Imported Human West Nile Virus Lineage 2 Infection in Spain: Neurological and Gastrointestinal Complications

Velasco, María; Sánchez-Seco, María Paz; Campelo, Carolina; Ory, Fernando de; Martin, O.; Herrero, Laura; Salmerón-Béliz, Octavio José; Minguito, Teodora; Campos, Ma Carmen; Molero, Fernando; Algora, A.; Vázquez, Ana

doi:10.3390/v12020156

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Lineage 2, also neurotropic but with lesser virulence, comprises isolates from Sub-Saharan Africa, Madagascar, and Europe. Viruses in this lineage have caused several outbreaks in humans, horses, and birds [76,146,150,[156][157][158][159][160].…”

Section: Genetic Diversification Within the Wnv Speciesmentioning

confidence: 99%

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

et al. 2020

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West Nile virus (WNV) is an important zoonotic flavivirus responsible for mild fever to severe, lethal neuroinvasive disease in humans, horses, birds, and other wildlife species. Since its discovery, WNV has caused multiple human and animal disease outbreaks in all continents, except Antarctica. Infections are associated with economic losses, mainly due to the cost of treatment of infected patients, control programmes, and loss of animals and animal products. The pathogenesis of WNV has been extensively investigated in natural hosts as well as in several animal models, including rodents, lagomorphs, birds, and reptiles. However, most of the proposed pathogenesis hypotheses remain contentious, and much remains to be elucidated. At the same time, the unavailability of specific antiviral treatment or effective and safe vaccines contribute to the perpetuation of the disease and regular occurrence of outbreaks in both endemic and non-endemic areas. Moreover, globalisation and climate change are also important drivers of the emergence and re-emergence of the virus and disease. Here, we give an update of the pathobiology, epidemiology, diagnostics, control, and “One Health” implications of WNV infection and disease.

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Section: Genetic Diversification Within the Wnv Speciesmentioning

confidence: 99%

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

et al. 2020

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“…The wide variety of circulating West Nile virus strains results in varying degrees of infection severity. For example, studies have shown that the T249P substitution in the NS3 protein leads to increased virulence [13][14][15][16]. Another important factor determining pathogenicity is the glycosylation of the envelope protein E [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Lethality of West Nile virus strains in a mouse model

Siniavin,

Dolzhikova,

Pochtovyi

et al. 2023

Preprint

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West Nile fever (WNF) is a viral infection caused by West Nile virus (WNV), a flavivirus of theFlaviviridaefamily. Virus circulates between mosquitoes and wild birds, but can infect other species, including humans. The first cases of West Nile fever were reported in Africa in the 1930s. Currently, WNV has a wide geographic range, which includes countries in Europe, Asia, Africa, Australia, and North and South America, where it periodically causes WNF outbreaks. The disease in human occurs with the development of fever, and in some cases ending up severe neurological complications. Studies of the virus in animal models demonstrate that virulence varies depending on the host species, the genotype of the virus, and the presence of substitutions in key viral proteins, even within the same genotype. These studies highlight the need for comparative studies of different WNV strains to evaluate the impact of amino acid substitutions on WNV pathogenesis. Analysis of key mutations and substitutions will allow the development of a safe and effective vaccine for the prevention of WNF.

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“…Less than 1% of infected cases develop a neuroinvasive disease (WNND) such as encephalitis, meningitis, and acute flaccid paralysis, frequently associated with risk factors such as aging, solid organ transplant, diabetes, hypertension, and other immunosuppression conditions related to fatal outcome ( Lindsey et al., 2012 ). Moreover, atypical or rare presentations of WNV disease (WNVD) such us myocarditis, pancreatitis, hepatitis, cerebellitis, rhabdomyolysis, and ocular manifestations have also been described ( Hasbun et al., 2016 ; Konjevoda et al., 2019 ; Velasco et al., 2020 ). WNVD has sometimes been associated with several sequelae, the most frequent being muscle weakness, fatigue, myalgia, memory loss, depression, and difficulty doing activities of daily living ( Carson et al., 2006 ; Hughes et al., 2007 ).…”

Section: Introductionmentioning

confidence: 99%

West Nile virus emergence in humans in Extremadura, Spain 2020

Macías¹,

Martín

Pérez‐Olmeda

et al. 2023

Front. Cell. Infect. Microbiol.

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In Spain, the largest human West Nile virus (WNV) outbreak among humans was reported in 2020, constituting the second most important outbreak in Europe that season. Extremadura (southwestern Spain) was one of the affected areas, reporting six human cases. The first autochthonous human case in Spain was reported in Extremadura in 2004, and no other human cases were reported until 2020. In this work, we describe the first WNV human outbreak registered in Extremadura, focusing on the most important clinical aspects, diagnostic results, and control actions which followed. In 2020, from September to October, human WNV infections were diagnosed using a combination of molecular and serological methods (an in-house specific qRT-PCR and a commercial ELISA for anti-WNV IgM and IgG antibodies) and by analysing serum, urine, and/or cerebrospinal fluid samples. Serological positive serum samples were further tested using commercial kits against related flaviviruses Usutu and Tick-borne encephalitis in order to analyse serological reactivity and to confirm the results by neutralisation assays. In total, six cases of WNV infection (five with neuroinvasive disease and one with fever) were identified. Clinical presentation and laboratory findings are described. No viral RNA was detected in any of the analysed samples, but serological cross-reactivity was detected against the other tested flaviviruses. Molecular and serological methods for WNV detection in various samples as well as differential diagnosis are recommended. The largest number of human cases of WNV infection ever registered in Extremadura, Spain, occurred in 2020 in areas where circulation of WNV and other flaviviruses has been previously reported in humans and animals. Therefore, it is necessary to enhance surveillance not only for the early detection and implementation of response measures for WNV but also for other emerging flaviviruses that could be endemic in this area.

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Imported Human West Nile Virus Lineage 2 Infection in Spain: Neurological and Gastrointestinal Complications

Cited by 5 publications

References 28 publications

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

Lethality of West Nile virus strains in a mouse model

West Nile virus emergence in humans in Extremadura, Spain 2020

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