Chikungunya Fever outbreak in Emilia-Romagna, Italy.

For the first time an outbreak of Chikungunya fever has been reported in Italy in the district of Ravenna, due to indigenous (local) transmission of Chikungunya virus (an Alphavirus). Previous cases over the years were all isolated and imported. A total of 135 cases up to 31 Aug. have been described, 27 of whom have been laboratory confirmed through antibody testing or PCR.

Region Emilia-Romagna has been affected with nearly all cases occurring in 2 small vilages (population 4,000) namely Castiglione di Cervia and Castiglione di Ravenna in the Ravenna region; 4 other cases have been reported from the Province of Ravenna.

The onset of symptoms of the first case was 4 July while the peak of the epidemic was on the 17-19 Aug. Up to the 4 September further sporadic cases have been reported in the Region of Emilia Romagna.

The index case is an Indian national from Kerala who travelled there from India and became symptomatic on 23 June. Surveillance is being undertaken and control measures with disinfestation of public areas and health education are underway.

Chikungunya Fever

The illness is characterised by high fever, headache, joint pains &/or petechial or maculopapular rash &/or asthenia. Incubation period is about 4-7 days after a mosquito bite. Joint pains can persist for many weeks and can be incapacitating. Rarely it can be fatal. It can also be transmitted via blood for transfusion.

The vector is thought to be Aedes albopictus but other mosquito species might be able to transmit the virus. Aedes albopictus has been reported in other countries: Albania, Italy, France, Belgium, Montenegro, Switzerland, Greece, Spain, Croatia, Netherlands, Slovenia, Bosnia-Herzegovina. For other Mediterranean countries it is assumed that the mosquito may be present. The vector has favourable climate conditions which are likely to persist for the next 1-2 months.

In a study in 1996 Aedes albopictus[1] species was not found to be present in Malta.  However though the risk is extremely small, it cannot be completely ruled out that any local mosquito species would be able to transmit the virus.