Emerging Disease In Europe Research Articles

L’essentiel sur l’anaplasmose granulocytaire humaine

Human granulocytic anaplasmosis caused by Anaplasma phagocytophilum is an emergent disease in Europe. It occurs in all Lyme disease endemic areas because the same vector (Ixodes tick) can transmit Borrelia, Anaplasma.The diagnosis should be considered for a patient with tick exposure who presents non spécific symptoms such as fever, headache, myalgies and abnormal laboratory features (leukopenia, thrombocytopenia and/or elevation of liver enzyme levels). The treatment of choice is doxycycline.

Congenital transmission of Chagas disease in a non-endemic area, is an early diagnosis possible?

BackgroundChagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life.MethodsA descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months.ResultsWe included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57–8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months.ConclusionsThe VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.

West Nile virus in horses during the summer and autumn seasons of 2015 and 2016, Portugal

West Nile fever (WNF) is an emergent disease in Europe, under surveillance in the European Union. Following a 5-year period of apparent silence (autumn 2010 to summer 2015), West Nile virus (WNV) reemerged in the South of Portugal, in July 2015.Here we present data from the onset, geographic location within mainland Portugal, and outcome of clinical cases of WNV infection in horses in 2015 and 2016. During the transmission seasons of 2015 and 2016, twenty-seven horses, most symptomatic (n=20) were found positive to IgM, pr-E immunoglobulins and VNT, leading to the subsequent report to Animal Disease Notification System of the European Commission (ADNS) by the Portuguese National Authority for Animal Health.Outbreaks occurred in the middle summer (August) and early/mid autumn (October/November) of 2015 and 2016, in the southern regions of the country (Alentejo and Algarve).Compared with the previous WNV transmission seasons of 2004 and 2010, a higher number of cases were reported in 2015 and 2016.The results of our study contribute to increase information concerning the geographic areas affected and time period for WNV transmission risk in Portugal.

Risk mapping of West Nile virus circulation in Spain, 2015

West Nile fever is an emergent disease in Europe. The objective of this study was to conduct a predictive risk mapping of West Nile Virus (WNV) circulation in Spain based on historical data of WNV circulation. Areas of Spain with evidence of WNV circulation were mapped based on data from notifications to the surveillance systems and a literature review. A logistic regression-based spatial model was used to assess the probability of WNV circulation. Data were analyzed at municipality level. Mean temperatures of the period from June to October, presence of wetlands and presence of Special Protection Areas for birds were considered as potential predictors. Two predictors of WNV circulation were identified: higher temperature [adjusted odds ratio (AOR) 2.07, 95% CI 1.82–2.35, p<0.01] and presence of wetlands (3.37, 95% CI 1.89–5.99, p<0.01). Model validations indicated good predictions: area under the ROC curve was 0.895 (95% CI 0.870–0.919) for internal validation and 0.895 (95% CI 0.840–0.951) for external validation. This model could support improvements of WNV risk- based surveillance in Spain. The importance of a comprehensive surveillance for WNF, including human, animal and potential vectors is highlighted, which could additionally result in model refinements.

Serological survey of Toxoplasma gondii and Besnoitia besnoiti in a wildlife conservation area in southern Portugal

Toxoplasma gondii and Besnoitia besnoiti are closely related apicomplexan protozoa. T. gondii is a zoonotic pathogen which may cause serious disease in man and warm-blooded animals, including wild species. B. besnoiti causes bovine besnoitiosis, an emergent disease in Europe, which is linked to important production losses. Unlike T. gondii, the life cycle of B. besnoiti remains a mystery, since the definitive host has not yet been identified. The aim of this work was to determine the seroprevalence of T. gondii in wildlife and feral cats from a hitherto unsampled area in southern Portugal and to identify likely candidates for definitive and/or other intermediate hosts of B. besnoiti. A total of 260 animals were screened for T. gondii and B. besnoiti by the modified agglutination tests, using the cut-off value of 1:20 and 1:80, respectively. The prevalence of T. gondii was 85.3% in Egyptian mongoose (Herpestes ichneumon; n=34), 83.3% in wildcats (Felis silvestris; n=6), 66.7% in stone martens (Martes foina; n=6), 47.1% in genets (Genetta genetta; n=17), 40% in foxes (Vulpes vulpes; n=25), 39.2% in cats (Felis catus; n=79), 33.3% in European polecats (Mustela putorius; n=3), 21.4% in red deer (Cervus elaphus; n=14), 7.7% in wild boars (Sus scrofa; n=26), 2.8% in rabbits (Oryctolagus cuniculus; n=36) and 0% in European otters (Lutra lutra; n=2), European badgers (Meles meles; n=6) and rodents (n=5). None of the species tested was positive for B. besnoiti. Based on the present results, the monitoring of T. gondii in native animal populations may be of major importance for wildlife conservation strategies and human health protection, while the search for other hosts of B. besnoiti requires further investigations in wild and domestic species.

Host cell targets for African swine fever virus

Viruses are strict intracellular pathogens that require the cellular environment to complete a successful infection. Among them, African swine fever virus (ASFV) is an evolutionary ancient DNA virus, endemic in Africa, which is nowadays causing an emergent disease in Europe with a potential high economic impact in the pig industry. It is well known that host-cell components are critical crossroads mapping the virus path for a productive infection, some of them at the endocytic pathway. Considering that ASFV infectious cycle strongly relies in several factors from the host cell, the study of virus–host interactions remains crucial as they will reveal the obstacles, routes and tracks, hints and the target waypoint in the virus journey to destination.

First report of a fatal autochthonous canine Angiostrongylus vasorum infection in Belgium

Canine angiostrongylosis is considered as an emergent disease in Europe and Canada. A fatal case of Angiostrongylus vasorum infection is described in a four and a half month old puppy born in Belgium. The dog was presented with marked neurological disorders, body weight loss, a profound weakness and mild respiratory signs. The dog was given antibiotics and mucolytic compounds with very little improvement and consequently was referred to a specialist for additional examinations. As the general condition of the dog was rapidly declining, the animal was euthanized shortly after on its owners' request and a necropsy was carried out. Extensive gross pulmonary lesions were observed and histopathological examination revealed the presence of numerous larvae with morphology compatible with A. vasorum. Larvae were also found in the product of a bronchoalveolar lavage but fecal material was not examined. The presence of A. vasorum circulating serum antigen was demonstrated through ELISA; additionally an A. vasorum specific PCR was performed on brain material and yielded a positive result. This case confirms that the clinical diagnosis of canine angiostrongylosis can be very challenging especially when respiratory signs are absent or very mild such in the present case. This is the first reported case of canine angiostrongylosis in Belgium.

Prevalence and geographic distribution of Besnoitia besnoiti infection in cattle herds in Portugal.

Bovine besnoitiosis, caused by the apicomplexan parasite Besnoitia besnoiti is considered an emergent disease in Europe. This study aimed to determine the prevalence and geographic distribution of B. besnoiti in cattle herds in continental Portugal and to identify potential spatial clustering of infection. A stratified two-stage cross-sectional serological survey was carried out between March 2012 and May 2013 with the five administrative NUTS II regions, Norte, Centro, Lisboa, Alentejo, and Algarve, as the stratification level. Sera from 391 herds in 220 parishes and 83 municipalities were analyzed by a serial testing strategy, with the modified agglutination test (B-MAT) as the first screening assay and the immunofluorescent antibody test (IFAT) as the confirmatory test. Within-herd prevalence of positive herds varied between 0.7 and 72.4% and was ≥10.3% in half of the infected herds. Using a Bayesian approach, the true prevalence of B. besnoiti in cattle herds was determined to be 5.1% (confidence interval (CI), 3.1-7.8%) and the mean within-herd prevalence of positive herds was 33.0% (CI, 20.3-46.0%). The sensitivity and specificity of the B-MAT were estimated to be 96.9% (CI, 93.7-98.8 %) and 99.7% (CI, 99.6-99.8%), whereas those of the IFAT were 89.6% (CI, 86.0-92.5%) and 99.7% (CI, 98.5-99.9%), respectively. Spatial scan statistics analysis identified one spatial cluster covering the majority of the Alentejo region. Seropositive herds were detected for the first time outside Alentejo, in the region Centro and in the northeast of Portugal. Further epidemiological research is needed to identify eco-biological factors, which could explain the geographic clustering of B. besnoiti in Portugal.

Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem

Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients. The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography (ICT) of Trypanosoma cruzi was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (± 8.4) and mean length of stay in Spain at the screening was 7.1 years (± 4.7). T. cruzi ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with confirmed positive T.cruzi serology were: Bolivia origin (p=0.016), Bolivia or Argentina origin (p=0.002), Southern Cone origin (p=0.015), rural origin (p=0.023), previously living in an adobe-made (p=0.001) or thatch-roofed house (p<0.0001), having a previous CD test (p=0.015), previous knowledge about CD (p=0.019), about vector (p=0.009) or recorded seeing vectors at home (p=0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols. Interviews of patients coming from endemic areas should include CD epidemiological questions.

A modified agglutination test for the diagnosis of Besnoitia besnoiti infection

Bovine besnoitiosis is caused by Besnoitia besnoiti, an obligate intracellular apicomplexan parasite. Affected animals present cutaneous and systemic manifestations and the disease may lead to considerable economic losses. Although generally associated to tropical and subtropical areas, bovine besnoitiosis is now considered an emergent disease in Europe, due to the increasing number of new cases and apparent geographical expansion. In this study we evaluated the performance of a modified agglutination test (B-MAT) in the serodiagnosis of bovine besnoitiosis in comparison to the indirect immunofluorescent-antibody test (IFAT). To establish optimal protocol conditions we used bovine sera with a known infection status for B. besnoiti infection. Positive animals ( n = 36) presented B. besnoiti dermal cysts and anti- B. besnoiti specific antibodies, as determined by the indirect immunofluorescence test (IFAT). Negative animals ( n = 103) were from non-endemic areas in Portugal and negative by the IFAT. From here, we evaluated the sensitivity and specificity of the B-MAT relative to the IFAT with a panel of sera from herds with history of bovine besnoitiosis in Portugal, Spain and France ( n = 402), using three serum dilutions (1:80, 1:160, 1:320). Considering the positive cut-off at 1:160 serum dilution, the B-MAT showed an almost perfect test agreement with the IFAT; ( κ = 0.968; 95% CI: 0.941–0.996) with a relative sensitivity of 97.2% (95% CI: 94.1–100%) and a relative specificity of 99.3% (95% CI: 98.4–100%). As a simple and inexpensive technique the B-MAT represents a valuable tool for the diagnosis and study of the epidemiology of bovine besnoitiosis.

The ecological changes of Breckland grass heaths and the consequences of management: P. M. Dolman & W. J. Sutherland, Journal of Applied Ecology, 29(2), 1992, pp 402–413

Toxoplasma gondii and Besnoitia besnoiti are closely related apicomplexan protozoa. T. gondii is a zoonotic pathogen which may cause serious disease in man and warm-blooded animals, including wild species. B. besnoiti causes bovine besnoitiosis, an emergent disease in Europe, which is linked to important production losses. Unlike T. gondii, the life cycle of B. besnoiti remains a mystery, since the definitive host has not yet been identified. The aim of this work was to determine the seroprevalence of T. gondii in wildlife and feral cats from a hitherto unsampled area in southern Portugal and to identify likely candidates for definitive and/or other intermediate hosts of B. besnoiti. A total of 260 animals were screened for T. gondii and B. besnoiti by the modified agglutination tests, using the cut-off value of 1:20 and 1:80, respectively. The prevalence of T. gondii was 85.3% in Egyptian mongoose (Herpestes ichneumon; n = 34), 83.3% in wildcats (Felis silvestris; n = 6), 66.7% in stone martens (Martes foina; n = 6), 47.1% in genets (Genetta genetta; n = 17), 40% in foxes (Vulpes vulpes; n = 25), 39.2% in cats (Felis catus; n = 79), 33.3% in European polecats (Mustela putorius; n = 3), 21.4% in red deer (Cervus elaphus; n = 14), 7.7% in wild boars (Sus scrofa; n = 26), 2.8% in rabbits (Oryctolagus cuniculus; n = 36) and 0% in European otters (Lutra lutra; n = 2), European badgers (Meles meles; n = 6) and rodents (n = 5). None of the species tested was positive for B. besnoiti. Based on the present results, the monitoring of T. gondii in native animal populations may be of major importance for wildlife conservation strategies and human health protection, while the search for other hosts of B. besnoiti requires further investigations in wild and domestic species.