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Abstract
Japanese encephalitis is a mosquito-borne disease that occurs in Asia and is caused by Japanese encephalitis virus (JEV), a member of the genus Flavivirus. Although many flaviviruses can cause encephalitis, JEV causes particularly severe neurological manifestations. The virus causes loss of more disability-adjusted life years than any other arthropod-borne virus owing to the frequent neurological sequelae of the condition. Despite substantial advances in our understanding of Japanese encephalitis from in vitro studies and animal models, studies of pathogenesis and treatment in humans are lagging behind. Few mechanistic studies have been conducted in humans, and only four clinical trials of therapies for Japanese encephalitis have taken place in the past 10 years despite an estimated incidence of 69,000 cases per year. Previous trials for Japanese encephalitis might have been too small to detect important benefits of potential treatments. Many potential treatment targets exist for Japanese encephalitis, and pathogenesis and virological studies have uncovered mechanisms by which these drugs could work. In this Review, we summarize the epidemiology, clinical features, prevention and treatment of Japanese encephalitis and focus on potential new therapeutic strategies, based on repurposing existing compounds that are already suitable for human use and could be trialled without delay. We use our newly improved understanding of Japanese encephalitis pathogenesis to posit potential treatments and outline some of the many challenges that remain in tackling the disease in humans.
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Sambri V, Capobianchi MR, Cavrini F, Charrel R, Donoso-Mantke O, Escadafal C, Franco L, Gaibani P, Gould EA, Niedrig M, Papa A, Pierro A, Rossini G, Sanchini A, Tenorio A, Varani S, Vázquez A, Vocale C, Zeller H. Diagnosis of west nile virus human infections: overview and proposal of diagnostic protocols considering the results of external quality assessment studies. Viruses 2013; 5:2329-48. [PMID: 24072061 PMCID: PMC3814591 DOI: 10.3390/v5102329] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 08/28/2013] [Accepted: 09/09/2013] [Indexed: 01/14/2023] Open
Abstract
West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD).
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Affiliation(s)
- Vittorio Sambri
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-331-8687352
| | - Maria R. Capobianchi
- National Institute for Infectious Diseases (INMI) “L. Spallanzani”, Rome 00149, Italy; E-Mail:
| | - Francesca Cavrini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Rémi Charrel
- UMR_D 190 “Emergence des Pathologies Virales”, APHM Public Hospitals of Marseille, EHESP French School of Public Health & IHU Mediterranee Infection, IRD French Institute of Research for Development, Aix Marseille University, 13005, Marseille, France; E-Mail: (R.C.)
| | - Olivier Donoso-Mantke
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Camille Escadafal
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Leticia Franco
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Paolo Gaibani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Ernest A. Gould
- UMR_D 190 “Emergence des Pathologies Virales”, APHM Public Hospitals of Marseille, EHESP French School of Public Health & IHU Mediterranee Infection, IRD French Institute of Research for Development, Aix Marseille University, 13005, Marseille, France; E-Mail: (R.C.)
- NERC Centre for Ecology and Hydrology, Wallingford, Oxon OX10 8BB, UK; E-Mail: (E.A.G.)
| | - Matthias Niedrig
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece; E-Mail:
| | - Anna Pierro
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Giada Rossini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Andrea Sanchini
- Centre for Biological Threats and Special Pathogens (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany; E-Mails: (O.D.-M.); (C.E.); (M.N.); (A.S.)
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden
| | - Antonio Tenorio
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Stefania Varani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Ana Vázquez
- National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain; E-Mails: (L.F.); (A.T.); (A.V.)
| | - Caterina Vocale
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy; E-Mails: (V.S.); (F.C.); (P.G.); (A.P.); (G.R.); (S.V.); (C.V.)
| | - Herve Zeller
- European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden; E-Mail:
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