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EU Parliament Office for Science and Technology- AVIESAN Work shop Brussels, 19 June 2012

EU Parliament Office for Science and Technology- AVIESAN Work shop Brussels, 19 June 2012. Arboviral diseases and the threats for Europe. Herve Zeller Emerging and vector-borne disease programme. Arthropod-borne diseases. Biological transmission Viremic natural host

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EU Parliament Office for Science and Technology- AVIESAN Work shop Brussels, 19 June 2012

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  1. EU Parliament Office for Science and Technology- AVIESANWork shop Brussels, 19 June 2012 Arboviraldiseases and the threats for Europe • Herve Zeller Emerging and vector-borne disease programme

  2. Arthropod-borne diseases • Biological transmission • Viremic natural host • Competent vector • Sensitive host • Mechanical transmission

  3. Why do webother? Blood and tissue donation Disease: Increase Publicconcern Limited knowledge Outbreaks: media attention Control issues Sensitive issue

  4. Some examples of emergence in Europe Bluetongue 2006-2007 multi-countries Schmallenberg 2011 multi-countries Crimean Congo hemorrhagicfever Turkey2002, Greece 2008 India 2009, Spain 2011 West Nile fever Italy 2008, GreeceTurkey 2010 Chikungunyafever Italy 2007 France 2010 Dengue France 2010

  5. Vector-borne diseases Braks et al. (2011) Towards an integrated approach in surveillance of vector-borne diseases in Europe. Parasites & Vectors 04:192

  6. Dengue • Arbovirosis in tropical/subtropical regions (Asia, Americas) • Expansion in Africa, Middle-East • 1st cause of hospitalisation of children in South East Asia • Emerging /reemergingdisease (WHO, 1993) • Average number of Dengue cases • reported to WHO per year Source: http://www.pdvi.org/about_dengue/GBD.asp Source: http://www.pdvi.org/about_dengue/GBD.asp

  7. Global Dengue Risk map 2012 Simmons CP et al. N Engl J Med 2012;366:1423-1432

  8. Chikungunya «whichbendsup» in Makondedialect Febrileillnesswith arthralgia+++ (long lasting) Togaviridae Alphavirus 100 nm O Schwartz, Pasteur Institute

  9. Chikungunyaoutbreak2005-2006 La Reunion Population: 750 000 2006 • Emergence of a virus with a mutation that increases the rate of transmission by the local mosquito vectors • major outbreak • infection of 35% population 2005

  10. Chikungunya outbreak in Italy, Aug 2007: Location of the outbreak Emilia-Romagna region

  11. Mosquito vector spread distribution Are Aedesalbopictusor other mosquito species from northern Italy competent to sustain new arboviral outbreaks? Medical and Veterinary Entomology (2010) 24, 83–87 Talbalhi S et al

  12. Invasive mosquito species in Europe Ae. aegypti Ae. albopictus Ae. japonicus Ae. koreicus

  13. West Nile fever • Natural cycle between birds • and mosquitoes • Human infection • Asymptomatic infections (>70%) • Mild febrile illness • Neuro-invasive illness in 1 out of 150-300 cases (mostly in elderly) with fatalities

  14. Affected countries/areas in 2011 (/2010) Risk of transmission through blood donations * Case fatality rate among patients with neuroinvasive illness: 18% (elderly)

  15. Cases in horses: Spain, Italy, Greece…

  16. Tick-Borne Encephalitis Annually 2,000–3,000 TBE-cases reported from the European countries. 6,000–8,000 cases reported from Russia Vaccine available • Average number of cases per 100.000 inhabitants • Level of endemicity Will be notifiable in 2013

  17. Crimean Congo Haemorrhagic fever Clinicaldescription: Crimea 1944-45 Virus isolation :1956: human in Congo 1967: ticks in Crimea, Russia CFR 5=30% Nosocomial infections, BSL 4 virus No disease in animals Hyalommamarginatum EID 2010, 16, No. 8 • August 2010 K Zakhashvili et al

  18. Crimean-Congo Hemorrhagic fever: a Re-emerging disease in Europe • 2008 • Greece • Bulgaria • Turkey • Russia • Nosocomial infections • Kosovo 2001 • Bulgaria 2008 • Turkey 2008 • Bulgaria 2009 www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18952 ; 18845; 18953

  19. Distribution of Crimean-Congo Hemorrhagic Fever virus CCHFV isolation Serology + Hyalomavectors Hyalomavectors Adapted from Bray, 2007 and Ergonul, 2007

  20. ECDC mission • Provides Member States with access to expertise, topical assessments of disease risks and decision support tools with the latest scientific knowledge Addedvalue for Europe ECDC’s role in shaping the EU research agenda • Identify, assess and communicate current and emerging threats to human health from communicable diseases.

  21. Surveillance and control of vector-borne diseases ENVIRONMENT CONTROL PREVENTION SUSCEPTIBLEHOST COMPETENT VECTOR SURVEILLANCE PATHOGEN

  22. Conclusions • Vector-borne diseases are a growing concern in Europe • Orphan diseases, lack of knowledge • Surveillance not uniform in EU, not always mandatory • Diagnostic tools to improve • Control issues: Development of more effective tools to prevent and control outbreaks • New developments for antiviral drugs and vaccines  Promote integrated approaches for a better understanding and knowledge on pathogen ecology in a changing environment to improve risk assessment and predictive models regarding potential threats, targeted preventive measures and control activities

  23. Thank for your attention

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