title: Emergence of Toscana virus in Europe.
abstract: Toscana virus (TOSV) is an arthropod-borne virus first identified in 1971 from the sandfly Phlebotomus perniciosus in central Italy. Many case reports in travelers and clinical research and epidemiologic studies conducted around the Mediterranean region have shown that TOSV has a tropism for the central nervous system (CNS) and is a major cause of meningitis and encephalitis in countries in which it circulates. In central Italy, TOSV is the most frequent cause of meningitis from May to October, far exceeding enteroviruses. In other northern Mediterranean countries, TOSV is among the 3 most prevalent viruses associated with meningitis during the warm seasons. Therefore, TOSV must be considered an emerging pathogen. Here, we review the epidemiology of TOSV in Europe and determine questions that should be addressed in future studies. Despite increasing evidence of its major role in medicine as an emerging cause of CNS infections, TOSV remains an unstudied pathogen, and few physicians are aware of its potential to cause CNS infections.
authors.affiliation: Unité des Virus Emergents, Faculté de Médecine, Université de la Méditerranée, 27 boulevard Jean Moulin, 13005 Marseille, France. rnc-virophdm@gulliver.fr
authors.forename: Rémi N
authors.initials: RN
authors.lastname: Charrel
authors.forename: Pierre
authors.initials: P
authors.lastname: Gallian
authors.forename: José-María
authors.initials: JM
authors.lastname: Navarro-Mari
authors.forename: Loredana
authors.initials: L
authors.lastname: Nicoletti
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.forename: Mária Paz
authors.initials: MP
authors.lastname: Sánchez-Seco
authors.forename: Antonio
authors.initials: A
authors.lastname: Tenorio
authors.forename: Xavier
authors.initials: X
authors.lastname: de Lamballerie
mesh_terms: D000818:Animals; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000821:virology; D018792:Encephalitis, Viral / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008587:Meningitis, Viral / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D010217:Phlebotomus Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D011576:Psychodidae / Q000821:virology; D029301:Sandfly fever Naples virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity