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West Nile Virus Serosurveillance in Horses - a Early Warning Model for Human Clinical Cases

West Nile Virus (WNV) is emergent pathogen of different species including horses and humans as an incidental host. Surveillance of WNV as important zoonotic pathogen is established in many countries with different surveillance program which in general includes surveillance of birds, vectors, sentinel animals and clinical cases. In Croatia surveillance program has been introduced since 2010 and it is based on detection of WNV specific IgG antibodies in randomly selected horses. During 2012 bird and mosquito surveillance program had been introduced. Also equine surveillance system was expanded with detection of IgM positive horses, as confirmation of acute infection. In the summer 2012 first clinical cases of WNV infection in human were confirmed in Croatia. Epidemiological analysis showed that human clinical cases were recorded in the areas with increased WNV seroprevalence in horses. In these areas acute infections in horses were confirmed almost a month earlier. No increased bird mortality or positive mosquito pools were recorded in that transmission season. Based on the results we concluded that increase in seroprevalence in horses determined the areas of high risk for public health. Furthermore, confirmation of acute infections in horses made possible to predict even the time when human cases are most probable to occur. Absence of bird mortality and lack of positive mosquito pools in Croatian areas with confirmed WNV activity makes WNV serosurveillance in horses the most suitable method to predict area and even the time of highest risk of WNV infection in humans in Croatia.

West Nile Virus; Epidemiology; Surveillance; Horses; Public Health

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