Time PCR tests, RT-PCR plus nested PCR and sequencing of positive samples) were performed.

RESULTS

DENV infection was the most frequently diagnosed (80 confirmed/probable cases), and all four genotypes were detected. However, an increase in imported CHIKV cases (41 confirmed/probable cases) was observed, along with the detection of the first ZIKV cases (4 confirmed cases), as a consequence of the recent spread of both CHIKV and ZIKV in the Americas.

CONCLUSIONS

Main diagnostic issues highlighted in our study are sensitivity limitations of molecular tests, and the importance of PRNT to confirm serological results for differential diagnosis of Arboviruses. The continuous evaluation of diagnostic strategy, and the implementation of laboratories networks involved in surveillance activities is essential to ensure correct diagnosis, and to improve the preparedness for a rapid and proper identification of viral threats.

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  • Authors+Show Affiliations

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    National Center for Epidemiology and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    National Center for Epidemiology and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy.

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    Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy.

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    Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

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    Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

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    Clinical Microbiology, Virology and Bioemergency, Luigi Sacco Hospital, Milan, Italy.

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    Clinical Microbiology, Virology and Bioemergency, Luigi Sacco Hospital, Milan, Italy.

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    Virology Section and Retrovirus Centre of the Department of Translational Research NSMT, University of Pisa, Pisa University Hospital (Azienda Ospedaliero-Universitaria Pisana), Pisa, Italy.

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    Department of Laboratory Diagnosis, Palermo University Hospital (Azienda Ospedaliera Universitaria Policlinico Palermo), Palermo, Italy.

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    Clinic of Infection Diseases, Department of Medicine, University of Perugia, Perugia, Italy.

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    Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy. Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy.

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    UOC Microbiology and Virology, Hospital for Infectious Diseases "D. Cotugno", AO dei Colli (Monaldi, Cotugno, CTO), Naples, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

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    Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. giulietta.venturi@iss.it.

    Source

    BMC infectious diseases 17:1 2017 Mar 16 pg 216

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28302072