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A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Vector-Borne Diseases".

Deadline for manuscript submissions: closed (1 November 2022) | Viewed by 28228

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Dr. Maddalena Peghin

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Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy
Interests: viral infections; multi-drug resistance; immunocompromised host

Special Issue Information

Dear Colleagues,

West Nile virus (WNV) represents the main cause of arboviral central nervous system (CNS) infection in the Western world. During the last decade, WNV outbreaks have progressively become more frequent worldwide. Specifically, the 2018 West Nile Virus (WNV) season was characterized by extraordinary high rates of WNV infections worldwide, especially in Europe. Whereas the majority of WNV infections are asymptomatic, a minority of patients can develop clinical manifestations, which range from mild febrile illness to devasting central nervous system involvement. WNV neuroinvasive forms can be extremely acute and severe. Overall mortality has been assessed around 10%. Prognosis strongly relates to the host’s pre-existing conditions (age, comorbidities, and immunological status). The diagnosis of WNV is principally based on clinical suspicion and laboratory confirmation through serologic tests and by viral nucleic acid testing in CSF, tissue, blood, or other body fluid. However, both techniques have significant pitfalls. Regarding serology, the usual serological enzyme-linked immunosorbent assay (ELISA) lacks specificity, as IgM can cross-react with other flaviviruses; nevertheless, IgM can persist for months after the primary infection, and some patients (e.g., those who are immunocompromised) cannot mount a specific antibody response. Furthermore, viremia is extremely fleeting, despite prolonged clinical manifestation. Specific antiviral treatment against WNV is lacking. A number of antiviral compounds (including interferon and high dose ribavirin) have been proposed as potentially active in vitro; however, no randomized control trials has been designed. Real-life analysis and case reports have also suggested that corticosteroids and passive immunization through intravenous immunoglobulin could be interesting treatment options. Given this premise, prevention of WNV infection appears crucial. However, no human vaccine has been licensed for human use so far. In our opinion, there are several interesting topics to explore, in order to expand the knowledge regarding this fascinating disease. With this Special Issue, we wish to invite our colleagues to submit original manuscripts, research papers, and meta-analyses, to build a systematic collection of the available knowledge about WNV.

The themes we propose for the research include, but are not limited to, the following:

Virology of WNV;
Vector control;
Clinical presentation in general population and “special categories”;
WNV in immunocompromised hosts;
Immunological aspects;
Diagnostic methods;
Organ and blood safety;
Treatment options:
a. Antivirals;
b. Immunomodulating agents;
c. Immunoglobulins.

Dr. Maddalena Peghin
Guest Editor

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Keywords

arthropods
vector-borne
West Nile
immunoglobulin
mosquito
transplant

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Published Papers (7 papers)

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Research

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9 pages, 611 KiB

Open AccessArticle

Autochthonous West Nile Virus Infection Outbreak in Humans (Asti, Piedmont, Italy, August–October 2018) and Long-Term Sequelae Follow-Up

by Tommaso Lupia, Valentina Libanore, Silvia Corcione, Valentina Fornari, Barbara Rizzello, Roberta Bosio, Giacomo Stroffolini, Paolo Bigliano, Silvia Fontana, Francesca Patti, Maria Teresa Brusa, Maria Degioanni, Erika Concialdi, Anna Sara Navazio, Maurizio Penna and Francesco Giuseppe De Rosa

Trop. Med. Infect. Dis. 2022, 7(8), 185; https://doi.org/10.3390/tropicalmed7080185 - 16 Aug 2022

Cited by 2 | Viewed by 1839

Abstract

West Nile virus (WNV) infection is a reemerging zoonosis recently provoking significant outbreaks throughout Europe. During the summer of 2018, the number of WNV infections rose with a peak of new diagnoses of West Nile neuro-invasive disease (WNND). Most of the Italian cases were clustered in the Po River Valley. We present a case series of nine patients with WNV infection admitted to the Cardinal Massaia Hospital from 30 August 2018 to 1 October 2018. Demographic, immunovirological, clinical and therapeutic data are shown, and a report on clinical sequelae from the subsequent follow-up in patients with WNV and WNND. We showed the clinical, radiological and biochemical characteristics of WNV-infected patients. The risk factors and the clinical presentation of WNV in most patients in our case series were typical of that described in the literature, although, despite the high morbidity and mortality of WNND, we showed survival of 100% and long-term sequelae in only three patients. Environmental conditions may be essential in WNV outbreaks, and WNND can be clinically neurological multiform. Our long-lasting follow-up with clinical or radiological monitoring confirmed the morbidity of long-term neurological sequelae after WNND. Further studies are needed to investigate the epidemiology and physiopathology of bacterial superinfections after WNV infection. Full article

(This article belongs to the Special Issue West Nile Infection)

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18 pages, 2350 KiB

Open AccessArticle

Seasonal Phenological Patterns and Flavivirus Vectorial Capacity of Medically Important Mosquito Species in a Wetland and an Urban Area of Attica, Greece

by Stavroula Beleri, Georgios Balatsos, Vasilios Karras, Nikolaos Tegos, Fani Sereti, Georgios Rachiotis, Christos Hadjichristodoulou, Nikolaos Papadopoulos, Dimitrios Papachristos, Antonios Michaelakis and Eleni Patsoula

Trop. Med. Infect. Dis. 2021, 6(4), 176; https://doi.org/10.3390/tropicalmed6040176 - 28 Sep 2021

Cited by 10 | Viewed by 3106

Abstract

Seasonal patterns of mosquito population density and their vectorial capacity constitute major elements to understand the epidemiology of mosquito-borne diseases. Using adult mosquito traps, we compared the population dynamics of major mosquito species (Culex pipiens, Aedes albopictus, Anopheles spp.) in an urban and a wetland rural area of Attica Greece. Pools of the captured Cx. pipiens were analyzed to determine infection rates of the West Nile virus (WNV) and the Usutu virus (USUV). The data provided were collected under the frame of the surveillance program carried out in two regional units (RUs) of the Attica region (East Attica and South Sector of Attica), during the period 2017–2018. The entomological surveillance of adult mosquitoes was performed on a weekly basis using a network of BG-sentinel traps (BGs), baited with CO₂ and BG-Lure, in selected, fixed sampling sites. A total of 46,726 adult mosquitoes were collected, with larger variety and number of species in East Attica (n = 37,810), followed by the South Sector of Attica (n = 8916). The collected mosquitoes were morphologically identified to species level and evaluated for their public health importance. Collected Cx. pipiens adults were pooled and tested for West Nile virus (WNV) and Usutu virus (USUV) presence by implementation of a targeted molecular methodology (real-time PCR). A total of 366 mosquito pools were analyzed for WNV and USUV, respectively, and 38 (10.4%) positive samples were recorded for WNV, while no positive pool was detected for USUV. The majority of positive samples for WNV were detected in the East Attica region, followed by the South Sector of Attica, respectively. The findings of the current study highlight the WNV circulation in the region of Attica and the concomitant risk for the country, rendering mosquito surveillance actions and integrated mosquito management programs as imperative public health interventions. Full article

(This article belongs to the Special Issue West Nile Infection)

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20 pages, 1011 KiB

Open AccessArticle

Public Perceptions on Non-Pharmaceutical Interventions for West Nile Virus Infections: A Survey from an Endemic Area in Northern Italy

by Matteo Riccò, Simona Peruzzi and Federica Balzarini

Trop. Med. Infect. Dis. 2021, 6(3), 116; https://doi.org/10.3390/tropicalmed6030116 - 29 Jun 2021

Cited by 11 | Viewed by 4775

Abstract

During the last decade, cases of West Nile Virus (WNV) have occurred in the Emilia Romagna Region (ERR). Even though the notification rates remain relatively low, ranging from 0.06 to 1.83 cases/100,000 inhabitants, the persistent pathogen’s circulation in settings characterized by favorable environmental characteristics suggests that WNV is becoming endemic to the Po River Valley. This study assesses knowledge, attitudes, and preventive practices toward WNV prevention among residents from 10 high-risk municipalities from the provinces of Parma and Reggio Emilia (total population: 82,317 inhabitants, census 2020). A web-based survey, based on the health belief model, was performed during the month of January 2021, with a convenience sampling of 469 participants from a series of closed discussion groups on social media (i.e., 2.1% of the potential responders). A total of 243 participants knew the meaning of WNV: Of them, 61.3% were aware of previous WNV infections in ERR, 76.5% acknowledged WNV infection as a severe one, but only 31.3% expressed any worry about WNV. Our results irregularly report preventive practices, either collective (e.g., draining standing water from items and the environment, 50.7%; spraying pesticides around the home, 33.0%) or individual (e.g., use of skin repellants when going outdoors, 42.6%). In a multivariate analysis, performed through binary logistic regression, participants reporting any worry towards WNV were more likely to characterize WNV as a severe disease (adjusted odds ratio [aOR] = 20.288, 95% confidence interval [CI] = 5.083–80.972). On the contrary, respondents supporting community mosquito control programs were more likely among people working with animals/livestock (aOR = 13.948, 95%CI = 2.793–69.653), and supporting tax exemptions for mosquito control programs (aOR = 4.069, 95%CI 2.098–7.893). In conclusion, our results suggest that future interventions promoting WNV prevention among residents in ERR should focus on perceptions of vulnerability to WNV, emphasizing the benefits of personal protective behaviors. Full article

(This article belongs to the Special Issue West Nile Infection)

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12 pages, 1168 KiB

Open AccessArticle

Screening of Mosquitoes for West Nile Virus and Usutu Virus in Croatia, 2015–2020

by Ana Klobucar, Vladimir Savic, Marcela Curman Posavec, Suncica Petrinic, Urska Kuhar, Ivan Toplak, Josip Madic and Tatjana Vilibic-Cavlek

Trop. Med. Infect. Dis. 2021, 6(2), 45; https://doi.org/10.3390/tropicalmed6020045 - 2 Apr 2021

Cited by 11 | Viewed by 3773

Abstract

In the period from 2015 to 2020, an entomological survey for the presence of West Nile virus (WNV) and Usutu virus (USUV) in mosquitoes was performed in northwestern Croatia. A total of 20,363 mosquitoes were sampled in the City of Zagreb and Međimurje county, grouped in 899 pools and tested by real-time RT-PCR for WNV and USUV RNA. All pools were negative for WNV while one pool each from 2016 (Aedes albopictus), 2017 (Culex pipiens complex), 2018 (Cx. pipiens complex), and 2019 (Cx. pipiens complex), respectively, was positive for USUV. The 2018 and 2019 positive pools shared 99.31% nucleotide homology within the USUV NS5 gene and both clustered within USUV Europe 2 lineage. The next-generation sequencing of one mosquito pool (Cx. pipiens complex) collected in 2018 in Zagreb confirmed the presence of USUV and revealed several dsDNA and ssRNA viruses of insect, bacterial and mammalian origin. Full article

(This article belongs to the Special Issue West Nile Infection)

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Review

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13 pages, 3242 KiB

Open AccessReview

Emerging Trends in the West Nile Virus Epidemiology in Croatia in the ‘One Health’ Context, 2011–2020

by Tatjana Vilibic-Cavlek, Vladimir Savic, Ana Klobucar, Thomas Ferenc, Maja Ilic, Maja Bogdanic, Irena Tabain, Vladimir Stevanovic, Marija Santini, Marcela Curman Posavec, Suncica Petrinic, Iva Benvin, Ivana Ferencak, Vlatko Rozac and Ljubo Barbic

Trop. Med. Infect. Dis. 2021, 6(3), 140; https://doi.org/10.3390/tropicalmed6030140 - 24 Jul 2021

Cited by 9 | Viewed by 4671

Abstract

West Nile virus (WNV) is one of the most widely distributed (re-)emerging arboviruses. In Croatia, acute WNV infections as well as seropositivity were detected in humans, horses, birds and poultry. Although serologic evidence of WNV human infections dates back to the 1970s, no clinical cases were reported until 2012. WNV outbreaks, as well as sporadic infections, were continuously recorded in continental Croatian counties from 2012 to 2018. In addition, acute asymptomatic infections (IgM antibodies) in horses have been regularly notified in continental regions since 2012, while seropositive horses (seroprevalence rates 3.7–21.4%) were detected in both continental and coastal regions. Moreover, WNV seropositivity in poultry (1.8–22.9%) was reported from 2013 to 2020. During the largest WNV outbreak in 2018, WNV RNA was detected for the first time in two dead goshawks (Accipiter gentilis) from the same aviary in North-West Croatia, while WNV antibodies were found in one buzzard (Butteo butteo) from the same region. In addition, WNV RNA was detected in a dead blackbird (Turdus merula) at the Croatian littoral. The phylogenetic analysis of 11 strains detected in urine samples of patients with neuroinvasive disease and 1 strain detected in a goshawk showed circulation of WNV lineage 2. Thus far, WNV has not been detected in mosquitoes in Croatia. Full article

(This article belongs to the Special Issue West Nile Infection)

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28 pages, 3772 KiB

Open AccessReview

Epidemiology of West Nile Virus Infections in Humans, Italy, 2012–2020: A Summary of Available Evidences

by Matteo Riccò, Simona Peruzzi and Federica Balzarini

Trop. Med. Infect. Dis. 2021, 6(2), 61; https://doi.org/10.3390/tropicalmed6020061 - 24 Apr 2021

Cited by 24 | Viewed by 5251

Abstract

In Italy, human cases of West Nile virus (WNV) infection have been recorded since 2008, and seasonal outbreaks have occurred almost annually. In this study, we summarize available evidences on the epidemiology of WNV and West Nile neuro-invasive disease (WNND) in humans reported between 2012 and 2020. In total, 1145 WNV infection cases were diagnosed; of them 487 (42.5%) had WNND. A significant circulation of the pathogen was suggested by studies on blood donors, with annual incidence rates ranging from 1.353 (95% confidence intervals (95% CI) 0.279–3.953) to 19.069 cases per 100,000 specimens (95% CI 13.494–26.174). The annual incidence rates of WNND increased during the study period from 0.047 cases per 100,000 (95% CI 0.031–0.068) in 2012, to 0.074 cases per 100,000 (95% CI 0.054–0.099) in 2020, peaking to 0.377 cases per 100,000 (95% CI 0.330–0.429) in 2018. There were 60 deaths. Cases of WNND were clustered in Northern Italy, particularly in the Po River Valley, during the months of August (56.7%) and September (27.5%). Higher risk for WNND was reported in subjects of male sex (risk ratio (RR) 1.545, 95% CI 1.392–1.673 compared to females), and in older age groups (RR 24.46, 95% CI 15.61–38.32 for 65–74 y.o.; RR 43.7, 95% CI 28.33–67.41 for subjects older than 75 years), while main effectors were identified in average air temperatures (incidence rate ratio (IRR) 1.3219, 95% CI 1.0053–1.7383), population density (IRR 1.0004, 95% CI 1.0001–1.0008), and occurrence of cases in the nearby provinces (IRR 1.0442, 95% CI 1.0340–1.0545). In summary, an enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures. Full article

(This article belongs to the Special Issue West Nile Infection)

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10 pages, 1895 KiB

Open AccessSystematic Review

West Nile Disease Symptoms and Comorbidities: A Systematic Review and Analysis of Cases

by Maria Bampali, Konstantinos Konstantinidis, Emmanouil E. Kellis, Theodoti Pouni, Ioannis Mitroulis, Christine Kottaridi, Alexander G. Mathioudakis, Apostolos Beloukas and Ioannis Karakasiliotis

Trop. Med. Infect. Dis. 2022, 7(9), 236; https://doi.org/10.3390/tropicalmed7090236 - 8 Sep 2022

Cited by 6 | Viewed by 2426

Abstract

West Nile virus (WNV) is a mosquito-borne flavivirus that has emerged as a major cause of viral encephalitis and meningitis, rarely leading to death. Several risk factors have been discussed in the past concerning the severity of the disease, while few reports have focused on precipitating conditions that determine of WNV-related death. Studies on cohorts of patients suffering of West Nile disease (WND) usually encompass low numbers of deceased patients as a result of the rarity of the event. In this systematic review and critical analysis of 428 published case studies and case series, we sought to evaluate and highlight critical parameters of WND-related death. We summarized the symptoms, comorbidities, and treatment strategies related to WND in all published cases of patients that included clinical features. Symptoms such as altered mental status and renal problems presented increased incidence among deceased patients, while these patients presented increased cerebrospinal fluid (CSF) glucose. Our analysis also highlights underestimated comorbidities such as pulmonary disease to act as precipitating conditions in WND, as they were significantly increased amongst deceased patients. CSF glucose and the role of pulmonary diseases need to be revaluated either retrospectively or prospectively in WND patient cohorts, as they may be linked to increased mortality risk. Full article

(This article belongs to the Special Issue West Nile Infection)

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