Autochthonous arbovirus infections in children in Europe, 2007–2024: A systematic review of the Italian Society of Pediatric Infectious Disease

Background: Imported and autochthonous cases of arboviral infections constitute an emerging and current public health threat in Europe. The aim of this work is to analyse epidemiological characteristics of pediatric autochthonous cases of Dengue (DENV), Chikungunya (CHIKV), West Nile (WNV) and Zika (ZIKV) virus in mainland Europe to help develop surveillance systems tailored to the pediatric population. Methods: A systematic review of the articles reporting autochthonous pediatric arboviral infections by Dengue, Chikungunya, West Nile and Zika in continental Europe from 2007 to 2024 was performed. Studies were identified through PUBMED, EMBASE, and official epidemiological reports. Findings: Pediatric autochthonous infections were uncommon and generally mild. Dengue represented the most frequently reported arbovirus, with pediatric cases identified in France, Italy, Spain and Croatia. Pediatric CHIKV cases were described during the 2007 and 2017 Italian outbreaks and in France in 2010. Although WNV is now endemic in Europe, children accounted for <1% of confirmed cases, with no fatal outcomes. Autochthonous ZIKV transmission was exceptional, and no pediatric cases were reported. Conclusion: Autochthonous arboviral infections in European children remain rare but may increase with the ongoing spread of Aedes vectors. Strengthening pediatric surveillance, improving diagnostic awareness and implementing rapid vector control measures are essential to prevent sustained transmission and mitigate future outbreaks in the pediatric population.