Abstract
Serologic evidence suggests that West Nile virus (WNV) is widely distributed in horses in southern Africa. However, because few neurologic cases have been reported, endemic lineage 2 strains were postulated to be nonpathogenic in horses. Recent evidence suggests that highly neuroinvasive lineage 2 strains exist in humans and mice. To determine whether neurologic cases are being missed in South Africa, we tested 80 serum or brain specimens from horses with unexplained fever (n = 48) and/or neurologic signs (n = 32) for WNV. From March 2007 through June 2008, using reverse transcription-PCR (RT-PCR) and immunoglobulin (Ig) M ELISA, we found WNV RNA or IgM in 7/32 horses with acute neurologic disease; 5 horses died or were euthanized. In 5/7 horses, no other pathogen was detected. DNA sequencing for all 5 RT-PCR-positive cases showed the virus belonged to lineage 2. WNV lineage 2 may cause neurologic disease in horses in South Africa.
Highlights
Serologic evidence suggests that West Nile virus (WNV) is widely distributed in horses in southern Africa
A lineage 2 strain was isolated from encephalitic birds in central Europe, which suggests that lineage 2 strains can spread outside their known geographic range and may cause severe disease in birds in non–WNV-endemic countries [19]
Most specimens from horses with neurologic signs came from Onderstepoort Veterinary Institute and the Department of Medical Virology, University of Pretoria; horses were from across the country; the specimens from horses with fever were mostly from horses with less severe disease in Gauteng
Summary
Serologic evidence suggests that West Nile virus (WNV) is widely distributed in horses in southern Africa. WNV lineage 2 may cause neurologic disease in horses in southern Africa. In the Karoo, a semidesert region in South Africa, in 1974, WNV caused one of the largest outbreaks ever recorded in humans, affecting tens of thousands of people. During this outbreak thousands of persons visited their local clinicians; no cases of neurologic disease were reported. In South Africa, severe disease has been recognized, including fatal hepatitis and several nonfatal encephalitis cases in humans as well as deaths in ostrich chicks, a foal, and a dog [2,18]. A lineage 2 strain was isolated from encephalitic birds in central Europe, which suggests that lineage 2 strains can spread outside their known geographic range and may cause severe disease in birds in non–WNV-endemic countries [19]
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