UNEXPECTEDLY HIGH NUMBER OF WEST NILE NEUROINVASIVE DISEASES IN BULGARIA IN 2018
DOI:
https://doi.org/10.58395/pipd.v46i2.19Keywords:
viral encephalitis, flavivirus, Bulgaria, West Nile virusAbstract
West Nile virus (WNV) is an emerging arbovirus in Europe and America which disseminated widely in recent years. This study analysed epidemiological data and laboratory findings of probable and confirmed human WNV cases in Bulgaria in 2018. A total of 15 patients with WNV
infection were detected in 2018, with 2 deaths among them. All patients were diagnosed in August or September. Four patients were from Sofia district, 4 from Burgas, 3 from Plovdiv and 1 from each of the following districts: Shumen, Yambol and Pazardzhik. Laboratory diagnosis for 7 of the patients was based solely on detection of specific antibodies in the serum samples. Eight patients met the criteria for confirmed WNV case. In 6 of them WNV genome was detected by RT-PCR in blood or urine sample and in 3 patients specific IgM antibodies were found in CSF samples which confirmed WNV neuroinvasive infection. The high number of diagnosed human WNV cases in 2018 in Bulgaria is a good sign of increasing recognition of the disease. More efforts are needed in proper transportation of clinical samples undergoing genetic detection of the viral genome. WNV neuroinvasive infection should be suspected and included in the differential diagnosis of viral encephalitis or meningoencephalitis especially in late summer and early autumn.
Downloads
References
Mostashari F, Bunning ML, Kitsutani PT, Singer DA, Nash D, Cooper MJ, Katz N, Liljebjelke KA, Biggerstaff BJ, Fine AD, Layton MC, Mullin SM, Johnson AJ, Martin DA, Hayes EB, Campbell GL.. Epidemic West Nile encephalitis. New York. 1999: results of a household-based seroepidemiological survey. The Lancet. 2001; 358(9278):261–264.
Hadjichristodoulou C, Pournaras S, Mavrouli M, Marka A, Tserkezou P, Baka A, Billinis C, Katsioulis A, Psaroulaki A, Papa A, Papadopoulos N, Mamuris Z, Tsakris A, Kremastinou J. West Nile virus seroprevalence in the Greek population in 2013: A nationwide cross-sectional survey. PLoS One. 2015; 10(11):e0143803.
Bakonyi T, Ivanics E, Erdélyi K, Ursu K, Ferenczi E, Weissenböck H, Nowotny N. Lineage 1 and 2 strains of encephalitic West Nile virus, central Europe. Emerg Infect Dis. 2006; 12(4): 618–623.
Baymakova M, Trifonova I, Panayotova E, Dakova S, Pacenti M, Barzon L, Lavezzo E, Hristov Y, Ramshev K, Plochev K, Palu G, Christova I. Fatal case of West Nile neuroinvasive disease in Bulgaria. Emerg Infect Dis. 2016; 22(12):2203-2204.
ECDC. Epidemiological update: West Nile virus transmission season in Europe, 2018. https://ecdc.europa.eu/en/news-events/epidemiological-update-west-nile-virus-transmis-sion-season-europe-2018.
Christova I, Panayotova E, Tchakarova S, Taseva E, Trifonova I, Gladnishka T. A nationwide seroprevalence screening for West Nile virus and tickborne encephalitis virus in the population of Bulgaria. J Med Virol. 2017; 89(10):1875-1878.
Argirova P, Boev I, Baltadzhiev I, Venchev Ch, Murdzheva M, Stoycheva M. Characteristics of current bacterial neuroinfections in Plovdiv region. Probl Infect Parasit Dis. 2017; 45(1):31-36.
Kurchatova A, Krumova S, Vladimirova N, Nikolaeva-Glomb L, Stoyanova A, Kantardjiev T, Gatcheva N. Preliminary findings indicate nosocomial transmission and Roma population as most affected group in ongoing measles B3 genotype outbreak in Bulgaria, March to August 2017. Euro Surveill. 2017; 22(36):30611.