Italian Health authorities have informed the World Health Organization (WHO) and the EU of an outbreak of chikungunya fever in the Emilia-Romagna region in North-East Italy. Between 4 July and 3 September, 151 cases of the tropical virus, causing one death, were reported.
In the EU, several hundred individual cases have been reported in the past two years mainly in tourists coming back from Africa, south-east Asia and the Indian sub-continent, where chikungunya is endemic. The outbreak in Italy is thought to have been caused by a traveller returning from India with the virus.
The Italian outbreak is the first known transmission of chikungunya virus in Europe. "It is significant but people should not be overly alarmed," said the spokesman of the European Centre for Disease Control and Prevention (ECDC), on 5 September 2007.
However, he added that "the theoretical risk/possibility of chikungunya virus transmissions in Europe, identified in the ECDC consultation on chikungunya risk assessment for Europe last year is now a real risk." He also explained that as mosquitos are present in many European countries, in particular in the Mediterranean region, transmissions of the chikungunya virus in the EU are possible.
Italy informed the other EU member states of the outbreak on 4 September via a teleconference on the EU's early warning and response system (EWRS). The system links member states' public-health authorities responsible for measures to control communicable diseases with the Commission and the ECDC.
The EU has added the province of Ravenna to the list of regions where tourists can contract the chikungunya virus and the ECDC recommends visitors to use anti-mosquito nets and sprays.
Italian local authorities from 18 August onwards began disinfecting public sites - streets, parks and gardens - in the most affected villages, used larvicides for door-to-door disinfection, as well as distributing information leaflets about mosquito control.
The virus causes high fever, joint pain, headache, muscle pain, a rash and gastro-intestinal symptoms. It is not generally fatal, but a high number of deaths were associated with the large outbreaks of the virus in 2005 and 2006 in La Réunion island, Mauritius, Mayotte and several Indian states. There is no vaccine or specific treatment for chikungunya.
