Tick-borne encephalitis in North-East Italy: A 14-year retrospective study, January 2000 to December 2013

G. Rezza, F. Farchi, P. Pezzotti, M. Ruscio, A. Lo Presti, M. Ciccozzi, V. Mondardini, C. Paternoster, M. Bassetti, M. Merelli, P. G. Scotton, R. Luzzati, J. Simeoni, P. Mian, R. Mel, V. Carraro, A. Zanin, R. Ferretto, E. Francavilla, Maria Grazia CiufoliniMaria Elena Remoli, Cristiano Fiorentini, Antonella Marchi, Claudia Fortuna, Pierlanfranco D'agaro, Cristina Pedrotti, Danila Bassetti, Elisabetta Pagani

Research output: Contribution to journalArticle

Abstract

Italy is considered at low incidence of tick-borne encephalitis (TBE), and the occurrence of human cases of TBE appears to be geographically restricted to the north east of the country. However, most information to date derives from case series, with no systematic data collection. To estimate incidence rates (IR) and spatial distribution of TBE cases, we conducted a retrospective study in north-eastern Italy. Data were collected through the infectious disease units and public health districts of three regions (Friuli Venezia Giulia, Trentino Alto Adige and Veneto) between 2000 and 2013. Overall, 367 cases were identified (IR: 0.38/100,000). The cases’ median age was 56 years and 257 (70%) were male. Central nervous system involvement was reported in 307 cases (84%). Annual fluctuations in case numbers occurred, with peaks in 2006 and in 2013, when 44 and 42 cases were respectively observed. A strong seasonality effect was noted, with the highest number of cases in July. In terms of geographical location, three main endemic foci with high TBE IR (> 10/100,000) were identified in three provinces, namely Belluno (Veneto region), Udine (Friuli Venezia Giulia) and Trento (Trentino Alto- Adige). When investigating the whole study area in terms of altitude, the IR between 400 and 600 m was greater (2.41/100,000) than at other altitudes (p< 0.01). In conclusion, the incidence of TBE in Italy is relatively low, even considering only the three known affected regions. However, three endemic foci at high risk were identified. In these areas, where the risk of TBEV infection is likely high, more active offer of TBE vaccination could be considered.

Original languageEnglish
JournalEurosurveillance
Volume20
Issue number40
DOIs
Publication statusPublished - Oct 8 2015

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Tick-Borne Encephalitis
Italy
Retrospective Studies
Incidence
Communicable Diseases
Vaccination
Central Nervous System
Public Health
Infection

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Virology

Cite this

Tick-borne encephalitis in North-East Italy : A 14-year retrospective study, January 2000 to December 2013. / Rezza, G.; Farchi, F.; Pezzotti, P.; Ruscio, M.; Lo Presti, A.; Ciccozzi, M.; Mondardini, V.; Paternoster, C.; Bassetti, M.; Merelli, M.; Scotton, P. G.; Luzzati, R.; Simeoni, J.; Mian, P.; Mel, R.; Carraro, V.; Zanin, A.; Ferretto, R.; Francavilla, E.; Ciufolini, Maria Grazia; Remoli, Maria Elena; Fiorentini, Cristiano; Marchi, Antonella; Fortuna, Claudia; D'agaro, Pierlanfranco; Pedrotti, Cristina; Bassetti, Danila; Pagani, Elisabetta.

In: Eurosurveillance, Vol. 20, No. 40, 08.10.2015.

Research output: Contribution to journalArticle

Rezza, G, Farchi, F, Pezzotti, P, Ruscio, M, Lo Presti, A, Ciccozzi, M, Mondardini, V, Paternoster, C, Bassetti, M, Merelli, M, Scotton, PG, Luzzati, R, Simeoni, J, Mian, P, Mel, R, Carraro, V, Zanin, A, Ferretto, R, Francavilla, E, Ciufolini, MG, Remoli, ME, Fiorentini, C, Marchi, A, Fortuna, C, D'agaro, P, Pedrotti, C, Bassetti, D & Pagani, E 2015, 'Tick-borne encephalitis in North-East Italy: A 14-year retrospective study, January 2000 to December 2013', Eurosurveillance, vol. 20, no. 40. https://doi.org/10.2807/1560-7917.ES.2015.20.40.30034
Rezza, G. ; Farchi, F. ; Pezzotti, P. ; Ruscio, M. ; Lo Presti, A. ; Ciccozzi, M. ; Mondardini, V. ; Paternoster, C. ; Bassetti, M. ; Merelli, M. ; Scotton, P. G. ; Luzzati, R. ; Simeoni, J. ; Mian, P. ; Mel, R. ; Carraro, V. ; Zanin, A. ; Ferretto, R. ; Francavilla, E. ; Ciufolini, Maria Grazia ; Remoli, Maria Elena ; Fiorentini, Cristiano ; Marchi, Antonella ; Fortuna, Claudia ; D'agaro, Pierlanfranco ; Pedrotti, Cristina ; Bassetti, Danila ; Pagani, Elisabetta. / Tick-borne encephalitis in North-East Italy : A 14-year retrospective study, January 2000 to December 2013. In: Eurosurveillance. 2015 ; Vol. 20, No. 40.
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T2 - A 14-year retrospective study, January 2000 to December 2013

AU - Rezza, G.

AU - Farchi, F.

AU - Pezzotti, P.

AU - Ruscio, M.

AU - Lo Presti, A.

AU - Ciccozzi, M.

AU - Mondardini, V.

AU - Paternoster, C.

AU - Bassetti, M.

AU - Merelli, M.

AU - Scotton, P. G.

AU - Luzzati, R.

AU - Simeoni, J.

AU - Mian, P.

AU - Mel, R.

AU - Carraro, V.

AU - Zanin, A.

AU - Ferretto, R.

AU - Francavilla, E.

AU - Ciufolini, Maria Grazia

AU - Remoli, Maria Elena

AU - Fiorentini, Cristiano

AU - Marchi, Antonella

AU - Fortuna, Claudia

AU - D'agaro, Pierlanfranco

AU - Pedrotti, Cristina

AU - Bassetti, Danila

AU - Pagani, Elisabetta

PY - 2015/10/8

Y1 - 2015/10/8

N2 - Italy is considered at low incidence of tick-borne encephalitis (TBE), and the occurrence of human cases of TBE appears to be geographically restricted to the north east of the country. However, most information to date derives from case series, with no systematic data collection. To estimate incidence rates (IR) and spatial distribution of TBE cases, we conducted a retrospective study in north-eastern Italy. Data were collected through the infectious disease units and public health districts of three regions (Friuli Venezia Giulia, Trentino Alto Adige and Veneto) between 2000 and 2013. Overall, 367 cases were identified (IR: 0.38/100,000). The cases’ median age was 56 years and 257 (70%) were male. Central nervous system involvement was reported in 307 cases (84%). Annual fluctuations in case numbers occurred, with peaks in 2006 and in 2013, when 44 and 42 cases were respectively observed. A strong seasonality effect was noted, with the highest number of cases in July. In terms of geographical location, three main endemic foci with high TBE IR (> 10/100,000) were identified in three provinces, namely Belluno (Veneto region), Udine (Friuli Venezia Giulia) and Trento (Trentino Alto- Adige). When investigating the whole study area in terms of altitude, the IR between 400 and 600 m was greater (2.41/100,000) than at other altitudes (p< 0.01). In conclusion, the incidence of TBE in Italy is relatively low, even considering only the three known affected regions. However, three endemic foci at high risk were identified. In these areas, where the risk of TBEV infection is likely high, more active offer of TBE vaccination could be considered.

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