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Infection. 2014 Aug;42(4):689-95. doi: 10.1007/s15010-014-0625-1. Epub 2014 May 5.

First evidence of simultaneous occurrence of West Nile virus and Usutu virus neuroinvasive disease in humans in Croatia during the 2013 outbreak.

Author information

1
Department of Virology, Croatian National Institute of Public Health, School of Medicine University of Zagreb, Rockefellerova 12, 10000, Zagreb, Croatia, tatjana.vilibic-cavlek@hzjz.hr.

Abstract

PURPOSE:

We report on first evidence of simultaneous occurrence of West Nile virus (WNV) and Usutu virus (USUV) neuroinvasive infection in humans in Croatia during the transmission season 2013.

METHODS:

From June to December 2013, a total of 95 patients with clinically suspected WNV infection (WNV fever and neuroinvasive disease) were tested for WNV IgM/IgG antibodies using enzyme-linked immunosorbent assay. Twenty-six reactive samples were further tested by virus neutralization test for confirmation.

RESULTS:

WNV neuroinvasive infection was confirmed in 20 patients, while in three patients USUV neutralizing antibodies were detected. Cases occurred during the 11-week interval (from 24 July to 07 October 2013). Both WNV and USUV cases were distributed in three north-western Croatian counties. In addition to human cases, recent asymptomatic WNV infection (detection of IgM antibodies) was recorded in 9/3,460 (0.3 %) tested sentinel horses. Infected animals were recorded in two eastern and one north-western county.

CONCLUSIONS:

Our results indicate co-circulation of WNV and USUV in Croatia. WNV infection could be misdiagnosed with other emerging infectious diseases presenting with neurological symptoms such as USUV infection.

PMID:
24793998
DOI:
10.1007/s15010-014-0625-1
[Indexed for MEDLINE]

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