Serologic evidence of West Nile virus infection in patients with exanthema in Hungary

Abstract

The presence of WNV in Europe has been well known for decades, although the first human infections and avian outbreaks were diagnosed in Hungary only in 2003. An annual average of 6-8 cases of the neuroinvasive form of WNV infection has been detected in the region since then, but a higher number (17) of WNV associated neuroinvasive disease occurred in 2008. In 2004, a surveillance system was established for monitoring WNV-associated meningo-encephalitis cases in Hungary, but a milder type of illness (with fever, rash and/or influenza like symptoms) is not followed. Fifty-two sera of 45 patients with mild clinical symptoms (fever, exanthema) were tested for anti-WNV antibodies in 2008 in a retrospective study by immunofluorescence test and ELISA. Seven patients had antibodies against WNV, serologic evidence of recent WNV infection was found in 4 out of the 7 patients. Infections could be acquired predominantly in August and in September, which seems to be a risk period for WNV in Hungary. The possibility of a recent WNV infection should be taken into consideration in the occurrence of fever and rush at late summer. Differential diagnosis of exanthematous patients should include WNV serology tests and should be done routinely.

Extraordinary increase in West Nile virus cases and first confirmed human Usutu virus infection in Hungary, 2018

“…From the beginning of July to the end of September 2018, clinical specimens from altogether 69 exanthematous patients were examined by the Hungarian NRL for Viral Zoonoses in collaboration with the Hungarian NRL for Viral Exanthematous Diseases. In accordance with previous years’ experiences [26], some of these patients (n = 23) were reported to the laboratory as clinically suspected measles virus infections, hence investigation for WNV was mostly conducted regardless of the clinicians’ request. Neither measles nor rubella virus infections could be confirmed during the given time period; however, in 23 of the 69 patients (33.3%), WNV infections were reported.…”

“…EDTA: ethylenediaminetetraacetic acid; ELISA: enzyme-linked immunosorbent assay; TBEV: tick-borne encephalitis virus; USUV: Usutu virus; WNV: West Nile virus.We used in-house developed indirect immunofluorescent assays for IgG, IgM and IgA detection of USUV, WNV and TBEV [26], a commercial ELISA (Focus Diagnostics, DiaSorin Molecular LLC, Cypress, United States) and an in-house developed quantitative RT-PCR [34]. Cut-off for antibody titres: <1:10: negative; ≥1:10: positive; 1:10: indeterminate.…”

West Nile Virus Seroprevalence Among Blood Donors in Hungary

“…Serological assays were performed at the NPHI. First round anti-WNV IgG antibody screening was carried out with WNV immunofluorescence assay (IFA) developed inhouse (Szomor et al 2011). Microscopic slides were coated with a mixture of WNV-infected and noninfected Vero cells.…”

“…In Hungary, the average annual number of laboratoryconfirmed or probable human infections is between 15 and 20. However, during the 2016 seasonal period, a significant increase was experienced with a total of 44 clinical cases (Krisztalovics et al 2008, Szomor et al 2011 Centre for Disease Prevention and Control 2016). The peak of locally acquired cases was reported in the period from late August till mid-September.…”

A nyugat-nílusi vírus kimutatása humán betegmintákból: nyomon követéses vizsgálatok a 2015. évi szezonális időszakban

“…Az esetek jelentős hányada szubklinikai, aspecifikus tünetekkel kísért [1]. A klinikailag manifesztálódó megbetegedések egy része enyhébb lefolyású, jellemző tünetek a láz, ízületi és izomfájdalmak, maculopapularis és roseoliform exanthemák [1,11]. Az enyhébb klinikai tünetekkel jellemezhető formát a szakirodalom nyugat-nílusi láz (West Nile fever -WNF) néven különíti el [1].…”