Toscana virus encephalitis in Southwest Germany: a retrospective study.
Emerging viruses
Encephalitis
Meningitis
Neuroinfectious diseases
Sandfly fever
Toscana virus
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
22 Dec 2021
22 Dec 2021
Historique:
received:
26
10
2021
accepted:
14
12
2021
entrez:
23
12
2021
pubmed:
24
12
2021
medline:
25
12
2021
Statut:
epublish
Résumé
Toscana virus (TOSV) is an arthropod-borne virus transmitted by phlebotomine sandflies (Phlebotomus sp.) widespread throughout the Mediterranean having the potential to cause meningoencephalitis in humans. In Germany, the vectors of TOSV are introduced recently and become endemic especially in Southwestern Germany. As TOSV is not investigated regularly in patients with meningoencephalitis, cases of TOSV-neuroinvasive disease may remain mostly undetected. We conducted a retrospective cohort study on patients with meningoencephalitis without identification of a causal pathogen from 2006 to 2016. Serologic assessment for anti-TOSV-IgG and IgM was performed on serum and CSF. Demographic, clinical and CSF data from TOSV-positive patients were compared to a cohort of patients with meningoencephalitis due to enterovirus. Informed consent was obtained from all included patients. We found 138 patients with meningoencephalitis without identified causal pathogen. From 98 of these patients CSF and serum was available for further testing. Additionally, we included 27 patients with meningoencephalitis due to enterovirus. We identified two patients with serological confirmed TOSV-neuroinvasive disease (TOSV-IgM and IgG positive, 2%) and two patients with possible TOSV-neuroinvasive disease (isolated TOSV-IgM positive, 2%). Overall, TOSV-neuroinvasive was detected in 4% of our cases with suspected viral meningoencephalitis. None of them had a history of recent travel to an endemic area. We found cases of TOSV-neuroinvasive disease in our German cohort of patients with meningoencephalitis. As no recent history of travel to an endemic area was reported, it remains probable that these cases resemble autochthonous infections, albeit we cannot draw conclusions regarding the origin of the respective vectors. TOSV could be considered in patients with meningoencephalitis in Germany.
Sections du résumé
BACKGROUND
BACKGROUND
Toscana virus (TOSV) is an arthropod-borne virus transmitted by phlebotomine sandflies (Phlebotomus sp.) widespread throughout the Mediterranean having the potential to cause meningoencephalitis in humans. In Germany, the vectors of TOSV are introduced recently and become endemic especially in Southwestern Germany. As TOSV is not investigated regularly in patients with meningoencephalitis, cases of TOSV-neuroinvasive disease may remain mostly undetected.
METHODS
METHODS
We conducted a retrospective cohort study on patients with meningoencephalitis without identification of a causal pathogen from 2006 to 2016. Serologic assessment for anti-TOSV-IgG and IgM was performed on serum and CSF. Demographic, clinical and CSF data from TOSV-positive patients were compared to a cohort of patients with meningoencephalitis due to enterovirus. Informed consent was obtained from all included patients.
RESULTS
RESULTS
We found 138 patients with meningoencephalitis without identified causal pathogen. From 98 of these patients CSF and serum was available for further testing. Additionally, we included 27 patients with meningoencephalitis due to enterovirus. We identified two patients with serological confirmed TOSV-neuroinvasive disease (TOSV-IgM and IgG positive, 2%) and two patients with possible TOSV-neuroinvasive disease (isolated TOSV-IgM positive, 2%). Overall, TOSV-neuroinvasive was detected in 4% of our cases with suspected viral meningoencephalitis. None of them had a history of recent travel to an endemic area.
CONCLUSIONS
CONCLUSIONS
We found cases of TOSV-neuroinvasive disease in our German cohort of patients with meningoencephalitis. As no recent history of travel to an endemic area was reported, it remains probable that these cases resemble autochthonous infections, albeit we cannot draw conclusions regarding the origin of the respective vectors. TOSV could be considered in patients with meningoencephalitis in Germany.
Identifiants
pubmed: 34937553
doi: 10.1186/s12883-021-02528-7
pii: 10.1186/s12883-021-02528-7
pmc: PMC8693482
doi:
Substances chimiques
Antibodies, Viral
0
Immunoglobulin G
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
495Informations de copyright
© 2021. The Author(s).
Références
Neurology. 2013 Apr 9;80(15):1444
pubmed: 23569000
J Clin Virol. 2012 Nov;55(3):204-8
pubmed: 22867730
J Neurol. 2012 Jan;259(1):175-7
pubmed: 21656341
Med Mal Infect. 2017 May;47(3):221-235
pubmed: 28341533
Parasit Vectors. 2020 Apr 21;13(1):173
pubmed: 32312300
Clin Infect Dis. 2004 Feb 15;38(4):515-20
pubmed: 14765344
Neurology. 2012 Aug 21;79(8):829-31
pubmed: 22875097
J Clin Virol. 2008 Feb;41(2):138-42
pubmed: 18006376
J Neurovirol. 2003 Dec;9(6):577-83
pubmed: 14602570
Clin Microbiol Infect. 2017 Nov;23(11):868-873
pubmed: 28344163
Parasitol Res. 2020 Sep;119(9):2765-2774
pubmed: 32671542
N Engl J Med. 2018 Aug 9;379(6):557-566
pubmed: 30089069
Dtsch Med Wochenschr. 2006 Dec 15;131(50):2838-40
pubmed: 17160766
BMC Geriatr. 2017 Aug 29;17(1):193
pubmed: 28851278
World J Virol. 2012 Oct 12;1(5):135-41
pubmed: 24175218
J Clin Virol. 2010 Jan;47(1):104-5
pubmed: 19889574