Tilston N, Skelly C, Weinstein P.
Int J Health Geogr. 2009 Oct 31;8:61.

Description: The first documented transmission of Chikungunya virus within Europe took place in Italy during the summer of 2007. Available evidence suggests that Aedes albopictus was the vector responsible. The index case was a visitor from India. This paper proposed pan-European surveillance zones for Chikungunya, based on the climatic conditions necessary for vector activity and viral transmission. A preliminary examination of inward bound airline passengers was also undertaken. This indicated that France and Italy are likely to be at greater risk due to the number of visitors they receive from Chikungunya active regions, principally viraemic visitors from India. Therefore this study represents a first attempt at creating risk stratified surveillance zones, which we believe could be usefully refined with the use of higher resolution climate data and more complete air travel data

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ECDC comment: 2010-01-04
Pan-European surveillance provides the best hope for an early-warning of outbreaks, because national boundaries do not play a role in defining the risk of this new vector borne disease. Other factors apart from vector distribution, such as the amount of visitors from endemic areas, should be taken into account when attempting to stratify the disease transmission risk. Other authors, as a first step towards assessing the likelihood of local transmission of chikungunya and dengue in Europe, have estimated the number of viremic person-days among air-travellers arriving in the European Union (EU). [Seyler et al. Assessing the risk of importing dengue and chikungunya viruses to the European Union. Epidemics, 1, 3: 175-184. Sep. 2009].  Further research is needed to better understand the disease transmission risk.

This paper has been selected by Dr Philippe GAUTRET (philippe.gautret@club-internet.fr) from Marseille, France.