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Vilibic-Cavlek T, Janev-Holcer N, Bogdanic M, Ferenc T, Vujica Ferenc M, Krcmar S, Savic V, Stevanovic V, Ilic M, Barbic L. Current Status of Vector-Borne Diseases in Croatia: Challenges and Future Prospects. Life (Basel) 2023; 13:1856. [PMID: 37763260 PMCID: PMC10532474 DOI: 10.3390/life13091856] [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: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Different vector-borne pathogens are present or have (re-)emerged in Croatia. Flaviviruses tick-borne encephalitis (TBEV), West Nile (WNV), and Usutu (USUV) are widely distributed in continental regions, while Toscana virus (TOSV) and sandfly fever viruses are detected at the Croatian littoral. Recently, sporadic clinical cases of Tahyna orthobunyavirus (TAHV) and Bhanja bandavirus infection and seropositive individuals have been reported in continental Croatia. Acute infections and serologic evidence of WNV, TBEV, USUV, and TAHV were also confirmed in sentinel animals and vectors. Autochthonous dengue was reported in 2010 at the Croatian littoral. Lyme borreliosis is the most widely distributed vector-borne bacterial infection. The incidence is very high in northwestern and eastern regions, which correlates with numerous records of Ixodes ricinus ticks. Acute human Anaplasma phagocytophilum infections are reported sporadically, but there are many records of serologic evidence of anaplasmosis in animals. Mediterranean spotted fever (Rickettsia conorii) and murine typhus (Rickettsia typhi) are the main rickettsial infections in Croatia. Human leishmaniasis is notified sporadically, while serologic evidence of leishmaniasis was found in 11.4% of the Croatian population. After the official eradication of malaria in 1964, only imported cases were reported in Croatia. Since vector-borne diseases show a growing trend, continuous monitoring of vectors is required to protect the population from these infections.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Natasa Janev-Holcer
- Environmental Health Department, Croatian Institute of Public Health, 10000 Zagreb, Croatia
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Thomas Ferenc
- Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia
| | - Mateja Vujica Ferenc
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Stjepan Krcmar
- Department of Biology, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Maja Ilic
- Department of Communicable Disease Epidemiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Sandfly-Borne Phleboviruses in Portugal: Four and Still Counting. Viruses 2022; 14:v14081768. [PMID: 36016390 PMCID: PMC9413822 DOI: 10.3390/v14081768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
According to ICTV, there are currently 66 known phlebovirus species. More than 40 of these viruses were isolated or detected in phlebotomine sandflies and some of them are known pathogens. In Portugal, information about sandfly-borne phleboviruses is scarce and scattered sandfly-borne diseases are neglected and often not considered in differential diagnoses. The main objective of this work was to gather the existing information and to raise awareness about the circulating phleboviruses in this country. To date, Massilia and Alcube phleboviruses have been isolated from sandflies in southern Portugal. Human infections with Toscana and Sicilian phleboviruses have been reported, as well as seroprevalence in cats and dogs. More studies are needed in order to understand if the viruses isolated during the entomological surveys have an impact on human health and to fully understand the real importance of the already recognized pathogens in our country.
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3
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Detection of Tahyna Orthobunyavirus-Neutralizing Antibodies in Patients with Neuroinvasive Disease in Croatia. Microorganisms 2022; 10:microorganisms10071443. [PMID: 35889162 PMCID: PMC9316594 DOI: 10.3390/microorganisms10071443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Tahyna orthobunyavirus (TAHV) is widely distributed in continental Europe. Very few studies have analyzed TAHV seroprevalence in Croatia. We analyzed the prevalence of TAHV RNA and antibodies in Croatian patients with neuroinvasive disease (NID). Methods: A total of 218 patients with unsolved NID detected during five consecutive arbovirus transmission seasons (April 2017–October 2021) were tested. Cerebrospinal fluid (CSF) and urine samples were tested for TAHV RNA using RT-PCR. In addition, CSF and serum samples were tested for TAHV antibodies using a virus neutralization test (VNT). Results: Clinical presentations in patients with NID were meningitis (141/64.7%), meningoencephalitis (56/25.7%), myelitis (8/3.7%), and ‘febrile headache’ (13/5.9%). TAHV RNA was not detected in any of the tested CSF or urine samples; however, TAHV-neutralizing (NT) antibodies were detected in 22/10.1% of patients. Detection of NT antibodies in the CSF of two patients presenting with meningitis suggested recent TAHV infection. TAHV seropositivity increased significantly with age, from 1.8% to 24.4%. There was no difference in seroprevalence between genders or areas of residence (urban, suburban/rural). The majority of seropositive patients (90.9%) resided in floodplains along the rivers in continental Croatia. Conclusions: The presented results confirm that TAHV is present in Croatia. The prevalence and clinical significance of TAHV infection in the Croatian population have yet to be determined.
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Ayhan N, Alten B, Ivovic V, Cvetkovikj A, Stefanovska J, Martinkovic F, Piorkowski G, Moureau G, Gould EA, Pettersson JHO, de Lamballerie X, Charrel RN. Field surveys in Croatia and North Macedonia reveal two novel phleboviruses circulating in sandflies. J Gen Virol 2021; 102. [PMID: 34797756 DOI: 10.1099/jgv.0.001674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Sandfly-borne phleboviruses are distributed widely throughout the Mediterranean Basin, presenting a threat to public health in areas where they circulate. However, the true diversity and distribution of pathogenic and apathogenic sandfly-borne phleboviruses remains a key issue to be studied. In the Balkans, most published data rely on serology-based studies although virus isolation has occasionally been reported. Here, we report the discovery of two novel sandfly-borne phleboviruses, provisionally named Zaba virus (ZABAV) and Bregalaka virus (BREV), which were isolated in Croatia and North Macedonia, respectively. This constitutes the first isolation of phleboviruses in both countries. Genetic analysis based on complete coding sequences indicated that ZABAV and BREV are distinct from each other and belong to the genus Phlebovirus, family Phenuiviridae. Phylogenetic and amino acid modelling of viral polymerase shows that ZABAV and BREV are new members of the Salehabad phlebovirus species and the Adana phlebovirus species, respectively. Moreover, sequence-based vector identification suggests that ZABAV is mainly transmitted by Phlebotomus neglectus and BREV is mainly transmitted by Phlebotomus perfiliewi. BREV neutralizing antibodies were detected in 3.3% of human sera with rates up to 16.7% in certain districts, demonstrating that BREV frequently infects humans in North Macedonia. In vitro viral growth kinetics experiments demonstrated viral replication of both viruses in mammalian and mosquito cells. In vivo experimental studies in mice suggest that ZABAV and BREV exhibit characteristics making them possible human pathogens.
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Affiliation(s)
- Nazli Ayhan
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
| | - Bulent Alten
- Faculty of Science, Department of Biology, Ecology Division, VERG Labs, Hacettepe University, Beytepe, Ankara, Turkey
| | - Vladimir Ivovic
- Faculty of Mathematics, Natural Sciences and Information Technologies (FAMNIT), University of Primorska, Koper, Slovenia
| | - Aleksandar Cvetkovikj
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, Republic of North Macedonia
| | - Jovana Stefanovska
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, Republic of North Macedonia
| | - Franjo Martinkovic
- Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases with Clinics, University of Zagreb, Zagreb, Croatia
| | - Geraldine Piorkowski
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
| | - Gregory Moureau
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
| | - Ernest A Gould
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
| | - John H-O Pettersson
- Department of Medical Biochemistry and Microbiology (IMBIM), Zoonosis Science Center, Uppsala University, Uppsala, Sweden.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, School of Life and Environmental Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
| | - Xavier de Lamballerie
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
| | - Remi N Charrel
- Unite des Virus Emergents (Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Mediterranee Infection), Marseille, France
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Vilibic-Cavlek T, Barbic L, Mrzljak A, Brnic D, Klobucar A, Ilic M, Janev-Holcer N, Bogdanic M, Jemersic L, Stevanovic V, Tabain I, Krcmar S, Vucelja M, Prpic J, Boljfetic M, Jelicic P, Madic J, Ferencak I, Savic V. Emerging and Neglected Viruses of Zoonotic Importance in Croatia. Pathogens 2021; 10:pathogens10010073. [PMID: 33467617 PMCID: PMC7829938 DOI: 10.3390/pathogens10010073] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
Several arboviruses have emerged in Croatia in recent years. Tick-borne encephalitis is endemic in continental counties; however, new natural micro-foci have been detected. Two autochthonous dengue cases were reported in 2010. West Nile virus emerged in 2012, followed by emergence of Usutu virus in 2013. Although high seroprevalence rates of Toscana virus have been detected among residents of Croatian littoral, the virus remains neglected, with only a few clinical cases of neuroinvasive infections reported. Lymphocytic choriomeningitis virus is a neglected neuroinvasive rodent-borne virus. So far, there are no reports on human clinical cases; however, the seroprevalence studies indicate the virus presence in the Croatian mainland. Puumala and Dobrava hantaviruses are widely distributing rodent-borne viruses with sporadic and epidemic occurrence. Hepatitis E virus is an emerging food-borne virus in Croatia. After the emergence in 2012, cases were regularly recorded. Seropositivity varies greatly by region and population group. Rotaviruses represent a significant healthcare burden since rotavirus vaccination is not included in the Croatian national immunization program. Additionally, rotaviruses are widely distributed in the Croatian ecosystem. A novel coronavirus, SARS-CoV-2, emerged in February 2020 and spread rapidly throughout the country. This review focuses on emerging and neglected viruses of zoonotic importance detected in Croatia.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (I.T.); (I.F.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Correspondence:
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.); (V.S.); (J.M.)
| | - Anna Mrzljak
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Department of Medicine, Merkur University Hospital, 10000 Zagreb, Croatia
| | - Dragan Brnic
- Department of Virology, Croatian Veterinary Institute, 10000 Zagreb, Croatia; (D.B.); (L.J.); (J.P.)
| | - Ana Klobucar
- Department of Epidemiology, Andrija Stampar Institute of Public Health, 10000 Zagreb, Croatia;
| | - Maja Ilic
- Department of Epidemiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
| | - Natasa Janev-Holcer
- Environmental Health Department, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (N.J.-H.); (P.J.)
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (I.T.); (I.F.)
| | - Lorena Jemersic
- Department of Virology, Croatian Veterinary Institute, 10000 Zagreb, Croatia; (D.B.); (L.J.); (J.P.)
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.); (V.S.); (J.M.)
| | - Irena Tabain
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (I.T.); (I.F.)
| | - Stjepan Krcmar
- Department of Biology, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Marko Vucelja
- Faculty of Forestry, University of Zagreb, 10000 Zagreb, Croatia; (M.V.); (M.B.)
| | - Jelena Prpic
- Department of Virology, Croatian Veterinary Institute, 10000 Zagreb, Croatia; (D.B.); (L.J.); (J.P.)
| | - Marko Boljfetic
- Faculty of Forestry, University of Zagreb, 10000 Zagreb, Croatia; (M.V.); (M.B.)
| | - Pavle Jelicic
- Environmental Health Department, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (N.J.-H.); (P.J.)
| | - Josip Madic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.); (V.S.); (J.M.)
| | - Ivana Ferencak
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (I.T.); (I.F.)
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia;
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Clinical, Virological, and Immunological Findings in Patients with Toscana Neuroinvasive Disease in Croatia: Report of Three Cases. Trop Med Infect Dis 2020; 5:tropicalmed5030144. [PMID: 32937866 PMCID: PMC7557803 DOI: 10.3390/tropicalmed5030144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 01/14/2023] Open
Abstract
Toscana virus (TOSV) is an arthropod-borne virus, transmitted to humans by phlebotomine sandflies. Although the majority of infections are asymptomatic, neuroinvasive disease may occur. We report three cases of neuroinvasive TOSV infection detected in Croatia. Two patients aged 21 and 54 years presented with meningitis, while a 22-year old patient presented with meningoencephalitis and right-sided brachial plexitis. Cerebrospinal fluid (CSF), serum, and urine samples were collected and tested for neuroinvasive arboviruses: tick-borne encephalitis, West Nile, Usutu, TOSV, Tahyna, and Bhanja virus. In addition, CSF and serum samples were tested for the anti-viral cytokine response. High titers of TOSV IgM (1000–3200) and IgG (3200−10,000) antibodies in serum samples confirmed TOSV infection. Antibodies to other phleboviruses (sandfly fever Sicilian/Naples/Cyprus virus) were negative. CSF samples showed high concentrations of interleukin 6 (IL-6; range 162.32−2683.90 pg/mL), interferon gamma (IFN-γ; range 110.12−1568.07 pg/mL), and IL-10 (range 28.08−858.91 pg/mL), while significantly lower cytokine production was observed in serum. Two patients recovered fully. The patient with a brachial plexitis improved significantly at discharge. The presented cases highlight the need of increasing awareness of a TOSV as a possible cause of aseptic meningitis/meningoencephalitis during summer months. Association of TOSV and brachial plexitis with long-term sequelae detected in one patient indicates the possibility of more severe disease, even in young patients.
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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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8
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Morini S, Calzolari M, Rossini G, Pascarelli N, Porcellini A, Randi V, Re MC, Albieri A, Bonilauri P, Bellini R, Ayhan N, Charrel R, Varani S. Detection of Specific Antibodies against Toscana Virus among Blood Donors in Northeastern Italy and Correlation with Sand Fly Abundance in 2014. Microorganisms 2020; 8:microorganisms8020145. [PMID: 31973058 PMCID: PMC7074719 DOI: 10.3390/microorganisms8020145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/16/2019] [Indexed: 11/16/2022] Open
Abstract
Toscana virus (TOSV) is a Phlebovirus transmitted by phlebotomine sand flies and is an important etiological agent of summer meningitis in the Mediterranean basin. Since TOSV infection is often asymptomatic, we evaluated the seroprevalence in blood donors (BDs) in the Bologna and Ferrara provinces (Northeastern Italy)-the areas with the highest and lowest numbers of TOSV neuroinvasive cases in the region, respectively. A total of 1208 serum samples from BDs were collected in April-June 2014 and evaluated for the presence of specific TOSV-IgG by ELISA. The IgG-reactive samples were confirmed by indirect immunofluorescence assay (IIF) and by microneutralization test (MN). Serum samples were defined as positive for anti-TOSV IgG when reactive by ELISA and by at least one second-level test; TOSV seroprevalence was 6.8% in the Bologna province, while no circulation of TOSV was detected in the Ferrara province. Sand fly abundance in 2014 was also estimated by a geographic information system using a generalized linear model applied to a series of explanatory variables. TOSV seroprevalence rate was strongly associated with the sand fly abundance index in each municipality, pointing out the strong association between sand fly abundance and human exposure to TOSV.
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Affiliation(s)
- Silvia Morini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (S.M.); (G.R.)
| | - Mattia Calzolari
- Laboratory of Entomology, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna “B. Ubertini” (IZLER), 42124 Reggio Emilia, Italy; (M.C.); (P.B.)
| | - Giada Rossini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (S.M.); (G.R.)
| | - Nadia Pascarelli
- Centro Regionale Sangue Emilia-Romagna, Maggiore Hospital, 40133 Bologna, Italy; (N.P.); (A.P.); (V.R.)
| | - Andrea Porcellini
- Centro Regionale Sangue Emilia-Romagna, Maggiore Hospital, 40133 Bologna, Italy; (N.P.); (A.P.); (V.R.)
| | - Vanda Randi
- Centro Regionale Sangue Emilia-Romagna, Maggiore Hospital, 40133 Bologna, Italy; (N.P.); (A.P.); (V.R.)
| | - Maria Carla Re
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (S.M.); (G.R.)
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Alessandro Albieri
- Department of Medical and Veterinary Entomology, Centro Agricoltura Ambiente ‘G. Nicoli’, 40014 Crevalcore, Italy; (A.A.); (R.B.)
| | - Paolo Bonilauri
- Laboratory of Entomology, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna “B. Ubertini” (IZLER), 42124 Reggio Emilia, Italy; (M.C.); (P.B.)
| | - Romeo Bellini
- Department of Medical and Veterinary Entomology, Centro Agricoltura Ambiente ‘G. Nicoli’, 40014 Crevalcore, Italy; (A.A.); (R.B.)
| | - Nazli Ayhan
- Unité des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection), 13005 Marseille, France; (N.A.); (R.C.)
| | - Remi Charrel
- Unité des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection), 13005 Marseille, France; (N.A.); (R.C.)
| | - Stefania Varani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (S.M.); (G.R.)
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-2143013
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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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Kniha E, Obwaller AG, Dobler G, Poeppl W, Mooseder G, Walochnik J. Phlebovirus seroprevalence in Austrian Army personnel returning from missions abroad. Parasit Vectors 2019; 12:416. [PMID: 31445517 PMCID: PMC6708154 DOI: 10.1186/s13071-019-3674-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/17/2019] [Indexed: 01/03/2023] Open
Abstract
Background Phleboviruses are mainly transmitted by sand flies and infections can result in various symptoms, including meningitis and meningoencephalitis. In endemic regions, seroprevalences in humans and animals are high. Military personnel on missions in endemic areas are at increased risk of infection, however, for soldiers from central European countries, data are scarce. The aims of this study were to determine the exposure to phleboviruses of Austrian soldiers returning from missions abroad and to assess potential risk factors. A retrospective serological study was performed with sera of 753 healthy Austrian soldiers returning from missions in Bosnia and Herzegovina (BIH, n = 61), Kosovo (n = 261), Syria (n = 101) and Lebanon (n = 63) and of soldiers prior to their missions (n = 267). Results Altogether, 119 sera (15.8%, 119/753) were positive for anti-Phlebovirus IgG antibodies, with highest seroprevalences found in soldiers returning from Kosovo (20.69%, 54/261), followed by Syria (17.82%, 18/101), Lebanon (14.29%, 9/63) and BIH (11.48%, 7/61). Of the soldiers tested prior to their missions 11.61% (31/267) were positive. Of the 119 seropositive individuals, 30 (25.2%, 30/119) also had anti-Phlebovirus IgM antibodies. Phlebovirus seropositivity significantly correlated with symptoms of febrile illness during the respective mission (OR: 1.9, 95% CI: 1.1–3.4, P = 0.03) and with Leishmania seropositivity (OR: 2.7, 95% CI: 1.2–5.8, P = 0.009). Also, the outdoor activity “running” during the mission showed a strong trend towards an association with Phlebovirus seropositivity (OR: 1.9, 95% CI: 0.9–4.4, P = 0.08), and seropositivity generally increased with the duration of a mission (OR: 2.5, 95% CI: 0.9–7.5, P = 0.07). Conclusions This study indicates that soldiers are exposed to sand flies and at significant risk for Phlebovirus infection during missions in the Mediterranean area and the Middle East. Adequate prevention measures should be applied particularly during vespertine outdoor activities.
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Affiliation(s)
- Edwin Kniha
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Adelheid G Obwaller
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Federal Ministry of Defence, Division of Science, Research and Development, Vienna, Austria
| | - Gerhard Dobler
- Bundeswehr Institute of Microbiology (BwIM), Munich, Germany
| | - Wolfgang Poeppl
- Department of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.,Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - Gerhard Mooseder
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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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, Alten B, Ivovic V, Martinkovic F, Kasap OE, Ozbel Y, de Lamballerie X, Charrel RN. Cocirculation of Two Lineages of Toscana Virus in Croatia. Front Public Health 2017; 5:336. [PMID: 29312917 PMCID: PMC5732939 DOI: 10.3389/fpubh.2017.00336] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/27/2017] [Indexed: 01/02/2023] Open
Affiliation(s)
- Nazli Ayhan
- UMR Emergence des Pathologies Virales (EPV), Aix-Marseille Université, IRD 190, INSERM 1207, École des Hautes Etudes en Santé Publique (EHESP), Marseille, France.,IHU Méditerranée Infection, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Bulent Alten
- VERG Labs, Ecology Division, Faculty of Science, Department of Biology, Hacettepe University, Ankara, Turkey
| | - Vladimir Ivovic
- Faculty of Mathematics, Natural Sciences and Information Technologies (FAMNIT), University of Primorska, Koper, Slovenia
| | - Franjo Martinkovic
- Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases with Clinics, University of Zagreb, Zagreb, Croatia
| | - Ozge E Kasap
- VERG Labs, Ecology Division, Faculty of Science, Department of Biology, Hacettepe University, Ankara, Turkey
| | - Yusuf Ozbel
- Medical Faculty, Department of Parasitology, Ege University, Bornova, Turkey
| | - Xavier de Lamballerie
- UMR Emergence des Pathologies Virales (EPV), Aix-Marseille Université, IRD 190, INSERM 1207, École des Hautes Etudes en Santé Publique (EHESP), Marseille, France.,IHU Méditerranée Infection, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Remi N Charrel
- UMR Emergence des Pathologies Virales (EPV), Aix-Marseille Université, IRD 190, INSERM 1207, École des Hautes Etudes en Santé Publique (EHESP), Marseille, France.,IHU Méditerranée Infection, Assistance Publique Hôpitaux de Marseille, Marseille, France
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Ayhan N, Alten B, Ivovic V, Dvořák V, Martinkovic F, Omeragic J, Stefanovska J, Petric D, Vaselek S, Baymak D, Kasap OE, Volf P, Charrel RN. Direct evidence for an expanded circulation area of the recently identified Balkan virus (Sandfly fever Naples virus species) in several countries of the Balkan archipelago. Parasit Vectors 2017; 10:402. [PMID: 28851425 PMCID: PMC5575908 DOI: 10.1186/s13071-017-2334-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/15/2017] [Indexed: 02/08/2023] Open
Abstract
Background Recently, Balkan virus (BALKV, family Phenuiviridae, genus Phlebovirus) was discovered in sand flies collected in Albania and genetically characterised as a member of the Sandfly fever Naples species complex. To gain knowledge concerning the geographical area where exposure to BALKV exists, entomological surveys were conducted in 2014 and 2015, in Croatia, Bosnia and Herzegovina (BH), Kosovo, Republic of Macedonia and Serbia. Results A total of 2830 sand flies were trapped during 2014 and 2015 campaigns, and organised as 263 pools. BALKV RNA was detected in four pools from Croatia and in one pool from BH. Phylogenetic relationships were examined using sequences in the S and L RNA segments. Study of the diversity between BALKV sequences from Albania, Croatia and BH showed that Albanian sequences were the most divergent (9–11% [NP]) from the others and that Croatian and BH sequences were grouped (0.9–5.4% [NP]; 0.7–5% [L]). The sand fly infection rate of BALKV was 0.26% in BH and 0.27% in Croatia. Identification of the species content of pools using cox1 and cytb partial regions showed that the five BALKV positive pools contained Phlebotomus neglectus DNA; in four pools, P neglectus was the unique species, whereas P. tobbi DNA was also detected in one pool. Conclusions We report here (i) the first direct evidence that the Balkan virus initially described in coastal Albania has a much wider dissemination area than originally believed, (ii) two real-time RT-PCR assays that may be useful for further screening of patients presenting with fever of unknown origin that may be caused by Balkan virus infection, (iii) entomological results suggesting that Balkan virus is likely transmitted by Phlebotomus neglectus, and possibly other sand fly species of the subgenus Larroussius. So far, BALKV has been detected only in sand flies. Whether BALKV can cause disease in humans is unknown and remains to be investigated.
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Affiliation(s)
- Nazli Ayhan
- UMR "Emergence des Pathologies Viralesˮ (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP - IHU Méditerranée Infection), Marseille, France
| | - Bulent Alten
- Faculty of Science, Department of Biology, Ecology Division, VERG Labs, Hacettepe University, Beytepe, Ankara, Turkey
| | | | - Vit Dvořák
- Faculty of Science, Department of Parasitology, Charles University, Prague, Czech Republic
| | - Franjo Martinkovic
- Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases with Clinics, University of Zagreb, Zagreb, Croatia
| | - Jasmin Omeragic
- Department of Parasitology, Veterinary Faculty of Sarajevo, Zmaja od Bosne 90, 71000, Sarajevo, Bosnia and Herzegovina
| | - Jovana Stefanovska
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Dusan Petric
- Faculty of Agriculture, Laboratory for Medical and Veterinary Entomology, University of Novi Sad, Novi Sad, Serbia
| | - Slavica Vaselek
- Faculty of Agriculture, Laboratory for Medical and Veterinary Entomology, University of Novi Sad, Novi Sad, Serbia
| | - Devrim Baymak
- National Institute of Public Health, Pristina, Kosovo
| | - Ozge E Kasap
- Faculty of Science, Department of Biology, Ecology Division, VERG Labs, Hacettepe University, Beytepe, Ankara, Turkey
| | - Petr Volf
- Faculty of Science, Department of Parasitology, Charles University, Prague, Czech Republic
| | - Remi N Charrel
- UMR "Emergence des Pathologies Viralesˮ (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP - IHU Méditerranée Infection), Marseille, France.
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Alkan C, Bichaud L, de Lamballerie X, Alten B, Gould EA, Charrel RN. Sandfly-borne phleboviruses of Eurasia and Africa: Epidemiology, genetic diversity, geographic range, control measures. Antiviral Res 2013; 100:54-74. [DOI: 10.1016/j.antiviral.2013.07.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/03/2013] [Accepted: 07/09/2013] [Indexed: 12/12/2022]
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