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ORGANISMO ANIMATO (DI
SOLITO ARTROPODE) CHE
DOPO AVER ASSUNTO I
MICRORGANISMI DALLA
SORGENTE DI INFEZIONE, LI
INOCULA NELL...
Malaria
Febbre Gialla
Chykungunya
Dengue
Filariosi
Febbre del Nilo alcune Encefaliti
Zanzara Tigre (Aedes spp)
Anopheles
C...
Malaria
Inquadramento nosografico
È una parassitosi provocata da Sporozoi del genere
Plasmodium
100 specie conosciute
Pato...
MALARIA
• Periodo di incubazione:
• In media 10-20 giorni
• 7-14 gg per P.falciparum,
• 8-14 gg. per P.ovale e P.vivax
• 7-30 gg o...
Contagiosità:
I pazienti non trattati possono rimanere
infettanti per 1 anno, nel caso di P.falciparum,
1-2 anni nel caso ...
Più del 90% dei casi di
malaria e la grande
maggioranza dei decessi
si verifica in Africa
tropicale
World Health Organizat...
Epidemiologia in Europa
Malaria autoctona
Casi sporadici sono stati registrati anche in
Kazakistan, Kirghizistan, Federazi...
Epidemiologia in Europa
Malaria di importazione
• Tra i Paesi dell’U.E. è la malaria di importazione la
più temibile.
• Ne...
Casi di Malaria in Italia
2002-06
Sistema di Sorveglianza
E’ inclusa tra le malattie infettive di classe III e come tale soggetta a
denuncia obbligatoria.
L...
Strategie di profilassi
1. Bonifica ambientale
2. Comportamento antipuntura
3. Chemioprofilassi
(raccomandazioni specifich...
Chemioprofilassi: raccomandazioni specifiche
per i viaggiatori
• L’OMS ha diviso le aree endemiche in 4 zone a cui è
neces...
• La preparazione di vaccini antimalarici ha avuto
notevole impulso da quando è possibile allestire
colture continue in vi...
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Malaria

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Malaria

  1. 1. ORGANISMO ANIMATO (DI SOLITO ARTROPODE) CHE DOPO AVER ASSUNTO I MICRORGANISMI DALLA SORGENTE DI INFEZIONE, LI INOCULA NELL’OSPITE VETTORE PERSONA, ANIMALE O AMBIENTE IN CUI NORMALMENTE UN AGENTE INFETTIVO VIVE, DA CUI TRAE LA SUA SOPRAVVIVENZA E DOVE SI RIPRODUCE IN MODO DA POTER ESSERE POTENZIALMENTE TRASMESSO AD UN OSPITE RECETTIVO SERBATOIO Malattie Trasmesse da Zanzare
  2. 2. Malaria Febbre Gialla Chykungunya Dengue Filariosi Febbre del Nilo alcune Encefaliti Zanzara Tigre (Aedes spp) Anopheles Culex pipiens Generi di Zanzare presenti in Italia
  3. 3. Malaria Inquadramento nosografico È una parassitosi provocata da Sporozoi del genere Plasmodium 100 specie conosciute Patogene per l’uomo 4 Plasmodium falciparum Plasmodium ovale Plasmodium vivax Plasmodium malariae malaria terzana malignamalaria terzana maligna }} malaria terzana benignamalaria terzana benigna malaria quartanamalaria quartana
  4. 4. MALARIA
  5. 5. • Periodo di incubazione: • In media 10-20 giorni • 7-14 gg per P.falciparum, • 8-14 gg. per P.ovale e P.vivax • 7-30 gg o più per P.malariae
  6. 6. Contagiosità: I pazienti non trattati possono rimanere infettanti per 1 anno, nel caso di P.falciparum, 1-2 anni nel caso di P.vivax e fino a 3 anni nel caso di P.malariae L’anofele rimane contagiosa per tutta la vita
  7. 7. Più del 90% dei casi di malaria e la grande maggioranza dei decessi si verifica in Africa tropicale World Health Organization. Malaria 1982-1997. Weekly Epidemiological Record 1999 Epidemiologia STATUS GLOBALE A rischio: oltre il 40% della popolazione globale (vivono in zone endemiche) Casi Clinici: 300-500 milioni annualmente Casi letali: 1.5-2.0 milioni annualmente (la maggior parte di questi casi si verifica nei bambini sotto i 5 anni e nelle donne in gravidanza)
  8. 8. Epidemiologia in Europa Malaria autoctona Casi sporadici sono stati registrati anche in Kazakistan, Kirghizistan, Federazione Russa, Uzbekistan, Moldavia, Bulgaria, Grecia e Italia. Malaria nella Regione Europea dell'OMS-Euro Surveill 2001;6(4):61-65
  9. 9. Epidemiologia in Europa Malaria di importazione • Tra i Paesi dell’U.E. è la malaria di importazione la più temibile. • Negli ultimi 30 anni 51 Paesi Europei hanno fatto contare 230.000 casi (il 50% tra il 1990 e il 2000) • Il 90% riguarda l’Est Europa • Dal 1974 è in crescita inesorabile la prevalenza di P.falciparum (69,9%)
  10. 10. Casi di Malaria in Italia 2002-06
  11. 11. Sistema di Sorveglianza E’ inclusa tra le malattie infettive di classe III e come tale soggetta a denuncia obbligatoria. Le ASL notificano i casi all’Ufficio V Malattie Infettive e Profilassi Internazionale, della Direzione Generale della Prevenzione del Ministero della Salute (MS)*. La notifica viene effettuata attraverso l’invio della scheda epidemiologica (modello 15) e dei preparati emoscopici relativi ad ogni caso. I vetrini vengono poi inviati all’ISS, Dipartimento Malattie Infettive Parassitarie e Immunomediate (MIPI), Reparto Malattie trasmesse da Vettori e Sanità Internazionale, per la conferma di diagnosi. Annualmente il MS e l’ISS effettuano l’elaborazione dei dati epidemiologici relativi ai casi confermati.
  12. 12. Strategie di profilassi 1. Bonifica ambientale 2. Comportamento antipuntura 3. Chemioprofilassi (raccomandazioni specifiche per livello di rischio) 4. Vaccinoprofilassi
  13. 13. Chemioprofilassi: raccomandazioni specifiche per i viaggiatori • L’OMS ha diviso le aree endemiche in 4 zone a cui è necessario applicare 4 gradi di protezione: Rischio malarico Tipo di prevenzione Tipo I Rischio di trasmissione malarica molto limitato Solo prevenzione delle punture di insetto Tipo II Rischio di P.vivax o di P.falciparum pienamente sensibile alla clorochina Prevenzione delle punture di insetto più chemioprofilassi con clorochina Tipo III Rischio di trasmissione malarica e resistenza emergente alla clorochina Prevenzione delle punture di insetto più chemioprofilassi con l’associazione clorochina- proguanil Tipo IV Alto rischio di malaria falciparum più farmaco resistenza o rischio moderato/basso di malaria falciparum e farmaco-resistenza molto elevata Prevenzione delle punture di insetto più o meflochina o doxiciclina o malarone www.who.com
  14. 14. • La preparazione di vaccini antimalarici ha avuto notevole impulso da quando è possibile allestire colture continue in vitro di P.falciparum • Sono in fase di studio: Vaccini pre-eritrocitari (contro gli sporozoiti) Vaccini eritrocitari (contro i merozoiti) Vaccini contro le forme sessuate (gametociti) Vaccinoprofilassi

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