Dengue fever as autochthonous infectious disease in Italy: epidemiological, clinical and virological characteristics

• Published in: Travel medicine and infectious disease Vol. 62; p. 102762
• Main Authors: Vita, Serena, Lalle, Eleonora, Caputi, Priscilla, Faraglia, Francesca, D’Abramo, Alessandra, Bordi, Licia, De Carli, Gabriella, Sberna, Giuseppe, Giancola, Maria Letizia, Maffongelli, Gaetano, Mija, Cosmina, Antinori, Andrea, Cicalini, Stefania, Maggi, Fabrizio, Girardi, Enrico, Vairo, Francesco, Nicastri, Emanuele
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.11.2024; Elsevier
• Subjects: Autochthonous dengue; Dengue fever; Vector-borne diseases; autochthonous Dengue; Dengue fever; vector-borne diseases
• ISSN: 1477-8939; 1873-0442; 1873-0442
• DOI: 10.1016/j.tmaid.2024.102762

Since August to November 2023, 82 cases of autochthonous or non-travel related Dengue virus (DENV) infection have been reported in Italy, highlighting a concerning trend of local transmission. We describe the clinical and laboratory findings of 10 autochthonous DENV in the metropolitan area of Rome admitted to the Lazzaro Spallanzani National Institute for Infectious Diseases. Ten patients (3 males, 7 females; median age: 51) with classic dengue fever symptoms were admitted between August and November 2023. Laboratory tests confirmed dengue infection through DENV non-structural protein 1 and/or immunoglobulins (IgM/IgG) positive tests, moreover leukopenia, thrombocytopenia, elevated transaminases were detected. A subset of patients underwent extensive biological sampling, including real-time RT-PCR and immunofluorescence, to monitor DENV-RNA and antibody levels over 30 days. DENV-1 was detected in 8 patients and DENV-3 in 2. IgM antibodies were found in 7 patients at admission, and IgG antibodies in 4 by day 6. DENV RNA was consistently detected in blood within the first 8 days but was less common in saliva and urine. No DENV RNA was detected after day 24. These findings contribute to the understanding of the clinical course of DENV infection in a non-endemic setting as integrated epidemiological and clinical model to increase syndromic surveillance and timely diagnosis of DENV infections.