Fatal Case of West Nile Neuroinvasive Disease in Bulgaria

Baymakova, Magdalena; Trifonova, Iva; Panayotova, Elitsa; Dakova, S.; Pacenti, Monia; Barzon, Luisa; Lavezzo, Enrico; Hristov, Yancho; Ramshev, K.; Plochev, K.; Palù, Giorgio; Christova, Iva

doi:10.3201/eid2212.151968

Cited by 17 publications

(12 citation statements)

References 11 publications

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“…Nevertheless, they showed that WNV is widespread in the country. The highest WNV seroprevalence rate was detected in Sofia Province, where the first confirmed neuroinvasive case was described in 2015 [36] and an additional case was confirmed in 2016. WNV IgM antibodies were detected in people only from this district, giving a certainty that it is a "hot spot," and more cases from this area could be expected in the future.…”

Section: A Nationwide Seroprevalence Screening For West Nile Virus Inmentioning

confidence: 99%

“…First in 2015, a few probable WNV human cases appeared in Bulgaria. Then, one confirmed WNV neuroinvasive infection was described [36]. The causative strain belonged to WNV lineage 2, closely related to Greek strains that caused Vector-Borne Infections in Bulgaria DOI: http://dx.doi.org /10.5772/intechopen.81916 the largest outbreak of WNV in Europe 2010-2013 [37] and also close to the WNV that caused outbreak in Hungary in 2008, when the WNV lineage 2 emerged for the first time outside Africa [38].…”

Section: West Nile Fever 41 Introductionmentioning

confidence: 99%

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Vector-Borne Infections in Bulgaria

Christova¹

2019

Vectors and Vector-Borne Zoonotic Diseases

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Bulgaria is an endemic country for Lyme borreliosis and Crimean-Congo hemorrhagic fever (CCHF). Sporadic cases of tick-borne encephalitis (TBE) and West Nile virus (WNV) encephalitis have been also reported. The reported incidence of Lyme borreliosis in Bulgaria is about 6/100,000 population. Two peaks in the seasonal distribution of cases and more frequent presentation of neuroborreliosis than of Lyme arthritis appear to be characteristics of Lyme borreliosis in Bulgaria. Borrelia afzelii is highly prevalent in Bulgarian Ixodes ricinus ticks. With sporadic cases or small outbreaks, CCHF appeared every year since the 1950s. For the last 10 years, a total of 60 CCHF cases were officially recorded. There is a tendency for CCHF to spread in previously non-endemic areas. The strains causing CCHF in the country belong to lineage Europe 1. A mean of 3.7% CCHF seroprevalence among the Bulgarian population is established. Both Europe 1 and Europe 2 CCHF virus lineages are present in ticks in Bulgaria. Tick-borne encephalitis (TBE) is very unusual. Only a few cases of TBE have been detected. Overall seroprevalence of 0.6% for TBE virus was found in humans. In 2015, a few WNV human cases were detected caused by lineage 2. Overall WNV seroprevalence in human population in the country is 1.5%.

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Section: A Nationwide Seroprevalence Screening For West Nile Virus Inmentioning

confidence: 99%

Section: West Nile Fever 41 Introductionmentioning

confidence: 99%

Vector-Borne Infections in Bulgaria

Christova¹

2019

Vectors and Vector-Borne Zoonotic Diseases

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“…There was no further detection until 2015 when 3 human cases were reported. Phylogenetic analysis showed that the virus was closely related to the WNV lineage 2 strain isolated in Greece [27]. In 2014, also WNV lineage 2, similar to the Greek isolate, was detected in the brain of a horse with severe clinical signs in Bursa region in eastern Turkey [28], but so far no human cases have been reported.…”

Section: Flaviviruses (Genus Flavivirus Family Flaviviridae)mentioning

confidence: 99%

West Nile virus and other mosquito-borne viruses present in Eastern Europe

Napp

Petrić

Busquets

2018

Pathogens and Global Health

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Eastern Europe (EE) has been severely affected by mosquito-borne viruses (moboviruses). In this review, we summarize the epidemiology of moboviruses, with particular attention to West Nile virus (WNV). The study of WNV human cases in EE between 2010 and 2016, revealed that the epidemiology of WNV in EE is complex with the combination of introduction of different WNV strains from lineages 1 and 2, and the establishment of endemic cycles. We found a positive correlation between the risk of WNV re-emergence in an area and the number of human cases reported in the previous year. We also report the main ecological and biological characteristics of the key mosquito species vectors of moboviruses. Recent expansion of invasive mosquito species in EE, mainly Aedes albopictus but also Aedes aegypti and Culex quinquefasciatus, may result in new scenarios with an increased risk of transmission of moboviruses. Main gaps of knowledge in relation to moboviruses and their vectors in EE are identified. Understanding the epidemiology of moboviruses in EE is essential for the improvement of their surveillance and the control of the diseases they cause.

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“…Determinants of susceptibility to West Nile Virus (WNV). Resistance and susceptibility to WNV infection result from exposure history and immune status including immunosuppression, cardiovascular disease, chronic renal disease and hepatitis C virus infection [7,[21][22][23]. Individual susceptibility also derives from host factors such as single nucleotide polymorphisms (SNPs) in immune response genes [5,[24][25][26][27][28][29][30], and control of cytokine responses to infection [32][33][34][35][36][37] (a).…”

Section: Host Factors Are a Risk For Severe West Nile Virus Infectionmentioning

confidence: 99%

Age-related alterations in immune responses to West Nile virus infection

Montgomery

2016

Clinical and Experimental Immunology

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SummaryWest Nile virus (WNV) is the most important causative agent of viral encephalitis worldwide and an important public health concern in the United States due to its high prevalence, severe disease, and the absence of effective treatments. Infection with WNV is mainly asymptomatic, but some individuals develop severe, possibly fatal, neurological disease. Individual host factors play a role in susceptibility to WNV infection, including genetic polymorphisms in key anti-viral immune genes, but age is the most well-defined risk factor for susceptibility to severe disease. Ageing is associated with distinct changes in immune cells and a decline in immune function leading to increased susceptibility to infection and reduced responses to vaccination. WNV is detected by pathogen recognition receptors including Toll-like receptors (TLRs), which show reduced expression and function in ageing. Neutrophils, monocyte/macrophages and dendritic cells, which first recognize and respond to infection, show age-related impairment of many functions relevant to antiviral responses. Natural killer cells control many viral infections and show agerelated changes in phenotype and functional responses. A role for the regulatory receptors Mertk and Axl in blood-brain barrier permeability and in facilitating viral uptake through phospholipid binding may be relevant for susceptibility to WNV, and age-related up-regulation of Axl has been noted previously in human dendritic cells. Understanding the specific immune parameters and mechanisms that influence susceptibility to symptomatic WNV may lead to a better understanding of increased susceptibility in elderly individuals and identify potential avenues for therapeutic approaches: an especially relevant goal, as the world's populating is ageing.

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Fatal Case of West Nile Neuroinvasive Disease in Bulgaria

Cited by 17 publications

References 11 publications

Vector-Borne Infections in Bulgaria

Vector-Borne Infections in Bulgaria

West Nile virus and other mosquito-borne viruses present in Eastern Europe

Age-related alterations in immune responses to West Nile virus infection

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