West Nile, one dead in Brescia: in a week there are 10. The number of infections in Italy is growing: 144 cases in 7 days

A Brescia died for the Nile feverthe disease caused by the West Nile virus spread by mosquito bite. The victim is a resident of Cigolein Lower Brescia. He was one of the two most serious patients of the four cases in the area and was hospitalized. According to the data ofIss the number of cases of infection continues to grow in Italy West Nile. In the last week of surveillance, those recorded since the beginning of June rose to 144 in total, compared to 94 in the previous week. Deaths increased to 10 (there were 7). According to the latest bulletin of the Higher Institute of Health, updated to 9 August, 87 of the total of 144 cases occurred in the neuro-invasive form (22 in Emilia-Romagna, 50 in Veneto, 8 in Piedmont, 5 in Lombardy and 2 in Friuli-Venezia Giulia), 23 cases identified in blood donors (3 in Lombardy, 11 in Veneto, 6 in Emilia-Romagna, 3 in Piedmont), 33 cases of fever (1 in Piedmont, 3 in Lombardy, 27 in Veneto, 2 in Emilia-Romagna) and 1 symptomatic case (in Veneto). As for the 10 deaths reported among the confirmed cases: 6 are in Veneto, 2 in Piedmont, 1 in Lombardy and 1 in Emilia-Romagna. The two asymptomatic cases of Usutu virus in Italy, reported in Friuli-Venezia Giulia, are also registered.

The first case of West Nile was first isolated in 1937 in Uganda, within the West Nile district from which the virus takes its name. The disease is prevalent mainly in Africa, Western Asia, Europe, Australia and America. In Italy the first outbreak dates back to the summer of 1998, when some cases were ascertained among horses in the Padule di Fucecchio area, in Tuscany. Following this event, the Ministry of Health has activated the National Surveillance Plan since 2002, in order to monitor the circulation of the virus throughout the national territory. The main reservoirs of the virus are wild birds and mosquitoes (especially Culex), whose bites are the main means of transmission to humans. Fever, in fact, is not transmitted through contact with infected people, but can also involve other mammals (especially horses, but also dogs, cats and rabbits).

L’incubation of the disease from the moment of the bite varies between 2 and 14 days, but it can also be 21 days in subjects with deficiencies in the immune system. Most people infected has no symptoms and among the few symptomatic, about 20% have mild symptoms such as fever, headache, nausea, vomiting, swollen lymph nodes, skin rashes. Symptoms can last a few days and in rare cases a few weeks, but above all they can vary a lot according to age: they are in fact milder in healthy young people. In the elderly and debilitated people, however, the symptoms can be more severe and can include high fever, severe headaches, muscle weakness, disorientation, tremors, visual disturbances, numbness, convulsions, up to paralysis and coma. Some neurological effects can also be permanent. Only in the most problematic cases (about 1 in a thousand) the virus can cause lethal encephalitis. Diagnosis is mainly made through serum and, where indicated, cerebrospinal fluid tests for IgM antibodies.

The lesser known Usutu virus (USUV), also a flavivirus, was first observed in Europe in 1996, and in Italy it was sporadically reported in Emilia-Romagna. The two viruses mainly affect wild birds, are both transmitted by mosquitoes (especially Culex spp.) And can pass from avian populations to mammals, including humans. in which they can cause neurological pathologies.

Obviously, it is necessary to “keep high attention and monitoring but, at the same time, it must also be said that the West Nile virus infection is a pathology that in the vast majority of cases does not present serious forms “he underlines Roberto Cauda, director of the Infectious Diseases Unit of the Agostino Gemelli University Hospital and full professor of Infectious Diseases at the Catholic University of Rome. Cauda invites us to avoid alarmism. On the one hand, you explain that the latest data pushes to “implement reclamation works in the area as soon as possible”, on the other “it must be clarified that we are not talking about a serious disease like Covid-19”. West Nile infection, he says, “is mostly benign and asymptomatic. Only rarely, in about 0.1% of cases, does it present severe forms, especially if there are pre-existing pathologies “. The carriers of the virus, he recalls, “are the mosquitoes but also the wild birds they equidae; the man is infected but the disease it is not passed on from person to person“. In the spread of this as well as other “exotic” pathologies, the expert notes, “a central role is undoubtedly played by climatic variations, which have brought viruses and pathologies typical of other continents to the West as well. However, it is also true that today, after the Covid-19 pandemic, there is greater attention than in the past with respect to infectious diseases. This is obviously positive, but alarmism must be avoided ”.

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