title: Ongoing activity of Toscana virus genotype A and West Nile virus lineage 1 strains in Turkey: a clinical and field survey.
abstract: Toscana virus (TOSV), West Nile virus (WNV) and tickborne encephalitis virus (TBEV) are among major viral pathogens causing febrile disease and meningitis/encephalitis. The impact of these viruses was investigated at a referral centre in Ankara Province, Central Anatolia in 2012, where previous reports suggested virus circulation but with scarce information on clinical cases and vector activity. Serum and/or cerebrospinal fluid samples from 94 individuals were evaluated, in addition to field-collected arthropod specimens that included 767 sandflies and 239 mosquitoes. Viral nucleic acids in clinical samples and arthropods were sought via specific and generic nested/real-time PCRs, and antibody responses in clinical samples were investigated via commercial indirect immunofluorescence tests (IIFTs) and virus neutralization. A WNV antigen assay was also employed for mosquitoes. WNV neuroinvasive disease has been identified in a 63-year-old male via RNA detection, and the WNV strain was characterized as lineage 1. TOSV infections were diagnosed in six individuals (6.3%) via RNA or IgM detection. Partial sequences in a 23-year-old female, presented with fever and transient pancytopenia, were characterized as TOSV genotype A. Febrile disease with arthralgia and/or peripheral cranial nerve involvement was noted in cases with TOSV infections. Previous WNV and TOSV exposures have been observed in 5.3% and 2.1% of the subjects, respectively. No confirmed TBEV exposure could be identified. Morphological identification of the field-collected mosquitoes revealed Culex pipiens sensu lato (74.4%), Anopheles maculipennis (20.9%), An. claviger (2.1%) and others. Sandfly species were determined as Phlebotomus papatasi (36.2%), P. halepensis (27.3%), P. major s. l. (19.3%), P. sergenti (8.9%), P. perfiliewi (4.4%), P. simici (2.6%) and others. Viral infections in arthropods could not be demonstrated. TOSV genotype A and WNV lineage 1 activity have been demonstrated as well as serologically proven exposure in patients. Presence of sandfly and mosquito species capable of virus transmission has also been revealed.
authors.affiliation: Virology Unit, Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ocal
authors.forename: S
authors.initials: S
authors.lastname: Orsten
authors.forename: A C
authors.initials: AC
authors.lastname: Inkaya
authors.forename: E
authors.initials: E
authors.lastname: Yetim
authors.forename: N P
authors.initials: NP
authors.lastname: Acar
authors.forename: S
authors.initials: S
authors.lastname: Alp
authors.forename: O Erisoz
authors.initials: OE
authors.lastname: Kasap
authors.forename: F
authors.initials: F
authors.lastname: Gunay
authors.forename: E M
authors.initials: EM
authors.lastname: Arsava
authors.forename: B
authors.initials: B
authors.lastname: Alten
authors.forename: A
authors.initials: A
authors.lastname: Ozkul
authors.forename: D
authors.initials: D
authors.lastname: Us
authors.forename: M
authors.initials: M
authors.lastname: Niedrig
authors.forename: K
authors.initials: K
authors.lastname: Ergunay
mesh_terms: D000328:Adult; D000818:Animals; D002044:Bunyaviridae Infections / Q000097:blood* / Q000134:cerebrospinal fluid*; D009033:Culicidae / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007303:Insect Vectors / Q000821:virology; D008297:Male; D008875:Middle Aged; D011576:Psychodidae / Q000821:virology; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D029301:Sandfly fever Naples virus / Q000235:genetics / Q000302:isolation & purification; D017421:Sequence Analysis; D014421:Turkey; D014901:West Nile Fever / Q000097:blood* / Q000134:cerebrospinal fluid*; D014902:West Nile virus / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult; D015047:Zoonoses / Q000097:blood / Q000134:cerebrospinal fluid / Q000821:virology
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: Toscana virus; Turkey; West Nile virus; anatolia; sandfly fever