Abstract
We illustrate the potential for specialist laboratory networks to be used as preparedness and response tool through rapid collection and sharing of data. Here, the Emerging Viral Diseases-Expert Laboratory Network (EVD-LabNet) and a laboratory assessment of chikungunya virus (CHIKV) in returning European travellers related to an ongoing outbreak in Thailand was used for this purpose. EVD-LabNet rapidly collected data on laboratory requests, diagnosed CHIKV imported cases and sequences generated, and shared among its members and with the European Centre for Disease Prevention and Control. Data across the network showed an increase in CHIKV imported cases during 1 October 2018–30 April 2019 vs the same period in 2018 (172 vs 50), particularly an increase in cases known to be related to travel to Thailand (72 vs 1). Moreover, EVD-LabNet showed that strains were imported from Thailand that cluster with strains of the ECSA-IOL E1 A226 variant emerging in Pakistan in 2016 and involved in the 2017 outbreaks in Italy. CHIKV diagnostic requests increased by 23.6% between the two periods. The impact of using EVD-LabNet or similar networks as preparedness and response tool could be improved by standardisation of the collection, quality and mining of data in routine laboratory management systems.
Highlights
The rapid increase in chikungunya virus (CHIKV) cases in Thailand since October 2018 raised concerns in Europe about the potential increased risk for public health of CHIKV importation through returning travellers [1,2]
EVD-LabNet showed that strains were imported from Thailand that cluster with strains of the East-Central-South African (ECSA)-Indian Ocean lineage (IOL) E1 A226 variant emerging in Pakistan in 2016 and involved in the 2017 outbreaks in Italy
It has been suggested that the A226V mutation in the E1 gene of the CHIKV genome could potentially influence the fitness of CHIKV East-Central-South African (ECSA)Indian Ocean lineage (IOL) strains for certain Ae. albopictus populations [14]
Summary
The rapid increase in chikungunya virus (CHIKV) cases in Thailand since October 2018 raised concerns in Europe about the potential increased risk for public health of CHIKV importation through returning travellers [1,2]. It has been suggested that the A226V mutation in the E1 gene of the CHIKV genome could potentially influence the fitness of CHIKV East-Central-South African (ECSA)Indian Ocean lineage (IOL) strains for certain Ae. albopictus populations [14] This variant caused the first European outbreak in Italy in 2007 [11] and several autochthonous infection foci in France in 2014 and 2017 [8,9,12]. To substantiate the need for a heightened awareness for a possible increased public health risk of import of CHIKV cases from Thailand into Europe, we investigated whether the outbreak was reflected in the diagnostic requests and outcomes at EVD-LabNet member laboratories. On 27 March 2019, the 51 EVD-LabNet laboratories that offer molecular CHIKV diagnostics were initially asked by email whether they had diagnosed any CHIKV cases related to the ongoing outbreak in Thailand and if sequence information was (or could) become available.
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