Reporting delays of chikungunya cases during the 2017 outbreak in Lazio region, Italy.


Journal

PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488

Informations de publication

Date de publication:
09 2023
Historique:
received: 14 04 2023
accepted: 22 08 2023
medline: 18 9 2023
pubmed: 14 9 2023
entrez: 14 9 2023
Statut: epublish

Résumé

Emerging arboviral diseases in Europe pose a challenge due to difficulties in detecting and diagnosing cases during the initial circulation of the pathogen. Early outbreak detection enables public health authorities to take effective actions to reduce disease transmission. Quantification of the reporting delays of cases is vital to plan and assess surveillance and control strategies. Here, we provide estimates of reporting delays during an emerging arboviral outbreak and indications on how delays may have impacted onward transmission. Using descriptive statistics and Kaplan-Meyer curves we analyzed case reporting delays (the period between the date of symptom onset and the date of notification to the public health authorities) during the 2017 Italian chikungunya outbreak. We further investigated the effect of outbreak detection on reporting delays by means of a Cox proportional hazard model. We estimated that the overall median reporting delay was 15.5 days, but this was reduced to 8 days after the notification of the first case. Cases with symptom onset after outbreak detection had about a 3.5 times higher reporting rate, however only 3.6% were notified within 24h from symptom onset. Remarkably, we found that 45.9% of identified cases developed symptoms before the detection of the outbreak. These results suggest that efforts should be undertaken to improve the early detection and identification of arboviral cases, as well as the management of vector species to mitigate the impact of long reporting delays.

Sections du résumé

BACKGROUND
Emerging arboviral diseases in Europe pose a challenge due to difficulties in detecting and diagnosing cases during the initial circulation of the pathogen. Early outbreak detection enables public health authorities to take effective actions to reduce disease transmission. Quantification of the reporting delays of cases is vital to plan and assess surveillance and control strategies. Here, we provide estimates of reporting delays during an emerging arboviral outbreak and indications on how delays may have impacted onward transmission.
METHODOLOGY/PRINCIPAL FINDINGS
Using descriptive statistics and Kaplan-Meyer curves we analyzed case reporting delays (the period between the date of symptom onset and the date of notification to the public health authorities) during the 2017 Italian chikungunya outbreak. We further investigated the effect of outbreak detection on reporting delays by means of a Cox proportional hazard model. We estimated that the overall median reporting delay was 15.5 days, but this was reduced to 8 days after the notification of the first case. Cases with symptom onset after outbreak detection had about a 3.5 times higher reporting rate, however only 3.6% were notified within 24h from symptom onset. Remarkably, we found that 45.9% of identified cases developed symptoms before the detection of the outbreak.
CONCLUSIONS/SIGNIFICANCE
These results suggest that efforts should be undertaken to improve the early detection and identification of arboviral cases, as well as the management of vector species to mitigate the impact of long reporting delays.

Identifiants

pubmed: 37708121
doi: 10.1371/journal.pntd.0011610
pii: PNTD-D-23-00458
pmc: PMC10501639
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0011610

Informations de copyright

Copyright: © 2023 Manica et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Mattia Manica (M)

Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy.
Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.

Giovanni Marini (G)

Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy.
Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.

Angelo Solimini (A)

Department of Public Health and Infectious Diseases, Università di Roma SAPIENZA, Rome, Italy.

Giorgio Guzzetta (G)

Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.

Piero Poletti (P)

Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.

Paola Scognamiglio (P)

Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani"; IRCCS, Rome, Italy.

Chiara Virgillito (C)

Department of Public Health and Infectious Diseases, Università di Roma SAPIENZA, Rome, Italy.

Alessandra Della Torre (A)

Department of Public Health and Infectious Diseases, Università di Roma SAPIENZA, Rome, Italy.

Stefano Merler (S)

Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.

Roberto Rosà (R)

Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy.
Center Agriculture Food Environment, University of Trento, San Michele all'Adige (TN), Italy.

Francesco Vairo (F)

Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani"; IRCCS, Rome, Italy.

Beniamino Caputo (B)

Department of Public Health and Infectious Diseases, Università di Roma SAPIENZA, Rome, Italy.

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