|Aedes Albupictus - Credit ECDC VBORNET|
In 2007 Chikungunya arrived, albeit briefly, to the province of Ravenna (in the northeast of Italy) carried in by a traveler who had recently returned from India (see It's A Smaller World After All). Before the outbreak ended, roughly 300 people were infected.
This was a huge wake up call for Europe, as it demonstrated how easily an exotic tropical arbovirus could be imported, and transmit in a region normally thought immune to such things.
Since then, we’ve seen a procession of studies suggesting that Europe is increasingly at risk for many of these vector borne diseases to spread. In 2010 the journal Eurosurveillance devoted an entire issue to The Threat Of Vector Borne Diseases.
In 2011, in ECDC: Local Malaria Acquisition In Greece we saw more reasons for concern with the return of a scourge that had – due to diligent mosquito control measures over the past 50 years – been all but eliminated across Europe.
In 2012 we looked at series of initiatives that looked at the likelihood that vectorborne diseases like Dengue, Chikungunya, Malaria, and yes . . . Zika . . . might find a suitable environment in Europe.
While southern Europe has always been slightly vulnerable to mosquito-borne diseases, in October of 2014, in WHO: Locally Acquired Chikungunya In France, we saw another example of autochthonous transmission of a formerly tropical disease, this time in a Central European nation.
The ECDC, via VBORNET, maintains an updated set of mosquito vector maps for Europe, which can be accessed here, showing those areas where various species of mosquitoes may be found.
For Zika, the current concern is over Aedes Aegypti, and potentially Aedes Albopictus. Research is ongoing into other possible mosquito vectors.In light of the potential for some European mosquito species to vector the Zika Virus, today the World Health Organization has released the following statement urging European nations prepare to deal with the threat.
Statement by Dr Zsuzsanna Jakab, WHO Regional Director for EuropeThe WHO Director-General has declared that the recent cluster of microcephaly and neurological disorders in Latin America and the Caribbean constitutes a public health emergency of international concern and requires a united response. She has defined it an "extraordinary event" and a public health threat to other parts of the world, on the basis of a strong suspicion of a causal link between this cluster of disorders and Zika virus disease, as agreed by the experts on the International Health Regulations Emergency Committee.
The combination of broad geographical distribution of mosquito species that can transmit the virus, the absence of immunity against the virus throughout the world and lack of both a vaccine and rapid, reliable diagnostic tests raises concerns that Zika virus disease will spread globally.
Recommendations to European countriesEvery European country in which Aedes mosquitos are present can be at risk for the spread of Zika virus disease. A number of travellers infected with Zika have entered Europe, but the disease has not been transmitted further, as the mosquito is still inactive. With the onset of spring and summer, the risk that Zika virus will spread increases.
Now is the time for countries to prepare themselves to reduce the risk to their populations. As there is no vaccine or treatment for Zika virus disease, we must protect the European Region by stopping the disease at its source. I urge European countries to act early in a coordinated way to:
We at WHO stand ready to support countries in the European Region in preventing the spread of Zika virus disease, where requested. This will include:
- control the mosquitoes, including community engagement in eliminating mosquito breeding sites and planning for insecticide spraying and killing of larvae in case of outbreaks;
- inform people at risk, especially pregnant women, about preventing mosquito bites;
- enhance surveillance and ensure laboratory detection of Zika virus disease and its neurological complications; and
- step up research to understand Zika virus disease and develop diagnostic tests and vaccines.
- providing guidance on integrated vector control strategies;
- facilitating shipment of samples to WHO reference laboratories or delivering diagnostic tools for local testing; and
- advising on risk communication.
No restrictions on travel or tradeOn the basis of the available evidence, WHO does not recommend travel or trade restrictions related to Zika virus disease. As a precautionary measure, national governments may issue travel recommendations to their own populations after assessing the available evidence and local risk factors.
People travelling to high-risk areas should protect themselves from mosquito bites by using repellents, wearing light-coloured, long-sleeved shirts and trousers and ensuring that rooms are fitted with screens to prevent mosquitoes from entering. As Aedes mosquitoes bite during the day, these measures should be applied all day long.
Women who are pregnant or planning to become pregnant should take extra care to protect themselves from mosquito bites. They might also consult their local health authorities if they are travelling to an area with ongoing Zika virus transmission.
Health authorities are advised to collaborate with the transport sector to ensure disinsection of aircraft arriving from affected areas.