Abstract
West Nile virus (WNV) infection is notifiable in humans and equids in the European Union (EU). An area where a human case is detected is considered affected until the end of the mosquito transmission season (week 48) and blood safety measures have to be implemented. We used human and equine case notifications between 2013 and 2017 to define the WNV distribution in the EU and to investigate the relevance of using equine cases as a complementary trigger for blood safety measures. Adding areas with equine cases to the definition of an affected area would have a major impact on blood safety measures. Adding areas with equine cases where human cases have been reported in the past would increase the timeliness of blood safety measures with only a limited impact. Although the occurrence of human and/or equine cases confirms virus circulation in the EU, no evidence was found that occurrence of equine cases leads to human cases and vice versa. We conclude that information about equine data should contribute to raising awareness among public health experts and trigger enhanced surveillance. Further studies are required before extending the definition of affected areas to areas with human and/or equine cases.
Highlights
West Nile fever (WNF) is a viral zoonotic disease that is considered a re-emerging public health challenge in the European Union (EU)
We present a descriptive epidemiological study based on the human and equine West Nile virus (WNV) infections notified at the EU level, and discuss the added value of using equine WNV infections as a complementary trigger for the implementation of blood safety measures in the
WNV transmission occurred in 140 areas; human cases were reported in 109 areas and equine cases in 81 areas
Summary
West Nile fever (WNF) is a viral zoonotic disease that is considered a re-emerging public health challenge in the European Union (EU). Mosquitoes, primarily Culex genus, serve as vectors, and wild birds as reservoir hosts. Equids and humans are dead-end hosts [1]. Most human infections are acquired via mosquito bites but transmission via blood transfusion, organ transplantation, in laboratory settings and from mother to fetus during www.eurosurveillance.org pregnancy can occur [2]. The majority of human cases remain asymptomatic; ca 20% of infected individuals develop febrile illness and less than 1% develop severe neurological symptoms [3]. 10% of the infected equids develop neurological symptoms with different levels of severity [4]. No vaccine is available for humans, a vaccine for equids has been available in the EU since 2008 [5]
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