Biologia ed ecologia
I flebotomi o pappataci sono insetti di piccole dimensioni (<3,5 mm), dal volo a corto raggio (<300-500 m) e silenzioso. Hanno un colore giallo pallido simile a quello della sabbia (sand fly) e il torace, l’addome e le ali sono ricoperti da una fitta peluria.
Tutti i flebotomi sono generalmente attivi durante le ore crepuscolari e notturne, mentre durante il giorno rifuggono la luce solare nascondendosi in ambienti freschi e umidi quali stalle, pollai, cantine, abitazioni, fessure di muri, di roccia e del suolo. Vivono sia in ambienti domestici, che peri-domestici e selvatici. Sono assenti solo in Nuova Zelanda e nelle isole del Pacifico. La loro distribuzione altitudinale va da sotto il livello del mare, nel Mar Morto, fino ad arrivare a 3300 m s.l.m. in Afghanistan. In Italia il limite massimo è stato registrato in Sicilia nelle Madonie a 1200 m e a Filetto (AQ) a 1070 m s.l.m. Non sono mai state riportate colonizzazioni di nuovi territori mediante trasporto passivo da regioni distanti. È invece ipotizzabile una lenta colonizzazione di territori contigui quando le condizioni ambientali diventano favorevoli.
Il ciclo vitale si articola in uno stadio embrionale di uovo (~10 gg) seguito da 4 stadi larvali (~25-35 gg) e uno di pupa (~10 gg). La durata è strettamente legata ai fattori climatici: nelle zone temperate come le nostre, il ciclo dura 45-60 giorni, con almeno due cicli di sviluppo completi per stagione riproduttiva (giugno-settembre).
Come per le zanzare, solo le femmine sono ematofaghe. I maschi sono glicifagi. La puntura è fastidiosa perché attraverso le dentellature dell’apparato pungitore lacerano i capillari dermici fino a formare una piccola raccolta di sangue e contestualmente secernono saliva per impedire la coagulazione del sangue. Questa modalità si distingue da ematofagi più specializzati come i culicidi, i quali, invece, introducono l’apparato pungitore direttamente all’interno del capillare causando un danno cutaneo minore. Le femmine di flebotomo non hanno preferenza d’ospite e possono pungere qualsiasi vertebrato a sangue caldo (solo Sergentomyia si nutre prevalentemente sui rettili). L’accoppiamento avviene dopo l’assunzione del pasto di sangue o in presenza di un ospite su cui effettuarlo. Successivamente vengono deposte le uova e ciò non è casuale, ma le femmine riconoscono le nicchie ecologiche guidate prima dai costituenti chimici e fisici del substrato, poi dai feromoni presenti sulle uova della stessa specie già collocate in quel luogo. Ogni femmina può produrne da 50 a100 alla volta.
Le larve sono terricole, a differenza di quelle delle zanzare che sono acquatiche, e si sviluppano in oscurità quasi completa, in presenza di elevata umidità relativa (~90%) e temperatura costante (24-30°C) su terreni ricchi di materiale organico in decomposizione, di cui si nutrono.
La sopravvivenza durante la stagione fredda avviene grazie alle larve diapausanti nelle specie Paleartiche e allo stadio di uovo nei climi temperati.
Ruolo sanitario
Su oltre 800 specie di flebotomo descritte, circa 100 sono vettori, provati o sospetti, di leishmaniosi. L’Italia è endemica per 8 specie appartenenti a due generi, Phlebotomus e Sergentomyia, di cui sette appartenenti al genere Phlebotomus (P.perniciosus, P. perfiliewi, P. neglectus, P. ariasi, P. papatasi, P. sergenti e P. mascitti) mentre il secondo genere è rappresentato dalla sola specie Sergentomyia minuta che, nutrendosi su animali a sangue freddo (principalmente gechi e lucertole), non riveste importanza dal punto di vista sanitario, ma può costituire un importante indicatore ecologico per la presenza di flebotomi in un territorio (Tab.). La specie più diffusa e più abbondante è sicuramente P. perniciosus, la quale riveste un notevole interesse epidemiologico, essendo vettore accertato di leishmaniosi viscerale sia nell’uomo che nel cane.
Genere
|
Specie
|
Localizzazione
|
Leishmania
|
Phlebovirus
|
Phlebotomus
|
P. perniciosus
|
Italia
Spagna
Francia
Portogallo
|
L. infantum
|
Toscana virus
|
P. perfiliewi
|
Italia
|
L. infantum
|
Toscana virus
|
P. neglectus
|
Italia
Grecia
Albania
|
L. infantum
|
|
P. ariasi
|
Italia
|
L. infantum
|
|
P. papatasi
|
Italia
Spagna
|
-
|
|
P. sergenti
|
Sicilia
Spagna
|
-
|
|
P. mascittii
|
Italia
Francia
Svizzera
|
-
|
|
Sergentomya
|
S. minuta
|
Italia
|
L. tarentolae
parassita dei rettili
|
|
Tab. Specie di flebotomo endemiche in Italia
Sia per le caratteristiche biologiche che dell’habitat, questi insetti non hanno una presenza uniforme sul territorio italiano. Infatti, a partire dai primi anni ’90 si è assistito ad una espansione dai versanti tirrenici, ionici e adriatici centromeridionali della penisola e dalle isole, al versante centro-settentrionale adriatico e in molte aree collinari prealpine e preappenniniche. All'origine di questo fenomeno sembrano esserci diversi fattori concomitanti: l'aumento della popolazione canina, il randagismo e le mutate condizioni climatico-ambientali che hanno permesso ai vettori di colonizzare nuove aree.
I flebotomi possono trasmettere VIRUS (Febbre da pappataci o dei tre giorni con i virus Napoli e Sicilia; meningite estiva benigna con il virus Toscana); BATTERI (Bartonellosi, non presente in Italia) e PROTOZOI (Leishmaniosi). Nella maggior parte dei casi le arbovirosi decorrono in maniera asintomatica o con sintomi simil-influenzali, e solo talvolta possono dare origine ad infezioni acute del sistema nervoso centrale. Il virus Toscana è quello più rappresentato in Italia e dal 1° gennaio al 30 settembre 2020, il sistema di sorveglianza nazionale dell'Istituto Superiore di Sanità ha confermato 36 casi di infezione neuro-invasiva, tutti autoctoni, nessun decesso, verificatisi nelle Regioni Emilia-Romagna, Toscana, Lazio, Sicilia e 2 casi nelle Marche.
L’importanza sanitaria dei flebotomi è sostanzialmente legata alla trasmissione delle leishmaniosi, un vasto complesso di malattie causate da protozoi del genere Leishmania. In Italia la leishmaniosi si presenta in 3 diverse forme, tutte dovute al medesimo parassita Leishmania infantum: 1) la leishmaniosi viscerale umana (grave e mortale se non curata); 2) la leishmaniosi cutanea sporadica nell’uomo (forma benigna, autolimitante); 3) la leishmaniosi canina.
![](data:image/png;base64,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)
La trasmissione della leishmaniosi non avviene direttamente da cane a cane o da cane a uomo ma attraverso la puntura del flebotomo, che rappresenta il vettore, e il cane in ambiente antropizzato, che rappresenta il serbatoio. In altri contesti possono avere un ruolo di serbatoio anche i canidi selvatici (volpe, lupo) pur se in Italia è da ritenersi poco rilevante, mentre il ruolo del gatto è ancora da chiarire.
Il ciclo comincia con il pasto di sangue del flebotomo su un cane infetto e l’ingestione della forma aflagellata del protozoo. Nel tratto digerente del vettore si moltiplica e assume la forma flagellata la quale risale nel faringe e forma un tappo che sarà espulso al momento di una nuova puntura, provocando così l’infezione. La trasmissione avviene prevalentemente durante i mesi estivi a causa della stagionalità del vettore.
Gran parte delle infezioni umane colpisce individui immunocompetenti; inoltre, è possibile la trasmissione interumana per trasfusioni di sangue o attraverso siringhe contaminate.
Approfondimento
Sito dell’ECDC (European Centre for Disease Prevention and Control) per visualizzare le mappe sulla distribuzione delle varie specie di Phlebotomus, anche se non rappresentano i dati ufficiali dei paesi interessati.
Autore: Dr.ssa Maria Gabriella Pistilli
La presente nota è stata redatta in attuazione alla Determina DG/ASUR n.734/2016 nell’ambito della comunicazione del rischio AV5-2020