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Abstract

Background

West Nile virus (WNV), found in Berlin in birds since 2018 and humans since 2019, is a mosquito-borne virus that can manifest in humans as West Nile fever (WNF) or neuroinvasive disease (WNND). However, human WNV infections and associated disease are likely underdiagnosed.

Aim

We aimed to identify and genetically characterise WNV infections in humans and mosquitoes in Berlin.

Methods

We investigated acute WNV infection cases reported to the State Office for Health and Social Affairs Berlin in 2021 and analysed cerebrospinal fluid (CSF) samples from patients with encephalitis of unknown aetiology (n = 489) for the presence of WNV. Mosquitoes were trapped at identified potential exposure sites of cases and examined for WNV infection.

Results

West Nile virus was isolated and sequenced from a blood donor with WNF, a symptomatic patient with WNND and a WNND case retrospectively identified from testing CSF. All cases occurred in 2021 and had no history of travel 14 days prior to symptom onset (incubation period of the disease). We detected WNV in mosquitoes sampled at the exposure site of one case in 2021, and in 2022. Genome analyses revealed a monophyletic Berlin-specific virus clade in which two enzootic mosquito-associated variants can be delineated based on tree topology and presence of single nucleotide variants. Both variants have highly identical counterparts in human cases indicating local acquisition of infection.

Conclusion

Our study provides evidence that autochthonous WNV lineage 2 infections occurred in Berlin and the virus has established an endemic maintenance cycle.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2023.28.48.2300258
2023-11-30
2024-04-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.48.2300258
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Ecological and clinical evidence of the establishment of West Nile virus in a large urban area in Europe, Berlin, Germany, 2021 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Claudia+Ruscher&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ruscher Claudia</a>, <a href="/search?value1=Corinna+Patzina-Mehling&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Patzina-Mehling Corinna</a>, <a href="/search?value1=Julia+Melchert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melchert Julia</a>, <a href="/search?value1=Selina+L+Graff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Graff Selina L</a>, <a href="/search?value1=Sarah+E+McFarland&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McFarland Sarah E</a>, <a href="/search?value1=Christian+Hieke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hieke Christian</a>, <a href="/search?value1=Anne+Kopp&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kopp Anne</a>, <a href="/search?value1=Anita+Prasser&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Prasser Anita</a>, <a href="/search?value1=Torsten+Tonn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tonn Torsten</a>, <a href="/search?value1=Michael+Schmidt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schmidt Michael</a>, <a href="/search?value1=Caroline+Isner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Isner Caroline</a>, <a href="/search?value1=Christian+Drosten&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Drosten Christian</a>, <a href="/search?value1=Dirk+Werber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Werber Dirk</a>, <a href="/search?value1=Victor+M+Corman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Corman Victor M</a>, <a href="/search?value1=Sandra+Junglen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Junglen Sandra</a></span>. Ecological and clinical evidence of the establishment of West Nile virus in a large urban area in Europe, Berlin, Germany, 2021 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(48):pii=2300258. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.48.2300258" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.48.2300258</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 17 May 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Sept 2023 </span> </p>
/content/10.2807/1560-7917.ES.2023.28.48.2300258
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