Autochthonous West Nile virus infection outbreak in humans, Leipzig, Germany, August to September 2020

Pietsch, Corinna; Michalski, Dominik; Münch, Johannes; Petros, Sirak; Bergs, Sandra; Trawinski, Henning; Lübbert, Christoph; Liebert, Uwe G.

doi:10.2807/1560-7917.es.2020.25.46.2001786

Cited by 41 publications

(43 citation statements)

References 19 publications

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“…The WNV epizootic continued in 2020, and a multitude of birds and horses were affected in the already known impacted areas of Eastern Germany [42]. In addition, a significant increase in human WNV cases was recorded in 2020, including the first fatal case [43,44]. Currently, WNV is spreading farther northwards, with a recent publication on the first detection of WNV in the Netherlands in mosquitoes, birds, and humans [45,46].…”

Section: Introductionmentioning

confidence: 99%

Seroepidemiological Survey of West Nile Virus Infections in Horses from Berlin/Brandenburg and North Rhine-Westphalia, Germany

Bergmann

Trachsel

Stoeckle

et al. 2022

Viruses

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Following the introduction of the West Nile virus (WNV) into eastern Germany in 2018, increasing infections have been diagnosed in birds, equines, and humans over time, while the spread of WNV into western Germany remained unclear. We screened 437 equine sera from 2018 to 2020, excluding vaccinated horses, collected from convenience sampled patients in the eastern and western parts of Germany, for WNV-specific antibodies (ELISAs followed by virus/specific neutralization tests) and genomes (RT-qPCRs). Clinical presentations, final diagnoses, and demographic data were also recorded. In the eastern part, a total of eight horses were found WNV seropositive in 2019 (seroprevalence of 8.16%) and 27 in 2020 (13.77%). There were also two clinically unsuspected horses with WNV-specific antibodies in the western part from 2020 (2.63%), albeit travel history-related infections could not be excluded. None of the horse sera contained WNV-specific genomes. Eight horses in eastern Germany carried WNV-IgM antibodies, but only four of these showed typical clinical signs. These results underline the difficulty of detecting a WNV infection in a horse solely based on clinical signs. Thus, WNV circulation is established in the horse population in eastern Germany, but not yet in the western part.

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Section: Introductionmentioning

confidence: 99%

Seroepidemiological Survey of West Nile Virus Infections in Horses from Berlin/Brandenburg and North Rhine-Westphalia, Germany

Bergmann

Trachsel

Stoeckle

et al. 2022

Viruses

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“…Some earlier reports on the integrated surveillance system have been published [ 16 , 17 , 18 , 19 , 20 ], but all of them predates the transmission season of 2018, in which 1605 confirmed cases reported across European countries nearly doubled the total cases registered in the previous three years combined [ 21 , 22 ]. Moreover, despite the quarantine measures that various EU countries implemented during 2020, the WNV transmission season was associated with remarkable outbreaks both in previously affected and previously spared areas, with a proportion of WNND that largely exceeded the average of previous 5 years [ 12 , 23 ]. As a consequence, an updated and comprehensive reappraisal of surveillance data may be particularly useful to national and local health authorities for the implementation of appropriate response measures, including blood safety, and preventive campaigns focusing on vector control and communication [ 19 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of West Nile Virus Infections in Humans, Italy, 2012–2020: A Summary of Available Evidences

Riccò

Peruzzi

Balzarini³

2021

TropicalMed

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In Italy, human cases of West Nile virus (WNV) infection have been recorded since 2008, and seasonal outbreaks have occurred almost annually. In this study, we summarize available evidences on the epidemiology of WNV and West Nile neuro-invasive disease (WNND) in humans reported between 2012 and 2020. In total, 1145 WNV infection cases were diagnosed; of them 487 (42.5%) had WNND. A significant circulation of the pathogen was suggested by studies on blood donors, with annual incidence rates ranging from 1.353 (95% confidence intervals (95% CI) 0.279–3.953) to 19.069 cases per 100,000 specimens (95% CI 13.494–26.174). The annual incidence rates of WNND increased during the study period from 0.047 cases per 100,000 (95% CI 0.031–0.068) in 2012, to 0.074 cases per 100,000 (95% CI 0.054–0.099) in 2020, peaking to 0.377 cases per 100,000 (95% CI 0.330–0.429) in 2018. There were 60 deaths. Cases of WNND were clustered in Northern Italy, particularly in the Po River Valley, during the months of August (56.7%) and September (27.5%). Higher risk for WNND was reported in subjects of male sex (risk ratio (RR) 1.545, 95% CI 1.392–1.673 compared to females), and in older age groups (RR 24.46, 95% CI 15.61–38.32 for 65–74 y.o.; RR 43.7, 95% CI 28.33–67.41 for subjects older than 75 years), while main effectors were identified in average air temperatures (incidence rate ratio (IRR) 1.3219, 95% CI 1.0053–1.7383), population density (IRR 1.0004, 95% CI 1.0001–1.0008), and occurrence of cases in the nearby provinces (IRR 1.0442, 95% CI 1.0340–1.0545). In summary, an enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

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“…Monitoring of birds for WNV has been conducted in Germany for over 10 years [5][6][7]10], but the first confirmed cases were only detected during an outbreak in 2018 and included blackbirds (Turdus merula), northern goshawks (Accipiter gentilis), and great grey owls (Strix nebulosa), as well as horses [8]. In 2019 and 2020, the emergence of WNV was again observed in birds and horses, but for the first time several autochthonous human cases were also registered, including one fatal case in 2020 [11,12]. As an alternative to dead-bird monitoring, mosquito surveillance could provide an opportunity to detect enzootic WNV circulation [13].…”

Section: Introductionmentioning

confidence: 99%

Rapid assessment of West Nile virus circulation in a German zoo based on honey-baited FTA cards in combination with box gravid traps

et al. 2021

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Background For over a decade, monitoring of West Nile virus (WNV) in Germany has consisted of a bird monitoring programme as well as a mosquito-based surveillance programme employing CO2-baited encephalitis vector surveillance (EVS) traps for mass trapping and screening of mosquitoes. In contrast to the EVS traps, the Reiter/Cummings type box gravid trap collects gravid female mosquitoes, which have already taken a blood meal, increasing the likelihood of being infected with pathogens. The traps can be equipped with a honey-baited Flinders Technology Associates® (FTA) card to encourage sugar feeding by the trapped mosquitoes. FTA cards contain nucleic acid preserving substances, which prevent the degradation of viral RNA in the expectorated mosquito saliva and allows for testing the card for flavivirus RNA. This study aimed to assess the suitability of the method for WNV surveillance in Germany as an alternative to previous methods, which are expensive, time-consuming, and predominantly target host-seeking populations less likely to be infected with WNV. Methods In the Thüringer Zoopark Erfurt, snowy owls (Nyctea scandiaca) and greater flamingos (Phoenicopterus roseus) died of WNV infections in July and August 2020. In response, five Reiter/Cummings type box gravid traps were positioned during the daytime on the 10th, 13th, and 16th of September in five different locations. The FTA cards and mosquitoes in the chamber were collected, kept in a cool chain, and further processed for virus detection using a modified generic flavivirus reverse transcription PCR. Results A total of 15 trappings during September collected a total of 259 female mosquitoes, 97% of which were Culex pipiens sensu lato, as well as 14 honey-baited FTA cards. Eight mosquitoes tested PCR-positive for WNV. Four FTA cards tested PCR-positive for mosquito-borne flaviviruses, two of which were confirmed as WNV, and the remaining two confirmed as Usutu virus. Conclusion The suitability of the FTA cards in preserving viral RNA in the field and rapid turnaround time from collection to result is combined with a simple, cost-effective, and highly specific trapping method to create an arbovirus surveillance system, which circumvents many of the difficulties of previous surveillance programmes that required the analysis of mosquitoes in the laboratory. Graphical Abstract

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Autochthonous West Nile virus infection outbreak in humans, Leipzig, Germany, August to September 2020

Cited by 41 publications

References 19 publications

Seroepidemiological Survey of West Nile Virus Infections in Horses from Berlin/Brandenburg and North Rhine-Westphalia, Germany

Seroepidemiological Survey of West Nile Virus Infections in Horses from Berlin/Brandenburg and North Rhine-Westphalia, Germany

Epidemiology of West Nile Virus Infections in Humans, Italy, 2012–2020: A Summary of Available Evidences

Rapid assessment of West Nile virus circulation in a German zoo based on honey-baited FTA cards in combination with box gravid traps

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