Innovative approaches helpful to enhance knowledge on weather-related stroke events over a wide geographical area and a large population.

BACKGROUND AND PURPOSE: Results on the effect of weather on stroke occurrences are still confusing and controversial. The aim of this study was to retrospectively investigate in Tuscany (central Italy) the weather-related stroke events through the use of an innovative source of weather data (Reanalysis) together with an original statistical approach to quantify the prompt/delayed health effects of both cold and heat exposures. METHODS: Daily stroke hospitalizations and meteorologic data from the Reanalysis 2 Achieve were obtained for the period 1997 to 2007. Generalized linear and additive models and an innovative modeling approach, the constrained segmented distributed lag model, were applied. RESULTS: Both daily averages and day-to-day changes of air temperature and geopotential height (a measure that approximates the mean surface pressure) were selected as independent predictors of all stroke occurrences. In particular, a 5°C temperature decrease was associated with 16.5% increase of primary intracerebral hemorrhage of people ≥65 years of age. A general short-term cold effect on hospitalizations limited to 1 week after exposure was observed and, for the first time, a clear harvesting effect (deficit of hospitalization) for cold-related primary intracerebral hemorrhage was described. Day-to-day changes of meteorologic parameters disclosed characteristic U- and J-shaped relationships with stroke occurrences. CONCLUSIONS: Thanks to the intrinsic characteristic of Reanalysis, these results might simply be implemented in an operative forecast system regarding weather-related stroke events with the aim to develop preventive health plans.

Temperature Characterization of Different Urban Microhabitats of Aedes albopictus (Diptera Culicidae) in Central-Northern Italy.

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.

Transmission potential of chikungunya virus and control measures: the case of Italy.

During summer 2007 Italy has experienced an epidemic caused by Chikungunya virus - the first large outbreak documented in a temperate climate country - with approximately 161 laboratory confirmed cases concentrated in two bordering villages in North-Eastern Italy comprising 3,968 inhabitants. The seroprevalence was recently estimated to be 10.2%. In this work we provide estimates of the transmission potential of the virus and we assess the efficacy of the measures undertaken by public health authorities to control the epidemic spread. To such aim, we developed a model describing the temporal dynamics of the competent vector, known as Aedes albopictus, explicitly depending on climatic factors, coupled to an epidemic transmission model describing the spread of the epidemic in both humans and mosquitoes. The cumulative number of notified cases predicted by the model was 185 on average (95% CI 117-278), in good agreement with observed data. The probability of observing a major outbreak after the introduction of an infective human case was estimated to be in the range of 32%-76%. We found that the basic reproduction number was in the range of 1.8-6 but it could have been even larger, depending on the density of mosquitoes, which in turn depends on seasonal meteorological effects, besides other local abiotic factors. These results confirm the increasing risk of tropical vector-borne diseases in temperate climate countries, as a consequence of globalization. However, our results show that an epidemic can be controlled by performing a timely intervention, even if the transmission potential of Chikungunya virus is sensibly high.