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WEST NILE VIRUS - EURASIA (11): ITALY (VENETO)
**********************************************
A ProMED-mail post
Date: Fri 22 Oct 2010
From: Anna Beltrame [edited]
beltrame.anna@aoud.sanita.fvg.it
We report the 1st case of West Nile [virus]
meningoencephalitis in Italy in 2010.
On 30 Aug 2010, a 41-year-old Algerian male
resident in Veneto (Santo Stino di Livenza) was
admitted to the Hospital of S. Vito al
Tagliamento in Friuli Venezia Giulia (FVG), where
his brother lives, complaining of fever (40 C
[104 F]) and vomiting for the last 3 days. The
patient appeared confused, disoriented, agitated
without a neck stiffness.
A lumbar puncture (LP) was performed and
disclosed a clear fluid with a white blood cell
(WBC) count of 40 cells/mm3, a glucose level of
147 mg/dL and a protein level of 0.7 g/L. Samples
of blood and cerebrospinal fluid (CSF) were taken
and tested for neurotropic agents but not for
West Nile virus (WNV). A presumptive diagnosis of
viral meningoencephalitis was made. After 3 days,
as clinical conditions did not improve he was
transferred to the Clinic of Infectious Disease
at the Hospital of Udine (FVG) where a diagnosis
of WNV infection was suspected.
On 3 Sep [2010], a serum sent for WNV
[serological testing] was positive for IgG
(1:1000) in immunofluorescence (IF) assay. A 2nd
blood test taken 12 days later was positive for
both IgM (1:10) and IgG (1:1000). He had never
been vaccinated against fellow fever or Japanese
encephalitis [viruses] and had not travelled
outside Italy in the last 6 months.
Blood samples were sent to the Regional Reference
Laboratory for West Nile virus (U.C.O. Hygiene
and Preventive Medicine, University of Trieste,
Italy) in according with the regional
surveillance system. The results were confirmed
by Regional and National referral centres
(Istituto Superiore di Sanit?; Rome, Italy).
After the recent active and passive surveillance
strategies for the monitoring of WNV in humans,
equines, birds and mosquitoes, increased cases in
animals has been reported in various Regions of
Italy but until now human cases have been
notified only in the northeast (Emilia-Romagna,
Veneto and Lombardy). We believe that the
serological tests for WNV should be available
also in peripheral centres, so that they can
follow the indications of the national monitoring
program of this emerging virus
--
Communicated by:
Anna Beltrame, MD
Clinic of Infectious Diseases
S.M. Misericordia University Hospital
P.le M. M. Misericordia nƒ 15, 33100 Udine, Italy
Claudio Scarparo, MD
Clinical Microbiology Laboratory,
S.M. Misericordia University Hospital, Udine, Italy
Tolinda Gallo, MD
Local Prevention Department of Health, Udine, Italy
ProMED
**********************************************
A ProMED-mail post
Date: Fri 22 Oct 2010
From: Anna Beltrame [edited]
beltrame.anna@aoud.sanita.fvg.it
We report the 1st case of West Nile [virus]
meningoencephalitis in Italy in 2010.
On 30 Aug 2010, a 41-year-old Algerian male
resident in Veneto (Santo Stino di Livenza) was
admitted to the Hospital of S. Vito al
Tagliamento in Friuli Venezia Giulia (FVG), where
his brother lives, complaining of fever (40 C
[104 F]) and vomiting for the last 3 days. The
patient appeared confused, disoriented, agitated
without a neck stiffness.
A lumbar puncture (LP) was performed and
disclosed a clear fluid with a white blood cell
(WBC) count of 40 cells/mm3, a glucose level of
147 mg/dL and a protein level of 0.7 g/L. Samples
of blood and cerebrospinal fluid (CSF) were taken
and tested for neurotropic agents but not for
West Nile virus (WNV). A presumptive diagnosis of
viral meningoencephalitis was made. After 3 days,
as clinical conditions did not improve he was
transferred to the Clinic of Infectious Disease
at the Hospital of Udine (FVG) where a diagnosis
of WNV infection was suspected.
On 3 Sep [2010], a serum sent for WNV
[serological testing] was positive for IgG
(1:1000) in immunofluorescence (IF) assay. A 2nd
blood test taken 12 days later was positive for
both IgM (1:10) and IgG (1:1000). He had never
been vaccinated against fellow fever or Japanese
encephalitis [viruses] and had not travelled
outside Italy in the last 6 months.
Blood samples were sent to the Regional Reference
Laboratory for West Nile virus (U.C.O. Hygiene
and Preventive Medicine, University of Trieste,
Italy) in according with the regional
surveillance system. The results were confirmed
by Regional and National referral centres
(Istituto Superiore di Sanit?; Rome, Italy).
After the recent active and passive surveillance
strategies for the monitoring of WNV in humans,
equines, birds and mosquitoes, increased cases in
animals has been reported in various Regions of
Italy but until now human cases have been
notified only in the northeast (Emilia-Romagna,
Veneto and Lombardy). We believe that the
serological tests for WNV should be available
also in peripheral centres, so that they can
follow the indications of the national monitoring
program of this emerging virus
--
Communicated by:
Anna Beltrame, MD
Clinic of Infectious Diseases
S.M. Misericordia University Hospital
P.le M. M. Misericordia nƒ 15, 33100 Udine, Italy
Claudio Scarparo, MD
Clinical Microbiology Laboratory,
S.M. Misericordia University Hospital, Udine, Italy
Tolinda Gallo, MD
Local Prevention Department of Health, Udine, Italy
ProMED
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