Emergence and co-infections of West Nile virus and Toscana virus in Eastern Thrace, Turkey

Abstract

The objective of this study was to identify the impact of West Nile virus (WNV) and Toscana virus (TOSV) in febrile diseases of unknown aetiology in Eastern Thrace, Turkey; this study was conducted during August-October 2012, and included 18 clinical cases and 296 blood donors for local serosurveillance. Antibodies were determined via commercial assays and further tested for specificity via neutralization assays (NA). Viral RNAs were sought via specific and/or generic primers. WNV infections were diagnosed in seven patients (38.8%), detected via RNA+IgM in four, RNA in one and IgM and low avidity IgG in two cases. The most common symptom was fever (>38°C), followed by headache, malaise/fatigue, myalgia/arthralgia, muscle stiffness/lower back pain, anorexia, nausea/vomiting, diarrhoea, supraorbital/retrobulbar pain and abdominal pain. Neurological symptoms were noted in one individual. WNV strains in RNA-detectable patients were characterized as lineage 1. TOSV RNA or IgM were identified in two individuals with confirmed WNV infections and in one patient without evidence of WNV exposure. The clinical and laboratory findings in individuals with WNV/TOSV co-infection were comparable to those in WNV-induced disease. The TOSV strain in the patient with detectable viral RNA was characterized as genotype A. In local blood donors, seroreactivity for specific WNV and TOSV immunoglobulins was observed in 1.7% (5/296) and 14.4% (26/180), respectively. These findings indicate the emergence of WNV and TOSV-associated diseases in Eastern Thrace. WNV/TOSV co-infections were documented for the first time.

Serological Investigation of Phlebovirus Exposure in Blood Donors from the Mediterranean Province of Mersin, Turkey

“…Türkiye adresli güncel raporlarda, çeşitli bölgelerde TOSV aktivitesinin devam ettiği, tanısı doğrulanmış ya da muhtemel çeşitli olgu serileri ile gösterilmektedir 17,18 . Güncel olarak Tekirdağ ili ve çev-resinde olgular rapor edilmiş ve bölgede yaşayan kişilerde %14.4 oranında özgül antikor varlığı saptanmıştır 19 .…”

Flavivirus Seroepidemiology in Blood Donors in Mersin Province, Turkey

“…Yine Orta Anadolu'da 1200 kan donöründe PRNT doğrulama testinden sonra %0.8 oranında WNV pozitifl iği rapor edilmiştir 30 . Yakın zamanlarda ise Trakya bölgesinde 296 kan donörünün %1.7'sinde WNV nötralizan antikorunun ve klinik olarak doğrulanmış olgularda WNV RNA'sının gösterildiği belirtilmiştir 31 .…”

Phlebovirus and Leishmania detection in sandflies from eastern Thrace and northern Cyprus

“…Entomological surveillance provides crucial information on the circulating pathogens and their vectors, for assessing potential public health threat, for establishing optimal diagnostics and interventions to prevent transmission. The present study was carried out to detect and identify phlebovirus and Leishmania strains in two separate regions, the eastern Thrace and northern Cyprus, where reported cases suggest phleboviral infections and leishmaniasis [19,35,36]. It covers a relatively large geographical area including regions with preliminary data as well as previously unexplored locations.…”

“…The objective of the current study is to investigate phlebovirus and Leishmania infections and to characterize circulating strains in vector sandflies collected from several locations of eastern Thrace region in Turkey and northern Cyprus, where preliminary information suggest the activity of these sandfly-borne pathogens [19][20][21].…”