{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:49:32Z","timestamp":1772254172012,"version":"3.50.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The arrival of infected travelers from endemic regions can trigger sustained autochthonous transmission of mosquito-borne pathogens in Europe. In 2007 a Chikungunya outbreak was observed in central Italy, mostly affecting two villages characterised by a high density of <jats:italic>Aedes albopictus<\/jats:italic>. The outbreak was mitigated through intervention strategies reducing the mosquito abundance. Ten years later, in 2017, sustained Chikungunya transmission was documented in both central and southern Italy. The proposed analysis identifies suitable reactive measures for the containment and mitigation of future epidemics by combining epidemiological modeling with a health economic approach, considering different arrival times of imported infections and possible delays in the notification of cases. Obtained estimates suggest that, if the first notification will occur in the middle of the mosquito breeding season, the combination of larvicides, adulticides and breeding sites removal represents the optimal strategy. In particular, we found that interventions implemented in 2007 were cost-effective, with about 3200 prevented cases, 1450 DALYs averted and \u20ac13.5\u2009M saved. Moreover, larvicides are proven to be more cost beneficial in early summer and warmer seasons, while adulticides should be preferred in autumn and colder seasons. Our results provide useful indications supporting urgent decision-making of public health authorities in response to emerging mosquito-borne epidemics.<\/jats:p>","DOI":"10.1038\/s41598-018-27443-9","type":"journal-article","created":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T10:32:34Z","timestamp":1528367554000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The containment of potential outbreaks triggered by imported Chikungunya cases in Italy: a cost utility epidemiological assessment of vector control measures"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-7282","authenticated-orcid":false,"given":"F.","family":"Trentini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Poletti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Baldacchino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Drago","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Montarsi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Capelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Rizzoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Ros\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Rizzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Merler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2221-8898","authenticated-orcid":false,"given":"A.","family":"Melegaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2018,6,13]]},"reference":[{"issue":"6","key":"27443_CR1","first-page":"20696","volume":"19","author":"D Fischer","year":"2016","unstructured":"Fischer, D., Thomas, S. M., Neteler, M., Tjaden, N. B. & Beierkuhnlein, C. Climatic suitability of Aedes albopictus in Europe referring to climate change projections: comparison of mechanistic and correlative niche modelling approaches. Euro Surveillance. 19(6), 20696 (2016).","journal-title":"Euro Surveillance."},{"key":"27443_CR2","doi-asserted-by":"crossref","unstructured":"Guzzetta, G. et al. Assessing the potential risk of Zika virus epidemics in temperate areas with established Aedes albopictus populations. Euro Surveillance. 21(15) (2016).","DOI":"10.2807\/1560-7917.ES.2016.21.15.30199"},{"issue":"5","key":"27443_CR3","doi-asserted-by":"publisher","first-page":"e18860","DOI":"10.1371\/journal.pone.0018860","volume":"6","author":"P Poletti","year":"2011","unstructured":"Poletti, P. et al. Transmission potential of CHIKV virus and control measures: the case of Italy. PLoS One. 6(5), e18860 (2011).","journal-title":"PLoS One."},{"issue":"6","key":"27443_CR4","doi-asserted-by":"publisher","first-page":"e0004762","DOI":"10.1371\/journal.pntd.0004762","volume":"10","author":"G Guzzetta","year":"2016","unstructured":"Guzzetta, G. et al. Potential risk of dengue and chikungunya outbreaks in northern Italy based on a population model of Aedes albopictus (diptera: Culicidae). PLoS Neglected Tropical Diseases. 10(6), e0004762 (2016).","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"6","key":"27443_CR5","doi-asserted-by":"publisher","first-page":"e1197","DOI":"10.1371\/journal.pntd.0001197","volume":"5","author":"MK Soumahoro","year":"2011","unstructured":"Soumahoro, M. K. et al. The CHIKV epidemic on La Reunion Island in 2005\u20132006: a cost-of-illness study. PLoS Neglected Tropical Diseases. 5(6), e1197 (2011).","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"8","key":"27443_CR6","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/S1473-3099(06)70531-X","volume":"6","author":"P Reiter","year":"2006","unstructured":"Reiter, P., Fontenille, D. & Paupy, C. Aedes albopictus as an epidemic vector of CHIKV virus: another emerging problem. The Lancet infectious diseases. 6(8), 463\u2013464 (2006).","journal-title":"The Lancet infectious diseases."},{"key":"27443_CR7","unstructured":"CDC, Chikungunya Virus., https:\/\/www.cdc.gov\/chikungunya\/ (2017)."},{"issue":"3","key":"27443_CR8","doi-asserted-by":"publisher","first-page":"e2137","DOI":"10.1371\/journal.pntd.0002137","volume":"7","author":"C Schilte","year":"2013","unstructured":"Schilte, C. et al. CHIKV Virus-associated Long-term Arthralgia: A 36-month Prospective Longitudinal Study. PLoS Neglected Tropical Diseases. 7(3), e2137 (2013).","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"13","key":"27443_CR9","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1056\/NEJMra1406035","volume":"372","author":"SC Weaver","year":"2015","unstructured":"Weaver, S. C. & Lecuit, M. CHIKV virus and the global spread of a mosquito-borne disease. New England Journal of Medicine. 372(13), 1231\u20131239 (2015).","journal-title":"New England Journal of Medicine."},{"issue":"2","key":"27443_CR10","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.trstmh.2009.07.014","volume":"104","author":"T Seyler","year":"2010","unstructured":"Seyler, T. et al. Estimating the burden of disease and the economic cost attributable to CHIKV, Andhra Pradesh, India, 2005\u20132006. Transactions of the Royal Society of Tropical Medicine and Hygiene. 104(2), 133\u2013138 (2010).","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene."},{"issue":"12","key":"27443_CR11","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1093\/trstmh\/trv094","volume":"109","author":"JA Cardona-Ospina","year":"2015","unstructured":"Cardona-Ospina, J. A., Villamil-G\u00f3mez, W. E., Jimenez-Canizales, C. E., Casta\u00f1eda-Hern\u00e1ndez, D. M. & Rodr\u00edguez-Morales, A. J. Estimating the burden of disease and the economic cost attributable to CHIKV, Colombia, 2014. Transactions of The Royal Society of Tropical Medicine and Hygiene. 109(12), 793\u2013802 (2015).","journal-title":"Transactions of The Royal Society of Tropical Medicine and Hygiene."},{"issue":"9602","key":"27443_CR12","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.1016\/S0140-6736(07)61779-6","volume":"370","author":"G Rezza","year":"2007","unstructured":"Rezza, G. et al. Infection with CHIKV virus in Italy: an outbreak in a temperate region. The Lancet. 370(9602), 1840\u20131846 (2007).","journal-title":"The Lancet."},{"key":"27443_CR13","unstructured":"ECDC, Rapid Risk Assessment: Cluster of autochthonous chikungunya cases in France (2017)."},{"issue":"9816","key":"27443_CR14","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/S0140-6736(11)60281-X","volume":"379","author":"FJ Burt","year":"2012","unstructured":"Burt, F. J., Rolph, M. S., Rulli, N. E., Mahalingam, S. & Heise, M. T. Chikungunya: a re-emerging virus. The Lancet. 379(9816), 662\u201371 (2012).","journal-title":"The Lancet."},{"key":"27443_CR15","unstructured":"ECDC, Clusters of autochthonous chikungunya cases in Italy. Rapid Risk Assessment, https:\/\/ecdc.europa.eu\/en\/publications-data\/rapid-risk-assessment-clusters-autochthonous-chikungunyacases-italy (2017)."},{"key":"27443_CR16","unstructured":"Istituto Superiore di Sanit\u00e0, Bulletin of Chikungunya outbreak., www.salute.gov.it\/portale\/temi\/documenti\/chikungunya\/bollettino_chikungunya_ULTIMO.pdf (2018)."},{"key":"27443_CR17","doi-asserted-by":"crossref","unstructured":"Manica, M., et al. Transmission dynamics of the ongoing chikungunya outbreak in Central Italy: from coastal areas to the metropolitan city of Rome, summer 2017. Eurosurveillance, 22(44) (2017).","DOI":"10.2807\/1560-7917.ES.2017.22.44.17-00685"},{"issue":"4","key":"27443_CR18","doi-asserted-by":"publisher","first-page":"e107","DOI":"10.1016\/S1473-3099(16)30385-1","volume":"17","author":"FJ Burt","year":"2017","unstructured":"Burt, F. J. et al. Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen. The Lancet Infectious Diseases. 17(4), e107\u2013e117 (2017).","journal-title":"The Lancet Infectious Diseases."},{"issue":"2","key":"27443_CR19","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1038\/nm.4253","volume":"23","author":"JH Erasmus","year":"2017","unstructured":"Erasmus, J. H. et al. A chikungunya fever vaccine utilizing an insect-specific virus platform. Nature medicine. 23(2), 192\u2013199 (2017).","journal-title":"Nature medicine."},{"issue":"3","key":"27443_CR20","doi-asserted-by":"publisher","first-page":"e0174293","DOI":"10.1371\/journal.pone.0174293","volume":"12","author":"K Erguler","year":"2017","unstructured":"Erguler, K. et al. A large-scale stochastic spatiotemporal model for Aedes albopictus-borne chikungunya epidemiology. PLoS One. 12(3), e0174293 (2017).","journal-title":"PLoS One."},{"issue":"1","key":"27443_CR21","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1002\/ps.4417","volume":"73","author":"F Baldacchino","year":"2017","unstructured":"Baldacchino, F. et al. An integrated pest control strategy against the Asian tiger mosquito in northern Italy: a case study. Pest Management Science. 73(1), 87\u201393 (2017).","journal-title":"Pest Management Science."},{"issue":"4","key":"27443_CR22","doi-asserted-by":"publisher","first-page":"444","DOI":"10.3390\/ijerph14040444","volume":"14","author":"M Canali","year":"2017","unstructured":"Canali, M., Rivas-Morales, S., Beutels, P. & Venturelli, C. The Cost of Arbovirus Disease Prevention in Europe: Area-Wide Integrated Control of Tiger Mosquito, Aedes albopictus, in Emilia-Romagna, Northern Italy. International journal of environmental research and public health 14(4), 444 (2017).","journal-title":"International journal of environmental research and public health"},{"issue":"1","key":"27443_CR23","first-page":"26","volume":"46","author":"K Krishnamoorthy","year":"2009","unstructured":"Krishnamoorthy, K., Harichandrakumar, K. T., Kumari, A. K. & Das, L. K. Burden of CHIKV in India: estimates of disability adjusted life years (DALY) lost in 2006 epidemic. Journal of vector borne diseases. 46(1), 26 (2009).","journal-title":"Journal of vector borne diseases."},{"issue":"1","key":"27443_CR24","doi-asserted-by":"publisher","first-page":"e2609","DOI":"10.1371\/journal.pntd.0002609","volume":"8","author":"J Thuilliez","year":"2014","unstructured":"Thuilliez, J., Bellia, C., Dehecq, J. S. & Reilhes, O. Household-level expenditure on protective measures against mosquitoes on the island of la R\u00e9union, France. PLoS Neglected Tropical Diseases. 8(1), e2609 (2014).","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"9","key":"27443_CR25","doi-asserted-by":"publisher","first-page":"e0005918","DOI":"10.1371\/journal.pntd.0005918","volume":"11","author":"G Guzzetta","year":"2017","unstructured":"Guzzetta, G. et al. Effectiveness and economic assessment of routine larviciding for prevention of chikungunya and dengue in temperate urban settings inEurope. PLoS Neglected Tropical Diseases. 11(9), e0005918 (2017).","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"9778","key":"27443_CR26","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1016\/S0140-6736(11)60246-8","volume":"377","author":"PM Luz","year":"2011","unstructured":"Luz, P. M., Vanni, T., Medlock, J., Paltiel, A. D. & Galvani, A. P. Dengue vector control strategies in an urban setting: an economic modelling assessment. The Lancet 377(9778), 1673\u20131680 (2011).","journal-title":"The Lancet"},{"issue":"5","key":"27443_CR27","doi-asserted-by":"publisher","first-page":"e0004743","DOI":"10.1371\/journal.pntd.0004743","volume":"10","author":"JA Alfaro-Murillo","year":"2016","unstructured":"Alfaro-Murillo, J. A. et al. A cost-effectiveness tool for informing policies on Zika virus control. PLoS neglected tropical diseases, 10(5), e0004743 (2016).","journal-title":"PLoS neglected tropical diseases,"},{"key":"27443_CR28","unstructured":"Canali, M., Controllo della zanzara tigre: analisi dei costi sostenuti dagli Enti locali., http:\/\/salute.regione.emilia-romagna.it\/documentazione\/rapporti\/contributi\/contributi_73_zanzara_tigre.pdf\/view (2012)."},{"issue":"3","key":"27443_CR29","doi-asserted-by":"publisher","first-page":"508","DOI":"10.4269\/ajtmh.2010.09-0322","volume":"82","author":"ML Moro","year":"2010","unstructured":"Moro, M. L. et al. CHIKV virus in North-Eastern Italy: a seroprevalence survey. The American journal of tropical medicine and hygiene. 82(3), 508\u201311 (2010).","journal-title":"The American journal of tropical medicine and hygiene."},{"key":"27443_CR30","unstructured":"ECDC, Aedes albopictus - current known distribution: September 2017., https:\/\/ecdc.europa.eu\/sites\/portal\/files\/images\/mosquitoes-maps-Aedes-albopictus-April-2017.jpg (2017)."},{"key":"27443_CR31","unstructured":"ECDC, Development of Aedes albopictus risk maps., http:\/\/www.epicentro.iss.it\/problemi\/zanzara\/epid.asp (2009)."},{"key":"27443_CR32","unstructured":"ECDC, Vector control with a focus on Aedes aegypti and Aedes albopictus mosquitoes: literature review and analysis of information, https:\/\/ecdc.europa.eu\/en\/publications-data\/vector-control-focus-aedes-aegypti-and-aedes-albopictusmosquitoes-literature (2017)."},{"key":"27443_CR33","unstructured":"European Chemical Agency, Transitional Guidance on Efficacy Assessment for Product Type 18, Insecticide, Acaricides & other Biocidal Products against Arthropods and Product Type 19, Repellents & Attractants (2017)."},{"key":"27443_CR34","unstructured":"Ministero della Salute, Sorveglianza dei casi umani di Chikungunya, Dengue, West Nile Disease ed altre arbovirosi e valutazione del rischio di trasmissione in Italia., http:\/\/www.epicentro.iss.it\/problemi\/westNile\/pdf\/Circolare_arbovirosi_2015.pdf (2015)."},{"key":"27443_CR35","unstructured":"Ministero della Salute, Piano nazionale di sorveglianza e risposta alle arbovirosi trasmesse da zanzare (aedes sp.) con particolare riferimento ai virus chikungunya, dengue e zika, http:\/\/www.salute.gov.it\/portale\/news\/p3_2_1_1_1.jsp?lingua=italiano&menu=notizie&p=dalministero&id=3013 (2017)."},{"issue":"6","key":"27443_CR36","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/S0167-6296(97)00005-2","volume":"16","author":"S Anand","year":"1997","unstructured":"Anand, S. & Kara, H. Disability-adjusted life years: a critical review. Journal of health economics. 16(6), 685\u2013702 (1997).","journal-title":"Journal of health economics."},{"issue":"1","key":"27443_CR37","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-9-1","volume":"9","author":"AD LaBeaud","year":"2011","unstructured":"LaBeaud, A. D., Bashir, F. & King, C. H. Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four prevalent infections. Population health metrics. 9(1), 1 (2011).","journal-title":"Population health metrics."},{"key":"27443_CR38","doi-asserted-by":"crossref","unstructured":"Stinnet, A. & Mullay, J. Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis. Medical Decision Making, 18(2suppl), pp. S68\u2013S80 (1998).","DOI":"10.1177\/0272989X98018002S09"},{"key":"27443_CR39","unstructured":"World Health Organization. The world health report 2002: reducing risks, promoting healthy life, http:\/\/www.who.int\/whr\/2002\/en\/ (2002)."},{"key":"27443_CR40","unstructured":"Istituto Nazionale di Statistica, Serie storica PIL., http:\/\/dati.istat.it\/Index.aspx (2017)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-27443-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-27443-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-27443-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T06:30:29Z","timestamp":1671604229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-27443-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,13]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["27443"],"URL":"https:\/\/doi.org\/10.1038\/s41598-018-27443-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,13]]},"assertion":[{"value":"8 January 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"9034"}}