[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Clin Microbiol Infect. 2020 Jan 2. pii: S1198-743X(19)30672-X. doi: 10.1016/j.cmi.2019.12.015. [Epub ahead of print]
An update on Toscana virus distribution, genetics, medical and diagnostic aspects.
Ayhan N1, Charrel RN2.
Author information: 1 Unite des Virus Emergents (Aix-Marseille Univ – IRD 190 – Inserm 1207 – IHU Mediterranee Infection), Marseille, France; EA7310, Laboratoire de Virologie, Université de Corse-Inserm, Corte, France. 2 Unite des Virus Emergents (Aix-Marseille Univ – IRD 190 – Inserm 1207 – IHU Mediterranee Infection), Marseille, France. Electronic address: firstname.lastname@example.org.
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 less than 250 peer-reviewed articles since the 1970’s.
The last review article on Toscana virus was published in 2012. The aim was to compile peer-reviewed articles in order to provide an updated review highlighting recent findings to complement previous review articles.
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.
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. Beside 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 that have been reported for forty years, various neuroinvasive forms have been recently reported such as Guillain-Barré syndrome, hydrocephalus, myositis, fasciitis, polymyeloradiculopathy, deafness, facial paralysis.
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.
Copyright © 2019. Published by Elsevier Ltd.
PMID: 31904562 DOI: 10.1016/j.cmi.2019.12.015
Keywords: Arbovirus; Toscana virus; Encephalitis; Meningitis; Neurology.