[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]
Clinical and virological findings in patients with Usutu virus infection, northern Italy, 2018
Monia Pacenti 1,2, Alessandro Sinigaglia 2,3, Thomas Martello 2, Elena De Rui 3, Elisa Franchin 2,3, Silvana Pagni 2,3, Elektra Peta 3, Silvia Riccetti 3, Adelaide Milani 4, Fabrizio Montarsi 4, Gioia Capelli 4, Carlo Giovanni Doroldi 5, Francesco Bigolin 5, Luca Santelli 6, Lucia Nardetto 6, Marco Zoccarato 6, Luisa Barzon 2,3
Affiliations: 1 Microbiology and Virology Unit, Padua University Hospital, Padova, Italy; 2 These authors contributed equally as first authors; 3 Department of Molecular Medicine, University of Padova, Padova, Italy; 4 Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro PD, Italy; 5 Medicine Unit, Camposampiero Hospital, Azienda ULSS 6 Euganea, Padova, Italy; 6 Neurology Department, Ospedale S. Antonio, Azienda ULSS 6 Euganea, Padova, Italy
Correspondence: Luisa Barzon
Citation style for this article: Pacenti Monia, Sinigaglia Alessandro, Martello Thomas, De Rui Elena, Franchin Elisa, Pagni Silvana, Peta Elektra, Riccetti Silvia, Milani Adelaide, Montarsi Fabrizio, Capelli Gioia, Doroldi Carlo Giovanni, Bigolin Francesco, Santelli Luca, Nardetto Lucia, Zoccarato Marco, Barzon Luisa. Clinical and virological findings in patients with Usutu virus infection, northern Italy, 2018. Euro Surveill. 2019;24(47):pii=1900180. https://doi.org/10.2807/1560-7917.ES.2019.24.47.1900180
Received: 12 Mar 2019; Accepted: 20 May 2019
Usutu virus (USUV) is a mosquito-borne flavivirus, which shares its transmission cycle with the phylogenetically related West Nile virus (WNV). USUV circulates in several European countries and its activity has increased over the last 5 years.
To describe human cases of USUV infection identified by surveillance for WNV and USUV infection in the Veneto Region of northern Italy in 2018.
From 1 June to 30 November 2018, all cases of suspected autochthonous arbovirus infection and blood donors who had a reactive WNV nucleic acid test were investigated for both WNV and USUV infection by in-house molecular methods. Anti-WNV and anti-USUV IgM and IgG antibodies were detected by ELISA and in-house immunofluorescence assay, respectively; positive serum samples were further tested by WNV and USUV neutralisation assays run in parallel.
Eight cases of USUV infection (one with neuroinvasive disease, six with fever and one viraemic blood donor who developed arthralgia and myalgia) and 427 cases of WNV infection were identified. A remarkable finding of this study was the persistence of USUV RNA in the blood and urine of three patients during follow-up. USUV genome sequences from two patients shared over 99% nt identity with USUV sequences detected in mosquito pools from the same area and clustered within lineage Europe 2.
Clinical presentation and laboratory findings in patients with USUV infection were similar to those found in patients with WNV infection. Cross-reactivity of serology and molecular tests challenged the differential diagnosis.
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Keywords: Arbovirus; Flavivirus; Usutu virus; Italy.