Case-time series study on the short-term impact of meteorological factors on West Nile Virus incidence in Italy at the local-administrative unit level, 2012 to 2021

Introduction: West Nile Virus (WNV) is a significant public health concern in southern Europe, with meteorological, climatic, and environmental factors playing a critical role in its transmission dynamics. This study aims to assess the short-term effects of meteorological variables on the incidence of WNV in five Italian regions in Northern Italy from 2012 to 2021. Methods: Linking epidemiological data from the national surveillance system and local meteorological data, we conducted a Case-Time Series analysis to examine the association between WNV incident cases and temperature, humidity, and precipitation recorded up to ten weeks before case occurrence at the local administrative unit level. We employed conditional quasi14 Poisson regression and distributed lag non-linear models to explore delayed effects. Results: Our study analyzed 1,110 autochthonous human cases of WNV. We found a positive association between WNV incidence and weekly mean temperature recorded between one to nine weeks before the diagnosis, with the highest effect at one week lag (IRR: 1.16; 95% CI 1.11-1.21). An increase in weekly precipitations between the sixth and ninth weeks before diagnosis was also positively associated with WNV incidence. Variations in minimum weekly humidity did not show a consistent impact. Conclusions: Our findings underscore the influence of temperature and, to a lesser extent, precipitation on WNV incidence in Northern Italy, highlighting the potential of climatic data in developing early warning systems for WNV surveillance and public health interventions.