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McGill F, Tokarz R, Thomson EC, Filipe A, Sameroff S, Jain K, Bhuva N, Ashraf S, Lipkin WI, Corless C, Pattabiraman C, Gibney B, Griffiths MJ, Geretti AM, Michael BD, Beeching NJ, McKee D, Hart IJ, Mutton K, Jung A, Miller A, Solomon T. Viral capture sequencing detects unexpected viruses in the cerebrospinal fluid of adults with meningitis. J Infect 2022; 84:499-510. [PMID: 34990710 DOI: 10.1016/j.jinf.2021.12.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Many patients with meningitis have no aetiology identified leading to unnecessary antimicrobials and prolonged hospitalisation. We used viral capture sequencing to identify possible pathogenic viruses in adults with community-acquired meningitis. METHODS Cerebrospinal fluid (CSF) from 73 patients was tested by VirCapSeq-VERT, a probe set designed to capture viral targets using high throughput sequencing. Patients were categorised as suspected viral meningitis - CSF pleocytosis, no pathogen identified (n = 38), proven viral meningitis - CSF pleocytosis with a pathogen identified (n = 15) or not meningitis - no CSF pleocytosis (n = 20). RESULTS VirCapSeq-VERT detected virus in the CSF of 16/38 (42%) of those with suspected viral meningitis, including twelve individual viruses. A potentially clinically relevant virus was detected in 9/16 (56%). Unexpectedly Toscana virus, rotavirus and Saffold virus were detected and assessed to be potential causative agents. CONCLUSION VirCapSeq-VERT increases the probability of detecting a virus. Using this agnostic approach we identified Toscana virus and, for the first time in adults, rotavirus and Saffold virus, as potential causative agents in adult meningitis. Further work is needed to determine the prevalence of atypical viral candidates as well as the clinical impact of using sequencing methods in real time. This knowledge can help to reduce antimicrobial use and hospitalisations leading to both patient and health system benefits.
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Affiliation(s)
- Fiona McGill
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
| | - Rafal Tokarz
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Emma C Thomson
- Institute of infection, immunity and inflammation, University of Glasgow, Glasgow, UK
| | - Ana Filipe
- Institute of infection, immunity and inflammation, University of Glasgow, Glasgow, UK
| | - Stephen Sameroff
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Komal Jain
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Nishit Bhuva
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Shirin Ashraf
- Institute of infection, immunity and inflammation, University of Glasgow, Glasgow, UK
| | - W Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Caroline Corless
- Liverpool Specialist virology centre, Department of Infection and Immunity, Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Chitra Pattabiraman
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; National Institute for Mental Health and Neurosciences, Bangalore, India
| | - Barry Gibney
- UK Health Security Agency (previously Public Health England), UK
| | - Michael J Griffiths
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Alder Hey Children's NHS Foundation Trust, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - Anna Maria Geretti
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Faculty of Medicine, University of Rome Tor Vergata
| | - Benedict D Michael
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - Nicholas J Beeching
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Liverpool School of Tropical Medicine, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - David McKee
- Central Manchester Foundation Trust, Manchester, UK
| | - Ian J Hart
- Liverpool Specialist virology centre, Department of Infection and Immunity, Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Ken Mutton
- University of Manchester, Manchester, UK
| | - Agam Jung
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alastair Miller
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Tom Solomon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
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Clinically Important Phleboviruses and Their Detection in Human Samples. Viruses 2021; 13:v13081500. [PMID: 34452365 PMCID: PMC8402687 DOI: 10.3390/v13081500] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
The detection of phleboviruses (family: Phenuiviridae) in human samples is challenged by the overall diversity and genetic complexity of clinically relevant strains, their predominantly nondescript clinical associations, and a related lack of awareness among some clinicians and laboratorians. Here, we seek to inform the detection of human phlebovirus infections by providing a brief introduction to clinically relevant phleboviruses, as well as key targets and approaches for their detection. Given the diversity of pathogens within the genus, this report focuses on diagnostic attributes that are generally shared among these agents and should be used as a complement to, rather than a replacement of, more detailed discussions on the detection of phleboviruses at the individual virus level.
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Thirion L, Pezzi L, Pedrosa-Corral I, Sanbonmatsu-Gamez S, Lamballerie XD, Falchi A, Perez-Ruiz M, Charrel RN. Evaluation of a Trio Toscana Virus Real-Time RT-PCR Assay Targeting Three Genomic Regions within Nucleoprotein Gene. Pathogens 2021; 10:pathogens10030254. [PMID: 33668339 PMCID: PMC7996202 DOI: 10.3390/pathogens10030254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/01/2021] [Accepted: 02/16/2021] [Indexed: 12/30/2022] Open
Abstract
Toscana virus (TOSV) can cause central nervous system infections in both residents of and travelers to Mediterranean countries. Data mining identified three real-time RT-qPCR assays for detecting TOSV RNA targeting non-overlapping regions in the nucleoprotein gene. Here, they were combined to create a multi-region assay named Trio TOSV RT-qPCR consisting of six primers and three probes. In this study, (i) we evaluated in silico the three RT-qPCR assays available in the literature for TOSV detection, (ii) we combined the three systems to create the Trio TOSV RT-qPCR, (iii) we assessed the specificity and sensitivity of the three monoplex assays versus the Trio TOSV RT-qPCR assay, and (iv) we compared the performance of the Trio TOSV RT-qPCR assay with one of the reference monoplex assays on clinical samples. In conclusion, the Trio TOSV RT-qPCR assay performs equally or better than the three monoplex assays; therefore, it provides a robust assay that can be used for both research and diagnostic purposes.
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Affiliation(s)
- Laurence Thirion
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France; (L.T.); (L.P.); (X.D.L.)
| | - Laura Pezzi
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France; (L.T.); (L.P.); (X.D.L.)
- UR7310, Laboratoire de Virologie, Université de Corse-Inserm, 20250 Corte, France;
| | - Irene Pedrosa-Corral
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.Granada, 18014 Granada, Spain; (I.P.-C.); (S.S.-G.); (M.P.-R.)
| | - Sara Sanbonmatsu-Gamez
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.Granada, 18014 Granada, Spain; (I.P.-C.); (S.S.-G.); (M.P.-R.)
| | - Xavier De Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France; (L.T.); (L.P.); (X.D.L.)
| | - Alessandra Falchi
- UR7310, Laboratoire de Virologie, Université de Corse-Inserm, 20250 Corte, France;
| | - Mercedes Perez-Ruiz
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.Granada, 18014 Granada, Spain; (I.P.-C.); (S.S.-G.); (M.P.-R.)
| | - Remi N. Charrel
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France; (L.T.); (L.P.); (X.D.L.)
- Correspondence:
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Reusken C, Baronti C, Mögling R, Papa A, Leitmeyer K, Charrel RN. Toscana, West Nile, Usutu and tick-borne encephalitis viruses: external quality assessment for molecular detection of emerging neurotropic viruses in Europe, 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 31847946 PMCID: PMC6918591 DOI: 10.2807/1560-7917.es.2019.24.50.1900051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BackgroundNeurotropic arboviruses are increasingly recognised as causative agents of neurological disease in Europe but underdiagnosis is still suspected. Capability for accurate diagnosis is a prerequisite for adequate clinical and public health response.AimTo improve diagnostic capability in EVD-LabNet laboratories, we organised an external quality assessment (EQA) focusing on molecular detection of Toscana (TOSV), Usutu (USUV), West Nile (WNV) and tick-borne encephalitis viruses (TBEV).MethodsSixty-nine laboratories were invited. The EQA panel included two WNV RNA-positive samples (lineages 1 and 2), two TOSV RNA-positive samples (lineages A and B), one TBEV RNA-positive sample (Western subtype), one USUV RNA-positive sample and four negative samples. The EQA focused on overall capability rather than sensitivity of the used techniques. Only detection of one, clinically relevant, concentration per virus species and lineage was assessed.ResultsThe final EQA analysis included 51 laboratories from 35 countries; 44 of these laboratories were from 28 of 31 countries in the European Union/European Economic Area (EU/EEA). USUV diagnostic capability was lowest (28 laboratories in 18 countries), WNV detection capacity was highest (48 laboratories in 32 countries). Twenty-five laboratories were able to test the whole EQA panel, of which only 11 provided completely correct results. The highest scores were observed for WNV and TOSV (92%), followed by TBEV (86%) and USUV (75%).ConclusionWe observed wide variety in extraction methods and RT-PCR tests, showing a profound absence of standardisation across European laboratories. Overall, the results were not satisfactory; capacity and capability need to be improved in 40 laboratories.
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Affiliation(s)
- Chantal Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Department of Viroscience, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Cecile Baronti
- Unite des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Mediterranee Infection), Marseille, France
| | - Ramona Mögling
- Department of Viroscience, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katrin Leitmeyer
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Remi N Charrel
- Unite des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Mediterranee Infection), Marseille, France
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Abstract
In Italy, Toscana virus is the most common cause of meningitis from May to October. Though only a few cases have been reported in U.S. travelers returning from Europe, most cases are likely unrecognized due to lack of familiarity with the disease. Here, we describe the case of an 82-year-old man presenting with fever, profound weakness, and hearing loss after returning to the United States following a 2-week summertime vacation in southern Italy who was ultimately diagnosed with Toscana virus encephalitis. This case should alert clinicians to the possibility of Toscana virus infection in returning travelers and provides information on how to obtain testing if Toscana virus is suspected.
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Abstract
In this chapter, we describe 73 zoonotic viruses that were isolated in Northern Eurasia and that belong to the different families of viruses with a single-stranded RNA (ssRNA) genome. The family includes viruses with a segmented negative-sense ssRNA genome (families Bunyaviridae and Orthomyxoviridae) and viruses with a positive-sense ssRNA genome (families Togaviridae and Flaviviridae). Among them are viruses associated with sporadic cases or outbreaks of human disease, such as hemorrhagic fever with renal syndrome (viruses of the genus Hantavirus), Crimean–Congo hemorrhagic fever (CCHFV, Nairovirus), California encephalitis (INKV, TAHV, and KHATV; Orthobunyavirus), sandfly fever (SFCV and SFNV, Phlebovirus), Tick-borne encephalitis (TBEV, Flavivirus), Omsk hemorrhagic fever (OHFV, Flavivirus), West Nile fever (WNV, Flavivirus), Sindbis fever (SINV, Alphavirus) Chikungunya fever (CHIKV, Alphavirus) and others. Other viruses described in the chapter can cause epizootics in wild or domestic animals: Geta virus (GETV, Alphavirus), Influenza A virus (Influenzavirus A), Bhanja virus (BHAV, Phlebovirus) and more. The chapter also discusses both ecological peculiarities that promote the circulation of these viruses in natural foci and factors influencing the occurrence of epidemic and epizootic outbreaks
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Lisi O, D'Urso V, Vaccalluzzo V, Bongiorno G, Khoury C, Severini F, Di Muccio T, Gramiccia M, Gradoni L, Maroli M. Persistence of phlebotomine Leishmania vectors in urban sites of Catania (Sicily, Italy). Parasit Vectors 2014; 7:560. [PMID: 25487039 PMCID: PMC4267132 DOI: 10.1186/s13071-014-0560-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 11/23/2014] [Indexed: 11/26/2022] Open
Abstract
Background Pioneering research on “Mediterranean Kala-Azar” carried out by Adler and Theodor early in the past century (~1930s) had identified Catania city (Sicily) as a major focus of the disease nowadays known as zoonotic visceral leishmaniasis (VL). Despite the fact that disease in both humans and dogs has continued to be highly prevalent in the Catania province up to the present times, research on Leishmania vectors in this urban focus dates back to that distant period. This study aimed to evaluate the persistence and current composition of the sand fly fauna in urban environments of Catania in recent years, 2006 and 2013. Methods In 2006 fifty-one suitable collecting sites were identified within 44 sub-units of a grid drawn to include the urban Catania area. In 2013 the survey was restricted to four of the most productive and representative sites resulting from the 2006 survey. In both periods 3 collections per month were performed using standard sticky traps set for 3 days in wall holes/cavities along public roads, from the end of April through December. Results 43/51 sites (84.3%) were found positive for sand flies. The 2006 collections accounted for a total of 4341 specimens including six species. Among competent Leishmania vector species, P. perniciosus was the most prevalent (36.5%) being identified in all sand fly-positive sites, with significant abundance in those of the old city centre. Other species of interest were P. sergenti (2.5%) and P. neglectus (1.5%). The 2013 survey produced 1130 sand flies, of which 39.5% were P. perniciosus, 1.6% P. sergenti and 0.7% P. neglectus. A search for Leishmania DNA in a small sample of 72 P. perniciosus females revealed 11% infection prevalence. Conclusions Our findings from an old urban focus of leishmaniasis demonstrate that phlebotomine sand flies have adapted fairly well to the drastic environmental changes that have occurred in cities of the Western world in the past century and still represent a potential risk for Leishmania transmission.
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Affiliation(s)
- Oscar Lisi
- Department of Biological, Geological and Environmental Sciences, Section of Animal Biology "M. La Greca", University of Catania, Via Androne 81, 95124, Catania, Italy.
| | - Vera D'Urso
- Department of Biological, Geological and Environmental Sciences, Section of Animal Biology "M. La Greca", University of Catania, Via Androne 81, 95124, Catania, Italy.
| | - Valerio Vaccalluzzo
- Department of Biological, Geological and Environmental Sciences, Section of Animal Biology "M. La Greca", University of Catania, Via Androne 81, 95124, Catania, Italy.
| | - Gioia Bongiorno
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Cristina Khoury
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Francesco Severini
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Trentina Di Muccio
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Marina Gramiccia
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Luigi Gradoni
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Michele Maroli
- Unit of Vector-Borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Abstract
The list of emerging and reemerging pathogens that cause neurologic disease is expanding. Various factors, including population growth and a rise in international travel, have contributed to the spread of pathogens to previously nonendemic regions. Recent advances in diagnostic methods have led to the identification of novel pathogens responsible for infections of the central nervous system. Furthermore, new issues have arisen surrounding established infections, particularly in an increasingly immunocompromised population due to advances in the treatment of rheumatologic disease and in transplant medicine.
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Affiliation(s)
- Felicia C Chow
- Division of Infectious Diseases, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Carol A Glaser
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Li W, Cao Y, Fu S, Wang J, Li M, Jiang S, Wang X, Xing S, Feng L, Wang Z, Shi Y, Zhao S, Wang H, Wang Z, Liang G. Tahyna virus infection, a neglected arboviral disease in the Qinghai-Tibet Plateau of China. Vector Borne Zoonotic Dis 2014; 14:353-7. [PMID: 24745971 DOI: 10.1089/vbz.2013.1351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Tahyna virus (TAHV) was first isolated from mosquitoes collected in the suburbs of Geermu city in the Qinghai-Tibet Plateau of China in 2007. Since then, TAHV antibodies have been detected in local livestock in Geermu, Qinghai. To determine whether the disease caused by TAHV was present in local residents, an investigation was conducted in the summer of 2009. During this investigation, ward inspections were conducted in rural clinics, and clinical information and specimens were collected from patients who complained mainly of acute fever. The collected samples were tested by serological and molecular methods. The results showed that four samples were positive for TAHV immunoglobulin M and had four-fold or higher levels of TAHV-neutralizing antibody titers between convalescent-phase and acute-phase, and that TAHV nucleotide sequences were detected in two acute sera. Clinical features of TAHV infection commonly included fever, accounting for 100%. Among all other symptoms, the one with the highest frequency was pharyngitis (80%), followed by malaise, inappetence, arthralgia, headache, and drowsiness. Follow-up surveys revealed that all cases recovered in 2-5 days after onset, and no serious or deadly cases were observed. This is the first time that the disease caused by TAHV infection has been reported in China. TAHV infection is another known mosquito-borne arboviral disease in China.
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Affiliation(s)
- Wenjuan Li
- 1 State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Institute for Viral Disease Control and Prevention , China CDC, Changping District, Beijing, P.R. China
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Ocal M, Orsten S, Inkaya AC, Yetim E, Acar NP, Alp S, Kasap OE, Gunay F, Arsava EM, Alten B, Ozkul A, Us D, Niedrig M, Ergunay K. Ongoing activity of Toscana virus genotype A and West Nile virus lineage 1 strains in Turkey: a clinical and field survey. Zoonoses Public Health 2013; 61:480-91. [PMID: 25285941 DOI: 10.1111/zph.12096] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Indexed: 12/30/2022]
Abstract
Toscana virus (TOSV), West Nile virus (WNV) and tickborne encephalitis virus (TBEV) are among major viral pathogens causing febrile disease and meningitis/encephalitis. The impact of these viruses was investigated at a referral centre in Ankara Province, Central Anatolia in 2012, where previous reports suggested virus circulation but with scarce information on clinical cases and vector activity. Serum and/or cerebrospinal fluid samples from 94 individuals were evaluated, in addition to field-collected arthropod specimens that included 767 sandflies and 239 mosquitoes. Viral nucleic acids in clinical samples and arthropods were sought via specific and generic nested/real-time PCRs, and antibody responses in clinical samples were investigated via commercial indirect immunofluorescence tests (IIFTs) and virus neutralization. A WNV antigen assay was also employed for mosquitoes. WNV neuroinvasive disease has been identified in a 63-year-old male via RNA detection, and the WNV strain was characterized as lineage 1. TOSV infections were diagnosed in six individuals (6.3%) via RNA or IgM detection. Partial sequences in a 23-year-old female, presented with fever and transient pancytopenia, were characterized as TOSV genotype A. Febrile disease with arthralgia and/or peripheral cranial nerve involvement was noted in cases with TOSV infections. Previous WNV and TOSV exposures have been observed in 5.3% and 2.1% of the subjects, respectively. No confirmed TBEV exposure could be identified. Morphological identification of the field-collected mosquitoes revealed Culex pipiens sensu lato (74.4%), Anopheles maculipennis (20.9%), An. claviger (2.1%) and others. Sandfly species were determined as Phlebotomus papatasi (36.2%), P. halepensis (27.3%), P. major s. l. (19.3%), P. sergenti (8.9%), P. perfiliewi (4.4%), P. simici (2.6%) and others. Viral infections in arthropods could not be demonstrated. TOSV genotype A and WNV lineage 1 activity have been demonstrated as well as serologically proven exposure in patients. Presence of sandfly and mosquito species capable of virus transmission has also been revealed.
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Affiliation(s)
- M Ocal
- Virology Unit, Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Nougairede A, Bichaud L, Thiberville SD, Ninove L, Zandotti C, de Lamballerie X, Brouqui P, Charrel RN. Isolation of Toscana Virus from the Cerebrospinal Fluid of a Man with Meningitis in Marseille, France, 2010. Vector Borne Zoonotic Dis 2013; 13:685-8. [DOI: 10.1089/vbz.2013.1316] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Antoine Nougairede
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
- Virology laboratory, IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Laurence Bichaud
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
| | - Simon-Djamel Thiberville
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
- Service de Maladies Infectieuses et Tropicales, IHU Méditerranée Infection, Assistance Publique–Hôpitaux de Marseille, Marseille, France
| | - Laetitia Ninove
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
- Virology laboratory, IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Christine Zandotti
- Virology laboratory, IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Xavier de Lamballerie
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
- Virology laboratory, IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Philippe Brouqui
- Service de Maladies Infectieuses et Tropicales, IHU Méditerranée Infection, Assistance Publique–Hôpitaux de Marseille, Marseille, France
| | - Remi N. Charrel
- UMR_D 190 “Emergence des Pathologies Virales,” Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France
- Virology laboratory, IHU Mediterranee Infection, APHM Public Hospitals of Marseille, Marseille, France
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Bichaud L, Izri A, de Lamballerie X, Moureau G, Charrel RN. First detection of Toscana virus in Corsica, France. Clin Microbiol Infect 2013; 20:O101-4. [PMID: 23992202 DOI: 10.1111/1469-0691.12347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/10/2013] [Accepted: 07/15/2013] [Indexed: 12/18/2022]
Abstract
Toscana virus (TOSV) was detected for the first time from Phlebotomus perniciosus sandflies in Corsica, a French Mediterranean island. Genetic analysis showed that Corsican TOSV belongs to lineage A, together with Italian, Tunisian, Turkish and other French strains. The demonstration of TOSV in Corsica indicates that autochthonous and tourist populations are at risk of infection. Hence, physicians must consider TOSV as a possible cause of aseptic meningitis and unidentified febrile illness during the warm season.
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Affiliation(s)
- L Bichaud
- UMR_D 190 'Emergence des Pathologies Virales', IRD French Institute of Research for Development, EHESP French School of Public Health, Aix Marseille University, Marseille, France; IHU Mediterranée Infection, APHM Public Hospitals of Marseille, Marseille, France
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Maroli M, Feliciangeli MD, Bichaud L, Charrel RN, Gradoni L. Phlebotomine sandflies and the spreading of leishmaniases and other diseases of public health concern. MEDICAL AND VETERINARY ENTOMOLOGY 2013; 27:123-47. [PMID: 22924419 DOI: 10.1111/j.1365-2915.2012.01034.x] [Citation(s) in RCA: 455] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Phlebotomine sandflies transmit pathogens that affect humans and animals worldwide. We review the roles of phlebotomines in the spreading of leishmaniases, sandfly fever, summer meningitis, vesicular stomatitis, Chandipura virus encephalitis and Carrión's disease. Among over 800 species of sandfly recorded, 98 are proven or suspected vectors of human leishmaniases; these include 42 Phlebotomus species in the Old World and 56 Lutzomyia species in the New World (all: Diptera: Psychodidae). Based on incrimination criteria, we provide an updated list of proven or suspected vector species by endemic country where data are available. Increases in sandfly diffusion and density resulting from increases in breeding sites and blood sources, and the interruption of vector control activities contribute to the spreading of leishmaniasis in the settings of human migration, deforestation, urbanization and conflict. In addition, climatic changes can be expected to affect the density and dispersion of sandflies. Phlebovirus infections and diseases are present in large areas of the Old World, especially in the Mediterranean subregion, in which virus diversity has proven to be higher than initially suspected. Vesiculovirus diseases are important to livestock and humans in the southeastern U.S.A. and Latin America, and represent emerging human threats in parts of India. Carrión's disease, formerly restricted to regions of elevated altitude in Peru, Ecuador and Colombia, has shown recent expansion to non-endemic areas of the Amazon basin.
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Affiliation(s)
- M Maroli
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
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Brisbarre NM, Plumet S, de Micco P, Leparc-Goffart I, Emonet SF. Toscana virus inhibits the interferon beta response in cell cultures. Virology 2013; 442:189-94. [PMID: 23684418 DOI: 10.1016/j.virol.2013.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/02/2013] [Accepted: 04/18/2013] [Indexed: 12/24/2022]
Abstract
Toscana virus (TOSV) is an emerging pathogen in the Mediterranean basin where it causes summertime outbreaks of aseptic meningitis and meningoencephalitis. Many aspects of TOSV biology remain unknown including the possible implication of an amplifying mammalian host besides its vector. The three experiments described here were designed to assess the relationship between TOSV and type-I interferon (IFN) response. The main findings were as follows. First, TOSV growth in Vero cells is sensitive to an antiviral state induced by low-dose addition of exogenous IFN beta (IFN-β) (10IU/ml). Second, no IFN-β mRNA or IFN-β was detectable after infection of HeLa and 293T cells by TOSV. Finally, TOSV inhibits IFN-β production induced by Sendaï virus, a well known inducer of IFN-β production. In addition to showing that TOSV can inhibit the IFN-β response, these findings suggest that anti-IFN capability is maintained by regular contact with that of a mammalian host.
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Affiliation(s)
- Nadege M Brisbarre
- UMR CNRS 6578, French Blood Agency, Alpes-Mediterranee and Aix-Marseille University, Viral Emergence and Co-evolution Unit, 27 boulevard Jean Moulin, Marseille, France
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15
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Jaijakul S, Arias CA, Hossein M, Arduino RC, Wootton SH, Hasbun R. Toscana meningoencephalitis: a comparison to other viral central nervous system infections. J Clin Virol 2012; 55:204-8. [PMID: 22867730 PMCID: PMC3445752 DOI: 10.1016/j.jcv.2012.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/11/2012] [Accepted: 07/13/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND Toscana virus (TOSV) is an emerging pathogen causing central nervous system (CNS) infection in Mediterranean countries, mostly during summer season. OBJECTIVES To compare the clinical and laboratory characteristics of Toscana CNS infections to the most common viral pathogens seen in the United States. STUDY DESIGN We performed a case series of patients with 41 TOSV infection and compared the clinical characteristics, laboratory findings, imaging results and clinical outcomes to the most commonly recognized viral causes of meningoencephalitis in the US [enterovirus (n=60), herpes simplex virus (n=48), and West Nile virus (n=30)] from our multi-center study of patients with aseptic meningoencephalitis syndromes in the Greater Houston area. RESULTS TOSV infection occurs in different age groups compared to enterovirus, HSV, and WNV. All infections most frequently occur during summer-fall except HSV which distributes throughout the year. All patients with TOSV had history of travel to endemic areas. There are differences in clinical presentation and CSF findings comparing TOSV and enterovirus, HSV, and WNV infection. There are no significant differences in outcomes of each infection except WNV meningoencephalitis which had a poorer outcome compared to TOSV infection. CONCLUSIONS TOSV is an emerging pathogen that should be considered in the differential diagnosis of patients with CNS infections and a recent travel history to endemic areas.
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Affiliation(s)
- Siraya Jaijakul
- University of Texas Health Science Center at Houston, Texas, USA
| | - Cesar A. Arias
- University of Texas Health Science Center at Houston, Texas, USA
| | - Monir Hossein
- University of Texas Health Science Center at Houston, Texas, USA
| | | | - Susan H. Wootton
- University of Texas Health Science Center at Houston, Texas, USA
| | - Rodrigo Hasbun
- University of Texas Health Science Center at Houston, Texas, USA
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Charrel RN, Bichaud L, de Lamballerie X. Emergence of Toscana virus in the mediterranean area. World J Virol 2012; 1:135-41. [PMID: 24175218 PMCID: PMC3782275 DOI: 10.5501/wjv.v1.i5.135] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 09/18/2012] [Accepted: 10/10/2012] [Indexed: 02/05/2023] Open
Abstract
Toscana virus (TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments (S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system (CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea (Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.
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Affiliation(s)
- Remi N Charrel
- Remi N Charrel, Laurence Bichaud, Xavier de Lamballerie, Aix Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 "Emergence des Pathologies Virales", 13005 Marseille, France
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Punda-Polić V, Mohar B, Duh D, Bradarić N, Korva M, Fajs L, Saksida A, Avšič-Županc T. Evidence of an autochthonous Toscana virus strain in Croatia. J Clin Virol 2012; 55:4-7. [DOI: 10.1016/j.jcv.2012.06.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 05/21/2012] [Accepted: 06/08/2012] [Indexed: 10/28/2022]
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Papa A, Andriotis V, Tzilianos M. Prevalence of Toscana virus antibodies in residents of two Ionian islands, Greece. Travel Med Infect Dis 2010; 8:302-4. [DOI: 10.1016/j.tmaid.2010.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 09/01/2010] [Accepted: 09/07/2010] [Indexed: 12/12/2022]
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