Abstract
Simple SummaryWest Nile fever is an arthropod-borne viral disease that is transmitted from birds to humans and animals by mosquitoes. Humans may develop a severe disease, which sometimes can be fatal. At the end of the 20th century, the first outbreaks of West Nile fever among humans in urban environments in Eastern Europe and the United States were reported. The epidemics were characterized by the neurological form of the disease with a fatal outcome. Since the first outbreak of the disease in Serbia, the highest number of cases occurred in 2018. West Nile fever spread is driven by location and time, which means nearby locations and periods have similar features. Recognition of patterns of spread of the disease has the potential to facilitate the mosquito control program and disease prevention. This study aimed to examine the geographical and temporal similarities of registered cases during the epidemics in the period 2017–2019 in South Banat District, Serbia. We identified the following factors as crucial for the prediction of possible outbreaks: the presence of virus in natural reservoirs, mosquito abundance; precipitation, high water level of rivers followed by a consequent sudden decrease of precipitation and withdrawal of rivers into the main bed, and favorable temperatures.West Nile virus (WNV) is an arthropod-born pathogen, which is transmitted from wild birds through mosquitoes to humans and animals. At the end of the 20th century, the first West Nile fever (WNF) outbreaks among humans in urban environments in Eastern Europe and the United States were reported. The disease continued to spread to other parts of the continents. In Serbia, the largest number of WNV-infected people was recorded in 2018. This research used spatial statistics to identify clusters of WNV infection in humans and animals in South Banat County, Serbia. The occurrence of WNV infection and risk factors were analyzed using a negative binomial regression model. Our research indicated that climatic factors were the main determinant of WNV distribution and were predictors of endemicity. Precipitation and water levels of rivers had an important influence on mosquito abundance and affected the habitats of wild birds, which are important for maintaining the virus in nature. We found that the maximum temperature of the warmest part of the year and the annual temperature range; and hydrographic variables, e.g., the presence of rivers and water streams were the best environmental predictors of WNF outbreaks in South Banat County.
Highlights
West Nile virus (WNV) is a single-stranded RNA arbovirus from the Flaviviridae family, genus Flavivirus
The analyses conducted in this paper aimed to discover spatial, temporal, and spatiotemporal clusters of WNV infection in humans and animals in South Banat District, Serbia, researching for causal relationships, i.e., identifying such clusters of WNV
The hot spot analysis for the numbers of cases indicated that the disease is most prevalent in locations nearby water streams
Summary
West Nile virus (WNV) is a single-stranded RNA arbovirus from the Flaviviridae family, genus Flavivirus. Humans and horses can be infected as spillovers host, but the infection in these organisms ends without further transmission of the virus, i.e., these organisms are dead-end hosts [1,2]. WNV is today considered the most important cause of viral encephalitis in humans worldwide [3]. Since 1998, cases of viral encephalitis caused by WNV in horses have been reported in Italy, France, and North America. Research conducted in parts of Europe and the Middle East has established that as much as one-third of the tested horses were exposed to the WNV, with or without symptoms of the disease [5,6]
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