Managing the risk of vector borne diseases in adaptation measures

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Managing the risk of vector borne diseases in
adaptation measures
Luciana Sinisi, Italy Chair Task Force Extreme
Weather Events luciana.sinisi_at_apat.it
Water and adaptation- International workshop,
Amsterdam July 1-2, 2008
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THE RISK FACTORS
Vector-borne diseases (VBD) are infections
transmitted by the bite of infected , climate
sensitive, arthropod species, such as mosquitoes,
ticks, sandflies and blackflies
increases in global temperatures, more frequent
extreme weather events, warmer winters and
evenings Other cofactors (biodiversity loss,
urbanization) opportunity for increased
distribution, expanded breeding, prolonged
mosquito incubation period .
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OUTBREAK OF VECTOR BORNE DISEASE experience in
Italy

• The outbreak of chikungunya fever in
  north-eastern Italy
• is the first documented local vector-borne
  transmission
• of Chikungunya virus within the European main
  land.
• (EU CDC report, 2007)

• Further impact on blood trasfusion and
  transplants activities !!!!

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The geographical extent
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OUTBREAK MANAGEMENT
August 9 - Initial warning by a citizen of
Castiglione di Cervia August 14- 47 suspect cases
had been identified through this active case
search. August 20, blood samples were collected.
August 24, epidemiological surveillance was
extended to all general practitioners in the
province, August 29, the health authorities
developed criteria for active surveillance
purposes Since 18 August, vector control
measures (control of breeding sites,insecticides
)implementation and extension as the outbreak
progressed.
Source EU CDC Mission Report Chikungunya in
Italy, September 2007
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. PREPAREDNESS ELEMENTS..
1 Guidelines for the control of Aedes albopictus
were issued in Italy by the Ministry of Health
since 1994. 2. Current vector monitoring system
comprises 1 800 ovitraps in the region hitted by
the outbreaks 3. Weekly monitoring data are
available on a dedicated website
(www.zanzaratigreonline.it). 4.Based on current
operational evidence, this regional monitoring
system is among the most advanced in Italy, and
probably in most parts of Europe. 5. evidence
of trans-ovarian (vertical) virus transmission
gained from studies done in la Réunion
(2005-5)possibly increases the risk for
re-appearance of infected mosquitoes
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The ECDC risk assessment for chikungunja virus in
Europe
Note Many Countries miss data
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LESSON LEARNED/elements for discussion
1. The efficiency and preparedness of the Italian
region provide a good control of the outbreak 2.
Vector borne disease surveillance control are
pretty much fully delegate to public health
system gtgtgt ANY POSSIBLE SINERGY WITH OTHER
SECTOR TO STREGHTEN ? e.g. early warning,
ecosystem intervention .
2. Risk of VBD are an issue of adaptation
measures ? gtgtgt e.g. health risk assessment
ofopen reservoir in water management,recovery of
breeding sites after floods,..