Abstract
BackgroundWest Nile virus (WNV) circulates in an enzootic cycle involving mosquitoes and birds; humans are accidental hosts.AimWe analysed human WNV infections reported between 2010 and 2018 to the European Centre for Disease Prevention and Control to better understand WNV epidemiology.MethodsWe describe probable and confirmed autochthonous human cases of WNV infection reported by European Union (EU) and EU enlargement countries. Cases with unknown clinical manifestation or with unknown place of infection at NUTS 3 or GAUL 1 level were excluded from analysis.ResultsFrom southern, eastern and western Europe, 3,849 WNV human infections and 379 deaths were reported. Most cases occurred between June and October. Two large outbreaks occurred, in 2010 (n = 391) and in 2018 (n = 1,993). The outbreak in 2018 was larger than in all previous years and the first cases were reported unusually early. The number of newly affected areas (n = 45) was higher in 2018 than in previous years suggesting wider spread of WNV.ConclusionReal-time surveillance of WNV infections is key to ensuring that clinicians and public health authorities receive early warning about the occurrence of cases and potential unusual seasonal patterns. Human cases may appear shortly after first detection of animal cases. Therefore, public health authorities should develop preparedness plans before the occurrence of human or animal WNV infections.
Highlights
West Nile virus (WNV) circulates in an enzootic cycle involving mosquitoes and birds; humans are accidental hosts
This designation is without prejudice to positions on status, and is in line with United Nations Security Council Resolution 1244/99 and the International Court of Justice Opinion on the Kosovo declaration of independence
We suggest that the spread of WNV in Europe is largely due to local movements of long-range migratory and resident birds, while migratory birds returning from their overwintering places in Africa or other regions probably played a minimal role in recent years as the virus is already endemic in Europe [49]
Summary
West Nile virus (WNV) circulates in an enzootic cycle involving mosquitoes and birds; humans are accidental hosts. Methods: We describe probable and confirmed autochthonous human cases of WNV infection reported by European. Birds recovering from a WNV infection usually develop long-term immunity [41,42]. The first occurrence of WNV infections in North America in 1999 lead to a major WNV outbreak with more than 20,000 human cases. Birds in this area had no previous exposure to WNV before this outbreak and the lack of acquired and evolved immunity may have increased the intensity of the epidemic [44].
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