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European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2004; 23(3); 147-156; doi: 10.1007/s10096-003-1085-1

West Nile virus: an overview of its spread in Europe and the Mediterranean basin in contrast to its spread in the Americas.

Abstract: West Nile (WN) virus is a mosquito-transmitted flavivirus. It is widely distributed in Africa, the Middle East, Asia, and southern Europe and was recently introduced to North America. Birds are involved in the cycle of transmission as amplifying hosts. Humans and horses are considered accidental dead-end hosts. WN fever was initially considered a minor arbovirosis, usually inducing a nonsymptomatic or a mild flu-like illness in humans, but some cases of encephalitis associated with fatalities were reported in Israel in the 1950s. After two silent decades, several human and equine outbreaks of fatal encephalitis occurred from 1996 to 2000 in Romania, Morocco, Tunisia, Italy, Russia, Israel, and France. In Romania, a few cases of WN encephalitis in humans are noticed every year, and in France, recent WN infections have been detected in monitored sentinel birds in 2001 and 2002. Phylogenetic studies have shown two main lineages of WN strains. Strains from lineage I are present in Africa, India, and Australia and are responsible for the outbreaks in Europe and in the Mediterranean basin, and strains from lineage II have been reported only in sub-Saharan Africa. In 1998, a virulent WN strain from lineage I was identified in dying migrating storks and domestic geese showing clinical symptoms of encephalitis and paralysis in Israel. A nearly identical WN strain suddenly emerged in New York in 1999, killing thousands of native birds and causing fatal cases in humans. The virus is now well established in the New World, and it disseminates rapidly. New modes of transmission through blood donations, organ transplants, and the intrauterine route have been reported. In Europe, an enhanced surveillance of WN infection in humans, horses, birds, and vectors may reveal the presence of the virus in different locations. Nevertheless, outbreaks of WN virus remain unpredictable. Further coordinated studies are needed for a better understanding of the ecology and the pathogenicity of the WN virus.
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Publication Date: 2004-02-19 PubMed ID: 14986160DOI: 10.1007/s10096-003-1085-1Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study presents an overview of the distribution and impact of West Nile (WN) virus, particularly highlighting its rapid spread in Europe, the Mediterranean basin and the Americas. The research underscores the unpredictable nature of WN virus outbreaks and the need for enhanced surveillance and comprehensive studies for better comprehension of its ecology and pathogenicity.

Understanding West Nile Virus

  • West Nile virus is a flavivirus transmitted primarily by mosquitoes. It is found extensively in Africa, the Middle East, Asia, and southern Europe and has recently been introduced to North America.
  • Birds play a significant role in the transmission cycle, acting as amplifying hosts. Humans and horses, on the other hand, are seen as accidental hosts, usually encountering a dead-end with the virus.

History of Pathogenicity and Spread

  • While WN was initially deemed a minor arbovirosis causing non-symptomatic or mild flu-like illness, cases of fatal encephalitis tied to the virus were reported in Israel in the 1950s.
  • After approximately two decades of relative silence, several outbreaks struck between 1996 and 2000 in Romania, Morocco, Tunisia, Italy, Russia, Israel, and France. These outbreaks comprised notable occurrences of fatal encephalitis in humans and horses.
  • In Romania, cases of WN encephalitis continue to be reported annually. Meanwhile, in France, recent WN infections have been detected in monitored sentinel birds in 2001 and 2002.

Phylogenetic Lineages and Emergence in the Americas

  • The phylogenetic analysis conducted by the researchers identifies two main lineages of WN strains. Lineage I strains, found in Africa, India, and Australia, have been responsible for outbreaks in Europe and the Mediterranean basin. On the other hand, Lineage II strains have only been reported in sub-Saharan Africa.
  • In 1998, a virulent strain originating from Lineage I was identified in migrating storks and domestic geese showing clinical signs of encephalitis and paralysis in Israel.
  • A key highlight of the study was the emergence of an almost identical WN strain in New York in 1999, which resulted in the deaths of thousands of native birds and several fatal cases in humans. This signified the virus’ firm establishment in the Americas and its swift dissemination throughout the region.
  • New modes of transmission through blood donations, organ transplants, and intrauterine exposure were also reported, further complicating the containment and management of the virus.

Monitoring and Future Research

  • The study emphasizes that despite an increased surveillance of WN infection in humans, horses, birds, and vectors in Europe, the outbreaks remain unpredictably sporadic, making it challenging to forecast and control.
  • The authors conclude that further coordinated research efforts are essential to gain a deeper understanding of the virus’s ecology and pathogenicity which can lead to more effective prevention and control strategies.

Cite This Article

APA
Zeller HG, Schuffenecker I. (2004). West Nile virus: an overview of its spread in Europe and the Mediterranean basin in contrast to its spread in the Americas. Eur J Clin Microbiol Infect Dis, 23(3), 147-156. https://doi.org/10.1007/s10096-003-1085-1

Publication

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
ISSN: 0934-9723
NlmUniqueID: 8804297
Country: Germany
Language: English
Volume: 23
Issue: 3
Pages: 147-156

Researcher Affiliations

Zeller, H G
  • Institut Pasteur, National Reference Center for Arboviruses, 21 Avenue Tony Garnier, 69365 Lyon Cedex 07, France. zeller@cervi-lyon.inserm.fr
Schuffenecker, I

    MeSH Terms

    • Americas / epidemiology
    • Animals
    • Classification
    • Disease Outbreaks
    • Disease Reservoirs
    • Europe / epidemiology
    • Female
    • Humans
    • Incidence
    • Infection Control
    • Male
    • Mediterranean Region / epidemiology
    • Risk Factors
    • Survival Rate
    • West Nile Fever / epidemiology
    • West Nile Fever / prevention & control
    • West Nile virus / isolation & purification

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