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“One Health” approach in West Nile disease surveillance: the northwestern Italian experience

2019; Elsevier BV; Volume: 79; Linguagem: Inglês

10.1016/j.ijid.2018.11.337

1878-3511

Maria Cristina Radaelli, Federica Verna, Alessandra Pautasso, Veronica Bellavia, Marco Ballardini, Walter Mignone, Loretta Masoero, Alessandro Dondo, Riccardo Orusa, Luca Picco, Roberto Moschi, Andrea Mosca, R. Chianese, Laura Chiavacci, Cristina Casalone,

Zoonotic diseases and public health

Purpose: West Nile Disease (WND) is a zoonotic infection with a complicated transmission cycle, involving pathogen, human and animal hosts, vectors and ecosystem. Public Health Authorities are encouraging interaction between multiple disciplines to implement a comprehensive surveillance system. The aim of this work is to present the "One Health approach" enforced in Northern Italy, focusing on Piemonte, Liguria and Valle d'Aosta Regions (Northwestern Italy). Methods & Materials: Since 2015, Veterinary and Human Public Health Authorities of some Northern Italian Regions enforced an integrated Surveillance Plan aiming to early detect the West Nile Virus (WNV) spread during the transmission season and to activate control measures to reduce the risk of human transmission. The working group established throughout the whole Po river valley a standardized protocol of human, entomologic and veterinary surveillance activities. This allowed to connect the surveillance of human clinical cases with entomological surveillance and veterinary monitoring, giving an accurate assessment of the epidemiological situation, and implementing extensive control measures in case of outbreak. In order to apply the guidelines, in Piemonte, Liguria and Valle d'Aosta Regions an information network was activated between Veterinary Services and local Human Health Authority. Results: The first local WNV detection (animals, vectors or humans) in a Province during the transmission season was identified as trigger criteria to activate the information flows between Public Health Authorities. Immediately WNV Nucleic Acid Amplification Test (NAT) screening of all blood donations was introduced in affected areas and blood donors having been for at least one night in the affected Provinces were deferred from donations for 28 days. The integrated surveillance system allowed to detect WNV circulation in Piemonte Region in vectors, animal and human hosts. To date, more than 80.000 blood bags were screened, and no one tested positive. Conclusion: The described multidisciplinary approach allows to early detect WNV appearance during the transmission season. The network has been demonstrated a key point to timely implement control measures against the spread of the infection and the risk of human transmission. This approach was adopted at National level in 2016 where the Ministry of Health published the National integrated WNV Surveillance Plan, actually unique in Europe.