Where do the majority of Italians forced to deal with Dengue come from? From Brazil, a country where the infected have exceeded 3 million. We are talking about the disease caused by four very similar viruses (Den-1, Den-2, Den-3 and Den-4), transmitted to humans by mosquito bites which in turn bite an infected person.
There is therefore no direct contagion between humans, even if humans are the main host of the virus. And it is precisely this last aspect that has “saved” us from a large-scale epidemic to date. Even if there are infections in Italy, 117 since January (detected from January 1st to April 8th), and they affect fairly young people: the average is 42 years old, especially men.
The map of cases region by region
Therefore, in this period of just over three months, the national arbovirus surveillance system, managed by the Higher Institute of Health, “showed 117 confirmed cases of Dengue, all associated with travel abroad”. For now these are infections imported into Italy, none are indigenous. From the first bulletin of the ISS (Higher Institute of Health) for this season it emerges that those infected by the virus transmitted by mosquitoes have an average age of 42 years: half are women and the rest are men.
The 117 reported cases are concentrated in three regions: the first is Veneto, which records 24 infected people, closely followed by Lazio, with 23 and immediately after Lombardy, which has detected 21 Dengue cases. But there are also other regions that exceed, even if slightly, the 10 cases: they are Tuscany, with 13 infected, followed by Emilia Romagna, with 12 and finally Piedmont, with 11.
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The age group most affected is young
Looking at the map that shows the probable place of exposure of imported Dengue cases, the majority come from Brazil, 32 to be precise, where the infection has been fueling a record epidemic for months. The age group most affected? It is between 30 and 39 years of age, with an incidence of more than 4 cases per million inhabitants. This is followed by 20-29 year olds with around 3 cases per million, 40-49 year olds (2.8/million), the 50-59 year old group (2.4) and that of children under 9 (1.5).
Since the beginning of the year, the ISS has also counted “one confirmed case of Zika Virus (associated with travel abroad, no deaths); 3 confirmed cases of Chikungunya (all associated with travel abroad, median age of 46 years, 67% of male sex, no deaths); 1 confirmed case of neuro-invasive infection – Tbe (native, no deaths, no cases of Toscana virus).
Brazil, primary source of contagion
Therefore, Brazil is above all the privileged source of Dengue contagion. You just need to look at what is happening in that country to understand why this is possible. The threshold of 3 million cases of Dengue in 2024 has recently been exceeded, almost double the number recorded in 2023, according to data released by the Ministry of Health.
Until April 10, the country had 3,062,181 probable infections, according to the ministry’s Arbovirus Monitoring Panel, with a rate of 1,508 per 100,000 inhabitants, a record in the history of the green and gold nation. The number of confirmed deaths is also high: 1,256, while another 1,857 are under investigation. Leading the statistics of the states with the highest infections is the Federal District of Brasilia, with 7.3 thousand cases per 100 thousand inhabitants. According to the Pan American Health Organization, the South American giant will account for almost 80% of cases of the disease recorded throughout Latin America during 2024.
Dengue vaccines, the disease can be serious immediately
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In Argentina, deaths from Dengue fever rise to 197
But Argentina is also short of breath. Deaths from Dengue fever have risen to 197, after 36 new deaths were confirmed in the last week, according to official data released on April 14. According to the latest epidemiological bulletin from the Argentine Ministry of Health, the number of Dengue cases this season (from week 31 of 2023 to week 14 of 2024) is 269,678, an increase of 36,682 cases compared to the report of the previous seven days . This year alone, there were 269,678 cases of Dengue, of which 643 were classified as serious. Currently, 23 of Argentina’s 24 jurisdictions report indigenous dengue viral circulation, but according to the report, the nationwide epidemic curve shows a 32% decrease in the number of cases reported each week.
“In the analysis of the epidemic curve of Dengue at a national level, there was a decrease in the number of weekly cases – confirms the ministry in the document -. Death cases were recorded in all age groups, with the highest mortality rate in people aged over 80, confirmed by those aged 70 to 79, 60 to 69 and 30 to 39, while the greatest number of cases occurred in people of aged between 30 and 39”.
Bassetti: “Be careful not to let the outbreaks spread”
Returning to Italy, if for now the situation does not prove problematic, it does not mean that the virus will not spread. Matteo Bassettihead of infectious diseases at the San Martino Hospital in Genoa, underlines: “It is clear that the mosquito season begins precisely in this period. From now on we must be very careful so that imported cases do not turn into internal outbreaks “.
The point is who should get vaccinated. Bassetti speaks again: “People who, in the age groups in which the vaccine is recommended, go to endemic areas for long periods should certainly do so. But also those who have already had a first infection, because the second could be more serious.” And the others? “There is no recommendation for the vaccine – concludes Bassetti -. At this moment it is more important to do prevention, using different tools: from mosquito nets on windows to repellents, anti-mosquitoes with which to protect ourselves when we are outdoors”.
Pregliasco: “There is a greater risk with the arrival of the heat”
“It is still early for any outbreaks in Italy, but the risk is high.” Fabrizio Pregliasco, virologist and medical director of the Galeazzi hospital in Milan, does not exclude a potential spread of Dengue with humid heat and an increase in mosquitoes. Precisely in that period the tiger mosquito can infect us. “Recently, a malaria-carrying mosquito was found in Puglia – explains Pregliasco -. So the effect of the tropicalisation of the climate is being felt”.
“While imported cases can be recognized (if in the previous 14 days you have traveled to a risk area and you have symptoms, doubt must arise and laboratory investigations must be carried out) the difficult thing is to identify the native ones, given that in the majority, the clinical manifestations are severe flu, bone pain, eye pain and sometimes vomiting”, highlights the expert. Adding that it doesn’t always go so well: there is also a share of these infections that cause “heavier forms with encephalitis, and above all hemorrhagic Dengue”.
The danger also comes from the tiger mosquito
The countries in which, at the moment, the concern is greatest are Brazil and Argentina, “the tip of an iceberg that denounces a broader situation”, underlines the virologist. The Aedes aegypti mosquito, the specific insect vector of the Dengue virus, is present in those areas. In our country, the tiger mosquito is responsible for transmitting the disease”. Therefore, even if the Aedes aegypti mosquito is not present in Italy, the Dengue virus can be “transported” by local mosquitoes: as long as they have bitten an infected person.
Already last year the numbers were growing. In Italy there were 82 indigenous cases of Dengue, which occurred directly in the country, and 280 imported from travelers returning from places where the disease is endemic.
Forgotten tropical diseases, over half of which are also present in Italy
Here’s how to protect ourselves
But what can we do to protect ourselves from the virus in view of the summer heat? The health authorities are dealing with disinfestations in airports and ports but, as Pregliasco explains, “we also have responsibilities”. And he goes into detail: “For example, when watering, you must avoid overdoing it – he underlines -. The stagnant water in the saucer acts as a refreshment station for mosquitoes: it attracts them in droves”. So, will what is about to arrive be the summer of anti-mosquito spray to always keep in your bag? “I would say yes – replies Pregliasco -. We have gone from hand disinfectants against Covid to mosquito repellents, in order to avoid Dengue”.
And will the vaccine be necessary as a prevention weapon? “The vaccine is important, but it is needed for travellers, for those going to risk areas, certainly not for all of us – concludes the virologist -. Two doses are given three months apart. Thinking about mass vaccination at this time , no. It could be useful if important indigenous outbreaks arise.”
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– 2024-04-17 03:57:53
