engleski

Neuroinvasive arboviral infections in Croatia in the 'One Health' context, 2022

Aim: Neuroinvasive arboviruses such as tick-borne encephalitis virus (TBEV), West Nile virus (WNV) and Usutu virus (USUV) are widely distributed in continental Croatia. We analyzed the prevalence of neuroinvasive arboviral infections detected in humans and animals ('One Health') in the 2022 transmission season. Methods: Diagnosis in humans was confirmed by detection of viral RNA in the cerebrospinal fluid (CSF) or urine (WNV) and/or specific IgM antibodies in the CSF (TBEV, WNV). In horses, WNV IgM/IgG antibodies were detected in serum samples. In a bird, USUV RNA was detected in brain tissue by RT-PCR. Results: During the 2022 transmission season (up to 31 August), TBEV infection was confirmed in 15 patients (12 males and 3 females ; median age 58, IQR=23-69 years). Clinical presentations were 'febrile headache' (N=2), meningitis (N=12) and meningoencephalitis (N=1). WNV was detected in five patients presented with meningitis (N=2), encephalitis (N=2) and myelitis (N=1). The median patients' age was 54 (IQR=28- 65) years. TBEV infections occurred from April to August in Primorje-Gorski Kotar (cluster of 8 cases), Osijek-Baranja, Varaždin, Virovitica- Podravina and Brod-Posavina County. WNV was detected in August in Osijek-Baranja and Zagreb County. Two TBEV infections were imported from Bavaria (Germany) and Poland. In addition, acute asymptomatic WNV infections (IgM positive) was recorded in four horses from Zagreb, Zagreb County and Brod- Posavina County. For the first time in Croatia, clinically manifest WNV neuroinvasive infection was confirmed in one horse from Osijek- Baranja County. USUV was confirmed in a dead blackbird (Turdus merula) from Zagreb presented with neurologic symptoms. Conclusion: TBEV infections were continuously detected in continental Croatian regions. Human WNV infections re-emerged in 2022 after a three- year absence. For the first time in Croatia, clinically manifest neuroinvasive infection was confirmed in a horse (WNV) and a blackbird (USUV).

Arboviral ; infections ; Croatia ; One Health

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