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Chikungunya Virus; Outbreak In Italy 2007

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    In 2007 a mass outbreak of an unknown illness plagues two relatively rural villages in Northeastern Italy. Ravenna Providence public health officials noticed that there was a steady increase in the amount of fever-like illness occurring in the villages of Castiglone di Cervia and Castiglione di Ravenna. The Chikungunya parasite outbreak consisted of initial cases displaying symptoms similar to those seen in endemic countries with abundant Aedes albopictus mosquito populations. Patients experienced symptoms of vomiting as well as fever and chills, and yet the disease is self-limiting in nature usually only lasting for a week or so. The outbreak occurred over the span of three months from July to September, and hit its peak for number of infections occurring in August. There were 166 cases of the viral infection documented by health officials in the area, who had determined those infected to show signs of fever and pain in the joints. If the patient only exhibited fever without arthritic pain, the case was not considered in the outbreak.

    The outbreak was not severe and the illness subsided with one life claimed, but it was later reported that the patient was elderly with many existing health concerns. The outbreak in northeastern Italy was the first of its kind to occur in Europe, and led local health officials to question its transmission for the infection is normally endemic to tropical climates like those of Southeast Asia or regions like Africa and India. Chikungunya’s spread from Africa to India had been researched and identified to be due to the high incidence of travelers into and out of India; a carrier for the disease as well as the first documented case of infection traveled from India to Italy provided Chikungunya with a reservoir to yield an epidemic outbreak in 2007. It is predicted that soon other temperate climates may also see a rise in the frequency of the virus because of the advancement of worldwide trade and the growth of the human population.

    Also, the temporal changes of the climate are also contributing to the spread of the biological vector to other tropic environments across the world. The Aedes albopictus mosquito is the biological vector of the disease, and health officials discovered that during the time of the outbreak in Italy there were numerous areas with standing water in both villages of Castiglone di Cervia and Castiglione di Ravenna. These areas of standing water have been identified as zones where the Aedes can lay its eggs and breed its population. Numerous biological tests were performed on the infected population of Ravenna, and it was concluded that 82 percent of Ravenna’s infected inhabitants were symptomatic for the virus.

    The female Aedes mosquito is the biological vector for the virus, for the male population is unable to carry the infection. The infected female transmits the virus to one of four hosts; susceptible, latent, symptomatic infectious, and asymptomatic. If a susceptible host is infected the virus will develop in a couple of days to a week, while the latent host will need days to develop its infection and will remain infectious for its entire life span. Infected individuals will display fever-like symptoms such as headache, muscle pain, epidermal rash, and pain in the joints. The virus is identified to be easily cured without treatment or vaccination and it is recommended to patients to stay well hydrated and get rest. There are incidences where the pain or arthritis in the joints associated with this disease can linger for months in the affected host.

    August 2017 was the peak month of infection, and health officials devised a plan to remove some areas of standing water in the two northeastern villages and kill eggs of the biological vector with adulticides. They identified that infectious humans can spread the disease within the population to other susceptible hosts, and must be regulated to ensure the spread of the virus is reduced. This plan is effective in slowing the Chikungunya viruses’ transmission, but other preventative measures like wearing bug repellant and the use of mosquito nets when sleeping are also recommended. The outbreak was also controlled by the change in weather from summer to fall, as the virus occurs more frequently in the summer months. Close analysis, it was determined that the virus spreads more readily through villages and rural areas as there are higher incidences of infection.

    These findings would explain how the Chikungunya virus spread from its endemic regions to an area with similar temperate qualities in northeastern Italy. The arbovirus is found most likely to infect persons in the elderly population, and is generally not life-threatening and usually cured by the body’s own immune responses. The outbreak was relatively small for the two villages collectively had up to 4,000 occupants, for the outbreaks have the potential to affect greater amounts of people in endemic regions like India where there is a higher population density. Places like India and Africa are similar to the Italian providence of Ravenna in that they all have areas with standing water where mosquitos can breed. It has been topic of public health discussion whether the Chikungunya virus will spread to the United States, for there are millions of travelers who visit and have the ability to bring the biological vector as well as be a reservoir for infective mosquitos in the country.

    Work Cited

    1. Marie, V. (august 2007). Imported Chikungunya Infection, Italy. Emerging Infectious Diseases, 13(8), 1264-1266. Retrieved November 11, 2018, from https://wwwnc.cdc.gov/eid/article/13/8/pdfs/07-0161.pdf.
    2. Poletti, P., & Messeri, G. (May 3, 2011). Transmission Potential of Chikungunya Virus and Control Measures: The Case of Italy. PLOS One. doi:https://doi.org/10.1371/journal.pone.0018860
    3. Rezza, G., MD, & Nicoletti, L., PhD. (2007). Infection with chikungunya virus in Italy: An outbreak in a temperate region. The Lancet, 370(9602), 1840-1846. doi:https://doi.org/10.1016/S0140-6736(07)61779-6

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