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Culex pipiens (Linnaeus), one of the most abundant mosquito species in Europe, plays a crucial role in the endemic transmission of West Nile virus and caused the large outbreak with1600 human cases in 2018. Although evidence of resistance to pyrethroids has been reported for Cx. pipiens populations from Spain and Greece, resistance monitoring has been largely neglected in Italy. Herein, we investigate susceptibility of Italian Cx. pipiens populations to the pyrethroids permethrin and deltamethrin. Results from WHO-tube-bioassays revealed mortalities ranging from 14-54%, indicating high levels of resistance, in four out of 10 populations exposed to permethrin (0.75%) and of 63% in one of three populations exposed to deltamethrin (0.05%). Reduced susceptibility (mortality98%) was detected in almost all other populations. A clear association is shown between the resistant phenotype and the presence of kdr-alleles in position 1014 of the VSSC, strongly suggesting its role in reducing susceptibility. The study provides the first evidence of pyrethroid-resistance in Italian Cx. pipiens populations and reports levels of resistance paralleled in the European region only in Turkey. This highlights the urgent need to implement insecticide-resistance management plans to restore the efficacy of the nowadays only chemical weapon available to control arbovirus transmission in Europe.

We reported in this work the detection of three Arboviruses (Arthropod-borne viruses) in mosquitoes collected in Emilia-Romagna in 2021. In addition to West Nile and Usutu viruses, which were reported from more than 10 years in the study area, we detected and isolated Tahyna virus (TAHV).

The monitoring of Aedes urban species is usually conducted by ovitraps, which can provide a good estimate of population density at low cost and relatively easy management. When the monitoring network is managed by many operators, as in the case of the Emilia-Romagna regional plan, it becomes necessary to develop a quality control methodology capable of highlighting the possible data incoherency and ensuring that the monitoring system provides reliable data. This paper presents the procedure applied in the egg counting phase as developed in Emilia-Romagna in order to check the data quality and validate the data before being included in the database. Several steps have been identified and protocols developed to serve quality control such as training of technicians and intralaboratory quality check, daily random double counting of Masonite paddles and interlaboratory periodic comparison. The qualitative test showed that all operators were able to distinguish Aedes albopictus eggs from other mosquito species eggs. The quantitative test showed significant differences between the 11 operators, with a relative error resulting in the range of 0.1–25.8%. The daily internal double counting of randomly extracted Masonite slides was performed by the coordinator showing a relative error in the range 2.47–2.63% without statistical differences, confirming a good alignment of the operators with the coordinator throughout the monitoring period. The interlaboratory comparison trial produced an average relative error of 7.20% showing a sufficient alignment between the three laboratories. Moreover a new time-saving methods in egg counting was developed and tested in real condition.

The relevant ecological changes due to the anthropological pressure on the planet is causing reactions in the biological systems, which we must understand and characterize at the local scale to assist the adoption of suitable decisions in the public health risk management. The project presented in this paper is focused on the vector-borne diseases, mainly transmitted by mosquitoes. The species of mosquito currently playing an active role of public health importance in Italy are Aedes albopictus, as a vector of Chikungunya, Dengue and Zika viruses, as well as Culex pipiens, as a vector of West Nile and Usutu viruses. Predictive models are indicating the risk of introduction and establishment in the Mediterranean basin of Aedes aegypti, which is causing a mayor concern. The project has been conducted by the Emilia-Romagna, Piemonte, Veneto, Marche and Sicilia Regions, together with the Italian National Health Institute. The aim was to develop and pilot testing new approaches and technological tools possibly assisting the public health system in the management of the risk. The activities have been organized on six specific objectives: 1. Development and field testing of guidelines for the surveillance of invasive mosquito species; 2. Creation of risk maps for Chikungunya, Dengue and Zika viruses based on the quantitative monitoring of Aedes albopictus populations; 3. Shaping web platform models assisting the sharing of data from/to actors involved in the integrated surveillance of West Nile at the regional level; 4. Developing communication formats dealing with vector borne diseases addressing citizen and specific categories; 5. Approaching the cost-benefit analysis in the view to assist decision makers; 6. Sero-surveillance on arboviruses not included in the Ministry directive (Tick Borne Encephalitis and Toscana virus). The achieved results are presented and the acquired experience is made available to promote the adoptions on a larger scale of the approaches and methods to be certainly adapted in the specific contexts. The one health approach seems suitable to address the necessities emerging in this field by taking into consideration the different triggers shaping the dynamics we are observing.

In the last decades, the colonization of Mediterranean Europe and of other temperate regions by Aedes albopictus created an unprecedented nuisance problem in highly infested areas and new public health threats due to the vector competence of the species. The Sterile Insect Technique (SIT) and the Incompatible Insect Technique (IIT) are insecticide-free mosquito-control methods, relying on mass release of irradiated/manipulated males, able to complement existing and only partially effective control tools. The validation of these approaches in the field requires appropriate experimental settings, possibly isolated to avoid mosquito immigration from other infested areas, and preliminary ecological and entomological data. We carried out a 4-year study in the island of Procida (Gulf of Naples, Italy) in strict collaboration with local administrators and citizens to estimate the temporal dynamics, spatial distribution, and population size of Ae. albopictus and the dispersal and survival of irradiated males. We applied ovitrap monitoring, geo-spatial analyses, mark-release-recapture technique, and a citizen-science approach. Results allow to predict the seasonal (from April to October, with peaks of 928–9,757 males/ha) and spatial distribution of the species, highlighting the capacity of Ae. albopictus population of Procida to colonize and maintain high frequencies in urban as well as in sylvatic inhabited environments. Irradiated males shown limited ability to disperse (mean daily distance travelled, Author summary Mosquitoes represent a nuisance as well as public health risk due to their ability to transmit pathogens to humans. The Asian tiger mosquito Aedes albopictus is an invasive species nowadays established in all Mediterranean countries, reaching highest abundance in Italy. Innovative control approaches have been proposed to complement conventional ones and to increase the success of the fight against this aggressive day-biting species, but still need to be validated in the field. Small islands are ideal places for these validation experiments as they are naturally protected by the spill over of mosquitoes from neighbouring untreated areas. The island of Procida, in the gulf of Naples (Italy), has the right ecological characteristics (e.g., homogeneous landscape and high densities of human and Ae. albopictus populations) to represent an ideal experimental site. In collaboration with the Municipality and the residents we obtained relevant data on the mosquito distribution and seasonality on the island and performed preliminary experiments, creating an instrumental baseline information which will facilitate the effective testing of novel control schemes.

Background Diflubenzuron (DFB) is one of the most used insecticides in mosquito larval control including that of Culex pipiens, the proven vector of the recent West Nile Virus epidemics in Europe. Two mutations (I1043L and I1043M) in the chitin synthase (CHS) putative binding site of DFB have been previously reported in Cx. pipiens from Italy and associated with high levels of resistance against this larvicide. Methodology/Principal findings Here we report the identification of a third mutation at the same I1043 position of the CHS gene resulting in the substitution of Isoleucine to Phenylalanine (I1043F). This mutation has also been found in agricultural pests and has been functionally validated with genome editing in Drosophila, showing to confer striking levels (>15,000 fold) of DFB resistance. The frequency of the I1043F mutation was found to be substantially higher in Cx. pipiens mosquitoes surviving DFB doses largely exceeding the recommended field dose, raising concerns about the future efficient use of this insecticide. We monitored the presence and frequency of DFB mutations in Cx. pipiens mosquitoes from several Mediterranean countries, including Italy, France, Greece, Portugal and Israel. Among the Cx. pipiens populations collected in Northern Italy all but one had at least one of the three DFB mutations at allele frequencies reaching 93.3% for the I1043M, 64.8% for the I1043L and 10% for the I1043F. The newly reported I1043F mutation was also identified in two heterozygote individuals from France (4.2% allelic frequency). In contrast to Italy and France, no DFB resistant mutations were identified in the Cx. pipiens mosquitoes sampled from Greece, Portugal and Israel. Conclusions/Significance The findings of our study are of major concern for mosquito control programs in Europe, that rely on the use of a limited number of available larvicides, and highlight the necessity for the development of appropriate Insecticide Resistance Management (IRM) programs, to ensure the sustainable use of DFB., Author summary Diflubenzuron is one of the main larvicides used for the control of the West Nile Virus vector Culex pipiens in the Mediterranean. However, the efficiency of control is now under threat due to the selection of insecticide resistance. Two point mutations were previously identified at the Chitin synthase and shown to confer low and high levels of resistance and a diagnostic was developed to monitor the trait. This study reports the identification of a third mutation associated with high levels of diflubenzuron resistance in Italy. This mutation was also detected in France, whereas no resistance mutations were found in Cx. pipiens mosquitoes sampled from Greece, Portugal and Israel. The findings are of major concern for mosquito control programs in S. Europe, which rely on the use of a limited number of larvicides.

This study evaluated the vector competence of Aedes albopictus in transmitting USUV after oral infection under laboratory conditions. Ae. albopictus showed a low vector competence for USUV, although the positive body sample found with a very high number of viral copies at one week post infection indicates that a replication in the mosquito body can occur, and that USUV can escape the midgut barrier. Field data from an extensive entomological arboviruses surveillance program showed a relevant incidence of Ae. albopictus USUV positive pools in the period 2009-2012 while all pools were negative from 2013 on. No conceivable explanation regarding this field evidence was addressed, suggesting that attention must be paid to the trend of development of this vector-pathogen association, being aware of the potential rapid arbovirus' adaptation to new vectors, to prevent possible new disease's emergence.

Background West Nile virus (WNV) transmission was much greater in 2018 than in previous seasons in Europe. Focusing on Emilia-Romagna region (northern Italy), we analyzed detailed entomological and epidemiological data collected in 2013–2018 to quantitatively assess environmental drivers of transmission and explore hypotheses to better understand why the 2018 epidemiological season was substantially different than the previous seasons. In particular, in 2018 WNV was detected at least two weeks before the observed circulation in 2013–2017 and in a larger number of mosquito pools. Transmission resulted in 100 neuroinvasive human cases in the region, more than the total number of cases recorded between 2013 and 2017. Methodology We used temperature-driven mathematical models calibrated through a Bayesian approach to simulate mosquito population dynamics and WNV infection rates in the avian population. We then estimated the human transmission risk as the probability, for a person living in the study area, of being bitten by an infectious mosquito in a given week. Finally, we translated such risk into reported WNV human infections. Principal findings The estimated prevalence of WNV in the mosquito and avian populations were significantly higher in 2018 with respect to 2013–2017 seasons, especially in the eastern part of the region. Furthermore, peak avian prevalence was estimated to have occurred earlier, corresponding to a steeper decline towards the end of summer. The high mosquito prevalence resulted in a much greater predicted risk for human transmission in 2018, which was estimated to be up to eight times higher than previous seasons. We hypothesized, on the basis of our modelling results, that such greater WNV circulation might be partially explained by exceptionally high spring temperatures, which have likely helped to amplify WNV transmission at the beginning of the 2018 season., Author summary West Nile virus (WNV) is one of the most recent emerging mosquito-borne diseases in Europe and North America. While most human infections are asymptomatic, about 1% of them can result in severe neurological diseases which might be fatal. WNV transmission was unusually greater in 2018 than in previous years in many European countries, resulting in a large number of human infections. Focusing on Emilia-Romagna region (Italy), we developed an epidemiological model informed by entomological data; through that we found that exceptionally high spring temperatures might have contributed at amplifying WNV transmission at the beginning of the season, causing greater WNV prevalence in mosquito and avian populations during the summer, which resulted in a higher estimated risk for human transmission. Thus, weather anomalies at the beginning of the mosquito breeding season, which are likely to become more common under the projected scenarios of climate change, might act as an early warning signal for public health authorities, enabling them to design efficient surveillance and prevention strategies.

Introduction Aedes albopictus (Skuse) is an important vector of arboviral diseases, including dengue, chikungunya and Zika virus disease. Monitoring insecticide resistance and mechanisms by which the mosquito develops resistance is crucial to minimise disease transmission. Aim To determine insecticide resistance status and mechanisms in Ae. albopictus from different geographical regions. Methods We sampled 33 populations of Ae. albopictus from Asia, Europe and South America, and tested these for susceptibility to permethrin, a pyrethroid insecticide. In resistant populations, the target site for pyrethroids, a voltage-sensitive sodium channel (Vssc) was genotyped. Three resistant sub-strains, each harbouring a resistance allele homozygously, were established and susceptibilities to three different pyrethroids (with and without a cytochrome P450 inhibitor) were assayed. Results Most populations of Ae. albopictus tested were highly susceptible to permethrin but a few from Italy and Vietnam (4/33), exhibited high-level resistance. Genotyping studies detected a knockdown resistance (kdr) allele V1016G in Vssc for the first time in Ae. albopictus. Two previously reported kdr alleles, F1534C and F1534S, were also detected. The bioassays indicated that the strain homozygous for the V1016G allele showed much greater levels of pyrethroid resistance than other strains harbouring F1534C or F1534S. Conclusion The V1016G allele was detected in bothAsian and Italian Ae. albopictus populations, thus a spread of this allele beyond Italy in Europe cannot be ruled out. This study emphasises the necessity to frequently and regularly monitor the V1016G allele in Ae. albopictus, particularly where this mosquito species is the main vector of arboviruses.

International audience; Insecticide resistance is a major threat for vector control and prevention of mosquito borne diseases. In the Culex pipiens mosquitoes, resistance against diflubenzuron (DFB) was firstly detected in Ravenna (Emilia-Romagna region, Northern Italy), in 2015. The resistant phenotypes were associated with two mutations, I1043 M and I1043 L, at the amino acid 1043 of the chitin synthase gene. In this study, we monitored the presence, frequency and geographical distribution of the DFB resistant mutations in Cx. pipiens populations from Northern Italy, and in populations from Greece and France. In the Emilia-Romagna region, the resistant mutations were detected in 20 out of the 30 populations analysed, reaching allelic frequencies over 70%. The presence and distribution of the resistance mutations was highly focal, with a clear pattern of increasing resistant allelic frequencies moving from the Western towards the Eastern provinces of Emilia-Romagna. Contrary to Italy, DFB resistant alleles were not detected in the Cx. pipiens mosquitoes sampled from Greece and France. Following statistical, literature and bibliographical database analyses on the history of DFB insecticide use in the study areas, we suggest that the selection pressures from the intense agricultural DFB applications occurring throughout the' 80-'90 s against orchard pests, followed, from 2000s onwards by mosquito control DFB applications, may account for the high mutation frequencies observed in the Cx. pipiens populations of the Eastern provinces of Emilia-Romagna. The findings are of major concern for public health in Italy and Europe, as DFB remains a very important insecticide used for controlling arbovirus mosquito vectors, where alternative larvicides are extremely limited.

Background The highly invasive mosquito species Aedes albopictus has become a major health concern in temperate areas due to its role as vector of exotic arboviruses. Pyrethroid insecticides represent the main tools for limiting the circulation of such mosquito-borne viruses. The present work aim to extend previous reports on phenotypic pyrethroid-resistance in European Ae. albopictus, to identify its genetic basis and to monitor the geographical distribution of resistant genotypes, with a particular focus on sites experiencing the 2017 chikungunya outbreak in Italy. Results Bioassays, performed according to World Health Organization protocols, showed full susceptibility to deltamethrin (concentration = 0.05%) and varying levels of resistance to permethrin (0.75%) and/or α-cypermethrin (0.05%) across Italy, with highest levels in the core of the 2017 chikungunya outbreak. Partial genotyping of the VSSC gene revealed widespread distribution of V1016G mutation and confirmed its association with pyrethroid resistance. Conclusion The results obtained show that the condition for the spread of pyrethroid resistance in Ae. albopictus in Europe exists under strong selective pressure due to intensive insecticide spraying to control exotic arbovirus outbreak or high levels of nuisance. The results draw attention to the need for an evidence-based implementation of mosquito nuisance control, taking insecticide resistance management into consideration. © 2019 Society of Chemical Industry.

The sand flies are the biological vectors of a variety of viruses belonging to the Phlebovirus genus. As several of these viruses, like Toscana virus, are important agents of diseases in humans, the definition the phleboviruses circulating in a particular area is an important health issue. This work presents results obtained between 2013 and 2016, by testing 25,853 field-collected sand flies, sampled at 50 sites in the Northern edge of the Apennine Mountains, in Emilia-Romagna and Lombardy regions (Italy). Isolation of the three reassortant Ponticelli I, II, and III viruses was successful from five pools of sand flies. These results, and phylogenetic analysis made by obtained sequences, suggest the presence of eight different viruses: Toscana virus, Fermo-like virus, Corfou virus, Ponticelli viruses, and two unknown putative viruses. The co-circulation of different phlebovirus reported in this study, indicate a very dynamic and complex situation, which deserves a more detailed investigation to characterize their possible pathogenicity to humans and animals.

Background Different phleboviruses are important pathogens for humans; most of these viruses are transmitted by sand flies. An increasing number of new phleboviruses have been reported over the past decade, especially in Mediterranean countries, mainly via their detection in sand flies. Results At least five different phleboviruses co-circulated in sand flies that were collected in three sites in Emilia-Romagna (Italy) in the summer of 2013. The well-known Toscana virus (TOSV) was isolated; three new, closely related phleboviruses differing in their M segments and tentatively named Ponticelli I, Ponticelli II and Ponticelli III virus, respectively, were isolated; a fifth putative phlebovirus, related to the sand fly fever Naples phlebovirus species, was also detected. The co-circulation, in a restricted area, of three viruses characterized by different M segments, likely resulted from reassortment events. According to the phylogenetic analysis of complete genome sequences, the TOSV belongs to clade A, together with other Italian isolates, while the Ponticelli viruses fall within the Salehabad phlebovirus species. Conclusions Results highlight an unexpected diversity of phleboviruses that co-circulate in the same area, suggesting that interactions likely occur amongst them, that can present challenges for their correct identification. The co-circulation of different phleboviruses appears to be common, and the bionomics of sand fly populations seem to play a relevant role. Such a complex situation emphasizes the need for detailed investigations of the biology of these viruses to better characterize their pathogenic potential for mammals, including humans. Electronic supplementary material The online version of this article (10.1186/s13071-018-2668-0) contains supplementary material, which is available to authorized users.

Background Culex pipiens is the major vector of West Nile virus in Europe, and is causing frequent outbreaks throughout the southern part of the continent. Proper empirical modelling of the population dynamics of this species can help in understanding West Nile virus epidemiology, optimizing vector surveillance and mosquito control efforts. But modelling results may differ from place to place. In this study we look at which type of models and weather variables can be consistently used across different locations. Methods Weekly mosquito trap collections from eight functional units located in France, Greece, Italy and Serbia for several years were combined. Additionally, rainfall, relative humidity and temperature were recorded. Correlations between lagged weather conditions and Cx. pipiens dynamics were analysed. Also seasonal autoregressive integrated moving-average (SARIMA) models were fitted to describe the temporal dynamics of Cx. pipiens and to check whether the weather variables could improve these models. Results Correlations were strongest between mean temperatures at short time lags, followed by relative humidity, most likely due to collinearity. Precipitation alone had weak correlations and inconsistent patterns across sites. SARIMA models could also make reasonable predictions, especially when longer time series of Cx. pipiens observations are available. Conclusions Average temperature was a consistently good predictor across sites. When only short time series (~ 4 years) are available, SARIMAs can provide better statistical descriptions of Cx. pipiens dynamics, without the need for further weather variables. This suggests that density dependence is also an important determinant of Cx. pipiens dynamics. Electronic supplementary material The online version of this article (10.1186/s13071-017-2484-y) contains supplementary material, which is available to authorized users.

The selection of the ideal trap for arbovirus surveillance is an issue of primary importance to increase the sensitivity of virus detection and the cost-effectiveness of the entomological surveillance. During the summer 2011, the effectiveness of five types of mosquito traps (CDC gravid trap, CO2(-)baited trap, BG-Sentinel™ and two experimental prototypes) to attract females potentially infected with West Nile virus were assessed. The study was carried out in three natural wetland sites located in the Emilia-Romagna Region (Northern Italy), using a Latin square scheme. Single night collections of adult females were performed and determination of species and physiological state (gravid, nulliparous or parous) was made upon return to the laboratory. The species most frequently collected in the gravid trap was Culex pipiens sl. L., being gravid females the large majority of the individuals. Species diversity was much higher in CO2(-)baited traps, which may therefore enable a more comprehensive description of the vector species composition and their role in arboviruses circulation. Our findings indicate that gravid traps can be a valid tool and should be integrated in the West Nile virus surveillance system in the Emilia-Romagna region, mainly based on collections made with CO2-baited traps.

The dispersal and survival of laboratory-reared Aedes albopictus Skuse males were investigated during the summer of 2007 in three Northern Italy urban localities by mark-release-recapture techniques. Two marking methods were compared: one group of males was dusted with fluorescent pigments on the body (FP), and the other group was obtained from a strain whose natural infection of Wolbachia had been removed (WB0). FP- and WB0-marked males were released as adults and pupae, respectively, in one fixed station at each locality. Recaptures were performed by skilled technicians, within a radius of 350 m from the release site, on days 4, 5, and 7 after the release, and the males were collected while flying around the technician's body or in swarms. Recapture rates ranged from 0.63 to 4.72% for FP males and from 2.39 to 11.05% for WB0 males. The mean distance traveled for WB0 males was significantly higher than for FP males; no difference was observed between the dispersal distance measured for the males recaptured on human host versus males recaptured while swarming. No further increase of the dispersal occurred during the postrelease period investigated (from day 4 to day 7 after release). The mean survival rate at the release was 0.51 for FP-marked males and 0.81 for WB0 males. The data obtained are discussed for their significance in planning sterile insect technique programs against Ae. albopictus.

Recently, Italy-particularly the Emilia-Romagna region-was the location of consecutive outbreaks of human diseases caused by the arboviruses chikungunya virus and West Nile virus. The two outbreaks, spread by different species of mosquitoes, were not related, but pointed out the lack of an arboviral surveillance program in this region. Beginning in 2007 entomological surveillance was initiated in the Emilia-Romagna region, and in 2008 the program was improved and extended at Lombardia region. Using CO(2)-baited traps, 65,292 mosquitoes were collected; pooled by date of collection, location, and species; macerated manually; and tested by reverse transcription (RT)-polymerase chain reaction for the presence of alphaviruses, orthobunyaviruses, and flaviviruses. Amplicons were sequenced and employed for identification of viral RNA by basic local alignment search tool search in GenBank. Results of these assays showed (1) the presence of West Nile virus in two pools of Culex pipiens mosquitoes, (2) the presence of RNA of two orthobunyaviruses, Tahyna virus in a pool of Ochlerotatus caspius mosquitoes and Batai virus in a pool of Anopheles maculipennis mosquitoes, and (3) the presence of flavivirus RNAs in pools of Oc. caspius, Aedes albopictus, and Aedes vexans mosquitoes; the sequences of these amplicons were most closely related to flaviviruses that have been detected only in mosquitoes and had no recognized vertebrate host (Aedes flavivirus, Culex flavivirus, and Kamiti River virus).

The impact of weather variables on Culex pipiens L. (Diptera: Culicidae) population dynamics in the Po Valley, Northern Italy, a densely populated region containing the largest industrial and agricultural areas in Italy, was investigated. Monitoring of mosquitoes was carried out by using CO(2)-baited traps without light, collecting data weekly from 1700 to 0900 hours during the period May-September, from 1997 to 2011. Daily minimum, average, and maximum relative humidity; daily minimum, maximum, and average temperature; rainfall; and hydroclimatic balance (rainfall-potential evapotranspiration) were obtained from three weather stations within the surveillance zone. The average population dynamic trend over the 15-yr period showed a bell-shaped curve with a major peak in June and a secondary peak at the end of August in the rural areas, whereas bimodality was not evidenced in the urban areas. The correlation analyses showed that the mosquito seasonal population and the population in the period of maximum West Nile virus circulation (August-September) was mostly affected by the relative humidity registered from March to July, particularly in May, and, to a lower extent, also by hydroclimatic balance registered in April-July, and by the rainfall occurred in June-July. In addition, the rate of increase of the population during the spring months influenced the development of the mosquito population of the following months.

Since 2008 the Emilia-Romagna Regional public health authority activated a regional Plan for arbovirosis surveillance and control, focused on Chikungunya, Dengue and West Nile. The Plan integrates sanitary, entomological and veterinary surveillance allowing a prompt adoption of efficient measures, aiming at the prevention and reduction of arbovirosis transmission risk. Following the 2007 Chikungunya outbreak, no autochthonous Chikungunya or Dengue cases has been registered, while an increase of confirmed imported cases of Dengue and Chikungunya has been observed. The integrated surveillance system allowed a prompt, appropriate and efficient intervention in 98.2% of imported suspected cases. The humanWNND (West Nile Neuroinvasive Disease) surveillance reported confirmed cases in 2008, 2009 and then in 2013 and 2014. In all cases the entomological and ornithological surveillance detected WNV circulation well in advance respect to the appearance of the first human case. The integration of information provided by different surveillance sources allows to evaluate, even through the vector index (VI) calculation, the risk of transmission, to optimize preventive measures on blood, tissues and organs donation and to implement further measures of vector fight.

Aedes albopictus (Skuse) is an invasive mosquito species that has spread to many countries in temperate regions bordering the Mediterranean basin, where it is becoming a major public health concern. A good knowledge of the thermal features of the most productive breeding sites for Ae. albopictus is crucial for a better estimation of the mosquitoes' life cycle and developmental rates. In this article, we address the problem of predicting air temperature in three microhabitats common in urban and suburban areas and the air and water temperature inside an ordinary catch basin, which is considered the most productive breeding site for Ae. albopictus in Italy. Temperature differences were statistically proven between the three microhabitats and between the catch basin external and internal temperature. The impacts on the developmental rates for each life stage of Ae. albopictus were tested through a parametric function of the temperature, and the aquatic stages resulted as being the most affected using the specific temperature inside a typical catch basin instead of a generic air temperature. The impact of snow cover on the catch basin internal temperature, and consequently on the mortality of diapausing eggs, was also evaluated. These data can be useful to improve epidemiological models for a better prediction of Ae. albopictus seasonal and population dynamics in central-northern Italian urban areas.

West Nile virus (WNV) is a recently re-emerged health problem in Europe. In Italy, an increasing number of outbreaks of West Nile disease, with occurrences of human cases, have been reported since 2008. This is particularly true in northern Italy, where entomological surveillance systems have been implemented at a regional level. The aim of this study was to use, for the first time, all the entomological data collected in the five regions undergoing surveillance for WNV in northern Italy to characterize the viral circulation (at a spatial and temporal scale), identify potential mosquito vectors, and specify relationships between virus circulation and meteorological conditions. In 2013, 286 sites covering the entire Pianura Padana area were monitored. A total of 757,461 mosquitoes were sampled. Of these, 562,079 were tested by real-time PCR in 9,268 pools, of which 180 (1.9%) were positive for WNV. The largest part of the detected WNV sequences belonged to lineage II, demonstrating that, unlike those in the past, the 2013 outbreak was mainly sustained by this WNV lineage. This surveillance also detected the Usutu virus, a WNV-related flavivirus, in 241 (2.6%) pools. The WNV surveillance systems precisely identified the area affected by the virus and detected the viral circulation approximately two weeks before the occurrence of onset of human cases. Ninety percent of the sampled mosquitoes were Culex pipiens, and 178/180 WNV-positive pools were composed of only this species, suggesting this mosquito is the main WNV vector in northern Italy. A significantly higher abundance of the vector was recorded in the WNV circulation area, which was characterized by warmer and less rainy conditions and greater evapotranspiration compared to the rest of the Pianura Padana, suggesting that areas exposed to these conditions are more suitable for WNV circulation. This observation highlights warmer and less rainy conditions as factors able to enhance WNV circulation and cause virus spillover outside the sylvatic cycle.

Since 2013 in Emilia-Romagna, Italy, surveillance information generated in the public health and in the animal health sectors has been shared and used to guide public health interventions to mitigate the risk of West Nile virus (WNV) transmission via blood transfusion. The objective of the current study was to identify and estimate the costs and benefits associated with this One Health surveillance approach, and to compare it to an approach that does not integrate animal health information in blood donations safety policy (uni-sectoral scenario). Costs of human, animal, and entomological surveillance, sharing of information, and triggered interventions were estimated. Benefits were quantified as the averted costs of potential human cases of WNV neuroinvasive disease associated to infected blood transfusion. In the 2009–2015 period, the One Health approach was estimated to represent a cost saving of €160,921 compared to the uni-sectoral scenario. Blood donation screening was the main cost for both scenarios. The One Health approach further allowed savings of €1.21 million in terms of avoided tests on blood units. Benefits of the One Health approach due to short-term costs of hospitalization and compensation for transfusion-associated disease potentially avoided, were estimated to range from €0 to €2.98 million according to the probability of developing WNV neuroinvasive disease after receiving an infected blood transfusion.

Predicting West Nile virus (WNV) circulation and the risk of WNV epidemics is difficult due to complex interactions of multiple factors involved. Surveillance systems that timely detect virus activity in targeted areas, and allow evidence-based risk assessments may therefore be necessary. Since 2009, a system integrating environmental (mosquitoes and birds) and human surveillance has been implemented and progressively improved in the Emilia-Romagna region, Italy. The objective is to increase knowledge of WNV circulation and to reduce the probability of virus transmission via blood, tissue and organ donation. As of 2013, the system has shown highly satisfactory results in terms of early detection capacity (the environmental surveillance component allowed detection of WNV circulation 3–4 weeks before human cases of West Nile neuroinvasive disease (WNND) occurred), sensitivity (capacity to detect virus circulation even at the enzootic level) and area specificity (capacity to indicate the spatial distribution of the risk for WNND). Strong correlations were observed between the vector index values and the number of human WNND cases registered at the province level. Taking into consideration two scenarios of surveillance, the first with environmental surveillance and the second without, the total costs for the period from 2009 to 2013 were reduced when environmental surveillance was considered (EUR 2.093 million for the first scenario vs EUR 2.560 million for the second). Environmental surveillance helped to reduce costs by enabling a more targeted blood unit testing strategy. The inclusion of environmental surveillance also increased the efficiency of detecting infected blood units and further allowed evidence-based adoption of preventative public health measures.

To the Editor: Chikungunya virus (CHIKV) infection is a self-limiting illness characterized by fever, headache, weakness, rash, and arthralgia. Some patients show prolonged weakness or arthralgia lasting several months. In 2006, several Indian Ocean states and India experienced outbreaks of CHIKV infection, where the vector was postulated to be Aedes albopictus in at least some areas (1,2). Starting from mid July 2007, in 2 villages in Ravenna Province in Italy, Castiglione di Ravenna (≈1,700 inhabitants) and Castiglione di Cervia (≈2,000 inhabitants), several residents sought treatment at local hospitals and health centers for high fever and arthralgia, joint and muscular pain, severe headaches, body aches, and in some cases, rash. Since the beginning of August 2007, an increasing number of febrile syndromes associated with arthralgia have been recorded among the residents of the area. By the end of August, the number of sick persons had increased to ≈150 (3). At the beginning of September, the disease was confirmed as chikungunya fever by the Superior Institute of Health (4). On August 21 and 22, 2007, an entomologic investigation was carried out in the area. Ae. albopictus (215 females and 57 males), Culex pipiens (369 females and 15 males), and a few specimens of Ae. caspius (5 females) and Anopheles spp. (2 females) were collected by using 3 light traps without CO2 (Centers for Disease Control and Prevention [CDC], Atlanta, GA, USA) and 8 CO2-baited traps (similar to the CDC light trap) activated once overnight. Collections were obtained by using 2 small-handled aspirators per day of sampling. Collected mosquitoes were divided by species and pooled as described in the Table. Table Pooled mosquito samples analyzed for chikungunya virus, Italy Each pool was analyzed for CHIKV or nucleic acid (viral isolation and CHIKV-specific reverse transcription–PCR [RT-PCR]). Total RNA was extracted from supernatant of mosquitoes homogenized in minimal essential medium by using TRIzol LS (Invitrogen, Carlsbad, CA USA), and cDNA was synthesized by using SuperScript II (Invitrogen) and random primers. Two PCR protocols were used on the same samples: a nested RT-PCR (5) and a real-time PCR (6). Positive results were obtained from samples 1 and 2 (Table) with both PCR protocols. No positive control was available to the authors at the time of the first PCR-positive detection of virus from mosquitoes; therefore, laboratory contamination can be excluded. Moreover, from the same PCR-positive samples of Ae. albopictus (Table), viral isolation was achieved. The 172-bp PCR fragment obtained after the second round of the nested RT-PCR (5) was located in the E2 gene between nt positions 9486 and 9660 according to nucleotide sequence of the S27 strain genome (GenBank accession no. {"type":"entrez-nucleotide","attrs":{"text":"AF369024","term_id":"27734686"}}AF369024). The sequence of this fragment was obtained by using a BigDye Terminator Cycle Sequencing kit (Applied Biosystems, Foster City, CA, USA) and compared with the available CHIKV sequences, including Indian isolates obtained during 2005–2006 (IND-06), the earlier Indian isolates (1963 and 1973), the isolate from Yawat in 2000, Reunion isolates during 2005–2006 (RU), the Senegal strain (1983), and the S27 and Ross isolates (1952). The sequence of the isolate from Italy is clustered into the Central/East African genotype and showed highest nucleotide identity (99.4%–100.0%) with isolates from IND-06 and 100% identity at the amino acid level with isolates from IND-06 and from RU. These results must be considered carefully because the short-sequenced fragment does not enable confirmation of the epidemiologic origin of the isolate from Italy. The sequence of the whole genome of CHIKV isolates from mosquitoes in Italy is an ongoing process; when completed, results will be available in GenBank. The remainder of insect samples, which included a few male samples of Ae. albopictus, generated PCR-negative results with both protocols tested. Male mosquitoes were tested to detect evidence of transovarian transmission, but the small number of mosquitoes tested suggests possible vertical transmission of the virus in the Italian outbreak. Chikungunya fever in Italy has been reported recently by Beltrame et al. (7) but those cases involved 9 patients who were infected while traveling in regions where CHIKV was endemic. In spite of the large diffusion of Ae. albopictus in Italy recorded since 1990 and broadly distributed all over the country (8), this outbreak of Chikungunya fever is evidence of an active endogenous circulation of the virus and could represent a possible introduction of this disease in Italy. No prediction can be made about spread and persistence of the virus in Italy because the vector is now present in all areas of the country and recent winters have been characterized by mild temperatures. Most likely, because transovarial infection has not been demonstrated for CHIKV, spread of infection will remain limited. However, as this report documents, Italy is at risk for infection with arboviruses, such as dengue virus and West Nile virus, which have serious effects on public health.

West Nile virus (WNV) is one of the most serious public health threats that Europe and the Mediterranean countries are currently facing. In Italy, WNV emerged in 1998 and has been circulating since 2008. To tackle its continuous incursions, Italian national and regional institutions set up a surveillance program, which includes the serological screening of sentinel horses, sentinel-chickens and backyard poultry flocks and the surveillance on all equine neurological cases, resident captured and wild dead birds, and vectors. This communication aims to assess the importance of the entomological surveillance program as an early warning system for WNV circulation. In the province of Modena, the circulation of WNV lineage 2 strains was first detected in pools of Culex pipiens on July the 3rd, 42 days prior to the onset of the first 2013 human WNV neuroinvasive case reported in the same province. Similarly in Veneto, WNV was first detected on July 3rd in a pool of Cx. pipiens collected in the province of Venezia. The first human neuroinvasive case in this region occurred in the Rovigo province on July the 24th, seven days after the detection of WNV lineage 2 in a mosquito pool collected in the same province. Up to the end of July 2013, WNV circulation was further detected in several other pools of Cx. pipiens mosquitoes collected in Emilia-Romagna, Veneto and Lombardia. According to the NS3 partial sequence alignments including all recent European and Italian Lineage 2 strains, the new circulating WNV lineage 2 strains share high nt homology with the Hungarian and with the previous lineage 2 strains isolated in Veneto and Sardegna in 2011 and 2012. These data provide a clear and practical demonstration of the relevance of a reliable entomological surveillance program to early detect WNV in Italy.

BACKGROUND: The circulation of West Nile virus and Usutu virus was detected in the Emilia-Romagna region in 2008 and 2009. To evaluate the extent of circulation of both viruses, environmental surveillance, based on bird and mosquito testing, was conducted in 2008 and gradually improved over the years. METHODS: In February-March 2009-2011, 5,993 hibernating mosquitoes were manually sampled, out of which 80.1% were Culex pipiens; none tested positive for the viruses. From 2008 to 2011, 946,213 mosquitoes, sampled between May and October, were tested; 86.5% were Cx. pipiens. West Nile virus was detected in 32 Cx. pipiens pools, and Usutu virus was detected in 229 mosquito pools (217 Cx. pipiens, 10 Aedes albopictus, one Anopheles maculipennis s.l., and one Aedes caspius). From 2009 to 2011, of 4,546 birds collected, 42 tested positive for West Nile virus and 48 for Usutu virus. West Nile virus and Usutu virus showed different patterns of activity during the 2008-2011 surveillance period. West Nile virus was detected in 2008, 2009, and 2010, but not in 2011. Usutu virus, however, was continuously active throughout 2009, 2010, and 2011. CONCLUSIONS: The data strongly suggest that both viruses overwinter in the surveyed area rather than being continually reintroduced every season. The lack of hibernating mosquitoes testing positive for the viruses and the presence of positive birds sampled early in the season support the hypothesis that the viruses overwinter in birds rather than in mosquitoes. Herd immunity in key bird species could explain the decline of West Nile virus observed in 2011, while the persistence of Usutu virus may be explained by not yet identified reservoirs. Reported results are comparable with a peri-Mediterranean circulation of the West Nile virus lineage 1 related strain, which became undetectable in the environment after two to three years of obvious circulation.

The increasing concern about vector-borne diseases such as West Nile disease in northern Italy motivated our analysis of data on the mosquito fauna and the seasonal and daily flight patterns collected in 1998 in the Po Valley. Collections were performed once a week from May to November, with human landing collections and CO(2) traps. Culex pipiens was present from July to October and showed a clearly unimodal nocturnal flight habit. Culex modestus appeared in July-August and showed a bimodal flight pattern, (main peak during the evening and a minor one in the morning). Aedes caspius was present from May to November (highest densities in July-August) and showed a bimodal flight pattern with a major crepuscular peak and a minor dawn peak in the morning. Aedes detritus was the most abundant species in May, with a crepuscular sharply bimodal flight pattern, particularly according to human landing collections. Sunset and sunrise time, in combination with the solar phase (that determines daylight duration and its trend of changing) were the main factors affecting flight behavior. Temperature, relative humidity, and wind speed differently affected the flight behavior of mosquito females according to the species.

Our study compared different estimates of adult mosquito abundance (Pupal Demographic Survey [PDS], Human Landing Collection [HLC], Number of Bites declared by Citizens during interviews [NBC]) to the mean number of eggs laid in ovitraps. We then calculated a disease risk threshold in terms of number of eggs per ovitrap above which an arbovirus epidemic may occur. The study was conducted during the summers of 2007 and 2008 in the Emilia-Romagna region of Italy where a chikungunya epidemic occurred in 2007. Ovitrap monitoring lasted from May to September, while adult sampling by means of PDS, HLC, and NBC was repeated three times each summer. Based on calculated rate of increase of the disease (R(0)) and the number of bites per human per day measured during the outbreak, we estimated that only 10.1% of the females transmitted the chikungunya virus in the principal focus. Under our conditions, we demonstrated that a positive correlation can be found between the females' density estimated by means of PDS, HLC, and NBC and the mean number of eggs in the ovitraps. We tested our hypothesis during the 2007 secondary outbreak of CHIKV in Cervia, and found that R(0) calculated based on the number of biting females estimated from the egg density was comparable to the R(0) calculated based on the progression of the human cases. The identification of an epidemic threshold based on the mean egg density may define the high risk areas and focus control programs.

We investigated the impact of CHIKV strains on some Aedes albopictus (Skuse) reproductive parameters and the possibility of vertical transmission. Two strains were collected in the area where the epidemic occurred in 2007, one isolated from mosquitoes, the other one isolated from a viraemic patient. Different types of blood meals, either infected or non-infected, were offered to Ae. albopictus females, that were then analyzed at increasing time post infection. The virus titre, measured by two RT-PCR methods in the blood meals, influenced the rate of infection and the rate of dissemination of CHIKV in Ae. albopictus body. We found individual variability with respect to the infection/dissemination rates and their latency both considering the female's body and appendages. The hatching rate was significantly lower for the eggs laid by the infected females than for the control eggs, while the mortality during the larval development (from first instar larva to adult emergence) was similar among the progeny of infected and non-infected female groups. Our findings seem to support the hypothesis that the vertical transmission is a rare event under our conditions, and that a certain time period is required in order to get the ovarioles infected. Field observations conducted during the Spring 2008 showed no evidence of the presence of infected overwintering progeny produced by Ae. albopictus females infected during the 2007 outbreak.

The population of Aedes albopictus (Skuse) (Diptera: Culicidae) was measured in four towns in northern Italy by means of Stegomyia indices (house index: percentage of houses with at least one active breeding site; container index: percentage of containers with larvae; and Breteau index: number of active breeding sites per premises), pupae per premises index (PPI), pupae per hectare index (PHI), and ovitrap monitoring. A detailed investigation on types and number of productive or potential larval habitats in the inspected premises was performed. Catch basins were the most productive breeding sites in both private and public areas. The influence of the premises maintenance and premises shading indices (PMI and PSI) on the population indices and the correlations between the latter and egg density were assessed. The highest PPI was found in badly maintained premises, most times combined with shady coverage. Stegomyia indices and PPI were well correlated with each other, but not with the PHI, which also included the pupae collected in public areas. We obtained a highly positive correlation (R = 0.86) between the PHI and weekly mean egg density estimated 7-14 d after inspection of the premises. The number of females per hectare, calculated using the Focks model, was correlated with the mean egg density of the week after sampling (R = 0.79), and we propose that ovitrap monitoring can be used to evaluate the efficiency of the control activities or to determine a mean egg density threshold for epidemic risk evaluation.

Background In 2008, after the first West Nile virus (WNV) detection in the Emilia-Romagna region, a surveillance system, including mosquito- and bird-based surveillance, was established to evaluate the virus presence. Surveillance was improved in following years by extending the monitoring to larger areas and increasing the numbers of mosquitoes and birds tested. Methodology/Principal Findings A network of mosquito traps, evenly distributed and regularly activated, was set up within the surveyed area. A total of 438,558 mosquitoes, grouped in 3,111 pools and 1,276 birds (1,130 actively sampled and 146 from passive surveillance), were tested by biomolecular analysis. The survey detected WNV in 3 Culex pipiens pools while Usutu virus (USUV) was found in 89 Cx. pipiens pools and in 2 Aedes albopictus pools. Two birds were WNV-positive and 12 were USUV-positive. Furthermore, 30 human cases of acute meningoencephalitis, possibly caused by WNV or USUV, were evaluated for both viruses and 1,053 blood bags were tested for WNV, without any positive result. Conclusions/Significance Despite not finding symptomatic human WNV infections during 2010, the persistence of the virus, probably due to overwintering, was confirmed through viral circulation in mosquitoes and birds, as well as for USUV. In 2010, circulation of the two viruses was lower and more delayed than in 2009, but this decrease was not explained by the relative abundance of Cx. pipiens mosquito, which was greater in 2010. The USUV detection in mosquito species confirms the role of Cx. pipiens as the main vector and the possible involvement of Ae. albopictus in the virus cycle. The effects of meteorological conditions on the presence of USUV-positive mosquito pools were considered finding an association with drought conditions and a wide temperature range. The output produced by the surveillance system demonstrated its usefulness and reliability in terms of planning public health policies.

The chikungunya virus outbreak that occurred in 2007 in northern Italy (Emilia-Romagna region) prompted the development of a large scale monitoring system of the population density of Aedes albopictus (Skuse, 1894), comparable at the provincial and municipal levels. In 2007, egg density data presented an aggregated distribution (VMR >1) and Taylor's power law was applied to calculate the minimum number of ovitraps needed to obtain the prefixed precision levels: D=0.2 in the areas where the chikungunya epidemic occurred and D=0.3 in all the other urban areas >600 ha. The estimated minimum ovitrap number was then used to set up a monitoring network at the regional scale in season 2008 (May-October). In 242 municipalities 2,741 ovitraps were activated and the 2008 sampled data showed a similar aggregated distribution as in 2007. The adequacy of the monitoring design was evaluated by recalculating the Taylor's coefficients and the minimum ovitrap number for each urban area >600 ha using the 2008 egg density data. The comparison between the two estimates showed that the minimum ovitrap number calculated in 2007 was underestimated by 2.7% in weeks 22-41 but was overestimated by 29.4% if referring to the period of highest population density (weeks 27-37). The low cost of the proposed monitoring system, based on the use of fortnightly checked ovitraps, could make it economically sustainable even in a non-epidemic season.

BACKGROUND: In recent years human diseases due to mosquito-borne viruses were increasingly reported in Emilia-Romagna region (Italy), from the chikungunya virus in 2007 to the West Nile virus (WNV) in 2008. An extensive entomological survey was performed in 2009 to establish the presence and distribution of mosquito arboviruses in this region, with particular reference to flaviviruses. METHODOLOGY/PRINCIPAL FINDINGS: From May 6 to October 31, a total of 190,516 mosquitoes were sampled in georeferenced stations, grouped in 1,789 pools according date of collection, location, and species, and analyzed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of RNA belong to Flavivirus genus. WNV was detected in 27 mosquito pools, producing sequences similar to those of birds and human strains obtained in 2008 outbreak, pointed out the probable virus overwintering. Isolation of WNV was achieved from one of these pools. Moreover 56 pools of mosquitoes tested positive for Usutu virus (USUV). Most PCR positive pools consisted of Culex pipiens, which also was the most analyzed mosquito species (81.4% of specimens); interestingly, USUV RNA was also found in two Aedes albopictus mosquito pools. Simultaneous circulation of WNV and USUV in the survey area was highlighted by occurrence of 8 mosquito WNV- and USUV-positive pools and by the overlaying of the viruses "hot spots", obtained by kernel density estimation (KDE) analysis. Land use of sampled stations pointed out a higher proportion of WNV-positive Cx. pipiens pool in rural environments respect the provenience of total sampled pool, while the USUV-positive pools were uniformly captured in the different environments. CONCLUSIONS/SIGNIFICANCE: Obtained data highlighting the possible role of Cx. pipiens mosquito as the main vector for WNV and USUV in Northern Italy, and the possible involvement of Ae. albopictus mosquito in USUV cycle. The described mosquito-based surveillance could constitute the foundation for a public health alert system targeting mosquito borne arboviruses.

An epidemiological survey on canine leishmaniasis (CanL) was performed during a 3-year period (2007–2009) in a public kennel of the Bologna province. The presence of the disease was shown in the canine population for the first time in 2007 by indirect fluorescent antibody test (IFAT). The parasite circulation was confirmed also by direct diagnostic tools, as PCR, cytology and cultural method, performed on different bioptic materials. The parasite was isolated and identified as Leishmania infantum zymodeme MON 1. The serological monitoring was performed also in 2008 and 2009 on animals that previously showed negative or uncertain results. The incidence values calculated by significant seroconversions in IFAT titre ≥1/160, ranged between 4.9% and 6.6%, indicating a stable focus of leishmaniasis. The entomological survey, performed by sticky and CO 2 -baited traps in 2008, showed the presence of the vector Phlebotomus perfiliewi . This study allowed us to identify a stable focus of CanL in an area that was not considered eco-compatible with the presence of the vector and infection. Our results confirm the northward spread of CanL towards areas not previously affected by autochthonous foci.

Usutu virus (USUV) is a mosquito-borne flavivirus belonging to the Japanese encephalitis serocomplex, recently related to neurological disease in immunosuppressed patients. In the same area of Northern Italy where USUV human cases occurred in 2009, a regional West Nile virus (WNV) surveillance program based on mosquito monitoring and wild birds screening has been implemented since 2008. Mosquito pools and wild birds were tested using three different polymerase chain reactions (Flavivirus, WNV, and USUV). During summer 2009, 56 pools (54 consisting of Culex pipiens and 2 of Aedes albopictus) and 27 pools (Cx. pipiens) out of 1789 mosquito pools were, respectively, USUV and WNV positive. Moreover, out of 1218 wild birds tested, 44 were WNV positive, whereas only 11 birds were USUV positive by polymerase chain reaction. Data collected during 2009 prove a cocirculation of USUV and WNV in Northern Italy, but these two viruses show different incidence values in both mosquitoes and birds, suggesting involvement of different animals (other bird species or mammals) in their natural cycles. The cocirculation of WNV and USUV poses a new potential threat to human health in this area. The extent of WNV surveillance to other Flaviviruses will require new diagnostic procedures able to process a large number of samples in a limited period of time and highlights the importance of developing more specific serological tests that could be used in field.

With nuisance mosquito species, the goal of integrated pest management is to keep mosquito density below a tolerance level that is often set by economic, ecological, and political factors. This study compares actual human annoyance, as measured by a phone survey, with several measures of mosquito abundance, in order to determine a threshold that is both relevant and practical. The efficiency of CO2-baited traps, container index (CI), and oviposition traps for monitoring Aedes albopictus, and CO2-baited traps for monitoring Aedes caspius, was evaluated. CO2-baited traps were confirmed to be of low efficiency in Ae. albopictus collection, while correlation matrices showed a good relationship between CI and the number of eggs collected (R = 0.91), and between number of eggs and phone-survey nuisance level estimates (R = 0.88). Correlation between CI and phone-survey nuisance levels was slightly lower (R = 0.78). We found a close relationship between the nuisance level declared by residents and mosquito captures obtained with CO2-baited traps (Ae. caspius) and ovitraps (Ae. albopictus). An equation is presented to estimate annoyance according to dwelling characteristics and to the presence of children in the family.

Multilocus electrophoresis analysis has been used to study the genetic structure of 18 populations of Aedes albopictus newly introduced to Italy, in comparison with two populations in the United States, four in Japan, and four in Indonesia. Allozyme analysis revealed that 15 out of the 18 studied loci were polymorphic among the 28 populations. No significant deviations from Hardy-Weinberg equilibrium were found at polymorphic loci. High genetic affinity was observed between the Italian populations and those from the United States and Japan. The analysis of variance in allele frequencies showed that variance among subpopulations accounted for most of the total variance, suggesting that isolation of the Italian populations is not related to distance. Analysis of linkage disequilibrium using Ohta's method shows that the variance in the frequency of allele combinations could be explained by the action of the genetic drift which accompanies the establishment of new populations. The colonization process of Ae. albopictus in Italy is following a trend similar to that previously observed in the U.S. A., probably because both infestations derive from several successive introductions, each with large numbers of individuals.

The efficiency and practicality of two trapping methods for adult Phlebotomine sand flies in two areas of the Emilia-Romagna region (Italy) were evaluated. Suction traps (CO2) and sticky traps (ST) were used to collect sand flies every two weeks, from June to September, 1999, from 16:00 to 07:00. Two CO2 traps were activated at the same time for each area (one with light and one without light), whereas 38 (four with light and 34 without lights) and 48 (four with light and 44 without) sticky traps were activated in Borghi and Longiano, respectively. An Index of Apparent Abundance (IAA) was calculated for each trap type and area. A total of 2,253 sand flies was trapped over the four-month period, with 1,765 collected from Borghi and 488 from Longiano. Phlebotomus perfiliewi was the most abundant species collected, comprising 99.6% and 84.6% of the total flies trapped in Borghi and Longiano, respectively. Other species were also collected within the two areas (Phlebotomus perniciosus and Phlebotomus mascittii) but were not considered for further analyses due to low catches. Significantly more specimens were caught using CO2 than sticky traps and the addition of a light source also improved the catches, however, a significantly greater number of female specimens were collected by a CO2 trap without a light source. Phlebotomus perfiliewi thus appears to show a photophobic reaction in the case of females when trapped using CO2/light attractants.

Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.

BACKGROUND: Aedes albopictus has spread during the last few decades all over the world. This has increased significantly the risk of exotic arbovirus transmission (e.g. chikungunya, dengue, and Zika) also in temperate areas, as demonstrated by the Chikungunya 2007 and 2017 outbreaks in northeastern and central Italy. Insecticides are an important tool for limiting the circulation of these mosquito-borne viruses. The aim of the present study was to address the gap in current knowledge of pyrethroid insecticide resistance of European Ae. albopictus populations, focusing on populations from Italy, Albania and Greece. RESULTS: Bioassays for resistance to permethrin (0.75%), α-cypermethrin (0.05%) or deltamethrin (0.05%) were performed according to World Health Organization (WHO) protocols and showed reduced susceptibility (