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Loconsole D, Centrone F, Sallustio A, Casulli D, Colella V, Mongelli O, Venturi G, Bella A, Marino L, Martinelli D, Chironna M. Abrupt Increase in Detection of Locally Acquired West-Nile-Virus-Lineage-2-Mediated Neuroinvasive Disease in a Previously Non-Endemic Area of Southern Italy (2023). Viruses 2023; 16:53. [PMID: 38257753 PMCID: PMC10819189 DOI: 10.3390/v16010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
West Nile virus (WNV) is a public health concern in Europe. Rising temperatures and the migration of potential vectors promote the spread of viruses to previously unaffected areas. In 2023, the Apulia region of Southern Italy experienced an unexpected increase in West Nile neuroinvasive disease (WNND); no such cases had been reported in the previous 10 years. Overall, eight autochthonous cases of WNV infection were identified between July and October 2023, six of which were WNND. All cases were male (median age, 73 years). Two of the cases were blood donors. All WNND cases were hospitalized and all recovered within a few weeks. Surveillance data showed that, in the Apulia region, WNV Lineage 2 was detected in humans, mosquitoes, and horses. Based on the number of WNND cases reported, we can assume that a high number of infections occurred during the summer period. Changes in the climate in the region over recent years could be considered among the main drivers of the rapid increase in WNV infections. Therefore, integrated surveillance should be strengthened to avoid the potential massive spread of WNV in Southern Italy. Moreover, the implementation of whole-genome sequencing of WNV strains, as well as seroepidemiological studies in the area, will facilitate a better understanding of circulation dynamics.
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Affiliation(s)
- Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.)
| | - Francesca Centrone
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Anna Sallustio
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Daniele Casulli
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Vito Colella
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.)
| | - Onofrio Mongelli
- Department of Health Promotion and Animal Welfare, Apulia Region, 70124 Bari, Italy
| | - Giulietta Venturi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Leonardo Marino
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Domenico Martinelli
- Hygiene Section, Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.)
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2
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Angeloni G, Bertola M, Lazzaro E, Morini M, Masi G, Sinigaglia A, Trevisan M, Gossner CM, Haussig JM, Bakonyi T, Capelli G, Barzon L. Epidemiology, surveillance and diagnosis of Usutu virus infection in the EU/EEA, 2012 to 2021. Euro Surveill 2023; 28:2200929. [PMID: 37589592 PMCID: PMC10436690 DOI: 10.2807/1560-7917.es.2023.28.33.2200929] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/08/2023] [Indexed: 08/18/2023] Open
Abstract
BackgroundUsutu virus (USUV) is a flavivirus with an enzootic cycle between birds and mosquitoes; humans are incidental dead-end hosts. In Europe, the virus was first detected in Italy in 1996; since then, it has spread to many European countries.AimWe aimed to report on the epidemiology, surveillance, diagnosis and prevention of USUV infection in humans, mosquitoes and other animals in the European Union/European Economic Area (EU/EEA) from 2012 to 2021.MethodsWe collected information through a literature review, an online survey and an expert meeting.ResultsEight countries reported USUV infection in humans (105 cases, including 12 [corrected] with neurological symptoms), 15 countries in birds and seven in mosquitoes. Infected animals were also found among pets, wild and zoo animals. Usutu virus was detected primarily in Culex pipiens but also in six other mosquito species. Detection of USUV infection in humans is notifiable only in Italy, where it is under surveillance since 2017 and now integrated with surveillance in animals in a One Health approach. Several countries include USUV infection in the differential diagnosis of viral encephalitis and arbovirus infections. Animal USUV infection is not notifiable in any EU/EEA country.ConclusionHuman USUV infections, mainly asymptomatic and, less frequently, with a febrile illness or a neuroinvasive disease, have been reported in several EU/EEA countries, where the virus is endemic. Climate and environmental changes are expected to affect the epidemiology of USUV. A One Health approach could improve the monitoring of its evolution in Europe.
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Affiliation(s)
- Giorgia Angeloni
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro (Padua), Italy
- These authors contributed equally to the work and share first authorship
| | - Michela Bertola
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro (Padua), Italy
- These authors contributed equally to the work and share first authorship
| | - Elena Lazzaro
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro (Padua), Italy
| | - Matteo Morini
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro (Padua), Italy
| | - Giulia Masi
- Department of Molecular Medicine, University of Padua, Via Gabelli 63, Padua (Padua), Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padua, Via Gabelli 63, Padua (Padua), Italy
| | - Marta Trevisan
- Department of Molecular Medicine, University of Padua, Via Gabelli 63, Padua (Padua), Italy
| | - Céline M Gossner
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana M Haussig
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Tamas Bakonyi
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro (Padua), Italy
- These authors contributed equally to the work and share last authorship
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padua, Via Gabelli 63, Padua (Padua), Italy
- These authors contributed equally to the work and share last authorship
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3
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Reemtsma H, Holicki CM, Fast C, Bergmann F, Groschup MH, Ziegler U. A Prior Usutu Virus Infection Can Protect Geese from Severe West Nile Disease. Pathogens 2023; 12:959. [PMID: 37513806 PMCID: PMC10386565 DOI: 10.3390/pathogens12070959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Usutu virus (USUV) and West Nile virus (WNV) are closely related pathogens circulating between mosquitoes and birds, but also infecting mammals as dead-end hosts. Both viruses share the same susceptible hosts, vectors, and even distribution areas in Central Europe. The aim of the study was, therefore, to understand their amplification potential and interference upon a successive infection. Two-week old geese were initially infected with an USUV isolate from Germany and with a German WNV isolate17 days later. The geese were susceptible to the USUV and the WNV infections, as evidenced by specific flavivirus antibodies in all of the birds. Furthermore, in half of the USUV-inoculated geese, USUV genomes were detected in the blood and swab samples 2-4 days post-infection. Additionally, most of the examined organs contained USUV genomes and showed signs of encephalitis and ganglioneuritis. Interestingly, upon a sequential infection with WNV, the genome copy numbers in all of the examined samples were significantly lower and less frequent than after a WNV mono-infection. Similarly, the histopathological lesions were less severe. Therefore, it can be concluded that a previous USUV infection can protect birds from clinical disease in a subsequent WNV infection.
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Affiliation(s)
- Hannah Reemtsma
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
| | - Cora M Holicki
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
| | - Christine Fast
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
| | - Felicitas Bergmann
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
| | - Martin H Groschup
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
| | - Ute Ziegler
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, 17493 Greifswald-Insel Riems, Germany
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4
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L'Ambert G, Gendrot M, Briolant S, Nguyen A, Pages S, Bosio L, Palomo V, Gomez N, Benoit N, Savini H, Pradines B, Durand GA, Leparc-Goffart I, Grard G, Fontaine A. Analysis of trapped mosquito excreta as a noninvasive method to reveal biodiversity and arbovirus circulation. Mol Ecol Resour 2023; 23:410-423. [PMID: 36161270 PMCID: PMC10092573 DOI: 10.1111/1755-0998.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 01/04/2023]
Abstract
Emerging and endemic mosquito-borne viruses can be difficult to detect and monitor because they often cause asymptomatic infections in human or vertebrate animals or cause nonspecific febrile illness with a short recovery waiting period. Some of these pathogens circulate into complex cryptic cycles involving several animal species as reservoir or amplifying hosts. Detection of cases in vertebrate hosts can be complemented by entomological surveillance, but this method is not adapted to low infection rates in mosquito populations that typically occur in low or nonendemic areas. We identified West Nile virus circulation in Camargue, a wetland area in South of France, using a cost-effective xenomonitoring method based on the molecular detection of virus in excreta from trapped mosquitoes. We also succeeded at identifying the mosquito species community on several sampling sites, together with the vertebrate hosts on which they fed prior to being captured using amplicon-based metabarcoding on mosquito excreta without processing any mosquitoes. Mosquito excreta-based virus surveillance can complement standard surveillance methods because it is cost-effective and does not require personnel with a strong background in entomology. This strategy can also be used to noninvasively explore the ecological network underlying arbovirus circulation.
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Affiliation(s)
- Grégory L'Ambert
- Entente Interdépartementale Pour la Démoustication du Littoral Méditerranéen (EID Méditerranée), Montpellier, France
| | - Mathieu Gendrot
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Sébastien Briolant
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | | | - Sylvain Pages
- Entente Interdépartementale Pour la Démoustication du Littoral Méditerranéen (EID Méditerranée), Montpellier, France
| | - Laurent Bosio
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France.,Centre National de Référence des Arbovirus, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Vincent Palomo
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France.,Centre National de Référence des Arbovirus, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Nicolas Gomez
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Nicolas Benoit
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Hélène Savini
- IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,Service des Maladies Infectieuses, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Bruno Pradines
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France.,Centre National de Référence du Paludisme, Marseille, France
| | - Guillaume André Durand
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France.,Centre National de Référence des Arbovirus, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Isabelle Leparc-Goffart
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France.,Centre National de Référence des Arbovirus, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Gilda Grard
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France.,Centre National de Référence des Arbovirus, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Albin Fontaine
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France.,IRD, SSA, AP-HM, VITROME, Aix Marseille Univ, Marseille, France.,IHU Méditerranée Infection, Marseille, France
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Cadar D, Simonin Y. Human Usutu Virus Infections in Europe: A New Risk on Horizon? Viruses 2022; 15:77. [PMID: 36680117 PMCID: PMC9866956 DOI: 10.3390/v15010077] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
The Usutu virus (USUV), a neurotropic mosquito-borne flavivirus discovered in 1959 in South Africa, has spread over the last twenty years across the European continent. This virus follows an enzootic cycle involving mosquitoes and birds. This caused epizootics with significant bird mortality in Europe in 2016 and 2018. It can also occasionally infect humans and other mammals, including horses and bats, which act as incidental or dead-end hosts. The zoonotic risk associated with this succession of avian epizootics in Europe deserves attention, even if, to date, human cases remain exceptional. Human infection is most often asymptomatic or responsible for mild clinical symptoms. However, human Usutu infections have also been associated with neurological disorders, such as encephalitis and meningoencephalitis. One of the major complexities of the study of USUV pathogenesis is the presence of a great diversity of lineages which could co-circulate spatiotemporally. In this review we discuss several aspects of the circulation of Usutu virus in humans in Europe, the neurological disorders associated, involved viral lineages, and the issues and questions raised by their circulation.
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Affiliation(s)
- Dániel Cadar
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Hemorrhagic Fever Reference and Research, 20359 Hamburg, Germany
| | - Yannick Simonin
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, INSERM, EFS, 34000 Montpellier, France
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6
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Riccò M, Zaniboni A, Satta E, Ranzieri S, Cerviere MP, Marchesi F, Peruzzi S. West Nile Virus Infection: A Cross-Sectional Study on Italian Medical Professionals during Summer Season 2022. Trop Med Infect Dis 2022; 7:tropicalmed7120404. [PMID: 36548659 PMCID: PMC9786547 DOI: 10.3390/tropicalmed7120404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022] Open
Abstract
West Nile virus (WNV) has progressively endemized in large areas of continental Europe, and particularly in Northern Italy, in the Po River Valley. During summer season 2022, Italy experienced an unprecedented surge in incidence cases of WNV infections, including its main complications (West Nile fever (WNF) and West Nile neuroinvasive disease (WNND)). As knowledge, attitudes, and practices (KAP) of medical professionals may be instrumental in guaranteeing a prompt diagnosis and an accurate management of incident cases, we performed a cross-sectional study specifically on a sample of Italian medical professionals (1 August 2022-10 September 2022; around 8800 potential recipients). From a total of 332 questionnaires (response rate of 3.8%), 254 participating medical professionals were eventually included in the analyses. Knowledge status of participants was unsatisfying, as most of them exhibited knowledge gaps on the actual epidemiology of WNV, with similar uncertainties on the clinical features of WNF and WNND. Moreover, most of participants substantially overlooked WNV as a human pathogen when compared to SARS-CoV-2, TB, and even HIV. Interestingly, only 65.4% of respondents were either favorable or highly favorable towards a hypothetical WNV vaccine. Overall, acknowledging a higher risk perception on WNV was associated with individual factors such as reporting a seniority ≥ 10 years (adjusted odds ratio [aOR] 2.39, 95% Confidence interval [95%CI] 1.34 to 4.28), reporting a better knowledge score (aOR 2.92, 95%CI 1.60 to 5.30), having previously managed cases of WNV infections (aOR 3.65, 95%CI 1.14 to 14.20), being favorable towards a hypothetic vaccine (aOR 2.16, 95%CI 1.15 to 4.04), and perceiving WNV infections as potentially affecting daily activities (aOR 2.57, 95%CI 1.22 to 5.42). In summary, substantial knowledge gaps and the erratic risk perception collectively enlighten the importance and the urgency for appropriate information campaigns among medical professionals, and particularly among frontline personnel.
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Affiliation(s)
- Matteo Riccò
- Occupational Health and Safety Service on the Workplace/Servizio di Prevenzione e Sicurezza Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
- Correspondence: or ; Tel.: +39-339-2994343 or +39-522-837587
| | | | - Elia Satta
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | | | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, 42016 Guastalla, Italy
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7
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Berneck BS, Rockstroh A, Barzon L, Sinigaglia A, Vocale C, Landini MP, Rabenau HF, Schmidt-Chanasit J, Ulbert S. Serological differentiation of West Nile virus and Usutu virus induced antibodies by envelope proteins with modified cross-reactive epitopes. Transbound Emerg Dis 2021; 69:2779-2787. [PMID: 34919790 DOI: 10.1111/tbed.14429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/01/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne viruses belonging to the Japanese encephalitis virus serocomplex within the genus Flavivirus. Due to climate change and the expansion of mosquito vectors, flaviviruses are becoming endemic in increasing numbers of countries. WNV infections are reported with symptoms ranging from mild fever to severe neuro invasive disease. Until now, only a few USUV infections have been reported in humans, mostly with mild symptoms. The serological diagnosis and differentiation between flavivirus infections in general and between WNV and USUV in particular are challenging due the high degree of cross-reacting antibodies, especially of those directed against the conserved fusion loop (FL) domain of the envelope (E) protein. We have previously shown that E proteins containing four amino acid mutations in and near the FL strongly reduce the binding of cross-reactive antibodies leading to diagnostic technologies with improved specificities. Here, we expanded the technology to USUV and analyzed the differentiation of USUV and WNV induced antibodies in humans. IgG ELISAs modified by an additional competition step with the heterologous antigen resulted in overall specificities of 93.94% for WNV Equad and 92.75% for USUV Equad. IgM antibodies against WNV could be differentiated from USUV IgM in a direct comparison using both antigens. The data indicate the potential of the system to diagnose antigenically closely related flavivirus infections. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Beatrice Sarah Berneck
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
| | - Alexandra Rockstroh
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, Padova, 35121, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, Padova, 35121, Italy
| | - Caterina Vocale
- CRREM. Unità Operativa di Microbiologia, IRCCS Policlinico di S. Orsola, Via Massarenti 9, Bologna, 40138, Italy
| | - Maria Paola Landini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies-CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Paul-Ehrlich-Str. 40, Frankfurt, 60596, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, Hamburg, 20359, Germany
| | - Sebastian Ulbert
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig, 04103, Germany
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Salgado R, Hawks SA, Frere F, Vázquez A, Huang CYH, Duggal NK. West Nile Virus Vaccination Protects against Usutu Virus Disease in Mice. Viruses 2021; 13:v13122352. [PMID: 34960621 PMCID: PMC8704473 DOI: 10.3390/v13122352] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne flaviviruses that can cause neuroinvasive disease in humans. WNV and USUV circulate in both Africa and Europe and are closely related. Due to antigenic similarity, WNV-specific antibodies and USUV-specific antibodies have the potential to bind heterologous viruses; however, it is unclear whether this interaction may offer protection against infection. To investigate how prior WNV exposure would influence USUV infection, we used an attenuated WNV vaccine that contains the surface proteins of WNV in the backbone of a dengue virus 2 vaccine strain and protects against WNV disease. We hypothesized that vaccination with this attenuated WNV vaccine would protect against USUV infection. Neutralizing responses against WNV and USUV were measured in vitro using sera following vaccination. Sera from vaccinated CD-1 and Ifnar1-/- mice cross-neutralized with WNV and USUV. All mice were then subsequently challenged with an African or European USUV strain. In CD-1 mice, there was no difference in USUV titers between vaccinated and mock-vaccinated mice. However, in the Ifnar1-/- model, vaccinated mice had significantly higher survival rates and significantly lower USUV viremia compared to mock-vaccinated mice. Our results indicate that exposure to an attenuated form of WNV protects against severe USUV disease in mice and elicits a neutralizing response to both WNV and USUV. Future studies will investigate the immune mechanisms responsible for the protection against USUV infection induced by WNV vaccination, providing critical insight that will be essential for USUV and WNV vaccine development.
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Affiliation(s)
- Rebecca Salgado
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Seth A. Hawks
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Francesca Frere
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Ana Vázquez
- National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), CIBERESP, CIBER Epidemiology and Public Health, 28220 Madrid, Spain;
| | - Claire Y.-H. Huang
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, CO 80521, USA;
| | - Nisha K. Duggal
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
- Correspondence: ; Tel.: +1-540-231-6705
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Marchi S, Montomoli E, Viviani S, Giannecchini S, Stincarelli MA, Lanave G, Camero M, Alessio C, Coluccio R, Trombetta CM. West Nile Virus Seroprevalence in the Italian Tuscany Region from 2016 to 2019. Pathogens 2021; 10:pathogens10070844. [PMID: 34357994 PMCID: PMC8308575 DOI: 10.3390/pathogens10070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
Although in humans West Nile virus is mainly the cause of mild or sub-clinical infections, in some cases a neuroinvasive disease may occur predominantly in the elderly. In Italy, several cases of West Nile virus infection are reported every year. Tuscany was the first Italian region where the virus was identified; however, to date only two cases of infection have been reported in humans. This study aimed at evaluating the prevalence of antibodies against West Nile virus in the area of Siena Province to estimate the recent circulation of the virus. Human serum samples collected in Siena between 2016 and 2019 were tested for the presence of antibodies against West Nile virus by ELISA. ELISA positive samples were further evaluated using immunofluorescence, micro neutralization, and plaque reduction neutralization assays. In total, 1.9% (95% CI 1.2–3.1) and 1.4% (95% CI 0.8–2.4) of samples collected in 2016–2017 were positive by ELISA and immunofluorescence assay, respectively. Neutralizing antibodies were found in 0.7% (95% CI 0.3–1.5) of samples. Additionally, 0.9% (95% CI 0.4–1.7) and 0.65% (95% CI 0.3–1.45) of samples collected in 2018–2019 were positive by ELISA and immunofluorescence assay, respectively. The prevalence of neutralizing antibodies was 0.5% (95% CI 0.2–1.3). Although no human cases of West Nile infection were reported in the area between 2016 and 2019 and virus prevalence in the area of Siena Province was as low as less than 1%, the active asymptomatic circulation confirms the potential concern of this emergent virus for human health.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- Correspondence:
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- VisMederi S.r.l., 53100 Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
| | - Simone Giannecchini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Firenze, Italy; (S.G.); (M.A.S.)
| | - Maria A. Stincarelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Firenze, Italy; (S.G.); (M.A.S.)
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Michele Camero
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Caterina Alessio
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
| | - Rosa Coluccio
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- VisMederi S.r.l., 53100 Siena, Italy
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
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10
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Riccò M, Peruzzi S, Balzarini F. Epidemiology of West Nile Virus Infections in Humans, Italy, 2012-2020: A Summary of Available Evidences. Trop Med Infect Dis 2021; 6:61. [PMID: 33923347 PMCID: PMC8167603 DOI: 10.3390/tropicalmed6020061] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 11/25/2022] Open
Abstract
In Italy, human cases of West Nile virus (WNV) infection have been recorded since 2008, and seasonal outbreaks have occurred almost annually. In this study, we summarize available evidences on the epidemiology of WNV and West Nile neuro-invasive disease (WNND) in humans reported between 2012 and 2020. In total, 1145 WNV infection cases were diagnosed; of them 487 (42.5%) had WNND. A significant circulation of the pathogen was suggested by studies on blood donors, with annual incidence rates ranging from 1.353 (95% confidence intervals (95% CI) 0.279-3.953) to 19.069 cases per 100,000 specimens (95% CI 13.494-26.174). The annual incidence rates of WNND increased during the study period from 0.047 cases per 100,000 (95% CI 0.031-0.068) in 2012, to 0.074 cases per 100,000 (95% CI 0.054-0.099) in 2020, peaking to 0.377 cases per 100,000 (95% CI 0.330-0.429) in 2018. There were 60 deaths. Cases of WNND were clustered in Northern Italy, particularly in the Po River Valley, during the months of August (56.7%) and September (27.5%). Higher risk for WNND was reported in subjects of male sex (risk ratio (RR) 1.545, 95% CI 1.392-1.673 compared to females), and in older age groups (RR 24.46, 95% CI 15.61-38.32 for 65-74 y.o.; RR 43.7, 95% CI 28.33-67.41 for subjects older than 75 years), while main effectors were identified in average air temperatures (incidence rate ratio (IRR) 1.3219, 95% CI 1.0053-1.7383), population density (IRR 1.0004, 95% CI 1.0001-1.0008), and occurrence of cases in the nearby provinces (IRR 1.0442, 95% CI 1.0340-1.0545). In summary, an enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Via Amendola n.2, I-42122 Reggio Emilia, RE, Italy
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, I-42016 Guastalla, RE, Italy;
| | - Federica Balzarini
- Dipartimento P.A.A.P.S.S., Servizio Autorizzazione e Accreditamento, Agenzia di Tutela della Salute (ATS) di Bergamo, Via Galliccioli, 4, I-24121 Bergamo, BG, Italy;
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11
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Vlaskamp DR, Thijsen SF, Reimerink J, Hilkens P, Bouvy WH, Bantjes SE, Vlaminckx BJ, Zaaijer H, van den Kerkhof HH, Raven SF, Reusken CB. First autochthonous human West Nile virus infections in the Netherlands, July to August 2020. ACTA ACUST UNITED AC 2021; 25. [PMID: 33213687 PMCID: PMC7678035 DOI: 10.2807/1560-7917.es.2020.25.46.2001904] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
In October 2020, the first case of autochthonous West Nile virus neuroinvasive disease was diagnosed in the Netherlands with a presumed infection in the last week of August. Investigations revealed five more cases of local West Nile virus (WNV) infection. The cases resided in a region where WNV was detected in a bird and mosquitoes in August 2020. Molecular analysis was successful for two cases and identified the presence of WNV lineage 2.
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Affiliation(s)
- Danique Rm Vlaskamp
- These authors contributed equally.,Department of Neurology, St. Antonius hospital, Nieuwegein, the Netherlands
| | - Steven Ft Thijsen
- Department of Medical Microbiology and Immunology, Diakonessenhuis Hospital, Utrecht, the Netherlands.,These authors contributed equally
| | - Johan Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,These authors contributed equally
| | - Pieter Hilkens
- Department of Neurology, St. Antonius hospital, Nieuwegein, the Netherlands
| | - Willem H Bouvy
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands
| | - Sabine E Bantjes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bart Jm Vlaminckx
- Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Hans Zaaijer
- Sanquin Blood Supply Foundation and Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Hans Htc van den Kerkhof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Stijn Fh Raven
- Department of Infectious Diseases, Public Health Service region Utrecht, Utrecht, the Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,These authors contributed equally
| | - Chantal Bem Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,These authors contributed equally
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12
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Böszörményi K, Hirsch J, Kiemenyi Kayere G, Fagrouch Z, Heijmans N, Rodriguez Garcia R, Dwarka S, van Dijke A, Aaldijk B, Limpens R, Barcena M, Koster B, Verstrepen B, Bogers W, Kocken C, Cornellissen G, Verschoor E, Faber B. A Bacterially-Expressed Recombinant Envelope Protein from Usutu Virus Induces Neutralizing Antibodies in Rabbits. Vaccines (Basel) 2021; 9:vaccines9020157. [PMID: 33669414 PMCID: PMC7920429 DOI: 10.3390/vaccines9020157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Recently, an emerging flavivirus, Usutu virus (USUV), has caused an epidemic among birds in Europe, resulting in a massive die-off in Eurasian blackbirds. Currently found only in Europe and Africa, it can be envisioned that Usutu virus will follow the path of other flaviviruses, like West Nile virus and Zika virus, and will spread via its mosquito vectors and bird hosts to other parts of the world. Several cases of human infections by Usutu virus have already been published. Anticipating this spread, development of an efficacious vaccine would be highly desirable. Method: This study describes the production in E. coli, purification, and refolding of a partial USUV envelope protein. Prior to immunization, the protein was characterized using size exclusion chromatography, transmission electron microscopy and dynamic light scattering, showing the limited presence of virus-like structures, indicating that the protein solution is probably a mixture of mono and multimeric envelope proteins. Results: Immunizations of two rabbits with the refolded E-protein fraction, mixed with a strong adjuvant, resulted in the generation of neutralizing antibodies, as evidenced in an in vitro assay. Discussion: The way forward towards a subunit vaccine against Usutu virus infection is discussed.
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Affiliation(s)
- Kinga Böszörményi
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
- Correspondence: (K.B.); (B.F.); Tel.: +31-152842500 (K.B. & B.F.)
| | - Janet Hirsch
- Department of Biotechnology, Hamburg University of Applied Sciences, Ulmenliet 20, 21033 Hamburg, Germany; (J.H.); (G.C.)
| | - Gwendoline Kiemenyi Kayere
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
| | - Zahra Fagrouch
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
| | - Nicole Heijmans
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Roberto Rodriguez Garcia
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Soesjiel Dwarka
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Amy van Dijke
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Boyd Aaldijk
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Ronald Limpens
- Section Electron Microscopy, Leiden University Medical Center, Einthovenweg 20, 2300 RC Leiden, The Netherlands; (R.L.); (M.B.); (B.K.)
| | - Montserrat Barcena
- Section Electron Microscopy, Leiden University Medical Center, Einthovenweg 20, 2300 RC Leiden, The Netherlands; (R.L.); (M.B.); (B.K.)
| | - Bram Koster
- Section Electron Microscopy, Leiden University Medical Center, Einthovenweg 20, 2300 RC Leiden, The Netherlands; (R.L.); (M.B.); (B.K.)
| | - Babs Verstrepen
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
| | - Willy Bogers
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
| | - Clemens Kocken
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
| | - Gesine Cornellissen
- Department of Biotechnology, Hamburg University of Applied Sciences, Ulmenliet 20, 21033 Hamburg, Germany; (J.H.); (G.C.)
| | - Ernst Verschoor
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (G.K.K.); (Z.F.); (B.V.); (W.B.); (E.V.)
| | - Bart Faber
- Department of Parasitology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (N.H.); (R.R.G.); (S.D.); (A.v.D.); (B.A.); (C.K.)
- Correspondence: (K.B.); (B.F.); Tel.: +31-152842500 (K.B. & B.F.)
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13
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Modelling West Nile Virus and Usutu Virus Pathogenicity in Human Neural Stem Cells. Viruses 2020; 12:v12080882. [PMID: 32806715 PMCID: PMC7471976 DOI: 10.3390/v12080882] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022] Open
Abstract
West Nile virus (WNV) and Usutu virus (USUV) are genetically related neurotropic mosquito-borne flaviviruses, which frequently co-circulate in nature. Despite USUV seeming to be less pathogenic for humans than WNV, the clinical manifestations induced by these two viruses often overlap and may evolve to produce severe neurological complications. The aim of this study was to investigate the effects of WNV and USUV infection on human induced pluripotent stem cell-derived neural stem cells (hNSCs), as a model of the neural progenitor cells in the developing fetal brain and in adult brain. Zika virus (ZIKV), a flavivirus with known tropism for NSCs, was used as the positive control. Infection of hNSCs and viral production, effects on cell viability, apoptosis, and innate antiviral responses were compared among viruses. WNV displayed the highest replication efficiency and cytopathic effects in hNSCs, followed by USUV and then ZIKV. In these cells, both WNV and USUV induced the overexpression of innate antiviral response genes at significantly higher levels than ZIKV. Expression of interferon type I, interleukin-1β and caspase-3 was significantly more elevated in WNV- than USUV-infected hNSCs, in agreement with the higher neuropathogenicity of WNV and the ability to inhibit the interferon response pathway.
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14
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Pacenti M, Sinigaglia A, Martello T, De Rui ME, Franchin E, Pagni S, Peta E, Riccetti S, Milani A, Montarsi F, Capelli G, Doroldi CG, Bigolin F, Santelli L, Nardetto L, Zoccarato M, Barzon L. Clinical and virological findings in patients with Usutu virus infection, northern Italy, 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 31771697 PMCID: PMC6885746 DOI: 10.2807/1560-7917.es.2019.24.47.1900180] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BackgroundUsutu virus (USUV) is a mosquito-borne flavivirus, which shares its transmission cycle with the phylogenetically related West Nile virus (WNV). USUV circulates in several European countries and its activity has increased over the last 5 years.AimTo describe human cases of USUV infection identified by surveillance for WNV and USUV infection in the Veneto Region of northern Italy in 2018.MethodsFrom 1 June to 30 November 2018, all cases of suspected autochthonous arbovirus infection and blood donors who had a reactive WNV nucleic acid test were investigated for both WNV and USUV infection by in-house molecular methods. Anti-WNV and anti-USUV IgM and IgG antibodies were detected by ELISA and in-house immunofluorescence assay, respectively; positive serum samples were further tested by WNV and USUV neutralisation assays run in parallel.ResultsEight cases of USUV infection (one with neuroinvasive disease, six with fever and one viraemic blood donor who developed arthralgia and myalgia) and 427 cases of WNV infection were identified. A remarkable finding of this study was the persistence of USUV RNA in the blood and urine of three patients during follow-up. USUV genome sequences from two patients shared over 99% nt identity with USUV sequences detected in mosquito pools from the same area and clustered within lineage Europe 2.ConclusionsClinical presentation and laboratory findings in patients with USUV infection were similar to those found in patients with WNV infection. Cross-reactivity of serology and molecular tests challenged the differential diagnosis.
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Affiliation(s)
- Monia Pacenti
- These authors contributed equally as first authors.,Microbiology and Virology Unit, Padua University Hospital, Padova, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, Padova, Italy.,These authors contributed equally as first authors
| | | | | | - Elisa Franchin
- Department of Molecular Medicine, University of Padova, Padova, Italy.,These authors contributed equally as first authors
| | - Silvana Pagni
- Department of Molecular Medicine, University of Padova, Padova, Italy.,These authors contributed equally as first authors
| | - Elektra Peta
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Silvia Riccetti
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Adelaide Milani
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro PD, Italy
| | - Fabrizio Montarsi
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro PD, Italy
| | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro PD, Italy
| | | | - Francesco Bigolin
- Medicine Unit, Camposampiero Hospital, Azienda ULSS 6 Euganea, Padova, Italy
| | - Luca Santelli
- Neurology Department, Ospedale S. Antonio, Azienda ULSS 6 Euganea, Padova, Italy
| | - Lucia Nardetto
- Neurology Department, Ospedale S. Antonio, Azienda ULSS 6 Euganea, Padova, Italy
| | - Marco Zoccarato
- Neurology Department, Ospedale S. Antonio, Azienda ULSS 6 Euganea, Padova, Italy
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, Padova, Italy.,These authors contributed equally as first authors
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15
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Sinigaglia A, Pacenti M, Martello T, Pagni S, Franchin E, Barzon L. West Nile virus infection in individuals with pre-existing Usutu virus immunity, northern Italy, 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 31138361 PMCID: PMC6540647 DOI: 10.2807/1560-7917.es.2019.24.21.1900261] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In 2018, there was a large West Nile virus (WNV) outbreak in northern Italy. We observed five atypical cases of WNV infection that were characterised by the presence of WNV RNA and WNV IgG at the time of diagnosis, but no IgM response during follow-up. Neutralisation assays demonstrated pre-existing Usutu virus immunity in all patients. Besides challenging diagnosis, the immunological crosstalk between the two viruses warrants further investigation on possible cross-protection or infection enhancement effects.
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Affiliation(s)
| | - Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy
| | - Thomas Martello
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Silvana Pagni
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy.,Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Elisa Franchin
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy.,Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Luisa Barzon
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy.,Department of Molecular Medicine, University of Padova, Padova, Italy
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16
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Abstract
Usutu virus (USUV) is an emerging arbovirus that was first isolated in South Africa in 1959. This Flavivirus is maintained in the environment through a typical enzootic cycle involving mosquitoes and birds. USUV has spread to a large part of the European continent over the two decades mainly leading to substantial avian mortalities with a significant recrudescence of bird infections recorded throughout Europe within the few last years. USUV infection in humans is considered to be most often asymptomatic or to cause mild clinical signs. Nonetheless, a few cases of neurological complications such as encephalitis or meningoencephalitis have been reported. USUV and West Nile virus (WNV) share many features, like a close phylogenetic relatedness and a similar ecology, with co-circulation frequently observed in nature. However, USUV has been much less studied and in-depth comparisons of the biology of these viruses are yet rare. In this review, we discuss the main body of knowledge regarding USUV and compare it with the literature on WNV, addressing in particular virological and clinical aspects, and pointing data gaps.
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17
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Caracciolo I, Mora-Cardenas E, Aloise C, Carletti T, Segat L, Burali MS, Chiarvesio A, Totis V, Avšič–Županc T, Mastrangelo E, Manfroni G, D’Agaro P, Marcello A. Comprehensive response to Usutu virus following first isolation in blood donors in the Friuli Venezia Giulia region of Italy: Development of recombinant NS1-based serology and sensitivity to antiviral drugs. PLoS Negl Trop Dis 2020; 14:e0008156. [PMID: 32226028 PMCID: PMC7145266 DOI: 10.1371/journal.pntd.0008156] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/09/2020] [Accepted: 02/19/2020] [Indexed: 01/25/2023] Open
Abstract
Surveillance of Usutu virus is crucial to prevent future outbreaks both in Europe and in other countries currently naïve to the infection, such as the Americas. This goal remains difficult to achieve, notably because of the lack of large-scale cohort studies and the absence of commercially available diagnostic reagents for USUV. This work started with the first identification of USUV in a blood donor in the Friuli Venezia Giulia (FVG) Region in Northern-Eastern Italy, which is endemic for West Nile virus. Considering that only one IgG ELISA is commercially available, but none for IgM, a novel NS1 antigen based IgG/M ELISA has been developed. This assay tested successfully for the detection of Usutu virus in blood donors with the identification of a second case of transmission and high levels of exposure. Furthermore, two pan-flavivirus antiviral drugs, that we previously characterized to be inhibitors of other flavivirus infectivity, were successfully tested for inhibition of Usutu virus with inhibitory concentrations in the low micromolar range. To conclude, this work identifies North-Eastern Italy as endemic for Usutu virus with implications for the screening of transfusion blood. A novel NS1-based ELISA test has been implemented for the detection of IgM/G that will be of importance as a tool for the diagnosis and surveillance of Usutu virus infection. Finally, Usutu virus is shown to be sensitive to a class of promising pan-flavivirus drugs. Tropical viruses transmitted by ticks or mosquitoes are becoming a health threat in areas of the world that were previously naïve to these infections. Usutu virus is a mosquito-borne virus that is circulating in Europe causing massive outbreaks in birds. Transmission to humans is documented, with some reports of severe neurological disease. However, the real size of transmission to humans suffers from lack of data due to insufficient surveillance. The first confirmed case of human USUV infection in an asymptomatic blood donor from North-Eastern Italy is hereby demonstrated by molecular assays and virus isolation. Specific Usutu virus serology has also been developed taking advantage of the NS1 viral antigen, which is tested on a number of blood donors demonstrating a high level of Usutu positivity. These findings confirm the human transmission in the region and offer a novel tool for specific Usutu virus surveillance. Finally, two drugs that were previously shown to have a wide spectrum of activity towards members of this family of viruses are shown to inhibit also Usutu virus, opening the way to a novel class antivirals.
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Affiliation(s)
- Ilaria Caracciolo
- Regional Reference Centre for Arbovirus Infections, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Erick Mora-Cardenas
- Laboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano, Trieste, Italy
| | - Chiara Aloise
- Laboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano, Trieste, Italy
| | - Tea Carletti
- Laboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano, Trieste, Italy
| | - Ludovica Segat
- Regional Reference Centre for Arbovirus Infections, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Integrata di Trieste, UCO Igiene e Sanità Pubblica, Trieste, Italy
| | - Maria Sole Burali
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italy
| | - Alexsia Chiarvesio
- Centro Unico Regionale Produzione Emocomponenti C.U.R.P.E. P.O. Palmanova A.A.S.2 Bassa Friulana Isontina, Palmanova, Italy
| | - Vivianna Totis
- Centro Unico Regionale Produzione Emocomponenti C.U.R.P.E. P.O. Palmanova A.A.S.2 Bassa Friulana Isontina, Palmanova, Italy
| | - Tatjana Avšič–Županc
- Laboratory of Diagnostics of Zoonoses and WHO Centre, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | | | - Giuseppe Manfroni
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italy
| | - Pierlanfranco D’Agaro
- Regional Reference Centre for Arbovirus Infections, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Integrata di Trieste, UCO Igiene e Sanità Pubblica, Trieste, Italy
- * E-mail: (PD); (AM)
| | - Alessandro Marcello
- Laboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano, Trieste, Italy
- * E-mail: (PD); (AM)
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18
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Vilibic-Cavlek T, Savic V, Sabadi D, Peric L, Barbic L, Klobucar A, Miklausic B, Tabain I, Santini M, Vucelja M, Dvorski E, Butigan T, Kolaric-Sviben G, Potocnik-Hunjadi T, Balenovic M, Bogdanic M, Andric Z, Stevanovic V, Capak K, Balicevic M, Listes E, Savini G. Prevalence and molecular epidemiology of West Nile and Usutu virus infections in Croatia in the 'One health' context, 2018. Transbound Emerg Dis 2019; 66:1946-1957. [PMID: 31067011 DOI: 10.1111/tbed.13225] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/19/2019] [Accepted: 05/03/2019] [Indexed: 12/14/2022]
Abstract
In 2018, Croatia reported the largest outbreak of West Nile virus (WNV) infections as well as the re-occurrence of human Usutu virus (USUV) infections. For the first time, fatal WNV and USUV infections were detected in wild birds. We analysed epidemiological characteristics and molecular epidemiology of WNV and USUV infections detected during 2018 transmission season. From April to November, 178 patients with neuroinvasive disease and 68 patients with febrile disease were tested for WNV and USUV. Viral RNA was detected in cerebrospinal fluid (CSF) and urine samples using a real-time RT-PCR. Positive samples were tested by nested RT-PCR and nucleotide sequencing. IgM/IgG antibodies were detected in serum/CSF samples using ELISA with confirmation of cross-reactive samples by virus neutralization test (VNT). WNV neuroinvasive disease was confirmed in 54 and WNV fever in seven patients from 10 continental Croatian counties. Areas affected in 2018 were those in which cases occurred in previous seasons, while in three areas human cases were reported for the first time. Phylogenetic analysis of six strains from patients residing in different geographic areas showed circulation of WNV lineage 2. In three patients, neuroinvasive USUV infection was confirmed by RT-PCR or VNT. Sequence analysis of one detected strain revealed USUV Europe 2 lineage. During the same period, a total of 2,574 horse and 1,069 poultry serum samples were tested for WNV antibodies using ELISA. Acute asymptomatic WNV infection (IgM antibodies) was documented in 20/0.7% horses. WNV IgG antibodies were found in 307/11.9% horses and in 125/12.7% poultry. WNV RNA was detected in two goshawks and USUV RNA was detected in one blackbird from north-western Croatia. In the Zagreb area, 3,670 female mosquitoes were collected. One Culex pipiens pool collected in July tested positive for USUV RNA. Our results highlight the importance of continuous multidisciplinary 'One health' surveillance of these emerging arboviruses.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dario Sabadi
- Clinical Hospital Center Osijek, Osijek, Croatia.,Medical Faculty, Josip Juraj Stossmayer University of Osijek, Osijek, Croatia
| | - Ljiljana Peric
- Clinical Hospital Center Osijek, Osijek, Croatia.,Medical Faculty, Josip Juraj Stossmayer University of Osijek, Osijek, Croatia
| | - Ljubo Barbic
- Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Klobucar
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Bozana Miklausic
- University Hospital for Infectious Diseases "Dr Fran Mihaljevic", Zagreb, Croatia
| | - Irena Tabain
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Marija Santini
- School of Medicine, University of Zagreb, Zagreb, Croatia.,University Hospital for Infectious Diseases "Dr Fran Mihaljevic", Zagreb, Croatia
| | - Marko Vucelja
- Faculty of Forestry, University of Zagreb, Zagreb, Croatia
| | | | | | | | | | | | - Maja Bogdanic
- Croatian Institute of Public Health, Zagreb, Croatia
| | | | | | | | | | - Eddy Listes
- Croatian Veterinary Institute, Regional Institute Split, Split, Croatia
| | - Giovanni Savini
- OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale "G. Caporale", Teramo, Italy
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19
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Vilibic-Cavlek T, Savic V, Petrovic T, Toplak I, Barbic L, Petric D, Tabain I, Hrnjakovic-Cvjetkovic I, Bogdanic M, Klobucar A, Mrzljak A, Stevanovic V, Dinjar-Kujundzic P, Radmanic L, Monaco F, Listes E, Savini G. Emerging Trends in the Epidemiology of West Nile and Usutu Virus Infections in Southern Europe. Front Vet Sci 2019; 6:437. [PMID: 31867347 PMCID: PMC6908483 DOI: 10.3389/fvets.2019.00437] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/19/2019] [Indexed: 02/05/2023] Open
Abstract
The epidemiology of West Nile (WNV) and Usutu virus (USUV) has changed dramatically over the past two decades. Since 1999, there have been regular reports of WNV outbreaks and the virus has expanded its area of circulation in many Southern European countries. After emerging in Italy in 1996, USUV has spread to other countries causing mortality in several bird species. In 2009, USUV seroconversion in horses was reported in Italy. Co-circulation of both viruses was detected in humans, horses and birds. The main vector of WNV and USUV in Europe is Culex pipiens, however, both viruses were found in native Culex mosquito species (Cx. modestus, Cx. perexiguus). Experimental competence to transmit the WNV was also proven for native and invasive mosquitoes of Aedes and Culex genera (Ae. albopictus, Ae. detritus, Cx. torrentium). Recently, Ae. albopictus and Ae. japonicus naturally-infected with USUV were reported. While neuroinvasive human WNV infections are well-documented, USUV infections are sporadically detected. However, there is increasing evidence of a role of USUV in human disease. Seroepidemiological studies showed that USUV circulation is more common than WNV in some endemic regions. Recent data showed that WNV strains detected in humans, horses, birds, and mosquitoes mainly belong to lineage 2. In addition to European USUV lineages, some reports indicate the presence of African USUV lineages as well. The trends in WNV/USUV range and vector expansion are likely to continue in future years. This mini-review provides an update on the epidemiology of WNV and USUV infections in Southern Europe within a multidisciplinary "One Health" context.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
- *Correspondence: Tatjana Vilibic-Cavlek
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, Zagreb, Croatia
| | - Tamas Petrovic
- Department for Virology, Scientific Veterinary Institute, Novi Sad, Serbia
| | - Ivan Toplak
- Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases With Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Dusan Petric
- Laboratory for Medical and Veterinary Entomology, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Irena Tabain
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ivana Hrnjakovic-Cvjetkovic
- Center for Microbiology, Institute of Public Health Vojvodina, Novi Sad, Serbia
- Medical Faculty, University of Novi Sad, Novi Sad, Serbia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ana Klobucar
- Division of Disinfection, Disinfestation and Pest Control, Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Anna Mrzljak
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Medicine, Merkur University Hospital, Zagreb, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases With Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Luka Radmanic
- Department of Microbiology and Infectious Diseases With Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Federica Monaco
- OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale “G. Caporale”, Teramo, Italy
| | - Eddy Listes
- Laboratory for Diagnostics, Croatian Veterinary Institute, Regional Institute Split, Split, Croatia
| | - Giovanni Savini
- OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale “G. Caporale”, Teramo, Italy
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