ProMed: Novel flavvirus (Usutu virus) causes encephalitis case in Italy

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Archive Number 20091217.4273
Published Date 17-DEC-2009
Subject PRO/AH/EDR> Usutu virus - Italy


USUTU VIRUS - ITALY
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Date: Thu 17 Dec 2009
Source: Eurosurveillance, Vol 14, Issue 50 [edited]
<http://www.eurosurveillance.org/>


[The 2 articles below report the occurrence of Usutu virus infections in
humans, the 1st in Italy and in Europe. - Mod.TY]

Pecorari M, Longo G, Gennari W, Grottola A, Sabbatini AM, Tagliazucchi S,
et al. First human case of Usutu virus neuroinvasive infection, Italy,
August-September 2009. Euro Surveill 14ii=19446.
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19446>
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Usutu virus (USUV) is an arthropod-borne virus of the family Flaviviridae,
genus Flavivirus. It is included in the Japanese encephalitis virus (JEV)
group being closely related to human pathogens such as JEV and West Nile
virus (WNV). In the last decade, USUV was detected in a variety of central
European birds with encephalitis, myocardial degeneration, and necrosis in
liver and spleen. As far as we know, the virus had never been associated
with severe or fatal disease in humans; it was isolated once in the Central
African Republic in a man with fever and rash. Here we report evidence of a
neuroinvasive infection clinically related to USUV in Italy.

We report the 1st worldwide case of Usutu virus (USUV) neuroinvasive
infection in a patient with diffuse large B-cell lymphoma who presented
with fever and neurological symptoms and was diagnosed with
meningoencephalitits. The cerebrospinal fluid was positive for USUV, and
USUV was also demonstrated in serum and plasma samples by RT-PCR and
sequencing. Partial sequences of the premembrane and NS5 regions of the
viral genome were similar to the USUV Vienna and Budapest isolates.

******
Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, et al.
Usutu virus infection in a patient who underwent orthotropic liver
transplantation, Italy, August-September 2009. Euro Surveill 14ii=19448.
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19448>
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We report a case of Usutu virus (USUV)-related illness in a patient that
underwent an orthotropic liver transplant (OLT). Post transplant, the
patient developed clinical signs of a possible neuroinvasive disease with a
significant loss of cerebral functions. USUV was isolated in Vero E6 cells
from a plasma sample obtained immediately before the surgery, and USUV RNA
was demonstrated by RT-PCR and sequencing. This report enlarges the panel
of emerging mosquitoborne flavivirus-related disease in humans.

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[Usutu virus was 1st isolated from _Culex neavei_ mosquitoes collected by
BM McIntosh in Ndumu, Natal, South Africa on 30 Jan 1959. Usutu virus may
be fairly widespread in central and western Europe. There is serological
evidence of Usutu infections in wild birds in the UK and an outbreak in
birds in a zoo in Vienna. Information extracted from Gideon database cited
in ProMED-mail archive 20031024.2665 states:

"Usutu virus (vectors: _Coquillettidia aurites_, _Culex neavei_, and _Culex
perfuscus_) has been identified in a single case of human infection (fever
with rash) in South Africa. The agent is named after the Usutu River in
Swaziland, and has been found in rodents (African soft-furred rats of
_Praomys_ species) and in birds (_Andropadus virens_, _Bycanistes sharpei_,
_Turdus libonyanus_) in South Africa, Cameroon, Mozambique, Nigeria,
Uganda, Senegal, and the Central African Republic.

In 2001, Usutu virus was confirmed as the cause of death among several wild
and captive birds in Austria: blackbirds, Great Gray Owls (_Strix
nebulosa_), and Barn Swallows (_Hirundo rustica_) in Upper Austria and the
Vienna Zoo."
- Mod.TY]

[See also:
2006
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West Nile virus, sentinel birds - UK 20060920.2691
Usutu virus, avian - Switzerland 20060825.2402
Usutu virus, avian - Switzerland: corr. 20060826.2426
Usutu virus, avian - Switzerland 20060825.2402
2004
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Usutu virus, avian - Austria (02) 20041116.3084
Usutu virus, avian - Austria 20040827.2394
Arbovirus antibodies, birds - UK (02) 20040402.0904
Arbovirus antibodies, birds - UK 20040330.0868
2003
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Usutu virus, avian - Austria (02): background 20031024.2665
Usutu virus, avian - Austria 20031024.2661
West Nile virus, birds: antibody - UK (03) 20030804.1916
West Nile virus, birds: antibody - UK (02) 20030803.1903
West Nile virus, birds: antibody - UK 20030719.1772
2002
---
Usutu virus, emergence in Europe (02) 20020918.5339
Usutu virus, emergence in Europe 20020722.483
Usutu virus, avian - Austria (02): background 20031024.2665]

....................ty/ejp/sh

 

[Shiloh]

Re: ProMed: Novel flavvirus (Usutu virus) causes encephalitis case in Italy

Source: http://www.eht-forum.org/news.html?fileId=news091222022044&from=home&id=0

Tuesday 22 December 2009
Emerging avian virus hits humans
Experts say more people with weak immune systems may fall victim in the future


The first ever human cases of neuroinvasive Usutu virus (USUV) infection have surfaced in immunocompromised patients in Italy, according to reports1,2 in the latest edition of Eurosurveillance.

?It?s to me highly likely that we will be dealing again with USUV infections in immunocompromised patients in the next vector season, since USUV has been circulating among wildlife for years in our area,? says Vittorio Sambri, of the University of Bologna, Italy.

Usutu virus is a member of the flaviviruses family that includes West Nile Virus. It infects birds but is not known to have caused clinically relevant disease in humans before. It was first isolated from mosquitoes in South Africa in 1959, and until 2001 had never been associated with severe disease in vertebrate animals, according to a recent review in Veterinary Microbiology3 by Herbert Weissenb?ck, of the University of Veterinary Medicine in Vienna, Austria, and colleagues.

But in 2001 a more virulent strain emerged in central Europe, according to Weissenb?ck et al. ?The virus had caused large numbers of lethal infections in local birds (especially blackbirds) and we did not consider it unlikely that it might also pose a threat to human health,? Weissenb?ck tells EHTF News.

USUV now circulates in mosquitoes throughout central Europe, and may have already caused asymptomatic or very mild infections in humans, according to Weissenb?ck. ?I think (and hope) that the virus is not a threat for people with an intact immune system,? he says. But unusual neuroinvasiveness and neurovirulence of this particular USUV strain cannot be excluded, according to one of the Italian reports.

The first patient is thought to have acquired the virus from a mosquito bite, according to the report. The infection came to light after the female patient received chemotherapy treatment for lymphoma. She developed an extremely high fever and neurological symptoms including a resting tremor. Tests revealed USUV DNA in her cerebro-spiunal fluid.

The second patient probably picked up the virus from a serum transfusion, given as treatment for a blood clotting disorder, according to Sambri.

It is not yet clear whether the two infections were caused by the same strain of the virus, says Sambri. Viral samples are being sequenced for comparison with existing strains, and to rule out any mutations that could have enabled the virus to infect humans.

Reference and links

1. Pecorari M, Longo G, Gennari W, Grottola A, Sabbatini AM, Tagliazucchi S, Savini G, Monaco F, Simone ML, Lelli R, Rumpianesi F. First human case of Usutu virus neuroinvasive infection, Italy, August-September 2009. Euro Surveill 2009;14(50)ii=19446. Article
2. Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerundi GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009;14(50)ii=19448. Article
3. Weissenb?ck H, Hub?lek Z, Bakonyi T, Nowotny N. Zoonotic mosquito-borne flaviviruses: Worldwide presence of agents with proven pathogenicity and potential candidates of future emerging diseases. Veterinary Microbiology 2009. doi: 10.1016/j.vetmic.2009.08.025

 

[Gert van der Hoek]

Re: ProMed: Novel flavvirus (Usutu virus) causes encephalitis case in Italy

Vector Borne Zoonotic Dis. 2010 Sep 17.

Detection of Usutu Virus Within a West Nile Virus Surveillance Program in Northern Italy.

Abstract

Usutu virus (USUV) is a mosquito-borne flavivirus belonging to the Japanese encephalitis serocomplex, recently related to neurological disease in immunosuppressed patients.

In the same area of Northern Italy where USUV human cases occurred in 2009, a regional West Nile virus (WNV) surveillance program based on mosquito monitoring and wild birds screening has been implemented since 2008.

Mosquito pools and wild birds were tested using three different polymerase chain reactions (Flavivirus, WNV, and USUV). During summer 2009, 56 pools (54 consisting of Culex pipiens and 2 of Aedes albopictus) and 27 pools (Cx. pipiens) out of 1789 mosquito pools were, respectively, USUV and WNV positive.

Moreover, out of 1218 wild birds tested, 44 were WNV positive, whereas only 11 birds were USUV positive by polymerase chain reaction.

Data collected during 2009 prove a cocirculation of USUV and WNV in Northern Italy, but these two viruses show different incidence values in both mosquitoes and birds, suggesting involvement of different animals (other bird species or mammals) in their natural cycles.

The cocirculation of WNV and USUV poses a new potential threat to human health in this area.

The extent of WNV surveillance to other Flaviviruses will require new diagnostic procedures able to process a large number of samples in a limited period of time and highlights the importance of developing more specific serological tests that could be used in field.

http://www.ncbi.nlm.nih.gov/pubmed/20849275