#Prediction of unfavorable #outcomes in #WNV #neuroinvasive #infection – result of a multinational ID-IRI study (J Clin Virol., abstract)

[Source: Journal of Clinical Virology, full page: (LINK). Abstract, edited.]

Journal of Clinical Virology / Available online 11 November 2019, 104213 / In Press, Journal Pre-proof

Prediction of unfavorable outcomes in West Nile virus neuroinvasive infection – result of a multinational ID-IRI study

Corneliu Petru Popescu a,b,c,1, Simin Aysel Florescu a,b,1, Rodrigo Hasbun d, Arjan Harxhi e, Razi Evendar f, Hasip Kahraman g, Ami Neuberger f, Daniel Codreanu b, Mihaela Florentina Zaharia a,b,c, Selma Tosun h, Emanoil Ceausu b, Simona Maria Ruta a,i, Gorana Dragovacj, k, Natalia Pshenichnaya l,m, Galina Gopatsa n, Olga Shmaylenko o, Éva Nagy, p, Jelena Djekic Malbasaj k, Mirjana Strbac j, Nenad  Pandak q, Husnu Pullukcu g, Botond Lakatos p, Yasemin Cag r, Antonio Cascio s, Ilaria Coledan t, Serkan Oncu u, Hakan Erdemc v

{a} University of Medicine and Pharmacy Carol Davila Bucharest, Romania; {b} Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases Bucharest, Romania; {c} ESCMID Study Group for Infectious Diseases of the Brain – ESGIB, Switzerland; {d} Department of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA; {e} Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania; {f} Infectious Diseases Institute, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel; {g}
Ege University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey; {h} Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey; {i} Stefan S. Nicolau Institute of Virology, Bucharest, Romania; {j} Institute of Public Health of Vojvodina, Department of Prevention and Control of Diseases, Novi Sad, Serbia; {k}
University of Novi Sad, Faculty of Medicine, Department of Epidemiology, Novi Sad, Serbia; {l} National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia; {m} Central Scientific Research Laboratory, Rostov State Medical University, Rostov-on-Don, Russia; {n} Department of Infectious Diseases, Rostov State Medical University, Rostov-on-Don, Russia; {o} Department of Infectious Diseases #5, City Hospital #1 named after N.A. Semashko, Rostov-on-Don, Russia; {p}
National Institute of Hematology and Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary; {q} General Hospital Slavonski Brod, Department for Infectious Diseases, School of Medicine, University of Split, Split, Croatia; {r} Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey; {s} Section of Infectious and Tropical Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Italy; {t} Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy; {u} Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey; {v} ID-IRI, Ankara, Turkey

Received 30 August 2019, Revised 31 October 2019, Accepted 7 November 2019, Available online 11 November 2019. DOI: https://doi.org/10.1016/j.jcv.2019.104213

 

Highlights

  • Prognosis of unfavorable outcomes in West Nile virus neuroinvasive infection.
  • The relative risk for death by age.
  • Encephalitis, meningoencephalitis, meningitis.
  • Glasgow coma score was correlated with evolution to death.
  • Risk score was calculated according to age, co-morbidities, clinical manifestations.

 

Abstract

Background

WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans.

Objectives

Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010- 2017 and identified factors that can influence prognosis.

Study design

We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches.

Results

We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients.

Conclusions

WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients.

Keywords: West Nile virus – WNV – meningitis – encephalitis – neuroinvasive – death

{1} These authors contributed equally to this article.

© 2019 Elsevier B.V. All rights reserved.

Keywords: WNV; WNND; Neuroinvasion; Encephalitis; Meningitis; European Region.

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#Entomological Data and #Detection of #WNV in #Mosquitoes in #Greece (2014–2016), Before Disease Re-Emergence in 2017 (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Entomological Data and Detection of West Nile Virus in Mosquitoes in Greece (2014–2016), Before Disease Re-Emergence in 2017

Eleni Patsoula, Stavroula Beleri, Nikolaos Tegos, Rima Mkrtsian, Annita Vakali, and Danai Pervanidou

Published Online: 11 Nov 2019 / DOI: https://doi.org/10.1089/vbz.2018.2422

 

Abstract

West Nile virus (WNV) cases were seasonally recorded in humans and animals in Greece, from 2010 to 2014, and circulation of the virus was detected in different Regional Units of the country. Small scale entomological surveillance activities were carried out by several regions and regional units in Greece, during 2014–2016, with the participation of subcontractors for the vector control programs aiming to record presence/absence of mosquito species, and monitor and control mosquito populations. Mosquito traps were placed in rural and urban sites; specimens were collected, morphologically characterized, and pooled by date of collection, location, and species types. Mosquito pools containing Culex pipiens, Aedes caspius, and Aedes albopictus were examined for the presence of WNV and positive pools were detected in different areas of the country. Sequencing of a selected number of amplicons revealed WNV lineage 2 partial NS5 gene sequences. In this study, we present data on the mosquito species composition in the areas of study and WNV detection from several parts of Greece, in 6, 11, and 26 mosquito pools corresponding to the years 2014, 2015, and 2016, respectively. A total of 15 WNV human infections were reported to the public health authorities of the country in 2014, whereas no human cases were detected for 2015–2016. Taking into consideration the complex epidemiological profile of WNV and unforeseen changes in its circulation, re-emergence of WNV human cases in Greece was possible and expected, thus rendering surveillance activities imperative.

Keywords: West Nile Virus; Mosquitoes; Aedes spp.; Culex spp.; Greece.

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#Phylogenetic Analysis of #Bird-Virulent #WNV Strain, #Greece (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 12—December 2019 / Research Letter

Phylogenetic Analysis of Bird-Virulent West Nile Virus Strain, Greece

George Valiakos, Konstantinos Plavos, Alexandros Vontas, Marina Sofia, Alexios Giannakopoulos, Themis Giannoulis, Vassiliki Spyrou, Constantina N. Tsokana, Dimitrios Chatzopoulos, Maria Kantere, Vasilis Diamantopoulos, Angeliki Theodorou, Spyridoula Mpellou, Athanasios Tsakris, Zissis Mamuris, and Charalambos Billinis

Author affiliations: University of Thessaly, Karditsa, Greece (G. Valiakos, K. Plavos, A. Vontas, M. Sofia, A. Giannakopoulos, T. Giannoulis, V. Spyrou, C.N. Tsokana, D. Chatzopoulos, M. Kantere, Z. Mamuris, C. Billinis); Public Health Director—Region of Peloponnese, Tripoli, Greece (V. Diamantopoulos); Directorate-General for Regional Agricultural Economics and Veterinary—Region of Peloponnese, Nafplio, Greece (A. Theodorou); Bioefarmoges Eleftheriou LP—Integrated Mosquito Control, Marathon, Greece (S. Mpellou); University of Athens, Athens, Greece (A. Tsakris)

 

Abstract

We report the full polyprotein genomic sequence of a West Nile virus strain isolated from Eurasian magpies dying with neurologic signs in Greece. Our findings demonstrate the local genetic evolution of the West Nile virus strain responsible for a human disease outbreak in the country that began in 2010.

Keywords: West Nile Virus; Wild birds; Human; Greece.

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Lack of Efficacy of High-Titered #Immunoglobulin in Patients with #WNV #CNS Disease (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 11—November 2019 / CME ACTIVITY – Research

Lack of Efficacy of High-Titered Immunoglobulin in Patients with West Nile Virus Central Nervous System Disease

John W. Gnann  , Amy Agrawal, John Hart, Martha Buitrago, Paul Carson, Diane Hanfelt-Goade, Ken Tyler, Jared Spotkov, Alison Freifeld, Thomas Moore, Jorge Reyno, Henry Masur, Penelope Jester, Ilet Dale, Yufeng Li, Inmaculada Aban, Fred D. Lakeman, Richard J. Whitley  , and for the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group

Author affiliations: University of Alabama at Birmingham, Birmingham, Alabama, USA (J.W. Gnann, Jr., P. Jester, I. Dale, Y. Li, I. Aban, F.D. Lakeman, R.J. Whitley); National Institutes of Health Clinical Center, Bethesda, Maryland, USA (A. Agrawal, H. Masur); University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (J. Hart); Idaho Falls Infectious Diseases PLLC, Idaho Falls, Idaho, USA (M. Buitrago); North Dakota State University, Fargo, North Dakota, USA (P. Carson); University of New Mexico, Albuquerque, New Mexico, USA (D. Hanfelt-Goade); University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA (K. Tyler); Kaiser Permanente South Bay Medical Center, Harbor City, California, USA (J. Spotkov); University of Nebraska Medical Center, Omaha, Nebraska, USA (D. Freifeld); Via Christi Hospital St. Francis, Wichita, Kansas, USA (T. Moore); Infectious Diseases Consultations, Rapid City, South Dakota, USA (J. Reyno)aurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

 

Abstract

West Nile Virus (WNV) can result in clinically severe neurologic disease. There is no treatment for WNV infection, but administration of anti-WNV polyclonal human antibody has demonstrated efficacy in animal models. We compared Omr-IgG-am, an immunoglobulin product with high titers of anti-WNV antibody, with intravenous immunoglobulin (IVIG) and normal saline to assess safety and efficacy in patients with WNV neuroinvasive disease as part of a phase I/II, randomized, double-blind, multicenter study in North America. During 2003–2006, a total of 62 hospitalized patients were randomized to receive Omr-IgG-am, standard IVIG, or normal saline (3:1:1). The primary endpoint was medication safety. Secondary endpoints were morbidity and mortality, measured using 4 standardized assessments of cognitive and functional status. The death rate in the study population was 12.9%. No significant differences were found between groups receiving Omr-IgG-am compared with IVIG or saline for either the safety or efficacy endpoints.

Keywords: West Nile Virus; WNND; Immunoglobulins.

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Previous #dengue or #Zika virus #exposure can drive to #infection #enhancement or neutralisation of other #flaviviruses (Mem Inst Oswaldo Cruz, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Mem Inst Oswaldo Cruz. 2019;114:e190098. doi: 10.1590/0074-02760190098. Epub 2019 Aug 12.

Previous dengue or Zika virus exposure can drive to infection enhancement or neutralisation of other flaviviruses.

Oliveira RA1,2, de Oliveira-Filho EF1,3, Fernandes AI4,5, Brito CA6, Marques ET1,7, Tenório MC1, Gil LH1.

Author information: 1 Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Virologia, Recife, PE, Brasil. 2 Universidade Federal da Paraíba, Departamento de Fisiologia e Patologia, João Pessoa, PB, Brasil. 3 Charité-Universitätsmedizin Berlin, Berlin, Germany. 4 Universidade Federal da Paraíba, Hospital Universitário Lauro Wanderley, Serviço de Doenças Infecciosas e Parasitárias, João Pessoa, PB, Brasil. 5 Universidade Federal da Paraíba, Escola Técnica de Saúde, Grupo de Estudos e Pesquisas em Imunologia Humana, João Pessoa, PB, Brasil. 6 Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Recife, PE, Brasil. 7 University of Pittsburgh, Center for Vaccine Research, Department of Infectious Diseases and Microbiology, Pittsburgh, PA, USA.

 

Abstract

BACKGROUND:

Dengue virus (DENV) has circulated in Brazil for over 30 years. During this time, one serotype has cyclically replaced the other, until recently, when all four distinct serotypes began to circulate together. Persistent circulation of DENV for long time periods makes sequential infections throughout a person’s life possible. After primary DENV infection, life-long immunity is developed for the infecting serotype. Since DENV and Zika virus (ZIKV) are antigenically similar, the possibility of cross-reactions has attracted attention and has been demonstrated in vitro.

OBJECTIVE:

The aim of this study was to investigate whether immune-sera from DENV and ZIKV infected patients would cross-react in vitro with other Flaviviridae family members.

METHODS:

Cross-reaction of the studied samples with yellow fever virus (YFV), West Nile virus (WNV), Rocio virus (ROCV), Saint Louis virus (SLEV) and Ilheus virus (ILHV) has been investigated by plaque reduction neutralisation test (PRNT) and the antibody-dependent enhancement (ADE) by flow-cytometry.

FINDINGS:

Antibodies against ZIKV and DENV virus cross-reacted with other flaviviruses either neutralising or enhancing the infection. Thus, viral entrance into FcRFcɣRII-expressing cells were influenced by the cross-reactive antibodies. ZIKV or DENV immune sera enhanced cellular infection by WNV, ILHV, ROCV and SLEV. Finally, DENV immune sera presented higher neutralising activity for YFV and SLEV. While ZIKV immune sera neutralised WNV, ILHV and ROCV with high frequencies of positivity.

MAIN CONCLUSIONS:

The co-circulation of those viruses in the same area represents a risk for the development of severe infections if they spread throughout the country. Successive flavivirus infections may have an impact on disease pathogenesis, as well as on the development of safe vaccine strategies.

PMID: 31411310 DOI: 10.1590/0074-02760190098

Keywords: Flavivirus; Dengue fever; Zika Virus; WNV; Rocio Virus; St Louis Virus; Ilheus virus; Yellow Fever; Serology; ADE; Brazil.

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#Extraordinary increase in #WNV cases and first confirmed #human #Usutu virus #infection in #Hungary, 2018 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Extraordinary increase in West Nile virus cases and first confirmed human Usutu virus infection in Hungary, 2018

Anna Nagy1,2, Eszter Mezei2,3, Orsolya Nagy1,4, Tamás Bakonyi5,6, Nikolett Csonka1, Magdolna Kaposi1, Anita Koroknai1, Katalin Szomor7, Zita Rigó7, Zsuzsanna Molnár3, Ágnes Dánielisz3, Mária Takács1,4

Affiliations: 1 National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary; 2 These authors contributed equally to this work; 3 Department of Communicable Diseases Epidemiology and Infection Control; National Public Health Center, Budapest, Hungary; 4 Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary; 5 Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary; 6 Viral Zoonoses, Emerging and Vector-borne Infections Group, Institute of Virology, University of Veterinary Medicine, Vienna, Austria; 7 National Reference Laboratory for Viral Exanthematous Diseases; National Public Health Center, Budapest, Hungary

Correspondence: Anna Nagynagy.annannk.gov.hu

Citation style for this article: Nagy Anna, Mezei Eszter, Nagy Orsolya, Bakonyi Tamás, Csonka Nikolett, Kaposi Magdolna, Koroknai Anita, Szomor Katalin, Rigó Zita, Molnár Zsuzsanna, Dánielisz Ágnes, Takács Mária. Extraordinary increase in West Nile virus cases and first confirmed human Usutu virus infection in Hungary, 2018. Euro Surveill. 2019;24(28):pii=1900038. https://doi.org/10.2807/1560-7917.ES.2019.24.28.1900038

Received: 07 Jan 2019;   Accepted: 02 Apr 2019

 

Abstract

Background

During the 2018 WNV transmission season, similarly to other endemic areas in Europe, a large number of human West Nile virus (WNV) infections were reported in Hungary.

Aims

We summarise the epidemiological and laboratory findings of the 2018 transmission season and expand experiences in flavivirus differential diagnostics.

Methods

Every patient with clinical suspicion of acute WNV infection was in parallel tested for WNV, tick-borne encephalitis virus and Usutu virus (USUV) by serological methods. Sera, whole blood and urine samples were also tested for the presence of viral nucleic acid.

Results

Until the end of December 2018, 215 locally acquired and 10 imported human WNV infections were notified in Hungary. All reported cases were symptomatic; most of them exhibited neurological symptoms. In a large proportion of tested individuals, whole blood was the most appropriate sample type for viral nucleic acid detection, but because whole blood samples were not always available, testing of urine samples also extended diagnostic possibilities. In addition, the first human USUV infection was confirmed in 2018 in a patient with aseptic meningitis. Serological cross-reactions with WNV in different serological assays were experienced, but subsequent molecular biological testing and sequence analysis identified Europe lineage 2 USUV infection.

Conclusion

Careful interpretation and simultaneous application of different laboratory methods are necessary to avoid misdiagnosis of human USUV cases. Expansion of the laboratory-confirmed case definition criteria for detection of viral RNA in any clinical specimens to include urine samples could increase diagnostic sensitivity.

© This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: WNV; Usutu virus; Hungary.

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#Seroreactivity to #Chikungunya and #WNV Viruses in #Rwandan #Blood Donors (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Seroreactivity to Chikungunya and West Nile Viruses in Rwandan Blood Donors

Eric Seruyange, Karl Ljungberg, Claude Mambo Muvunyi, Jean Bosco Gahutu, Swaibu Katare, José Nyamusore, Yong-Dae Gwon, Magnus Evander, Heléne Norder, Peter Liljeström, and Tomas Bergström

Published Online: 27 Jun 2019

 

Abstract

Introduction:

Chikungunya virus (CHIKV) and West Nile virus (WNV) have previously been reported from several African countries, including those bordering Rwanda where they may have originated. However, there have been no serosurveillance reports from Rwanda regarding these two viral pathogens.

In this article, we present the first study of immunoglobulin G (IgG) seroreactivity of CHIKV and WNV in Rwandan blood donor samples.

Methods:

Blood donors from Rwanda (n = 874) and Sweden (n = 199) were tested for IgG reactivity against CHIKV, using an in-house enzyme-linked immunosorbent assay with the E1 envelope protein fused with p62 as antigen, and against WNV using a commercial kit. Data on mosquito distribution were obtained from the 2012 assessment of yellow fever virus circulation in Rwanda.

Results:

Seroreactivity to CHIKV was high in Rwanda (63.0%), when compared with Swedish donors, where only 8.5% were IgG positive. However, a cross-reactivity to O’nyong’nyong virus in neutralization test was noted in Rwandan donors. No significant difference in WNV seroreactivity was found (10.4% for Rwandan and 14.1% for Swedish donors). The relatively high seroreactivity to WNV among Swedish donors could partly be explained by cross-reactivity with tick-borne encephalitis virus prevalent in Sweden. Donors from the Eastern Province of Rwanda had the highest IgG reactivity to the two investigated viruses (86.7% for CHIKV and 33.3% for WNV). Five genera of mosquitoes were found in Rwanda where Culex was the most common (82.5%). The vector of CHIKV, Aedes, accounted for 9.6% of mosquitoes and this species was most commonly found in the Eastern Province.

Conclusions:

Our results showed high seroreactivity to CHIKV in Rwandan donors. The highest IgG reactivity to CHIKV, and to WNV, was found in the Eastern Province, the area reporting the highest number of mosquito vectors for these two viruses. Infection control by eliminating mosquito-breeding sites in population-dense areas is recommended, especially in eastern Rwanda.

Keywords: Arbovirus; Chikungunya virus; WNV; Serology; Seroprevalence; Rwanda.

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