A comparative analysis of the 2007 and 2017 Italian chikungunya outbreaks and implication for public health response

Beniamino Caputo, Gianluca Russo, Mattia Manica, Francesco Vairo, Piero Poletti, Giorgio Guzzetta, Stefano Merler, Carolina Scagnolari, Angelo Solimini

Research output: Contribution to journalReview articlepeer-review


KEY RESULTS: Both outbreaks started in small towns, but cases were also detected in nearby larger cities where transmission was limited to small clusters. The time spans between the first and the last symptom onsets were similar between the 2 outbreaks, and the delay from the symptom onset of the index case and the first case notified was considerable. Comparable infection and transmission rates were observed in laboratory. The basic reproductive number (R0) was estimated in the range of 1.8-6 (2007) and 1.5-2.6 (2017). Clinical characteristics were similar between outbreaks, and no acute complications were reported, though a higher frequency of ocular symptoms, myalgia, and rash was observed in 2017. Very little is known about the immune mediator profile of CHIKV-infected patients during the 2 outbreaks. Regarding public health responses, after the 2007 outbreak, the Italian Ministry of Health developed national guidelines to implement surveillance and good practices to prevent and control autochthonous transmission. However, only a few regional authorities implemented it, and the perception of outbreak risk and knowledge of clinical symptoms and transmission dynamics by general practitioners remained low. MAJOR CONCLUSIONS: Efforts should be devoted to developing suitable procedures for early detection of virus circulation in the population, possibly through the analysis of medical records in near real time. Increasing the awareness of CHIKV of general practitioners and public health officials through tailored education may be effective, especially in small coastal towns where the outbreak risk may be higher. A key element is also the shift of citizen awareness from considering Aedes mosquitoes not only as a nuisance problem but also as a public health one. We advocate the need of strengthening the surveillance and of promoting the active participation of the communities to prevent and contain future outbreaks.

Original languageEnglish
Pages (from-to)e0008159
Number of pages12
JournalPLoS Neglected Tropical Diseases
Issue number6
Publication statusPublished - Jun 11 2020

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


Dive into the research topics of 'A comparative analysis of the 2007 and 2017 Italian chikungunya outbreaks and implication for public health response'. Together they form a unique fingerprint.

Cite this