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Ayari R, Chaouch H, Findlay-Wilson S, Hachfi W, Ben Lasfar N, Bellazreg F, Dowall S, Hannachi N, Letaief A. Seroprevalence and Risk Factors Associated with Phleboviruses and Crimean-Congo Hemorrhagic Fever Virus among Blood Donors in Central Tunisia. Pathogens 2024; 13:348. [PMID: 38668303 PMCID: PMC11054088 DOI: 10.3390/pathogens13040348] [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: 03/14/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
The aim of this study was to determine the prevalence of six viruses, from two families of the order Bunyavirales, in the general population of central Tunisia. Sera collected from 377 asymptomatic blood donors were serologically assayed for Rift Valley fever virus (RVFV), Crimean-Congo hemorrhagic fever virus (CCHFV), and four sandfly-borne phleboviruses: Toscana virus (TOSV), sandfly fever Naples virus (SFNV), sandfly fever Sicilian virus (SFSV), and sandfly fever Cyprus virus (SFCV). Of the 377 subjects enrolled in this study, 17.3% were IgG positive for at least one of the viruses tested. The most frequently detected antibodies were against TOSV (13.3%), followed by SFCV (2.9%), RVFV (1.9%), SFSV (1.3%), and SFNV (1.1%). Only one sample was IgG positive for CCHFV. Dual reactivity was observed in nine cases: SFSV + SFCV in three cases (0.8%) and TOSV + SFNV, TOSV + SFCV, and TOSV + RVFV in two cases (0.5%) each. 15.9% of donors were IgG positive against sandfly-borne phleboviruses. Among the 65 donors IgG positive for phleboviruses, 50.8% were from rural areas compared to 12.3% from urban areas (p < 0.001); 92.3% had animals in their living quarters (p = 0.009); and 70.8% lived in the vicinity of stagnant water (p = 0.062). Seroprevalence was significantly higher among donors living with chronic diseases (p = 0.039). Furthermore, the seroprevalence of phleboviruses was higher in Kairouan, the central governorate, than in the two coastal governorates: Monastir and Sousse, with 33.4%, 24.2%, and 14.9%, respectively. The presence of antibodies in the general population needs further investigation to better assess the extent of these viruses. Only TOSV was known to have an extensive circulation in Tunisia and in North Africa. Continued surveillance and interventions are necessary to detect the emergence of all arboviruses and to prevent further transmission.
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Affiliation(s)
- Rym Ayari
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
| | - Houda Chaouch
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
| | - Stephen Findlay-Wilson
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (S.F.-W.); (S.D.)
| | - Wissem Hachfi
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Nadia Ben Lasfar
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Foued Bellazreg
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Stuart Dowall
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (S.F.-W.); (S.D.)
| | - Neila Hannachi
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
- Microbiology Laboratory, Farhat Hached University Hospital, Sousse 4000, Tunisia
| | - Amel Letaief
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
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Benbetka C, Hachid A, Benallal KE, Khardine FA, Ayhan N, Bouredjoul N, Boulehbal WM, Bellila D, Khaldi A, Charrel R. Epidemiology, Isolation, and Genetic Characterization of Toscana Virus in Algerian Patients Displaying Neurological Infection, 2016-2018. IJID REGIONS 2023; 7:193-198. [PMID: 37123383 PMCID: PMC10131063 DOI: 10.1016/j.ijregi.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/02/2023]
Abstract
Purpose The current study reports the results of the diagnosis of neuro-invasive Toscana virus (TOSV) infection in Algeria between 2016 and 2018 and describes the first isolation of TOSV strain from human samples in North Africa. Materiel and methods Cerebrospinal fluid (CSF) and sera samples were obtained from 720 hospitalized patients displaying neurological infection symptoms of unknown etiology, of which 604 were screened for TOSV. The diagnosis was performed by serological and/or RT-PCR tests. In addition, TOSV was isolated in vivo and in vitro from CSF and genetically characterized. Results 23 cases of TOSV neurological infections were detected. Cases were located in 11 Wilayas (administrative provinces), mainly in northern Algeria. In addition, we report the isolation of TOSV strain belonging to lineage A from human samples with its complete coding sequence. Conclusion Even though the number of infections is probably underestimated, TOSV is endemic in Algeria, with several cases of neuro-invasive diseases in humans recorded each year. Therefore, the diagnosis of TOSV should be included in the differential diagnosis of neurological diseases, especially aseptic meningitis, during the period of activity of the phlebotomine vector. Further studies are required to measure precisely the nationwide prevalence of TOSV in Algeria.
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Affiliation(s)
- Chahrazed Benbetka
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Department of Immunology, Béni-Messous Teaching Hospital, University of Algiers, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Aissam Hachid
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Kamal Eddine Benallal
- Laboratory of Parasitic Eco-epidemiology and Population Genetics, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Fayez Ahmed Khardine
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Nazli Ayhan
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Nesrine Bouredjoul
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | | | - Djamila Bellila
- Faculty of Natural Sciences, University of Algiers 1, 16000, Algiers, Algeria
| | - Aldjia Khaldi
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
| | - Rémi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
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Sellali S, Lafri I, Hachid A, Ayhan N, Benbetka C, Medrouh B, Messahel NE, El Amine Bekara M, Lafri M, Charrel RN, Bitam I. Presence of the sandfly-borne phlebovirus (Toscana virus) in different bio-geographical regions of Algeria demonstrated by a microneutralisation-based seroprevalence study in owned dogs. Comp Immunol Microbiol Infect Dis 2022; 88:101861. [DOI: 10.1016/j.cimid.2022.101861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 10/17/2022]
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Benallal KE, Garni R, Harrat Z, Volf P, Dvorak V. Phlebotomine sand flies (Diptera: Psychodidae) of the Maghreb region: A systematic review of distribution, morphology, and role in the transmission of the pathogens. PLoS Negl Trop Dis 2022; 16:e0009952. [PMID: 34990451 PMCID: PMC8735671 DOI: 10.1371/journal.pntd.0009952] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Phlebotomine sand flies (Diptera: Psychodidae) are important vectors of various human and animal pathogens such as Bartonella bacilliformis, Phlebovirus, and parasitic protozoa of the genus Leishmania, causative agent of leishmaniases that account among most significant vector-borne diseases. The Maghreb countries Mauritania, Morocco, Algeria, Tunisia, and Libya occupy a vast area of North Africa and belong to most affected regions by these diseases. Locally varying climatic and ecological conditions support diverse sand fly fauna that includes many proven or suspected vectors. The aim of this review is to summarize often fragmented information and to provide an updated list of sand fly species of the Maghreb region with illustration of species-specific morphological features and maps of their reported distribution. MATERIALS AND METHODS The literature search focused on scholar databases to review information on the sand fly species distribution and their role in the disease transmissions in Mauritania, Morocco, Algeria, Tunisia, and Libya, surveying sources from the period between 1900 and 2020. Reported distribution of each species was collated using Google Earth, and distribution maps were drawn using ArcGIS software. Morphological illustrations were compiled from various published sources. RESULTS AND CONCLUSIONS In total, 32 species of the genera Phlebotomus (Ph.) and Sergentomyia (Se.) were reported in the Maghreb region (15 from Libya, 18 from Tunisia, 23 from Morocco, 24 from Algeria, and 9 from Mauritania). Phlebotomus mariae and Se. africana subsp. asiatica were recorded only in Morocco, Ph. mascitti, Se. hirtus, and Se. tiberiadis only in Algeria, whereas Ph. duboscqi, Se. dubia, Se. africana africana, Se. lesleyae, Se. magna, and Se. freetownensis were reported only from Mauritania. Our review has updated and summarized the geographic distribution of 26 species reported so far in Morocco, Algeria, Tunisia, and Libya, excluding Mauritania from a detailed analysis due to the unavailability of accurate distribution data. In addition, morphological differences important for species identification are summarized with particular attention to closely related species such as Ph. papatasi and Ph. bergeroti, Ph. chabaudi, and Ph. riouxi, and Se. christophersi and Se. clydei.
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Affiliation(s)
- Kamal Eddine Benallal
- Laboratory of Parasitic Eco-Epidemiology and Genetic of Populations, Institut Pasteur of Algiers, Algiers, Algeria
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Rafik Garni
- Laboratory of Parasitic Eco-Epidemiology and Genetic of Populations, Institut Pasteur of Algiers, Algiers, Algeria
| | - Zoubir Harrat
- Laboratory of Parasitic Eco-Epidemiology and Genetic of Populations, Institut Pasteur of Algiers, Algiers, Algeria
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Vít Dvorak
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
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Development of a Reverse Genetics System for Toscana Virus (Lineage A). Viruses 2020; 12:v12040411. [PMID: 32272808 PMCID: PMC7232365 DOI: 10.3390/v12040411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 12/14/2022] Open
Abstract
Toscana virus (TOSV) is a Phlebovirus in the Phenuiviridae family, order Bunyavirales, found in the countries surrounding the Mediterranean. TOSV is an important cause of seasonal acute meningitis and encephalitis within its range. Here, we determined the full sequence of the TOSV strain 1500590, a lineage A virus obtained from an infected patient (Marseille, 2007) and used this in combination with other sequence information to construct functional cDNA plasmids encoding the viral L, M, and S antigenomic sequences under the control of the T7 RNA promoter to recover recombinant viruses. Importantly, resequencing identified two single nucleotide changes to a TOSV reference genome, which, when corrected, restored functionality to the polymerase L and made it possible to recover infectious recombinant TOSV (rTOSV) from cDNA, as well as establish a minigenome system. Using reverse genetics, we produced an NSs-deletant rTOSV and also obtained viruses expressing reporter genes instead of NSs. The availability of such a system assists investigating questions that require genetic manipulation of the viral genome, such as investigations into replication and tropism, and beyond these fundamental aspects, also the development of novel vaccine design strategies.
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Ayhan N, Prudhomme J, Laroche L, Bañuls AL, Charrel RN. Broader Geographical Distribution of Toscana Virus in the Mediterranean Region Suggests the Existence of Larger Varieties of Sand Fly Vectors. Microorganisms 2020; 8:microorganisms8010114. [PMID: 31947561 PMCID: PMC7022675 DOI: 10.3390/microorganisms8010114] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/06/2020] [Accepted: 01/10/2020] [Indexed: 12/12/2022] Open
Abstract
Toscana virus (TOSV) is endemic in the Mediterranean basin, where it is transmitted by sand flies. TOSV can infect humans and cause febrile illness as well as neuroinvasive infections affecting the central and peripheral nervous systems. Although TOSV is a significant human pathogen, it remains neglected and there are consequently many gaps of knowledge. Recent seroepidemiology studies and case reports showed that TOSV’s geographic distribution is much wider than was assumed a decade ago. The apparent extension of the TOSV circulation area raises the question of the sandfly species that are able to transmit the virus in natural conditions. Phlebotomus (Ph.)perniciosus and Ph. perfiliewi were historically identified as competent species. Recent results suggest that other species of sand flies could be competent for TOSV maintenance and transmission. Here we organize current knowledge in entomology, epidemiology, and virology supporting the possible existence of additional phlebotomine species such as Ph. longicuspis, Ph. sergenti, Ph. tobbi, Ph. neglectus, and Sergentomyia minuta in TOSV maintenance. We also highlight some of the knowledge gaps to be addressed in future studies.
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Affiliation(s)
- Nazli Ayhan
- Unité des Virus Emergents (Aix-Marseille Univ–IRD 190–Inserm 1207–IHU Méditerranée Infection), 13005 Marseille, France;
- Unité de Virologie EA7310 Bioscope, Université de Corse Pasquale Paoli (UCPP), 20250 Corte, France
- Correspondence: (N.A.); (J.P.); Tel.: +33-782-202794 (N.A.); +33-621-504351 (J.P.)
| | - Jorian Prudhomme
- UMR MIVEGEC (IRD—CNRS—Université de Montpellier), 911 avenue Agropolis, F34394 Montpellier, France; (L.L.); (A.-L.B.)
- Correspondence: (N.A.); (J.P.); Tel.: +33-782-202794 (N.A.); +33-621-504351 (J.P.)
| | - Lison Laroche
- UMR MIVEGEC (IRD—CNRS—Université de Montpellier), 911 avenue Agropolis, F34394 Montpellier, France; (L.L.); (A.-L.B.)
| | - Anne-Laure Bañuls
- UMR MIVEGEC (IRD—CNRS—Université de Montpellier), 911 avenue Agropolis, F34394 Montpellier, France; (L.L.); (A.-L.B.)
| | - Remi N. Charrel
- Unité des Virus Emergents (Aix-Marseille Univ–IRD 190–Inserm 1207–IHU Méditerranée Infection), 13005 Marseille, France;
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An update on Toscana virus distribution, genetics, medical and diagnostic aspects. Clin Microbiol Infect 2020; 26:1017-1023. [PMID: 31904562 DOI: 10.1016/j.cmi.2019.12.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/18/2019] [Accepted: 12/22/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Toscana virus is an arbovirus transmitted by sand flies within the Mediterranean area where it can cause febrile illness and neuroinvasive infections during the seasonal circulation period of the vector. Although it is an important cause of meningitis and encephalitis, it remains a neglected virus with limited published data, as demonstrated by <250 peer-reviewed articles since the 1970s. OBJECTIVE The last review article on Toscana virus was published in 2012. The aim was to compile peer-reviewed articles to provide an updated review highlighting recent findings to complement previous review articles. SOURCES PubMed database was searched using the 'Toscana virus' keyword from 2010 to present. A total of 152 articles were retrieved and identified studies were assessed for novel information on virus genetics, and geographic and medical aspects compared with existing knowledge reported in previous review articles. CONTENT Studies addressing medical, veterinary and entomological aspects have provided evidence that Toscana virus is present in North Africa, in the Balkan Peninsula, and in most of the Mediterranean islands. Besides the two previously recognized genetic lineages, a novel evolutionary lineage has been identified in the Balkan Peninsula. Co-circulation of two genetic lineages has been demonstrated in France, in Turkey and in Croatia. In addition to meningitis and meningo-encephalitis, which have been reported for 40 years, various neuroinvasive forms have been recently reported such as Guillain-Barré syndrome, hydrocephalus, myositis, fasciitis, polymyeloradiculopathy, deafness and facial paralysis. IMPLICATION Because it is endemic in countries bordering the Mediterranean, physicians should include Toscana virus in the differential diagnosis of patients presenting with febrile illness and/or neurological manifestations.
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Christova I, Panayotova E, Trifonova I, Taseva E, Gladnishka T, Ivanova V. Serologic evidence of widespread Toscana virus infection in Bulgaria. J Infect Public Health 2019; 13:164-166. [PMID: 31401037 DOI: 10.1016/j.jiph.2019.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 07/01/2019] [Accepted: 07/18/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Toscana virus (TOSV) is an emerging sandfly-borne virus that is endemic in Mediterranean countries. METHODS In order to detect TOSV circulation among the human population of Bulgaria, serum samples from 459 apparently healthy adult individuals, residing in19 out of 28 districts in the country, were tested for the presence of IgG antibodies to TOSV. RESULTS An overall seroprevalence rate of 24.4% was observed, ranging from 4.4% to 53.5% in the districts. Rates were highest in persons over 60 years of age and residing in the southern districts. CONCLUSION The results of the first TOSV seroprevalence study in Bulgaria revealed that infection is widespread. Physicians should be aware of the virus circulation during summer and consider the diagnosis in cases of febrile illness, meningitis or meningoencephalitis.
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Affiliation(s)
- Iva Christova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
| | - Elitsa Panayotova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iva Trifonova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Evgenia Taseva
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Ayhan N, Charrel RN. Of phlebotomines (sandflies) and viruses: a comprehensive perspective on a complex situation. CURRENT OPINION IN INSECT SCIENCE 2017; 22:117-124. [PMID: 28805633 DOI: 10.1016/j.cois.2017.05.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/19/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
Old World sandfly-borne phleboviruses are classified into three serological complexes: Sandfly fever Sicilian, Sandfly fever Naples and Salehabad. Human pathogens (febrile illness ['sandfly fever'], neuroinvasive infections) belong to the two first complexes. The increasing number of newly discovered sandfly-borne phleboviruses raises concerns about their medical and veterinary importance. They occupy a wide geographic area from Mediterranean basin to North Africa and the Middle East to the central Asia. At least nine species of sandflies can transmit these viruses. Recent results suggest that sandfly vectors are not as specific for viruses as initially believed. Recent seroprevalence studies demonstrate that humans and domestic animals are heavily exposed. Specific molecular diagnostic methods must be developed and implemented in clinical microbiology laboratories.
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Affiliation(s)
- Nazli Ayhan
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP - IHU Mediterranee Infection), Marseille, France
| | - Remi N Charrel
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP - IHU Mediterranee Infection), Marseille, France; Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
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Virus isolation, genetic characterization and seroprevalence of Toscana virus in Algeria. Clin Microbiol Infect 2015; 21:1040.e1-9. [DOI: 10.1016/j.cmi.2015.07.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/22/2015] [Accepted: 07/13/2015] [Indexed: 01/19/2023]
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Toscana virus meningitis case in Switzerland: an example of the ezVIR bioinformatics pipeline utility for the identification of emerging viruses. Clin Microbiol Infect 2014; 21:387.e1-4. [PMID: 25658528 DOI: 10.1016/j.cmi.2014.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 09/18/2014] [Accepted: 11/05/2014] [Indexed: 02/06/2023]
Abstract
Toscana virus (TOSV) represents a frequent cause of viral meningitis in the Mediterranean Basin that remains neglected in neighbouring countries. We report a documented TOSV meningitis case in a traveller returning from Tuscany to Switzerland. While routine serological and PCR assays could not discriminate between TOSV and Sandfly fever Naples virus infection, a high-throughput sequencing performed directly on the cerebrospinal fluid specimen and analysed with the ezVIR pipeline provided an unequivocal viral diagnostic. TOSV could be unequivocally considered as the aetiological agent, proving the potential of ezVIR to improve standard diagnostics in cases of infection with uncommon or emerging viruses.
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Fezaa O, M'ghirbi Y, Savellini GG, Ammari L, Hogga N, Triki H, Cusi MG, Bouattour A. Serological and molecular detection of Toscana and other Phleboviruses in patients and sandflies in Tunisia. BMC Infect Dis 2014; 14:598. [PMID: 25398483 PMCID: PMC4236749 DOI: 10.1186/s12879-014-0598-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/29/2014] [Indexed: 11/10/2022] Open
Abstract
Background Our aim is to detect the infection by Toscana virus (TOSV) and other Phleboviruses in the sera and cerebro-spinal fluid (CSF) of patients with meningitis in Tunisia. We examined various species of phlebotomus present in Tunisia to determine whether or not a direct relationship exists between cases of meningitis and the viruses circulating in the insect vectors. Methods Patients with the meningeal syndrome were tested for anti-TOSV IgM and IgG using an indirect Enzyme-Linked Immunosorbent Assay (ELISA) and for the presence of TOSV and other Phleboviruses using a RT-PCR test. An entomological study was carried out using CDC light traps to trap sandflies in different bioclimatic zones of Tunisia. Collected sandflies were tested by RT-PCR for the presence of TOSV and other Phleboviruses and subsequently by viral isolation on Vero cells. Results Of 263 patients were tested using ELISA of which 12.16% (n = 32/263) were IgM positive for anti TOSV. Of these 32 patients, 78% (n = 25/32) were IgG positive. 12.86% (n = 18/140) of the CSF samples tested by RT-PCR were positive for the Toscana virus. One CSF sample tested by RT-PCR revealed the presence of Sandfly Fever Sicilian Virus (SFSV). The Punique virus was identified in one sandfly pool. Conclusions This study confirms, for the first time, that TOSV is involved in a neurological disorder in North Africa. The incidence of this involvement in Tunisia conforms with observations made in other Mediterranean countries. Moreover, for the first time, a molecular approach was used to detect SFSV in a Tunisian patient displaying neurological symptoms. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0598-9) contains supplementary material, which is available to authorized users.
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