West Nile Fever in the Mediterranean basin: an overview. Federica Monaco OIE Reference Laboratory for WNF Algiers 24 November 2015

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1 West Nile Fever in the Mediterranean basin: an overview Federica Monaco OIE Reference Laboratory for WNF Algiers 24 November

2 West Nile Disease West Nile Disease (WND) is a vector-borne viral infectious disease capable of infecting a wide range of species including human, causing in a small percentage of them (20%) fever, headache, muscle weakness, and sometimes encephalitis or meningitis (<1%). West Nile virus belongs to the Flaviviridae Family, Flavivirus genus within the Japanese encephalitis sero-complex.

3 West Nile Disease Epidemiological cycle Mosquitoes Incidental hosts Birds

4 West Nile Disease Transmission West Nile Disease is not directly transmitted from person to person or from animal to animal. WNV NO WNV NO

5 Infection may rarely occur by: organ transplantation, blood transfusion and by vertical transmission mother-foetus during pregnancy. West Nile Disease Transmission - Humans

6 WND worldwide West Nile Disease occurrence in the «Old world» is well known since decades. The virus was identified for the first time in 1937 from a woman living in the province of West Nile in Uganda. Since then sporadic and epidemic outbreaks of West Nile Disease have been reported in Africa, Middle East, Europe and Asia.

7 How does it spread?? Continuos introductions? 7

8 WND in Europe and in the Mediterranean basin Clinical cases and positivity detected ( ) Data updated to 31 March 2010

9 WND in Europe and in the Mediterranean basin Clinical cases and positivity detected ( ) Data updated to 31 March 2010 Marsh areas

10 WND in Europe and in the Mediterranean basin Clinical cases and positivity detected ( ) Data updated to 31 March 2010 Marsh areas Migratory birds: short distance routs Migratory birds: long distance routs

11 Mediterranean Eastern European Sotelo et al.,

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13 Number of WNND USA E-V159A NA/WN02 MW/WN06 13

14 In Europe first human epidemic in Romania in In the last 20 years, the disease re-emerged in Europe and in the Mediterranean Basin, with an increasing incidence in animals and humans. WND in Europe and in the Mediterranean Basin

15 WND in Europe and in Mediterranean basin human and horses

16 WND in Europe and in Mediterranean basin human and horses

17 WND in Europe and in Mediterranean basin human and horses

18 WND in Europe and in Mediterranean basin human and horses

19 WND in Europe and in Mediterranean basin human and horses

20 WND in Europe and in Mediterranean basin human and horses

21 WND in Europe and in Mediterranean basin human and horses

22 WND in Europe and in Mediterranean basin human and horses

23 WND in Europe and in Mediterranean basin human and horses STATE SPECIES No. TOTAL CASES (1) No. CONFIRMED CASES (2) Bulgaria Human 2 0 Israel Human Romania Human Italy Human Horses Austria Human 3 3 Hungary Human Serbia Human Portugal Human 1 1 Horses 4 4 Russian Federation Human Palestine Human 1 0 France Human 1 1 Horses Spain Horses Total human Total horses Last update: 9/11/

24 Human cases in Europe and in Mediterranean basin SOURCE ecdc Eurosurveillance articles IIS EpiSouth bullettin

25 The Italian surveillance

26 West Nile Disease For the first time in Italy

27 Geographical distribution of WND in animals in Italy

28 Geographical distribution of WND in animals in Italy

29 Geographical distribution of WND in animals in Italy

30 Geographical distribution of WND in animals in Italy

31 Geographical distribution of WND in animals in Italy

32 Geographical distribution of WND in animals in Italy

33 Geographical distribution of WND in animals in Italy

34 Geographical distribution of WND in animals in Italy

35 National surveillance plan of WND the present Endemic area The rest of the country. 36

36 Surveillance activities on throughout the national territory Equidae: clinical surveillance (nervous symptoms) Equidae died for neurological sign National surveillance plan of WND the present Passive surveillance on wild birds, Activities to step up during the period of vector activity and surveillance of all episodes of abnormal mortality or increased incidence of mortality in wild species reported during the period of vector activity 37

37 Surveillance activities in endemic area National surveillance plan of WND the present 1. Target birds surveillance (synanthropic), or poultry surveillance 2. Entomological surveillance 38

38 Surveillance activities in the rest of the country Equidae surveillance serological: random checks on resident equidae from July to November National surveillance plan of WND the present serological surveillance of cattle, sheep and goats sampled as sentinels in the Bluetongue national surveillance plan (optional activities) serological surveillance of other animal species (dogs) (optional activities) 39

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41 2011 Positive birds 2008 rock Pigeon (Columba livia) carrion crow(corvus corone cornix) magpie (Pica pica) eurasian Jay (Garrulus glandarius) cormorant (Phalacrocorax carbo) yellow-legged Gull (Larus michahellis) 2009 owl (Athene noctua) carrion crow (Corvus corone cornix) magpie (Pica pica) eurasian Jay (Garrulus glandarius) mallard (Anas platyrhyncos) yellow-legged Gull (Larus michahellis) eurasian jay (Garrulus glandarius) carrion crow (Corvus corone cornix) howl (Athene noctua) buzzard (Buteo buteo) wild duck (Anas platyrhyncos) wild collared dove (Streptopelia decaocto) L magpie (Pica pica) L1 carrion crow (Corvus corone cornix) L1 &L2 skylarks (Alauds arvensis) L2 northern goshawks (Accipiter gentilis) L2 red-breasted goose (Branta ruficollis) L2

42 Positive birds 2013 Magpie (Pica pica) L2 Carrion crow (Corvus corone cornix) L2 Eurasian Jay (Garrulus glandarius) L2 Crow (Corvus corax) L2 Nort hern goshawk (Accipiter gentilis) L2 Flamingo (Phoenicopterus roseus) L2 European goldfinch (Carduelis carduelis ) L2 Kestrel (Falco tinnunculus) Blackbird (Turdus merula) L2 Collared dove (Streptopelia decaocto) L2 Hoopoe(Upupa epops) L2 Assiolo (Otus scops) L2 Little owl (Athene noctua) L2 European serin (Serinus serinus) L2 Martin (Delichon urbicum) L2 Common swift (Apus apus) 2014 Magpie (Pica pica) L2 Carrion crow (Corvus corone cornix) L2 Eurasian Jay (Garrulus glandarius) L2 Northern goshawk (Accipiter gentilis) L2 Collared dove (Streptopelia decaocto) L2 Italian sparrow (Passer italiae) L2 Little owl(athene noctua) L2 43

43 Which vector? 44

44 WNV vectors

45 WND in Italy Human 36 Neurological cases 10 West Nile Fever cases 13 positivity in donors Source: Reparto di Epidemiologia delle malattie infettive (Cnesps-Iss), con il contributo del Dipartimento di Malattie infettive parassitarie immunomediate (Mipi) dell Istituto superiore di sanità, e con il coordinamento dell Ufficio V della Direzione Generale della Prevenzione del Ministero della Salute 46

46 No neurological cases The date onset symptoms of cases is between 27 July and 16 September Timeline distribution of neurological cases WND in Italy Human First case: 27 July Month of onset neurological sign Source: Reparto di Epidemiologia delle malattie infettive (Cnesps-Iss), con il contributo del Dipartimento di Malattie infettive parassitarie immunomediate (Mipi) dell Istituto superiore di sanità, e con il coordinamento dell Ufficio V della Direzione Generale della Prevenzione del Ministero della Salute 47

47 Grazie Thank per l attenzione you Grazie per l attenzione