Intensive West Nile Virus Circulation in Serbia in 2018-Results of Integrated Surveillance Program

Public health contributions of entomological surveillance of West Nile virus (WNV) and other mosquito-borne arboviruses in a context of climate change

Background

Climate change is likely to increase the risk of human transmission of arboviruses endemic to Canada, including West Nile virus (WNV), Eastern equine encephalitis virus (EEEV) and California serogroup virus (CSV), calling for enhanced surveillance, including entomological surveillance targeting mosquito vectors. A scoping review was carried out to document the public health contributions of entomological surveillance of arboviruses of importance in Canada.

Methods

The Ovid® and EBSCO platforms and the grey literature were searched to identify documents published between 2009 and 2023, in English or French, dealing with entomological surveillance of arboviruses of interest, conducted annually for human health purposes under the aegis of a government authority, with specified public health objectives and actions.

Results

The 42 selected publications mainly reported two public health objectives of adult mosquito surveillance: early warning of viral circulation and assessment of the level of risk of human transmission. Recommended actions included clinical preparedness, risk communication, promotion of personal protection measures and vector control. The main objectives of immature mosquito surveillance were to identify sites with high larval densities, in order to reduce/eliminate them and target the application of larvicides.

Conclusion

In a context of climate change favouring the spread of arboviruses, this study highlights the potential public health contributions of regular entomological surveillance of endemic arboviruses of importance in Canada. It helps support concrete actions to protect the health of the population from the risks of arboviral transmission.

Seroprevalence of West Nile Virus among Equids in Bulgaria in 2022 and Assessment of Some Risk Factors

The aim of this study was to analyze the seroprevalence of West Nile virus (WNV) among equids in Bulgaria, confirm the results of a competitive ELISA versus the virus neutralization test (VNT) and investigate some predisposing factors for WNV seropositivity. A total of 378 serum samples from 15 provinces in northern and southern Bulgaria were tested. The samples originated from 314 horses and 64 donkeys, 135 males and 243 females, aged from 1 to 30 years. IgG and IgM antibodies against WNV protein E were detected by ELISA. ELISA-positive samples were additionally tested via VNT for WNV and Usutu virus. Thirty-five samples were WNV-positive by ELISA (9.26% [CI = 6.45-12.88]), of which 15 were confirmed by VNT; hence, the seroprevalence was 3.97% (CI = 2.22-6.55). No virus-neutralizing antibodies to Usutu virus were detected among the 35 WNV-ELISA-positive equids in Bulgaria. When compared with VNT, ELISA showed 100.0% sensitivity and 94.5% specificity. A statistical analysis showed that the risk factors associated with WNV seropositivity were the region (p < 0.0001), altitude of the locality (p < 0.0001), type of housing (p < 0.0001) and breed (p = 0.0365). The results of the study demonstrate, albeit indirectly, that WNV circulates among equids in northern and southern Bulgaria, indicating that they could be suitable sentinel animals for predicting human cases and determining the risk in these areas or regions of the country.

Cross-sectional serosurvey of selected infectious diseases in wild ruminants in Serbia

The role of wildlife in maintaining infectious diseases in veterinary medicine is often neglected, although the disease eradication process in domestic animals is continuously affected by the risk of pathogens transmission from wildlife as a primary source. The main aim of this paper was to estimate the prevalence and distribution of selected infectious diseases in wild ruminants in Serbia. In total, 259 sera from wild ruminants were tested for specific antibodies to bluetongue virus, Schmallenberg virus, Bovine viral diarrhea/border disease virus, Capripox virus, West Nile fever virus, Bovine herpes virus-1, Coxiella burnetii, Brucella spp., and Leptospira spp. Specific Capripox virus and Leptospira spp. antibodies were not detected in any of the 259 wild ruminant samples. Although one animal was detected positive for BVDV/BDV specific antibodies, with 99.8% confidence, the prevalence of BVD within this population could be very low i.e. essentially free from BVD infection. One and three positive animals were detected for Brucella spp. and Coxiella burnetii antibodies, respectively. Bovine herpes virus-1 specific antibodies were detected in 20.85% of the samples. The estimated seroprevalence of vector-borne diseases was 20.5% for Schmallenberg disease, 34.3% for West Nile fever, and 38.6% for Bluetongue. Considering the reported results, wildlife health status is a result of different factors in complex relation, such as the presence of disease in domestic animals, disease nature, pathogen characteristics, environmental factors, presence, and vector competence. Wildlife should be considered not only as a risk but as a source of important information on disease distribution and its indicators.

Evidence of tick-borne encephalitis virus neutralizing antibodies in Serbian individuals exposed to tick bites

Introduction

Tick-borne encephalitis (TBE) is an emerging vector-borne and food-borne disease caused by the tick-borne encephalitis virus (TBEV; Orthoflavivirus encephalitidis), with a distribution spanning the Eurasian continent. Despite its significant public health impact in various European regions, TBE remains largely underdiagnosed in Serbia due to limited awareness and diagnostic challenges. In response to this, our study aimed to comprehensively assess TBEV exposure in individuals infested with ticks and to identify potential TBEV foci within Serbia.

Materials and methods

From 2019 to 2021, we conducted an observational study involving 450 patients who reported tick infestations.

Results

Our demographic analysis revealed a median age of 38 years, with a slight male predominance among the participants. We documented tick infestations in 38 municipalities across 14 districts of Serbia, with a notable concentration in proximity to Fruška Gora Mountain. The ticks most frequently removed were Ixodes ricinus, with nymphs and adult females being the predominant stages. On average, nymphs were removed after about 27.1 hours of feeding, while adult females remained attached for approximately 44.4 hours. Notably, we found age as a significant predictor of infestation time for both nymphs and adult females. Furthermore, we detected TBEV-neutralizing antibodies in 0.66% of the serum samples, shedding light on potential TBEV foci, particularly in Fruška Gora Mountain and other regions of Serbia.

Conclusion

Our study emphasizes the urgent need for active TBE surveillance programs, especially in areas suspected of hosting TBEV foci, in order to assess the true TBE burden, identify at-risk populations, and implement effective preventive measures.

A dynamically structured matrix population model for insect life histories observed under variable environmental conditions

Various environmental drivers influence life processes of insect vectors that transmit human disease. Life histories observed under experimental conditions can reveal such complex links; however, designing informative experiments for insects is challenging. Furthermore, inferences obtained under controlled conditions often extrapolate poorly to field conditions. Here, we introduce a pseudo-stage-structured population dynamics model to describe insect development as a renewal process with variable rates. The model permits representing realistic life stage durations under constant and variable environmental conditions. Using the model, we demonstrate how random environmental variations result in fluctuating development rates and affect stage duration. We apply the model to infer environmental dependencies from the life history observations of two common disease vectors, the southern (Culex quinquefasciatus) and northern (Culex pipiens) house mosquito. We identify photoperiod, in addition to temperature, as pivotal in regulating larva stage duration, and find that carefully timed life history observations under semi-field conditions accurately predict insect development throughout the year. The approach we describe augments existing methods of life table design and analysis, and contributes to the development of large-scale climate- and environment-driven population dynamics models for important disease vectors.

West Nile Virus Lineage 2 Spreads Westwards in Europe and Overwinters in North-Eastern Spain (2017–2020)

West Nile virus lineage 2 (WNV-L2) emerged in Europe in 2004; since then, it has spread across the continent, causing outbreaks in humans and animals. During 2017 and 2020, WNV-L2 was detected and isolated from four northern goshawks in two provinces of Catalonia (north-eastern Spain). In order to characterise the first Spanish WNV-L2 isolates and elucidate the potential overwintering of the virus in this Mediterranean region, complete genome sequencing, phylogenetic analyses, and a study of phenotypic characterisation were performed. Our results showed that these Spanish isolates belonged to the central-southern WNV-L2 clade. In more detail, they were related to the Lombardy cluster that emerged in Italy in 2013 and has been able to spread westwards, causing outbreaks in France (2018) and Spain (2017 and 2020). Phenotypic characterisation performed in vitro showed that these isolates presented characteristics corresponding to strains of moderate to high virulence. All these findings evidence that these WNV-L2 strains have been able to circulate and overwinter in the region, and are pathogenic, at least in northern goshawks, which seem to be very susceptible to WNV infection and may be good indicators of WNV-L2 circulation. Due to the increasing number of human and animal cases in Europe in the last years, this zoonotic flavivirus should be kept under extensive surveillance, following a One-Health approach.

West Nile Virus Lineage 1 in Italy: Newly Introduced or a Re-Occurrence of a Previously Circulating Strain?

In Italy, West Nile virus (WNV) appeared for the first time in the Tuscany region in 1998. After 10 years of absence, it re-appeared in the areas surrounding the Po River delta, affecting eight provinces in three regions. Thereafter, WNV epidemics caused by genetically divergent isolates have been documented every year in the country. Since 2018, only WNV Lineage 2 has been reported in the Italian territory. In October 2020, WNV Lineage 1 (WNV-L1) re-emerged in Italy, in the Campania region. This is the first occurrence of WNV-L1 detection in the Italian territory since 2017. WNV was detected in the internal organs of a goshawk (Accipiter gentilis) and a kestrel (Falco tinnunculus). The RNA extracted in the goshawk tissue samples was sequenced, and a Bayesian phylogenetic analysis was performed by a maximum-likelihood tree. Genome analysis, conducted on the goshawk WNV complete genome sequence, indicates that the strain belongs to the WNV-L1 Western-Mediterranean (WMed) cluster. Moreover, a close phylogenetic similarity is observed between the goshawk strain, the 2008-2011 group of Italian sequences, and European strains belonging to the Wmed cluster. Our results evidence the possibility of both a new re-introduction or unnoticed silent circulation in Italy, and the strong importance of keeping the WNV surveillance system in the Italian territory active.