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West Nile virus (WNV) is a mosquito-borne flavivirus which circulates in birds, horses and humans. An estimated 80% of WNV infections are asymptomatic. Fewer than 1% of infected persons develop neuroinvasive disease, which typically presents as encephalitis, meningitis, or acute flaccid paralysis. This study was conducted from January 2008 to June 2009 in Isfahan, Iran. Patients attending the emergency department with fever and loss of consciousness were consecutively included. Cerebrospinal fluids (CSF) were initially analysed through bacteriology and biochemistry examinations, resulting in those with evidence of meningitis being excluded. Patients' CSF and serum were diagnosed by serological and molecular assays. A total of 632 patients with fever and loss of consciousness were tested by CSF analyses. Samples of the remaining patients (39·4%) were referred for WNV investigation. Three (1·2%) of the patients were positive for both serum and CSF by RT-PCR, and six (2·4%) were positive only for IgG antibodies. History of insect bite, and blood transfusion and transplantation were risk factors for being positive by RT-PCR (P=0·048) and being IgG positive (P=0·024), respectively. The results of this study showed that the prevalence of West Nile fever is low in patients with encephalitis.

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission also occurs. In the current study, we focused on CCHF in the province of Isfahan, located in the center of Iran and deemed to be the second most infected province. Human and livestock sera and resident ticks in the livestock are collected from different regions of the province and analyzed with specific IgG ELISA and RT-PCR tests. Overall, 12% and 12.7% of studied human and livestock populations were IgG positive, respectively. The genome of CCHFV was detected in 9% of ticks resident in livestock involved in this survey. The CCHFV isolates from infected ticks were genetically examined. Nucleotide sequence of the S-segment revealed that the different isolates were closely related to each other, with nucleotide sequence identities higher than 98%. Phylogenetic analysis demonstrated that a variant isolate clustered with the Iraq strain. This high proportion of IgG-positive sera and nearly high proportion of infected ticks increases the risk of CCHF outbreaks in the province and probably posits a great danger to other provinces.

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Hantavirus is a zoonosis transmitted from rodents to humans. Asymptomatic infected rodents can secrete hantaviruses in the urine, feces, and saliva. The main route of infection transmission to human is aerosols contaminated with the virus. This study was designed to evaluate the serological and molecular prevalence of hantavirus as an emerging zoonoses disease among street sweepers in Isfahan province, central Iran. Serum samples from 200 street sweepers in healthy condition and those with recent renal failure were tested by ELISA (IgM and IgG). Molecular analysis was subsequently applied for IgM positive cases. From these samples, 9 (4.5%) were positive, of which 2 (22.22%) were positive for both IgM and RT-PCR, while 7 (77.77%) were positive for IgG. The mean age and work experience of the positive cases were 39.7 and 11.5 respectively. According to our observations, all positive cases reported prevalence of rodents in their work place. The logistic regression test showed that the age and work experience were not risk factors for being positive, but prevalence of rodents in work place was a risk factor for being positive, when compared with negative cases. This is the first comprehensive study on the prevalence of hantavirus with positive results coming from Iranian population, which can raise the public awareness for the hantavirus infections as a public health threat.