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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Claudia Fortuna, Maria Elena Remoli, Caterina Rizzo, Eleonora Benedetti, Cristiano Fiorentini, Antonino Bella, Claudio Argentini, Francesca Farchi, Concetta Castilletti, Maria Rosaria Capobianchi, Lorenzo Zammarchi, Alessandro Bartoloni, Nadia Zanchetta, Maria Rita Gismondo, Luca Ceccherini Nelli, Giustina Vitale, Franco Baldelli, Pierlanfranco D’Agaro, Giuseppe Sodano, Giovanni Rezza, Giulietta Venturi, the Arbovirus Working Group

Published in: BMC Infectious Diseases | Issue 1/2017

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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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Metadata
Title
Imported arboviral infections in Italy, July 2014-October 2015: a National Reference Laboratory report
Authors
Claudia Fortuna
Maria Elena Remoli
Caterina Rizzo
Eleonora Benedetti
Cristiano Fiorentini
Antonino Bella
Claudio Argentini
Francesca Farchi
Concetta Castilletti
Maria Rosaria Capobianchi
Lorenzo Zammarchi
Alessandro Bartoloni
Nadia Zanchetta
Maria Rita Gismondo
Luca Ceccherini Nelli
Giustina Vitale
Franco Baldelli
Pierlanfranco D’Agaro
Giuseppe Sodano
Giovanni Rezza
Giulietta Venturi
the Arbovirus Working Group
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2320-1

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