Human Usutu Virus Infection with Atypical Neurologic Presentation, Montpellier, France, 2016

Simonin, Yannick; Sillam, Olivier; Carles, Marie; Gutiérrez, Serafín; Gil, Patricia; Constant, Orianne; Martin, Marie-France; Grard, Gilda; Perre, Philippe Van de; Salinas, Sara; Leparc-Goffart, Isabelle; Foulongne, Vincent

doi:10.3201/eid2405.171122

Cited by 95 publications

(90 citation statements)

References 15 publications

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“…Due to these rare instances, and because USUV was never associated with severe disease in animals or humans, it was not perceived as a potential threat to human health (Vazquez et al, )—until 2009, when the first cases of USUV‐related encephalitis in immunocompromised patients were described in Italy, providing evidence that USUV is capable of triggering severe neurological symptoms (Cavrini et al, ; Pecorari et al, ). Moreover, in 2016, a patient in France presented with acute USUV infection and possibly associated unilateral facial paralysis (Simonin et al, ).…”

Section: Discussionmentioning

confidence: 99%

Different dynamics of Usutu virus infections in Austria and Hungary, 2017–2018

Weidinger

Kolodziejek

Bakonyi

et al. 2019

Transbound Emerg Dis

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Usutu virus (USUV), a mosquito‐borne flavivirus closely related to West Nile virus, emerged in Austria in 2001, when it caused a considerable mass‐mortality of Eurasian blackbirds. Cases in birds increased until 2003 and quickly declined thereafter, presumably due to developing herd immunity. Since 2006, no further cases were recorded, until two blackbirds were tested positive in 2016. In Hungary, USUV first appeared in 2005 and has caused only sporadic infections since then. Initially, the only genetic USUV lineage found across both countries was Europe 1. This changed in 2015/2016, when Europe 2 emerged, which has since then become the prevalent lineage. Due to dispersal of these strains and introduction of new genetic lineages, USUV infections are now widespread across Europe. In 2009, the first cases of USUV‐related encephalitis were described in humans, and the virus has been frequently detected in blood donations since 2016. To monitor USUV infections among the Austrian wild bird population in 2017/2018, 86 samples were investigated by RT‐PCR. In 67 of them, USUV nucleic acid was detected (17 in 2017, 50 in 2018). The majority of succumbed birds were blackbirds, found in Vienna and Lower Austria. However, the virus also spread westwards to Upper Austria and southwards to Styria and Carinthia. In Hungary, 253 wild birds were examined, but only six of them were infected with USUV (five in 2017, one in 2018). Thus, in contrast to the considerable increase in USUV‐associated bird mortality in Austria, the number of infections in Hungary declined after a peak in 2016. Except for one case of USUV lineage Africa 3 in Austria in 2017, Europe 2 remains the most prevalent genetic lineage in both countries. Since USUV transmission largely depends on temperature, which affects vector populations, climate change may cause more frequent USUV outbreaks in the future.

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Section: Discussionmentioning

confidence: 99%

Different dynamics of Usutu virus infections in Austria and Hungary, 2017–2018

Weidinger

Kolodziejek

Bakonyi

et al. 2019

Transbound Emerg Dis

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“…Considering that no concurrent wave of neuro‐invasive or other disease in humans was perceived in the Netherlands, human USUV infection so far seems rather harmless. Of course it must be noted that human disease caused by USUV infection has been reported, and that the awareness of Dutch physicians of USUV being present as a potential cause of disease is very low. Three immunocompetent recipients of USUV RNA‐positive blood components did not show signs of infection.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2016 USUV causes seasonal mortality in Dutch birds. For humans, disease due to USUV infection seems limited to rare cases with non‐specific symptoms, or meningoencephalitis, or atypical neuro‐invasive disease . In Aachen, Vienna, and the Lazio region of Italy the screening of blood donors for WNV‐RNA revealed several cases of silent USUV infection …”

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confidence: 99%

Usutu virus infection in Dutch blood donors

et al. 2019

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BACKGROUND The screening of Dutch blood donations for West Nile virus (WNV) may be imminent, as WNV emerges in nearby countries and more donors travel to WNV‐affected regions. Since 2016 the related, mosquito‐borne Usutu virus (USUV) causes seasonal mortality in Dutch birds. To what extent will human USUV infections affect Dutch WNV donor screening? STUDY DESIGN AND METHODS From April through September 2018, plasma samples from blood donations in blackbird‐rich regions were stored. When increased bird mortality was reported in August, samples from July, August, and September were tested for USUV‐RNA in pools of eight, using a home‐brew combined WNV/USUV‐PCR assay. Reactive pools were deconstructed. Original plasma units and samples of previous and follow‐up donations of reactive donors were tested for USUV‐ and WNV‐RNA, and for antibody responses. RESULTS The number of USUV RNA‐positive, WNV RNA‐negative donations was 0 of 2688 donations in July, 6 of 4416 in August (1:736), and 1 of 4936 in September. The seven infected donors tested negative for USUV‐RNA in preceding and follow‐up donations. For 6 donors, seroconversion for USUV‐antibodies was demonstrated. All index donations tested positive in a commonly used PCR‐assay for WNV donor screening. Three exposed recipients did not show signs of infection. Screening a random subset of 1092 donations from September for USUV‐IgG antibodies showed that 22 donors tested reactive; for three donors retrospective testing identified an USUV PCR‐positive pre‐seroconversion donation. CONCLUSION Seasonal USUV infection in Dutch blood donors is common. Cross‐reactivity in molecular assays for WNV‐screening occurs, but can be resolved using USUV‐ and WNV‐specific PCR‐primers and sequencing of viral RNA.

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“…USUV infection in humans is often asymptomatic. Nonetheless, an increasing number of cases with neurological complications, such as encephalitis or meningoencephalitis, have recently been reported [3,[6][7][8][9][10][11]. In terms of animal health, USUV has been responsible for several epornitics in Europe since 1996 [12].…”

Section: Introductionmentioning

confidence: 99%

Experimental Usutu Virus Infection in Domestic Canaries Serinus canaria

Benzarti

Rivas

Sarlet

et al. 2020

Viruses

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Usutu virus (USUV) is a neurotropic flavivirus closely related to West Nile virus (WNV). Its enzootic cycle mainly involves mosquitoes and birds. Human infection can occur with occasional, but sometimes severe, neurological complications. Since its emergence and spread in Europe over the last two decades, USUV has been linked to significant avian outbreaks, especially among Passeriformes, including European blackbirds (Turdus merula). Strikingly, no in vivo avian model exists so far to study this arbovirus. The domestic canary (Serinus canaria) is a passerine, which is considered as a highly susceptible model of infection by WNV. Here, we experimentally challenged domestic canaries with two different doses of USUV. All inoculated birds presented detectable amounts of viral RNA in the blood and RNA shedding via feathers and droppings during the early stages of the infection, as determined by RT-qPCR. Mortality occurred in both infected groups (1/5 and 2/5, respectively) and was not necessarily correlated to a pure neurological disease. Subsequent analyses of samples from dead birds showed histopathological changes and virus tropism mimicking those reported in naturally infected birds. A robust seroconversion followed the infection in almost all the surviving canaries. Altogether, these results demonstrate that domestic canaries constitute an interesting experimental model for the study of USUV pathogenesis and transmission.

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Human Usutu Virus Infection with Atypical Neurologic Presentation, Montpellier, France, 2016

Cited by 95 publications

References 15 publications

Different dynamics of Usutu virus infections in Austria and Hungary, 2017–2018

Different dynamics of Usutu virus infections in Austria and Hungary, 2017–2018

Usutu virus infection in Dutch blood donors

Experimental Usutu Virus Infection in Domestic Canaries Serinus canaria

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