Italy reports autochthonous chikungunya - 428 cases

[Gert van der Hoek]

Lazio region

Three cases of Chikungunya in Lazio, blocked blood donations

sept 8, 2017

There are three confirmed cases and none of them had traveled in the weeks prior to the contagion. Take prevention measures

After the recent malaria case, attention is now shifted to Chikungunya, a feverish disease transmitted from infected mosquitoes to which three people were positive in Anzio, a center overlooking Tyrrhenian Sea, about 50 kilometers south of Rome. To confirm it is the Higher Health Institute.

None of the three people traveled to areas at risk in the weeks prior to the infection, which prompted the authorities to believe they had been hit in the area. Measures have been taken to prevent the spread of the virus, which is also transmitted via blood transfusions and, in this regard, the National Blood Center has recommended Anzio residents to stop any blood donations.

Even those who have been in the area since early August will not be able to donate blood for the next 28 days, and in the meantime a bulletin has been tabled asking the collection units to deepen the history of the donors.

The Lazio region imposed on the municipality of Anzio to proceed with the protocols of disinfestation, with the support of the Higher Health Institute which had attached the bait.

 

[Pathfinder]

Translation Google

Chikungunya, four new cases in Rome. "Not excluded stop blood donation"

In addition to the three sick patients registered in Anzio, others established in the territory of Asl Roma 2. The Region to the Municipality: "It serves disinfestation"

11 September 2017

There are four more cases of chikunguya in Rome. The Region says, which in a note also asks the City to start a disinfestation after the cases found in Anzio and now in the capital and convened a meeting on Tuesday, September 12. "In addition to the three cases of Chikungunya of Anzio, four more were found in the territory of Asl Roma 2 ( south area, ndr ) and already notified to the surveillance system," the region writes in a note. "Asl, for his part, has already indicated, twice, to the City of Rome to proceed to an extraordinary plan of disinfestation" by mosquitoes on the municipal territory. "Tomorrow in the Region, a meeting with the City of Rome, Environment Protection Department".

The meeting was called "to solicit the launch by Roma Capitale of an extraordinary campaign of disinfestation by mosquitoes on municipal territory". The cases of Anzio and Rome refer to "the data collected to date", according to the note of the Regione Lazio.

There is still no suspension of blood donation in Rome after the 4 cases of Chikungunya in Capital but the measure could be adopted in the next few hours. The precautionary measure, as happened last Friday at Anzio, is in fact prescribed by the ordinary procedure when faced with a risk of diseases that can be transmitted with the blood.

Chikungunya, which has caused 7 infections in Lazio, including 4 in Rome, is a viral disease that causes acute fever and is transmitted by infected mosquito bites. There is no vaccine. The first known epidemic was described in Tanzania in 1952, although an epidemic in Indonesia was already described in 1779, possibly attributable to the same viral agent. Since the 1950s, several chikungunya outbreaks have occurred in Asia and Africa. In Europe in August 2007, the first indigenous cases were reported in Emilia Romagna.

After a period of 3 to 12 days incubation, flu-like symptoms appear: high fever, chills, headache, nausea, vomiting and especially important arthralgias (resulting in the name chikungunya, which in swahili means "what curve "or" contorts "), so limiting the patient's movements, explains the website of the Higher Health Institute. Everything resolves spontaneously, usually within a few days, but joint pains can persist for months. The most serious complications are rare and may be of hemorrhagic nature (but not so severe as in the dengue) within 3-5 days, or neurologic, especially in children. In very rare cases, chikungunya can be fatal, more so in older people with underlying baseline conditions.

The responsible virus of chikungunya belongs to the family of togaviridae, the kind of alphavirus. Shown by mosquitoes of the genus Aedes, such as Aedes aegypti (the same that transmits yellow fever and dengue) and is present mainly in rural areas, while it is rare or even absent in proximity to the inhabited centers. Another important vector is Aedes albopictus, commonly called tiger mosquito, which is also present in the inhabited towns of our country.

There is no specific treatment against the chikungunya fever virus, therefore the therapy is based onadministration of symptomatic drugs especially for relieving joint pains (antipyretic and anti-inflammatory, except for acetylsalicylic acid), resting in bed and reintegration of liquids where necessary. Persons suffering from chikungunya fever should be protected from insect bites by applying repellents to the skin, using mosquito nets and insecticides in the environments in which they are staying, in order to prevent propagation of the infection.

http://roma.repubblica.it/cronaca/2...e_al_comune_serve_disinfestazione_-175228510/

 

[Pathfinder]

Outbreak of disease carried by mosquitoes halts blood donation in Rome

by Reuters
Thursday, 14 September 2017 12:42 GMT

ROME, Sept 14 (Reuters) - Italian health officials have banned residents across half of Rome from donating blood because of an outbreak of the painful, mosquito-borne illness Chikungunya.

At least 17 people in southeastern Rome have been diagnosed with the virus since the end of August, and the local health authority decided to suspend blood donations in the affected areas to prevent accidental transmission.

The ban covers some 1.2 million residents. Anyone who has visited the affected area of the capital since Aug. 25 should not give blood for 28 days.
...

http://news.trust.org/item/20170914124748-9gmxd

 

[Gert van der Hoek]

Chikungunya in Rome, cases go up to 27. Donations stopped; Zingaretti: "There will be no shortage of blood"

sept 14, 2017

The ten new newly discovered patients are residents or have stayed at Anzio. Excluding the extension of the ban to other areas beyond the Asl Roma 2 and Anzio. The Region's President: "Boosting solidarity in areas not involved in the bloc

After the cases of chikungunya found in Lazio and its blockade of donations in the Asl Roma 2 district and in the municipality of Anzio where the first infections were recorded (another case was found in Modena), worry now is the amount of blood available in the capital. But the president of the Regione Lazio Zingaretti assures: "There will be no problems for the health network". Excluding the extension of areas where blood donation is prohibited: "The picture is evolving, but the measures taken are nevertheless likely to have no extension to other blood donation blockers," assured the head of the cabin director of Lazio health, Alessio D'Amato. Regarding the fact that yesterday's sitting by the mayor of Rome, Virginia Raggi in the Dangerous Zone D'Amato, he added: "We have read the ordinance and now we are going to ask for a meeting to evaluate the areas and see if the initiatives put in place are working. " Meanwhile, the National Blood Center has announced that ten Italian regions have provided 849 units of blood to accommodate any deficiencies.

Meanwhile, 27 cases have been reported: "The 10 new cases compared to yesterday's day are resident or resident in Anzio and seven cases do not result in traveling to Italy or abroad in the 15 days prior to the onset of symptoms The notifications referring to the territory of Rome remain unaffected, "the Lazio Region explained in a note.

 

[Gert van der Hoek]

Lazio Region is divided in 4 provinces and 1 metropolitan city


Until now cases were reported from Rome (Anzio mentioned in the previous report is part of Rome); these 4 cases seem to be new cases, reported from Latina province.


Chikungunya: Asl Latina, 4 cases

"Two Certain and Two Probable", alerted competent mayors

(ANSA) - ROME, Sept. 15 - "In the province of Latina there were currently 4 cases, 2 certain and 2 probable, of Chikungunya". It is learned from a note published on the site of Asl of Latina. "After the cases recorded - it is explained - and based on the circular of the Ministry of Health, the Mayor of the Municipality of Latina has already been informed on the basis of competence. He is informing all the Provincial Statutory Auditors in order to prepare the actions for possible interventions of disinfestation when cases are found. "

 

[Shiloh]

Source: http://www.who.int/csr/don/15-september-2017-chikungunya-italy/en/

[h=1]Chikungunya ? Italy[/h] Disease outbreak news
15 September 2017

As of 14 September, fourteen autochthonous confirmed cases of chikungunya have been diagnosed in Italy, six in Rome and eight in the coastal area of Anzio (Lazio Region). There are additional cases being investigated.
The date of onset of symptoms of the first case was on 5 August 2017. The dates of onset of the latest cases are between 25 August and 7 September 2017.
[h=3]Public health response[/h] The following public health measures described in the Italian National Chikungunya Surveillance and Response Plan are implemented:

• Disinfestation and vector control measures in the Anzio and Rome areas;
• Communication to the population about chikungunya and information on protection against mosquito bites. Ministry of Health?s website has pages about chikungunya which can be found here;
• Measures to prevent transmission through blood transfusion;
• Information and guidelines for health care practitioners to manage patients.

The National Health Institute (Istituto Superiore di Sanit?) issued a public statement on 8 September 2017 concerning the outbreak.
[h=3]WHO risk assessment[/h] There is a risk for further transmission. This is due to:

• Aedes albopictus being established throughout the Mediterranean basin;
• this vector having demonstrated the capacity to sustain outbreaks of chikungunya in the past; and
• the area of the current case being highly populated and touristic particularly in summer months.

The disease mostly occurs in Africa, Asia, Americas and the Indian subcontinent. In 2007, transmission was reported for the first time in Europe, in the Emilia Romagna region of north-eastern Italy. There were 217 laboratory confirmed cases during this outbreak and it demonstrated that mosquito-borne outbreaks by Aedes albopictus are possible in Europe. Currently, there is another ongoing autochthonous outbreak in Var Department that started in early August 2017.
[h=3]WHO advice[/h] [h=4]Personal protection[/h] Basic precautions should be taken by people within and travelling to this area of Italy. These include wearing long sleeves and pants, use of repellents, and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
Clothing which minimizes skin exposure to the day-biting vectors is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET, IR3535, or Icaridin. People should sleep under a mosquito bed net and use air conditioning or window screens to prevent mosquito bites. Mosquito coils or other insecticide vaporizers may also reduce indoor biting.
[h=4]Vector control[/h] The Aedes albopictus species thrives in a wide range of water-filled containers, including tree-holes and rock pools, in addition to artificial containers such as unused vehicle tires, saucers beneath plant pots, rain water barrels and cisterns, and catch basins.
Prevention and control relies heavily on reducing the number of these natural and artificial water-filled container habitats that support breeding of the mosquitoes. This requires mobilization of affected communities, and strengthening monitoring of the vector mosquito. During outbreaks, indoor space spraying with insecticides may be performed to kill flying mosquitoes along with killing the immature larvae in water-filled containers through source reduction.
[h=3]About chikungunya[/h] Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash. Joint pain is often debilitating and can vary in duration. Hence the virus can cause acute, subacute or chronic disease. There is no cure for the disease and treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.

 

[Pathfinder]

Translation Google

Chikungunya, councilor: 'Outbreak not in Rome but Anzio'

Montanari: damaged by ineffective disinfestations of others

ANSA Editing
17 September 2017
17:13
NEWS

Write to the editorial staff

"Roma disinsectance and derating have been carried out with great commitment, to say or to imply the opposite is an irresponsible gesture towards the citizens The outbreak is not in Rome but in Anzio Rome has been damaged by ineffective disinfestations of other Lazio communities. Rome, with 2,875,364 inhabitants suffered 6 contagion cases. Anzio, with 54,211 inhabitants, found 19 cases. " So the Assessor of Sustainability in Rome, Pinuccia Montanari, about Chikungunya virus cases.

"Part of the Roman citizens who were positive to Chikungunya," he added, "had been on vacation at Anzio." While our low-toxic preventive treatments worked much better than others, we ask what other Administrations have done to to ensure the health of the people The new Raggi ordinance has been used to allow the intervention also on the private ground There is no step back and no delay on our part The adult-type treatments were already foreseen.In this case we will go to the bottom to restore the truth and we will evaluate all the possible, even legal, actions, denouncing the procured alarm and the spread of false news to protect the work of the Capitoline Administration. "

Day after day in Lazio and across Italy, the number of infected by the Chikungunya virus: Saturday, the evening newsletter of the Regional Lazial Infectious Disease Surveillance Service has risen to 64, against 47 on Friday. Of these, the overwhelming majority, 54, reside or have stayed in Anzio, the city of the southern coast of Rome where an outbreak has been identified; seven cases were recorded in Rome, three in Latina. And the Lazio Region convenes on Monday the representatives of Rome Capitale and other relevant administrations, Latina and Anzio, "to verify the action of disinfestation implemented so far."

After Lazio, Emilia Romagna and Lombardy, the Chikungunya virus also came to the Marche. This is a 65-year-old man in Castelplanio, in the province of Ancona, who has already been cured and resigned from Fabriano's hospital. His case, however, seems to be linked to the 'Roman' outbreak; he had spent part of the summer in a Lazio town where other cases occurred. The increasing spread of the virus has also alerted the Oms (World Health Organization), which does not rule out further cases in our country over the next few days. The tiger mosquito, in fact, writes experts on the Organization website, "is now stationed in the Mediterranean basin, has demonstrated the ability to support Chikungunya outbreaks in the past,

Negative Suspicious Case Analysis in Modena - The results of the suspected case of chikungunya virus detected in Modena on Saturday were negative. Laboratory analyzes, in fact, exclude the presence of the virus transmitted through the mosquito bite of the genus Aedes, the so-called tiger mosquito. The municipality of Modena has announced that it has canceled the ordinance and suspended the extraordinary treatments of disinfestation that on Saturday evening covered an area south of the city, between the ring road Neruda and Via Giardini. As a matter of practice, the report of the suspected case of health emergency came from the public hygiene service of Ausl Company and the City had immediately prepared the order for the implementation of treatments aimed at the removal of larval outbreaks to prevent the spread of disease.

http://www.ansa.it/sito/notizie/cro...io-_3ac8ff17-20e3-47c1-981c-5305b36be592.html

 

[Gert van der Hoek]

Lazio Region: 86 cases of Chikungunya, 10 new infections

Posted by Editorial Date: September 20, 2017

To date, a total of 86 notification of Chikungunya cases has been received at SERESMI (Regional Surveillance Service for Infectious Diseases). So 10 cases more than the last survey done on Tuesday, 19 September. Of these 10 new cases, 5 are residents or have taken a stay in Anzio in the 15 days prior to the onset of the symptoms. The remaining 5 new cases are resident in the municipality of Rome and have no connections with Anzio.

"We reiterate - said in a note from the Lazio Region - that in areas where individual indigenous cases or indigenous epidemic outbreaks (2 or more cases) are reported, take the disinfestation measures provided by the National Health Surveillance Plan 2017 of the Ministry of Health public and private soil, adult-friendly treatments with abrasive products, treatments of larval outbreaks, replication of all rainfall interventions, repeat the entire cycle after the first week. "

New disinsection operations have been activated in Latina.

 

[Gert van der Hoek]

Chikungunya, 6 new cases in Lazio

Rome, September 21 (AdnKronos) - "A total of 92 Chikungunya cases were reported to the Seresmi (Regional Surveillance Service for Infectious Diseases). So, 6 more cases than the last survey done on Wednesday, 20 September. Of these 6 new cases 3 are resident or have reported a stay in Anzio in the 15 days prior to the onset of the symptoms. The remaining 3 new cases are resident in the municipality of Rome and have no connections with Anzio.

"The Lazio Region reports in a note." We recall that in areas where individual indigenous cases or indigenous epidemic outbreaks (2 or more cases) are reported, the measures of disinfestation provided by the National Surveillance Plan 2017 of the Ministry of Health or treatments on public and private land - continues the note - adulticides treatment with abrasive products, treatment of larval outbreaks, replication of all the interventions in case of rain, repeat l 'whole cycle after the first week'.

 

[Gert van der Hoek]

Friday 22 September 2017 -

Chikungunya, Lazio Region: 10 new cases, 5 in Rome and 5 in Anzio

In total received at Seresmi 102 notifications Rome, 22 Sep. (askanews) - "Today, a total of 102 notifications of Chikungunya cases have been received at SERESMI (Regional Surveillance Unit for Infectious Diseases). So 10 cases more than the last survey carried out on Thursday, September 21, yesterday. "

The Lazio Region states in a note: "Of these 10 new cases, 5 are resident or have resided in the municipality of Anzio in the 15 days prior to the onset of the symptoms. The remaining 5 new cases are resident in the municipality of Rome and have no connections with Anzio.

The next bulletins on the evolution of the situation will be issued with a weekly cadence. "

 

[Shiloh]

Source: http://www.who.int/csr/don/29-september-2017-chikungunya-italy/en/ [h=1]Chikungunya ? Italy[/h] Disease outbreak news
29 September 2017

As of 26 September, 183 cases have been notified to the Lazio Region of Italy, which includes the coastal areas of Anzio and Latina as well as the city of Rome. Of the notified cases, 109 are confirmed and 74 additional cases are being investigated (all with an epidemiological link to the Lazio Region). Three more confirmed cases have also been notified from other areas with a travel history to Anzio.
The date of onset of symptoms of the first case was on 26 June 2017.
[h=3]Public health response[/h] The following public health measures described in the Italian National Chikungunya Surveillance and Response Plan are implemented:

• Italian National Chikungunya Surveillance and Response Plan

• Disinfestation and vector control measures in the Anzio and Rome areas;
• Communication to the population about chikungunya and information on protection against mosquito bites. Ministry of Health?s website has pages about chikungunya which can be found at the link below;
• Measures to prevent transmission through blood transfusion;
• Information and guidelines for health care practitioners to manage patients.

• Ministero della Salute ? FAQ Chikungunya

The National Health Institute (Istituto Superiore di Sanit?) issued a public statement on 8 September 2017 concerning the outbreak.

• Istituto Superiore di Sanit? ? Public statement

On 28 September 2017 the Ministry of Health issued new recommendations to strengthen surveillance and control activities at national level, including disinfestation at ports and airports (see link below).

• Istituto Superiore di Sanit? ? Recommendations

[h=3]WHO risk assessment[/h] There is a risk for further transmission. This is due to:

• Aedes albopictus being established throughout the Mediterranean basin;
• this vector having demonstrated the capacity to sustain outbreaks of chikungunya in the past; and
• the area of the current case being highly populated and touristic particularly in summer months.

The disease mostly occurs in Africa, Asia, Americas and the Indian subcontinent. In 2007, transmission was reported for the first time in Europe, in the Emilia Romagna region of north-eastern Italy. There were 217 laboratory confirmed cases during this outbreak and it demonstrated that mosquito-borne outbreaks by Aedes albopictus are possible in Europe. Currently, there is another ongoing autochthonous outbreak in Var Department, France that started in early August 2017.
[h=3]WHO advice[/h] [h=4]Personal protection[/h] Basic precautions should be taken by people within and travelling to this area of Italy. These include wearing long sleeves and pants, use of repellents, and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
Clothing which minimizes skin exposure to the day-biting vectors is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET, IR3535, or Icaridin. People should sleep under a mosquito bed net and use air conditioning or window screens to prevent mosquito bites. Mosquito coils or other insecticide vaporizers may also reduce indoor biting.
[h=4]Vector control[/h] The Aedes albopictus species thrives in a wide range of water-filled containers, including tree-holes and rock pools, in addition to artificial containers such as unused vehicle tires, saucers beneath plant pots, rain water barrels and cisterns, and catch basins.
Prevention and control relies heavily on reducing the number of these natural and artificial water-filled container habitats that support breeding of the mosquitoes. This requires mobilization of affected communities, and strengthening monitoring of the vector mosquito. During outbreaks, indoor space spraying with insecticides may be performed to kill flying mosquitoes along with killing the immature larvae in water-filled containers through source reduction.
[h=3]About chikungunya[/h] Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash. Joint pain is often debilitating and can vary in duration. Hence the virus can cause acute, subacute or chronic disease. There is no cure for the disease and treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.

 

[Gert van der Hoek]

Lazio Region ...........................................................Calabria Region

As of 4 October, Italy had reported 239 chikungunya cases in the Lazio region (146 confirmed and 93 probable) and six autochthonous confirmed cases in the city of Guardavalle, Calabria region. Furthermore, three confirmed cases were reported in Emilia-Romagna (1), Marche (1) and France (1) and one probable case was reported in Germany.

Three confirmed cases had an epidemiological link to the Anzio region, and one probable case in Rome.

Furthermore, four confirmed cases with a history of travel to Guardavalle marina were notified from Lazio (1) and Emilia-Romagna region (3). As of 4 October 2017, Calabria region had reported 55 chikungunya cases in Guardavalle.

As stated in the Eurosurveillance article 'Detection of a chikungunya outbreak in Central Italy, August to September 2017' published 28 September, the virus circulating in Italy belongs to the East Central South African (ECSA) lineage and show 100% similarity to a strain involved in an ongoing epidemic in Pakistan. The virus isolated does not carry the E1-A226V mutation. The outbreak sequence is available in GenBank.

ECDC assessment

The two outbreaks in France and Italy are unrelated and result from separate introductions of the virus, probably from Africa and Asia, respectively. Having concurrent, distinct outbreaks of chikungunya in France and Italy highlights that the environmental conditions in 2017 are favourable for the local transmission of introduced chikungunya virus strains. In France, response measures, including vector control, have been implemented. The fact that the strain harbours the E1-A226V mutation may explain the relatively larger number of autochthonous cases observed this year compared to the 2010 outbreak in the same region (i.e. two cases reported in 2010).

The conclusions of the latest ECDC rapid risk assessment published on 24 August 2017 on the 'Cluster of autochthonous chikungunya cases in France' remain valid. In Italy, this is the first known transmission of chikungunya in central and southern Italy and therefore, in the absence of herd immunity, most of the inhabitants should be considered as susceptible to chikungunya virus disease. The likelihood of further spread within Italy is still moderate with suitable but less favourable conditions for vector activity in the coming weeks. In the areas already affected more cases can be expected to be identified in the near future. There is a low likelihood of introduction of the virus and subsequent local transmission in other EU countries where Aedes albopictus is present and active.

 

[Gert van der Hoek]

Chikungunya Outbreak in Calabria (2017)


October 5, 2017 - After the local Chikungunya cases reported in Lazio, a new outbreak has been identified in Calabria. Everything started from four cases reported between 19 and 25 September 2017 - one in Lazio and three in Emilia-Romagna - about people resident in these regions who had developed indicative symptoms of infection last August while they were in Guardavalle Marina (CZ). These cases were positive for laboratory investigations.

On September 24, a team of the Department of Infectious Diseases of the Higher Health Institute (Iss), composed of entomologists and epidemiologists, went to Guardavalle Marina to investigate the outbreak of epidemics, collect human samples to confirm infection, monitor the carrier Aedes Albopictus (mosquito tiger) and provide support for the disinfestation of the affected areas. Through the retrospective epidemiological survey, in the period August-September 2017, Chikungunya reported 55 cases (suspected, probable and confirmed) by general practitioners (Mmg) and free choice pediatricians (PLs) in the Guardavalle area Figure 1).

All report high fever, joint pain (often disabling) often accompanied by skin rushes. For 6 suspected cases, laboratory diagnosis has been made, and cases have been confirmed. Epidemiological and microbiological assessments are underway to confirm the diagnosis in suspected cases and to assess whether this outbreak is related to that observed in Lazio.

Around the areas of residence and domicile of the case, vector monitoring activities were performed and mosquito larvae and adult specimens of species Ae were taken. albopictus. Agreements have also been made to carry out monitoring activities with oviplanes on the Guardavalle Marina territory and mapping the larval outbreaks of the area. For captured mosquitoes, analyzes are ongoing to verify the presence of the virus.

From the preliminary information collected, it seems to me now that there are no other municipalities involved. However, the Region has sent an alert to all Mgg, Pls, First Aid and Local Medical Guard to alert them to the diagnosis and reporting of patients presenting with clinical symptoms that may suggest Chikungunya's disease.

On September 29, 2017, the National Blood Center (CNS) announced the suspension of the collection of blood donations to donors in the Guardavalle City Council and to all those who stayed for a few hours in this area during the period considered.

 

[Gert van der Hoek]

Update ECDC

november 17, 2017

As of 10 November 2017, Italy has reported 428 cases of chikungunya. Of these, 359 cases have been reported in the Lazio region, 184 of which are confirmed, and 61 were reported in Guardavalle marina, Calabria region (50 of the 61 cases are confirmed). In addition, three confirmed cases with a travel history to Anzio have been reported in Emilia-Romagna (1), Marche (1) and France (1).

One confirmed case with travel history to Rome was reported in Germany. Furthermore, four probable cases with travel history to Guardavalle marina (3) and Rome (1) were reported in Emilia-Romagna.

As stated in an Eurosurveillance article entitled 'Detection of a chikungunya outbreak in Central Italy, August to September 2017' (published 28 September 2017), the virus circulating in Italy belongs to the East Central South African (ECSA) lineage and does not carry the E1-A226V mutation. The outbreak sequence is available in GenBank.


ECDC assessment
In Italy, this is the first known transmission of chikungunya in central and southern Italy. In the absence of herd immunity, most of the inhabitants should be considered as susceptible to chikungunya virus disease. In the areas already affected, more cases can be expected to be identified in the near future.

There is a low likelihood of the virus being introduced to other EU countries. There is an equally low likelihood of subsequent local transmission in other EU countries where Aedes albopictus is present and active.