Colucci et al.
Emergency department syndromic surveillance to monitor tick-borne diseases: A 6-year small-area analysis in Northeastern Italy
Int J Environ Res Public Health. 2023;20(19):6822. doi:10.3390/ijerph20196822

The surveillance of zoonotic diseases like Lyme disease and TBE is currently incomplete in northern Italy, and thus the currently available incidence data most likely only partially reflect the true risk of infection. The EU case definition for TBE includes only clinically relevant cases with laboratory-confirmed diagnosis, while most TBE virus infections are asymptomatic or mild forms of disease may go undiagnosed.

The emergency department syndromic surveillance (EDSyS) system monitors tick-bite-related risk consultations and not just a tick-borne disease like borreliosis. In Veneto, northeastern Italy, data on emergency visits of four hospitals were included for a syndromic EDSyS approach, by which information was generated to drive public health action by collecting, analyzing, and interpreting routine health-related data on symptoms and clinical signs reported by patients and clinicians.

By this EDSyS system to monitor tick-borne diseases, a total of 4,330 visits to the ED were analyzed between 2017 and 2022, which represented 0.48% of all ED visits. The seasonal distribution of tick-borne ED visits peaked earlier than hospitalizations in spring and autumn. 30/31 TBE hospitalizations were recorded between June and November.

The use of EDSyS may be key to providing timely information that is not currently available through other means. For Veneto, a TBE-related hospitalization rate (per 100,000/year) of 0.78 was found, and for the north-west subarea of Veneto, a rate of 1.84.

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