[5] In 2011, a national plan on integrated human surveillance of imported and autochthonous vector-borne disease (CHIKV, DENV, and West Nile disease) was issued.[10] Integrated human and entomological surveillance is crucial to monitor the spread of emerging vector-borne diseases and to implement public health measures in order to avoid transmission and control such diseases in humans.

Moreover, establishing an integrated surveillance could be valuable also to rapidly identify the risk of introduction of new vector-borne diseases in Europe, with the most obvious candidates being CHIKV[16] and DENV,[17] not forgetting also malaria.[18] The authors thank all colleagues from the regional and local Health Services for providing data on Chikungunya/Dengue INNO-406 cost imported cases: Finarelli A (Emilia Romagna); Gallo L (Friuli Venezia Giulia); Vitagliano A (Lazio); Palumbo A, Gramegna M (Lombardia); Audenino M CP868596 (Piemonte); Prato R, Quarto M (Puglia); Palermo M (Sicilia); Balocchini E, Pecori L (Toscana); Sudano L (Valle D’Aosta); Russo F, Zanella F (Veneto). We also thank Dott.ssa Flavia Riccardo for her support with Capstats database management and the Italian Ministry of Health Special Surveillance project (Grant no. 1M61) for

funding. The authors state they have no conflicts of interest to declare. “
“In most years varicella is the vaccine-preventable disease most frequently reported to Centers for Disease Control and Prevention (CDC) by cruise ships. Since 2005, CDC has received numerous isolated case reports of varicella among crew members and has investigated varicella outbreaks aboard vessels sailing into and from US seaports. CDC investigators reviewed electronic varicella case reports from 2005 to 2009 and outbreak reports from 2009 to characterize the response and control efforts implemented by cruise ships in accordance with CDC protocols. Outbreak reports from 2009 were manually reviewed for details of case identification, contact investigations, isolation SSR128129E and restriction of cases and contacts, respectively, and number of contacts administered varicella

vaccine post-exposure by cruise lines. During 2005 to 2009, cruise ships reported 278 cases of varicella to CDC among predominantly male (80%) crew members, three-quarters of whom were residents of Caribbean countries, Indonesia, the Philippines, or India, and whose median age was 29 years. Cases were more commonly reported during spring and winter months. During 2009, cruise ships reported 94 varicella cases among crew members of which 66 (70%) were associated with 18 reported varicella outbreaks. Outbreak response included isolation of 66 (100%) of 66 cases, restriction of 66 (26%) of 255 crew-contacts, and administration of post-exposure vaccine to 522 close contacts and other susceptible crew members per standard CDC recommendations.