Balancing risk communication and economic effects: the West Nile virus epidemic in the eastern Veneto Region
Š B. Kadirov/WHO
The eastern part of the Veneto Region is part of Health Authority 10 and includes 20 municipalities with about 220 000 inhabitants. This territory is characterized by vast lagoon areas and countryside with three rivers (Piave, Livenza and Tagliamento) that flow into the Adriatic Sea. This is a historically malaria-endemic area and from the 1920s underwent a massive remediation campaign. The major economic activity that has developed over the last 50 years is tourism due to the seaside towns of Cavallino, Jesolo, Caorle, Eraclea and Bibione. Each year from May to September, millions of tourists arrive to spend their vacations in this Region. The proximity of the city of Venice and the wide selection of accommodation make this an attractive holiday destination that provides employment for some 10 000 people. In 2004, the Veneto Region transferred the responsibility for public health campaigns (normally run by local health authorities) to the municipalities. The municipalities have the pest control mandate for public areas and distribute larvicides to families to deposit in gutters and bodies of stagnant water, but individuals need to take a number of precautions to prevent mosquito larvae developing in stagnant water. The health authorities retained responsibility for coordinating and carrying out medical and veterinary surveillance. In 2010, the first clinical cases in humans of West Nile neuro-invasiveness were seen, affecting older people in eastern Veneto. The Department of Prevention initiated a campaign to raise awareness in the municipalities of the importance of pest management and control. From 2010 to 2012, neither the municipalities nor individuals took disinfection seriously and not all municipalities carried out three cycles of disinfection as prescribed. There was also a general slowdown in clean-up operations. Hazardous infection sites in public areas amount to only 20–30% of the total; the remaining 70–80% are privately owned. As private areas contribute considerably to colonization by mosquitoes, full coverage cannot be reached without the active participation of private citizens.
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Health and environment: communicating the risks