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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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Al-numaani SA, Al-Nemari AT, El-Kafrawy SA, Hassan AM, Tolah AM, Alghanmi M, Zawawi A, Masri BE, Hindawi SI, Alandijany TA, Bajrai LH, Bukhari A, Mahmoud AB, Al Salem WS, Algaissi A, Charrel RN, Azhar EI, Hashem AM. Seroprevalence of Toscana and sandfly fever Sicilian viruses in humans and livestock animals from western Saudi Arabia. One Health 2023; 17:100601. [PMID: 37520847 PMCID: PMC10372353 DOI: 10.1016/j.onehlt.2023.100601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023] Open
Abstract
High seroprevalence rates of several phleboviruses have been reported in domestic animals and humans in sandfly-infested regions. Sandfly Fever Sicilian virus (SFSV) and Toscana virus (TOSV) are two of these viruses commonly transmitted by Phlebotomus sandflies. While SFSV can cause rapidly resolving mild febrile illness, TOSV could involve the central nervous system (CNS), causing diseases ranging from aseptic meningitis to meningoencephalitis. Sandfly-associated phleboviruses have not been investigated before in Saudi Arabia and are potential causes of infection given the prevalence of sandflies in the country. Here, we investigated the seroprevalence of SFSV and TOSV in the western region of Saudi Arabia in samples collected from blood donors, livestock animals, and animal handlers. An overall seroprevalence of 9.4% and 0.8% was found in humans for SFSV and TOSV, respectively. Seropositivity was significantly higher in non-Saudis compared to Saudis and increased significantly with age especially for SFSV. The highest seropositivity rate was among samples collected from animal handlers. Specifically, in blood donors, 6.4% and 0.7% tested positive for SFSV and TOSV nAbs, respectively. Animal handlers showed higher seroprevalence rates of 16% and 1% for anti-SFSV and anti-TOSV nAbs, respectively, suggesting that contact with livestock animals could be a risk factor. Indeed, sera from livestock animals showed seropositivity of 53.3% and 4.4% in cows, 27.5% and 7.8% in sheep, 2.2% and 0.0% in goats, and 10.0% and 2.3% in camels for SFSV and TOSV, respectively. Together, these results suggest that both SFSV and TOSV are circulating in the western region of Saudi Arabia in humans and livestock animals, albeit at different rates, and that age and contact with livestock animals could represent risk factors for infection with these viruses.
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Affiliation(s)
- Sarah Ayman Al-numaani
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa Talat Al-Nemari
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherif A. El-Kafrawy
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M. Hassan
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M. Tolah
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Maimonah Alghanmi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayat Zawawi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badr Essa Masri
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salwa I. Hindawi
- Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Thamir A. Alandijany
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Leena H. Bajrai
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah Bukhari
- Department of Medicine, Faculty of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ahmad Bakur Mahmoud
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunwarah, Saudi Arabia
| | - Waleed S. Al Salem
- Department of Agriculture, Ministry of Environment, Water and Agriculture, Riyadh, Saudi Arabia
| | - Abdullah Algaissi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
- Emerging and Epidemic Infectious Diseases Research Unit, Medical Research Center, Jazan University, Jazan, Saudi Arabia
| | - Remi N. Charrel
- Unité des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection), Marseille, France
| | - Esam I. Azhar
- Special Infectious Agents Unit- BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar M. Hashem
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Laroche L, Ayhan N, Charrel R, Bañuls AL, Prudhomme J. Persistence of Toscana virus in sugar and blood meals of phlebotomine sand flies: epidemiological and experimental consequences. Sci Rep 2023; 13:5608. [PMID: 37019992 PMCID: PMC10076283 DOI: 10.1038/s41598-023-32431-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/27/2023] [Indexed: 04/07/2023] Open
Abstract
Many virological studies have tested the persistence of enveloped RNA viruses in various environmental and laboratory conditions and shown their short-term persistence. In this article, we analyzed Toscana virus (TOSV) infectivity, a pathogenic sandfly-borne phlebovirus, in two different conditions: in the sugar meal and blood meal of sand flies. Our results showed that TOSV RNA was detectable up to 15 days in sugar solution at 26 °C and up to 6 h in blood at 37 °C. Moreover, TOSV remains infective for 7 days in sugar solution and for minimum 6 h in rabbit blood. TOSV has shown persistent infectivity/viability under different conditions, which may have important epidemiological consequences. These results strengthen new hypotheses about the TOSV natural cycle, such as the possibility of horizontal transmission between sand flies through infected sugar meal.
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Affiliation(s)
- Lison Laroche
- UMR MIVEGEC, Université de Montpellier - IRD 224 - CNRS 5290, 911 Avenue Agropolis, 34394, Montpellier, France.
| | - Nazli Ayhan
- UVE, Aix Marseille Université - IRD 190 - Inserm 1207 - AP-HM Hôpitaux Universitaires de Marseille, Marseille, France
| | - Rémi Charrel
- UVE, Aix Marseille Université - IRD 190 - Inserm 1207 - AP-HM Hôpitaux Universitaires de Marseille, Marseille, France
| | - Anne-Laure Bañuls
- UMR MIVEGEC, Université de Montpellier - IRD 224 - CNRS 5290, 911 Avenue Agropolis, 34394, Montpellier, France
| | - Jorian Prudhomme
- UMR MIVEGEC, Université de Montpellier - IRD 224 - CNRS 5290, 911 Avenue Agropolis, 34394, Montpellier, France
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France
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Giménez-Richarte Á, Ortiz de Salazar MI, Giménez-Richarte MP, Collado M, Fernández PL, Clavijo C, Navarro L, Arbona C, Marco P, Ramos-Rincon JM. Transfusion-transmitted arboviruses: Update and systematic review. PLoS Negl Trop Dis 2022; 16:e0010843. [PMID: 36201547 PMCID: PMC9578600 DOI: 10.1371/journal.pntd.0010843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/18/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background The detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics. Material and methods Systematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355. Results A total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety. Discussion In the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety. The transfusion of blood and blood components entails some risks and potential complications, chief among them the transmission of infectious agents. Organizations like the American Association of Blood Banks have warned of the risks posed by emerging and re-emerging viruses for transfusion safety and have classified transmission of several arboviruses as a high or very high risk to the transfusion of blood and blood components. Following recommendations by the World Health Organization (WHO), this study aims to enable safe blood transfusion services, by making available the latest updated information of transfusion-transmitted arboviruses and comprehensive knowledge of the current epidemiology of reported cases. Research revealed case reports of transfusion transmission of 10 arboviruses, with West Nile virus and dengue virus as the most prevalent. Main clinical characteristics of reported cases were collected, including the type of blood component transfused and the state of immunosuppression of the recipient. Research also revealed 18 additional arboviruses with potential risk of transmission through other direct transmission routes. This systematic review provides an updated overview of the clinical characteristics of reported cases of transfusion-transmitted arboviruses. It is the most complete record published to date that assesses the risk posed by arboviruses to blood transfusion.
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Affiliation(s)
| | | | | | - Miriam Collado
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | | | - Carlos Clavijo
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Laura Navarro
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Cristina Arbona
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Pascual Marco
- Service of Hematology, General- University Hospital of Alicante-ISABIAL. Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
| | - Jose-Manuel Ramos-Rincon
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
- * E-mail: (AG-R); (J-MR-R)
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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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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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A rapid and specific real time RT-PCR assay for diagnosis of Toscana virus infection. J Clin Virol 2015; 66:107-11. [PMID: 25866349 DOI: 10.1016/j.jcv.2015.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 02/26/2015] [Accepted: 03/06/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND To scan a virus (TOSV) belongs to the Phlebovirus genus within the Bunyaviridae family. TOSV is an arbovirus transmitted by sandflies. In Mediterranean countries, TOSV is one of the major viral pathogens involved in aseptic meningitis and meningoencephalitis. OBJECTIVES Development and assessment of a new sensitive and specific real-time RT-PCR assay for TOSV diagnosis. STUDY DESIGN TOSV-specific primers and probe targeting the S-segment of the genome were designed, based on recent TOSV sequences available in public databases. Sensitivity was assessed using 10-fold serial dilutions of a RNA transcript and serial dilutions of TOSV strains isolated from infected human beings. Specificity was determined by testing RNA extracts from closely related Phleboviruses. The assay was then used for TOSV infection diagnosis in 971 clinical samples and for TOSV detection in 2000 sandflies. RESULTS The real-time RT-PCR assay exhibited a sensitivity of under 257 copies per reaction for the RNA transcripts and 0.0056 and 0.014 TCID50 of Italian and Spanish TOSV genotypes per reaction, respectively. No other close Phleboviruses were detected. TOSV was identified in 17 clinical samples and in 3 sandflies. CONCLUSIONS The assay described is a rapid, robust and reliable real-time RT-PCR test for accurate diagnosis of human TOSV infection as well as for the surveillance of TOSV in vector populations.
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Marlinge M, Crespy L, Zandotti C, Piorkowski G, Kaphan E, Charrel RN, Ninove L. Afebrile meningoencephalitis with transient central facial paralysis due to Toscana virus infection, southeastern France, 2014 [corrected]. ACTA ACUST UNITED AC 2014; 19:20974. [PMID: 25496570 DOI: 10.2807/1560-7917.es2014.19.48.20974] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We report a case of meningoencephalitis caused by Toscana virus (TOSV) with central facial paralysis lasting over two days acquired in south-eastern France. The patient was not febrile either before or during the course of the disease. The diagnosis was established by both real-time RT-PCR and virus isolation with complete genome sequencing. This case emphasises the need to consider TOSV in non-febrile neurological syndromes in people living in or having travelled to the Mediterranean area.
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Affiliation(s)
- Mc Marlinge
- IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
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10
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Bunyavirus-vector interactions. Viruses 2014; 6:4373-97. [PMID: 25402172 PMCID: PMC4246228 DOI: 10.3390/v6114373] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/30/2014] [Accepted: 11/04/2014] [Indexed: 01/23/2023] Open
Abstract
The Bunyaviridae family is comprised of more than 350 viruses, of which many within the Hantavirus, Orthobunyavirus, Nairovirus, Tospovirus, and Phlebovirus genera are significant human or agricultural pathogens. The viruses within the Orthobunyavirus, Nairovirus, and Phlebovirus genera are transmitted by hematophagous arthropods, such as mosquitoes, midges, flies, and ticks, and their associated arthropods not only serve as vectors but also as virus reservoirs in many cases. This review presents an overview of several important emerging or re-emerging bunyaviruses and describes what is known about bunyavirus-vector interactions based on epidemiological, ultrastructural, and genetic studies of members of this virus family.
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Dupouey J, Bichaud L, Ninove L, Zandotti C, Thirion-Perrier L, de Lamballerie X, Charrel RN. Toscana virus infections: a case series from France. J Infect 2013; 68:290-5. [PMID: 24247068 DOI: 10.1016/j.jinf.2013.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/22/2013] [Accepted: 11/01/2013] [Indexed: 12/18/2022]
Abstract
Toscana virus (TOSV) is a neglected sandfly-borne pathogen in Mediterranean countries. Although discovered four decades ago, articles that describe the clinical aspects are scarce and consist mostly of case reports, with few series of cases. We studied retrospectively symptomatic TOSV infections in patients hospitalized in Marseille (France) from 2004 to 2011. Seventeen patients were classified as probable or confirmed cases. Fourteen cases (82%) occurred between June and September, and 3 cases in March, April and November. Two cases were potentially imported from Croatia and Tuscany. All patients presented with fever and neurological signs were observed such as aseptic meningitis (n = 6), muscular symptoms (n = 3), or encephalitis (n = 4). The outcome was always favorable. At the acute stage, anti TOSV IgM were observed in 14/17 patients, neutralization tests were positive for 3/8 patients, and RT-PCR confirmed TOSV infections in 5/8 CSF specimens.
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Affiliation(s)
- J Dupouey
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - L Bichaud
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - L Ninove
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - C Zandotti
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - L Thirion-Perrier
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - X de Lamballerie
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 Marseille, France
| | - R N Charrel
- UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, IRD French Institute of Research for Development, EHESP French School of Public Health, 13005 Marseille, France; IHU Mediterranee Infection, APHM Public Hospitals of Marseille, 13005 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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Bichaud L, Izri A, de Lamballerie X, Moureau G, Charrel RN. First detection of Toscana virus in Corsica, France. Clin Microbiol Infect 2013; 20:O101-4. [PMID: 23992202 DOI: 10.1111/1469-0691.12347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/10/2013] [Accepted: 07/15/2013] [Indexed: 12/18/2022]
Abstract
Toscana virus (TOSV) was detected for the first time from Phlebotomus perniciosus sandflies in Corsica, a French Mediterranean island. Genetic analysis showed that Corsican TOSV belongs to lineage A, together with Italian, Tunisian, Turkish and other French strains. The demonstration of TOSV in Corsica indicates that autochthonous and tourist populations are at risk of infection. Hence, physicians must consider TOSV as a possible cause of aseptic meningitis and unidentified febrile illness during the warm season.
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Affiliation(s)
- L Bichaud
- UMR_D 190 'Emergence des Pathologies Virales', IRD French Institute of Research for Development, EHESP French School of Public Health, Aix Marseille University, Marseille, France; IHU Mediterranée Infection, APHM Public Hospitals of Marseille, Marseille, France
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15
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Anagnostou V, Papa A. Prevalence of antibodies to phleboviruses within the sand fly fever Naples virus species in humans, northern Greece. Clin Microbiol Infect 2013; 19:566-70. [DOI: 10.1111/j.1469-0691.2012.03957.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Brisbarre NM, Plumet S, de Micco P, Leparc-Goffart I, Emonet SF. Toscana virus inhibits the interferon beta response in cell cultures. Virology 2013; 442:189-94. [PMID: 23684418 DOI: 10.1016/j.virol.2013.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/02/2013] [Accepted: 04/18/2013] [Indexed: 12/24/2022]
Abstract
Toscana virus (TOSV) is an emerging pathogen in the Mediterranean basin where it causes summertime outbreaks of aseptic meningitis and meningoencephalitis. Many aspects of TOSV biology remain unknown including the possible implication of an amplifying mammalian host besides its vector. The three experiments described here were designed to assess the relationship between TOSV and type-I interferon (IFN) response. The main findings were as follows. First, TOSV growth in Vero cells is sensitive to an antiviral state induced by low-dose addition of exogenous IFN beta (IFN-β) (10IU/ml). Second, no IFN-β mRNA or IFN-β was detectable after infection of HeLa and 293T cells by TOSV. Finally, TOSV inhibits IFN-β production induced by Sendaï virus, a well known inducer of IFN-β production. In addition to showing that TOSV can inhibit the IFN-β response, these findings suggest that anti-IFN capability is maintained by regular contact with that of a mammalian host.
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Affiliation(s)
- Nadege M Brisbarre
- UMR CNRS 6578, French Blood Agency, Alpes-Mediterranee and Aix-Marseille University, Viral Emergence and Co-evolution Unit, 27 boulevard Jean Moulin, Marseille, France
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Charrel RN, Bichaud L, de Lamballerie X. Emergence of Toscana virus in the mediterranean area. World J Virol 2012; 1:135-41. [PMID: 24175218 PMCID: PMC3782275 DOI: 10.5501/wjv.v1.i5.135] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 09/18/2012] [Accepted: 10/10/2012] [Indexed: 02/05/2023] Open
Abstract
Toscana virus (TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments (S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system (CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea (Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.
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Affiliation(s)
- Remi N Charrel
- Remi N Charrel, Laurence Bichaud, Xavier de Lamballerie, Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 "Emergence des Pathologies Virales", 13005 Marseille, France
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Amodio E, Cusi MG, Valenti RM, Valentini M, Mammina C, Gori-Savellini G, Vitale F, Romano N, Goedert JJ, Calamusa G. Immunoglobulin M seropositivity for Toscana virus in a random population sample in Sicily. Int J Infect Dis 2012; 16:e633-5. [PMID: 22726418 PMCID: PMC3604883 DOI: 10.1016/j.ijid.2012.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/11/2012] [Accepted: 04/30/2012] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES High Toscana virus (TOSV) antibody seropositivity rates have been documented in the last decade, especially in the Mediterranean area. It is unclear if these rates are associated with a recent or past exposure to the virus. This is of importance, as primary infection can cause neurologic complications, especially in adults. The aim of the present study was to assess the current active TOSV circulation in western Sicily. METHODS A cross-sectional seroprevalence study was conducted on 271 individuals aged 4-92 years, sampled from the general population of a small city. Each participant completed a self-administered questionnaire and provided serum, which was analyzed for the presence of specific anti-TOSV IgM and IgG. RESULTS Anti-TOSV IgM was detected in eight (3.0%) participants, of whom only three had anti-TOSV IgG. The prevalence of anti-TOSV IgM was highest in subjects aged 25-34 and 35-44 years (7.1% and 4.8%, respectively). All subjects positive for anti-TOSV IgM were resident in the suburban area. CONCLUSIONS The detection of IgM documented the circulation of TOSV, a Phlebovirus, in a random population sample of Sicilian adults. The highest risk of TOSV seroconversion in subjects living in the suburbs appears to suggest a high density of TOSV vectors in peri-urban areas.
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Affiliation(s)
- Emanuele Amodio
- Department of Sciences for Health Promotion G. D'Alessandro, University of Palermo, Via Del Vespro 133, Palermo, I-90127, Italy.
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Punda-Polić V, Jerončić A, Mohar B, Kraljevićc KŠ. Prevalence of Toscana virus antibodies in residents of Croatia. Clin Microbiol Infect 2012; 18:E200-3. [DOI: 10.1111/j.1469-0691.2012.03840.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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20
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Bichaud L, Souris M, Mary C, Ninove L, Thirion L, Piarroux RP, Piarroux R, De Lamballerie X, Charrel RN. Epidemiologic relationship between Toscana virus infection and Leishmania infantum due to common exposure to Phlebotomus perniciosus sandfly vector. PLoS Negl Trop Dis 2011; 5:e1328. [PMID: 21949894 PMCID: PMC3176742 DOI: 10.1371/journal.pntd.0001328] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 08/07/2011] [Indexed: 12/27/2022] Open
Abstract
Sand flies are recognised vectors of parasites in the genus Leishmania and a number of arthropod-borne viruses, in particular viruses within the genus Phlebovirus, family Bunyaviridae. In southern France, Toscana phlebovirus (TOSV) is recognized as a prominent cause of summer meningitis. Since Leishmania and TOSV have a common vector (Phlebotomus perniciosus), an epidemiologic link has been assumed for a long time. However, there is no scientific evidence of such a link between human leishmaniosis and phleboviral infections. To identify a possible link, we investigated the presence and distribution of antibodies against these two microorganisms (i) in individuals and (ii) at a spatial level in the city of Marseille (south-eastern France). Five hundred sera were selected randomly in the biobank of the Department of Parasitology of the Public Hospitals of Marseille. All sera were previously tested for IgG against Leishmania by Western Blotting, and TOSV IgG were detected by indirect immunofluorescence. The seropositivity rates were 21.4% for TOSV and 28% for Leishmania. Statistical analysis demonstrated that seropositivity for one pathogen was significantly associated with seropositivity to the other pathogen. This result provided the first robust evidence for the existence of an epidemiological relationship between Leishmania infantum and TOSV. Addresses of tested patients were geolocalized and integrated into Geographical Information System software, in order to test spatial relationship between the two pathogens. Spatial analysis did not allow to identify (i) specific patterns for the spatial distribution of positive serological results for TOSV or Leishmania, and (ii) a spatial relationship between Leishmania and TOSV positive serological results. This may reflect the fact that the sample studied was not powerful enough to demonstrate either a spatial clustering or co-location, i.e. that the actual risk exposure area is smaller than the mean of distance between patients in our study (245 m). Sand flies are tiny insects widely distributed in peri-Mediterranean countries where they can transmit Leishmania parasite and Toscana virus (TOSV). Since those microorganisms have a common vector, an epidemiologic link has been assumed for a long time. However, there is no scientific evidence of such a link between human leishmaniosis and phleboviral infections. To identify a possible link, we investigated the presence and distribution of antibodies to both Leishmania and TOSV in 500 sera of individuals living in Marseille, France. Antibodies are markers of past infections and reflect the exposition of population to pathogens. Statistical analysis demonstrated that seropositivity to one of these pathogens was significantly associated with seropositivity to the other pathogen. This result provided first robust evidence for an epidemiological relationship between Leishmania infantum and TOSV. Home addresses of tested patients were geolocalized in order to test spatial relationship between the two pathogens. This spatial analysis did not allow identifying either a spatial clustering or co-location, most probably because the sample was not powerful enough. Risk-factors of infection by TOSV (or Leishmania) would be investigated in seropositive patients' neighbourhood, in a range inferior to the mean of distance between patients in our study (245 meters).
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Affiliation(s)
- Laurence Bichaud
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
| | - Marc Souris
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
| | - Charles Mary
- Laboratoire de Parasitologie-Mycologie, AP-HM Timone, Marseille, France
| | - Laëtitia Ninove
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
| | - Laurence Thirion
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
| | - Raphaël P. Piarroux
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
| | - Renaud Piarroux
- Laboratoire de Parasitologie-Mycologie, AP-HM Timone, Marseille, France
| | | | - Rémi N. Charrel
- UMR 190, IRD-Université de la Méditerranée Aix-Marseille 2, Marseille, France
- * E-mail:
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